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NSG 430 Exam 1 Study Questions and Answers Top Graded 2025
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The nurse is caring for an unresponsive terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Which action would the nurse take? a. Suction the patient's mouth. b. Administer oxygen via face mask. c. Document the patient's respiratory pattern...

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  • December 21, 2024
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NSG 430 Exam 1



NSG 430 Exam 1 Study Questions and
Answers Top Graded 2025
The nurse is caring for an unresponsive terminally ill patient who has 20-second periods of
apnea followed by periods of deep and rapid breathing. Which action would the nurse take?
a. Suction the patient's mouth.
b. Administer oxygen via face mask.
c. Document the patient's respiratory pattern.
d. Place the patient in high Fowler's position.
Document the patient's respiratory pattern

Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and
rapid breaths. This respiratory pattern is expected in the last days of life and is not position
dependent. There is also no need for supplemental oxygen by face mask or suctioning the
patient.
The nurse is caring for a dying adolescent patient who is comatose. The patient's parents are
interested in organ donation and ask the nurse how the health care providers determine
brain
death. Which response by the nurse accurately describes brain death determination?
a. ―If CPR does not restore a heartbeat, the brain cannot function any longer.‖
b. ―Brain death has occurred if there is not any breathing or brainstem reflexes.‖
c. ―Brain death has occurred if a person has flaccid muscles and does not awaken.‖
d. ―If respiratory efforts cease and no apical pulse is audible, brain death is present.‖
―Brain death has occurred if there is not any breathing or brainstem reflexes.‖

The diagnosis of brain death is based on irreversible loss of all brain functions, including
brainstem functions that control respirations and brainstem reflexes. The other descriptions
describe other clinical manifestations associated with death but are insufficient to declare a
patient brain dead.
A patient in hospice is manifesting a decrease in all body system functions except for a heart
rate of 124 beats/min and a respiratory rate of 28 breaths/min. Which statement would be
accurate for the nurse to make to the patient's family?
a. ―These vital signs will continue to increase until death finally occurs.‖
b. ―These vital signs demonstrate the body's ability to compensate and heal.‖




NSG 430 Exam 1

,NSG 430 Exam 1


c. ―These vital signs are an expected response now but will slow down later.‖
d. ―These vital signs may indicate an improvement in the patient's condition.‖
―These vital signs are an expected response now but will slow down later.‖

An increase in heart and respiratory rate may occur before the slowing of these functions in
a
dying patient. Heart and respiratory rate typically slow as the patient progresses further
toward death. In a dying patient, high respiratory and pulse rates do not indicate
improvement
or compensation, and it would be inappropriate for the nurse to indicate this to the family
A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis
plans
a trip across the country ―to settle some issues with family members.‖ The nurse
recognizes
that the patient is manifesting which psychosocial response?
a. Protesting the unfairness of death
b. Anxiety about unfinished business
c. Fear of having lived a meaningless life
d. Restlessness about the uncertain prognosis
Anxiety about unfinished business

The patient's statement indicates that there is some unfinished family business that the
patient
would like to address before dying. There is no indication that the patient is protesting the
prognosis, feels uncertain about the prognosis, or fears that life has been meaningless.
A patient with terminal cancer is being admitted to a family-centered inpatient hospice. The
patient's spouse visits daily and cheerfully talks with the patient about wedding anniversary
plans for the next year. When the nurse asks about any concerns, the spouse says, ―I'm
busy at
work, but otherwise things are fine.‖ Which issue would the nurse identify as a concern in
working with the patient's spouse?
a. Fear
b. Anxiety
c. Hopelessness
d. Difficulty coping




NSG 430 Exam 1

,NSG 430 Exam 1


Difficulty coping

The spouse's behavior and statements indicate the absence of anticipatory grieving, which
may lead to impaired adjustment as the patient progresses toward death. The spouse does
not
appear to feel fearful, hopeless, or anxious
As the nurse admits a patient in end-stage renal disease to the hospital, the patient tells the
nurse, ―If my heart or breathing stop, I do not want to be resuscitated.‖ Which action
should
the nurse take first?
a. Place a ―Do Not Resuscitate‖ (DNR) notation in the patient's care plan.
b. Invite the patient to add a notarized advance directive in the health record.
c. Advise the patient to designate a person to make future health care decisions.
d. Ask if the decision has been discussed with the patient's health care provider.
Ask if the decision has been discussed with the patient's health care provider.

A health care provider's order should be written describing the actions that the nurses
should
take if the patient requires CPR, but the primary right to decide belongs to the patient or
family. The nurse should document the patient's request but does not have the authority to
place the DNR order in the care plan until it is prescribed by the HCP. A notarized advance
directive may be completed but is not needed to establish the patient's wishes. The patient
may need a durable power of attorney for health care (or the equivalent), but this does not
address the patient's current concern with possible resuscitation.
A young adult patient with metastatic cancer who is very close to death appears restless.
The
patient keeps repeating, ―I am not ready to die.‖ Which action by the nurse would show
respect for the patient?
a. Remind the patient that no one feels ready for death.
b. Sit at the bedside and ask if there is anything the patient needs.
c. Insist that family members remain at the bedside with the patient.
d. Tell the patient that everything possible is being done to delay death.
Sit at the bedside and ask if there is anything the patient needs.

Staying at the bedside and listening allows the patient to discuss any unresolved issues or
physical discomforts that should be addressed. Stating that no one feels ready for death
does


NSG 430 Exam 1

, NSG 430 Exam 1


not address the patient's concerns. Telling the patient that everything is being done does
not
address the patient's fears about dying, especially because the patient is likely to die soon.
Family members may not feel comfortable staying at the bedside of a dying patient, and the
nurse should not insist that they stay there.
The nurse is caring for a terminally ill patient who is experiencing continuous and severe
pain.
How would the nurse schedule the administration of opioid pain medications?
a. Plan around-the-clock routine administration of prescribed analgesics.
b. Provide prescribed doses of medication whenever the patient requests them.
c. Suggest small analgesic doses to avoid decreasing the respiratory rate.
d. Offer enough pain medication to keep the patient sedated and unaware of stimuli.
Plan around-the-clock routine administration of prescribed analgesics.

The principles of beneficence and nonmaleficence indicate that the goal of pain
management
in a terminally ill patient is adequate pain relief even if the effect of pain medications could
hasten death. Administration of analgesics on a PRN basis will not provide the consistent
level of analgesia the patient needs. Patients usually do not require so much pain
medication
that they are oversedated and unaware of stimuli. Adequate pain relief may require a
dosage
that will result in a decrease in respiratory rate.
The nurse is caring for a patient with lung cancer in a home hospice program. Which action
would the nurse implement?
a. Discuss cancer risk factors and appropriate lifestyle modifications.
b. Teach the patient about the purpose of chemotherapy and radiation.
c. Encourage the patient to discuss past life events and their meanings.
d. Accomplish a thorough head-to-toe assessment several times a week.
Encourage the patient to discuss past life events and their meanings.

The role of the hospice nurse includes assisting the patient with the important end-of-life
task
of finding meaning in the patient's life. Frequent head-to-toe assessments are not needed
for
hospice patients and may tire the patient unnecessarily. Patients admitted to hospice forego
curative treatments such as chemotherapy and radiation for lung cancer. Discussion of


NSG 430 Exam 1

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