An 80-year-old patient is receiving palliative care for heart failure. What are the
primary purposes of her receiving palliative care (select all that apply)?
A. Improve her quality of life.
B. Assess her coping ability with disease.
C. Have time to teach patient and family about disease.
D. Focus on reducing the severity of disease symptoms.
E. Provide care that the family is unwilling or unable to give.
A. Improve her quality of life.
D. Focus on reducing the severity of disease symptoms.
The focus of palliative care is to reduce the severity of disease symptoms. The
goals of palliative care are to prevent and relieve suffering and to improve quality
of life for patients with serious, life-limiting illnesses.
The home health nurse visits a 40-year-old breast cancer patient with metastatic
breast cancer who is receiving palliative care. The patient is experiencing pain at a
level of 7 (on a 10-point scale). In prioritizing activities for the visit, you would do
which of the following first?
A. Auscultate for breath sounds.
B. Administer prn pain medication.
C. Check pressure points for skin breakdown.
D. Ask family members about patient's dietary intake.
B. Administer PRN pain medication.
Meeting the patient's physiologic and safety needs is the priority. Physical care
focuses on the needs for oxygen, nutrition, pain relief, mobility, elimination, and
skin care. The patient is not experiencing oxygenation problems; the priority is to
treat the severe pain with pain medication.
During admission of a patient diagnosed with metastatic lung cancer, you assess
for which of the following as a key indicator of clinical depression related to
,terminal illness?
A. Frustration with pain
B. Anorexia and nausea
C. Feelings of hopelessness
D. Inability to carry out activities of daily living
C. Feelings of hopelessness
Feelings of hopelessness are likely in a patient with a terminal illness who has
clinical depression. This can be attributed to lack of control over the disease
process or outcome. You should assess for depression routinely when working
with patients with a terminal illness.
You are visiting with the wife of a patient who is having difficulty making the
transition to palliative care for her dying husband. What is the most desirable
outcome for the couple?
A. They express hope for a cure.
B. They comply with treatment options.
C. They set additional goals for the future.
D. They acknowledge the symptoms and prognosis.
D. They acknowledge the symptoms and prognosis.
The grief experience for the caregiver of the patient with a chronic illness often
begins long before the death. This is called anticipatory grief. Acceptance of the
expected loss is associated with more positive outcomes.
A patient has been receiving palliative care for the past several weeks in light of
her worsening condition after a series of strokes. The caregiver has rung the call
bell, stating that the patient "stops breathing for a while, then breathes fast and
hard, and then stops again." You recognize that the patient is experiencing
A. Apnea
B. Bradypnea
C. Death rattle
D. Cheyne-Stokes respirations
, D. Cheyne-Stokes respirations
Cheyne-Stokes respirations are a pattern of breathing characterized by alternating
periods of apnea and deep, rapid breathing. This type of breathing is usually seen
as a person nears death.
Which aspects of anticipatory grief are associated with positive outcomes for the
caregiver of a palliative patient (select all that apply)?
A. Strong spiritual beliefs
B. Medical diagnosis of the patient
C. Advanced age of the palliative patient
D. Acceptance of the expected death of the patient
E. Adequate time for the caregiver to prepare for the death
A. Strong spiritual beliefs
D. Acceptance of the expected death of the patient
E. Adequate time for the caregiver to prepare for the death
Acceptance of an impending loss, spiritual beliefs, and adequate preparation time
are all associated with positive outcomes regarding anticipatory grief. The age and
diagnosis of the patient are not key factors in influencing the quality of caregivers'
anticipatory grief.
What is the primary purpose of hospice?
A. Allow patients to die at home.
B. Provide better quality of care than the family can.
C. Coordinate care for dying patients and their families.
D. Provide comfort and support for dying patients and their families.
D. Provide comfort and support for dying patients and their families.
Hospice provides support and care at the end of life to help patients live as fully
and as comfortably as possible. The emphasis is on symptom management,
advance care planning, spiritual care, and family support, including bereavement.
The hospice nurse identifies an abnormal grief reaction by the wife of a dying
patient, who says
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