Exam (elaborations)
Chapter 10. Loss, Grief, and Dying.
- Course
- Fundamentals of Nursing Care
- Institution
- Allegany College Of Maryland Somerset Campus
Chapter 10. Loss, Grief, and Dying.
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Chapter 10. Loss, Grief, and DyingMultiple Choice
Identify the choice that best completes the statement or answers the question.
1. A nurse understands that when a terminal patient states, “No, I don’t need anything. What would you get
me anyway?” he or she is most likely in the stage of grief called
1. Denial.
2. Acceptance.
3. Anger.
4. Bargaining.
2. A nurse has just witnessed a terminally ill patient telling the physician that he does not wish to have his
life prolonged as stated in his living will. The nurse expects that the physician will
1. Explain to the patient why he should be more hopeful.
2. Write a do-not-resuscitate (DNR) order.
3. Speak to the patient’s family before writing a DNR order.
4. Ignore the patient’s request.
3. A patient dying of colon cancer tells a nurse that he is sure that he can beat the cancer if he changes his eating
habits. The nurse understands that the patient is likely in the stage defined by Kübler-Ross as
1. Acceptance.
2. Anger.
3. Denial.
4. Bargaining.
4. When questioned by a patient about the difference between palliative care and the services provided by
hospice, a nurse explains that palliative treatment
1. Is aggressive, but administered to cure the disease.
2. Is geared toward the patient, family, and their wishes.
3. May be aggressive and is directed at eliminating discomfort.
4. Indicates the patient has fewer than 6 months to live.
5. A nurse realizes that a terminally ill patient is ready to talk about dying when he or she states:
1. “I’m feeling a little stronger each day.”
2. “Do you think you could just sit with me for a while?”
3. “I’ve decided to begin taking chemotherapy again.”
4. “What do you think death feels like?”
6. The wife of a patient who is nearing the end of his life tells a nurse that she is worried because her husband is
not getting enough fluids. The nurse responds by saying:
1. “He will drink when he gets thirsty. Don’t worry about him.”
2. “It is natural to become dehydrated before death. It will actually make him
more comfortable.”
3. “I will let his physician know about it. He may want to start an IV to keep him hydrated.”
4. “Your husband has signed a living will indicating he doesn’t want to be given food
and water.”
7. Immediately after a patient’s death, a nurse performs postmortem care. Correct care would include
1. Insisting that the family bathe the patient so they can begin the grieving process.
2. Documenting the time when the patient stopped breathing and the heart ceased.
3. Notifying the physician so that the patient will be legally pronounced dead.
, 4. Bathing the body and removing all tubes, unless an autopsy might be ordered.
8. A wife is extremely upset about her husband’s respirations. A nurse explains that this type of breathing is
a symptom of end-stage disease. The breathing is called Cheyne-Stokes and is characterized by
1. Slow, shallow respirations.
2. Slow, deep respirations.
3. A cycle of shallow and deep respirations.
4. Cyanosis of the hands and feet.
9. The family of a terminally ill patient asks the nurse what they should expect when she dies. The nurse tells
the family:
1. “Her heart will stop, and she will stop breathing a few minutes later.”
2. “Respirations and heart rate first become very irregular and then stop altogether.”
3. “Everybody is different, so it is difficult to say.”
4. “Her breathing will stop, and her heart will cease beating within a few minutes.”
10. A nurse understands that perhaps the most important care that can be provided for the terminally ill patient is
1. Caring and touching.
2. Encouraging reminiscing.
3. Giving pain medication.
4. Encouraging visits from a member of the clergy.
11. A nurse understands that the physical change associated with the dying process that typically creates the
most anxiety for the family is
1. Restlessness and difficulty in sleeping.
2. Pallor and circumoral cyanosis.
3. Accumulation of secretions in the trachea.
4. Conjunctival dryness that causes tearing of the eyes.
12. A patient has a written document containing medical decisions should the patient be unable to make them as
the illness progresses. The nurse understands that the patient has a
1. Durable power of attorney (DPR).
2. Do-not-resuscitate (DNR) order.
3. Living will.
4. Terminal illness.
13. A nurse explains to a family that research supports that the last sense to leave a dying patient is
1. Sight.
2. Hearing.
3. Taste.
4. Vision.
14. While caring for a patient who has just been diagnosed with a terminal illness, a nurse expects to see the
patient exhibit the traditional first stage of grief, which is called
1. Bargaining.
2. Anger.
3. Denial.
4. Depression.
15. A patient with a terminal illness does not have a do-not-resuscitate (DNR) order, and upon entering the room,
a nurse finds that the patient is not breathing. The first action that the nurse will take is to
1. Ask another nurse to write the order for a DNR.
2. Call the physician to get an order for a DNR.
, 3. Begin cardiopulmonary resuscitation (CPR) because an order for a DNR is not written.
4. Notify the selected funeral home that the patient has expired.
16. A terminally ill patient is refusing to take adequate pain medication. The patient expresses worry that the use
of pain medication may result in addiction. A nurse should
1. Express admiration for the patient’s strength.
2. Explain to the patient that morphine does not cause addiction.
3. Place the medication in an intravenous (IV) drip.
4. Teach the patient that addiction is not a concern during the terminal stages of illness.
17. A patient’s daughter approaches a nurse to explain that upon his death, female nurses should not touch him.
The family also asks that the body remain completely covered with his feet turned toward Mecca. The
nurse identifies that the family is
1. Buddhist.
2. Jewish.
3. Muslim.
4. Orthodox.
18. The husband of a dying woman expresses that he believes remorse for the dead leads to more suffering of the
soul and will increase the soul’s difficulty in leaving the earthly plane. He prefers to think only happy
thoughts to facilitate her journey. A nurse identifies that the couple must be
1. Jewish.
2. Hindu.
3. Hispanic American.
4. Amish.
19. A patient suffering from dyspnea tells a nurse that she does not wish to take any additional drugs to help
relieve her condition. The nurse suggests a nonpharmacological intervention such as
1. Putting a fan near the bed to circulate the air
2. Giving the patient small sips of warm water
3. Providing additional movement and range-of-motion exercises
4. Music therapy
20. A terminally ill patient asks a nurse to promise him that all of his symptoms and discomfort will be effectively
managed until his death. The nurse promises the patient with confidence that
1. Pain can be relieved.
2. Nausea can be managed.
3. Respiratory distress can be eliminated.
4. All of the above.
21. A bedridden patient in hospice care is suffering from nausea, vomiting, confusion, constipation, lethargy,
decreased deep tendon reflexes, polyuria, and extreme thirst. A nurse identifies these symptoms as
1. Dyspnea.
2. Hypercalcemia.
3. Cyanosis.
4. Cheyne-Stokes respirations.
22. An elderly female patient is becoming progressively more confused. She begins talking to long-gone loved
ones about places and events that do not make any sense to her family. A nurse should
1. Verify the patient’s level of consciousness.
2. Attempt to reorient the patient.
3. Protect the patient from injury by bed rails or equipment.
4. Hydrate the patient.
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