Chapt. 16: End-of-Life Care Prep Exam Questions Answered Correctly.
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Course
End-of-Life Care
Institution
End-of-Life Care
1. In the past three to four decades, nursing has moved into the forefront in providing care for the dying. Which phenomenon has most contributed to this increased focus of care of the dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on d...
Chapt. 16: End-of-Life Care Prep Exam
Questions Answered Correctly.
1. In the past three to four decades, nursing has moved into the forefront in providing care for the dying.
Which phenomenon has most contributed to this increased focus of care of the dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on disease prevention
C) Larger numbers of people dying in hospital settings
D) Demographic changes in the population - Answer Ans: D
Feedback:
The focus on care of the dying has been motivated by the aging of the population, the prevalence of, and
publicity surrounding, life-threatening illnesses (e.g., cancer and AIDS), and the increasing likelihood of a
prolonged period of chronic illness prior to death. The salience of acute infections, prevention measures,
and death in hospital settings are not noted to have had a major influence on this phenomenon.
2. A nurse who works in the specialty of palliative care frequently encounters issues and situations that
constitute ethical dilemmas. What issue has most often presented challenging ethical issues, especially
in the context of palliative care?
A) The increase in cultural diversity in the United States
B) Staffing shortages in health care and questions concerning quality of care
C) Increased costs of health care coupled with inequalities in access
D) Ability of technology to prolong life beyond meaningful quality of life - Answer Ans: D
Feedback:
The application of technology to prolong life has raised several ethical issues. The major question is,
Because we can prolong life through increasingly sophisticated technology, does it necessarily follow that
we must do so? The increase in cultural diversity has not raised ethical issues in health care. Similarly,
costs and staffing issues are relevant, but not central to the most common ethical issues surrounding
palliative care.
,3. The nurse is caring for a patient who has been recently diagnosed with late stage pancreatic cancer.
The patient refuses to accept the diagnosis and refuses to adhere to treatment. What is the most likely
psychosocial purpose of this patients strategy?
A) The patient may be trying to protect loved ones from the emotional effects of the illness.
B) The patient is being noncompliant in order to assert power over caregivers.
C) The patient may be skeptical of the benefits of the Western biomedical model of health.
D) The patient thinks that treatment does not provide him comfort. - Answer Ans: A
Feedback:
Patients who are characterized as being in denial may be using this strategy to preserve important
interpersonal relationships, to protect others from the emotional effects of their illness, and to protect
themselves because of fears of abandonment. Each of the other listed options is plausible, but less likely.
4. A nurse who sits on the hospitals ethics committee is reviewing a complex case that has many of the
hallmarks of assisted suicide. Which of the following would be an example of assisted suicide?
A) Administering a lethal dose of medication to a patient whose death is imminent
B) Administering a morphine infusion without assessing for respiratory depression
C) Granting a patients request not to initiate enteral feeding when the patient is unable to eat
D) Neglecting to resuscitate a patient with a do not resuscitate order - Answer Ans: A
Feedback:
Assisted suicide refers to providing another person the means to end his or her own life. This is not to be
confused with the ethically and legally supported practices of withholding or withdrawing medical
treatment in accordance with the wishes of the terminally ill individual. The other listed options do not
fit this accepted definition of assisted suicide.
5. A medical nurse is providing palliative care to a patient with a diagnosis of end-stage chronic
obstructive pulmonary disease (COPD). What is the primary goal of this nurses care?
A) To improve the patients and familys quality of life
B) To support aggressive and innovative treatments for cure
C) To provide physical support for the patient
D) To help the patient develop a separate plan with each discipline of the health care team - Answer
Ans: A
Feedback:
, The goal of palliative care is to improve the patients and the familys quality of life. The support should
include the patients physical, emotional, and spiritual well-being. Each discipline should contribute to a
single care plan that addresses the needs of the patient and family. The goal of palliative care is not
aggressive support for curing the patient. Providing physical support for the patient is also not the goal
of palliative care. Palliative care does not strive to achieve separate plans of care developed by the
patient with each discipline of the health care team.
6. After contributing to the care of several patients who died in the hospital, the nurse has identified
some lapses in the care that many of these patients received toward the end of their lives. What have
research studies identified as a potential deficiency in the care of the dying in hospital settings?
A) Families needs for information and support often go unmet.
B) Patients are too sedated to achieve adequate pain control.
C) Patients are not given opportunities to communicate with caregivers.
D) Patients are ignored by the care team toward the end of life. - Answer Ans: A
Feedback:
Studies have demonstrated that the health care system continues to be challenged when meeting
seriously ill patients needs for pain and symptom management and their families needs for information
and support. Oversedation, lack of communication, and lack of care are not noted to be deficiencies to
the same degree.
7. An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has asked
the nurse about the possibility of hospice care. Which principle is central to a hospice setting?
A) The patient and family should be viewed as a single unit of care.
B) Persistent symptoms of terminal illness should not be treated.
C) Each member of the interdisciplinary team should develop an individual plan of care.
D) Terminally ill patients should die in the hospital whenever possible. Ans: - Answer Ans: A
Feedback:
Hospice care requires that the patient and family be viewed as a single unit of care. The other listed
principles are wholly inconsistent with the principles of hospice care.
8. A clinic nurse is providing patient education prior to a patients scheduled palliative radiotherapy to her
spine. At the completion of the patient teaching, the patient continues to ask the same questions that
the nurse has already addressed. What is the plausible conclusion that the nurse should draw from this?
A) The patient is not listening effectively.
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