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CHAPTER 13 MED-SURG PALLIATIVE END OF LIFE CARE TEST QUESTIONS AND ANSWERS
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CHAPTER 13 MED-SURG PALLIATIVE END OF LIFE CARE TEST QUESTIONS AND ANSWERS...
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CHAPTER 13 MED-SURG PALLIATIVE END OF LIFECARE TEST QUESTIONS AND ANSWERS
In recent 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 D.
Demographic changes in the population
Rationale: The focus on the care of the dying has been motivated by the
ageing 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.
P 368
Which issue has most often presented challenging ethical issues,
especially in the context of palliative care?
A. Increased cultural diversity 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 D. Ability of technology to prolong life beyond meaningful
quality of life
Rationale: 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.
P 389
,The nurse is assessing a client whose spouse died 16 months ago. The
client tells the nurse about joining a hiking group, volunteering as a
college mentor, and thinking about dating again. The nurse determines
that the client is in which stage of Rando's processes of mourning?
A. Reinvestment
B. Recognition of the loss
C. Recollection and reexperiencing the deceased D. Relinquishing old
attachments to the deceased - ANSWER A. Reinvestment
Rationale: Rando identified six processes of mourning that involve the
detachment from ties that bind the mourner to the deceased and
learning to live in a world without the deceased. By engaging in new
activities and forming emotional attachments to new people, the client is
reinvesting in a life without the spouse. Recognizing the loss refers to
acknowledging the death of the spouse. Recollection and reexperiencing
involve reviewing and reminiscing about the deceased spouse and the
relationship. Relinquishing old attachments to the spouse involves letting
go of the attachment to an old way of life.
P 385
A nurse who sits on the hospital's ethics committee is reviewing a
complex case that has many of the characteristics of assisted suicide.
Which of the following would be an example of assisted suicide? A.
Administering a lethal dose of medication to a client whose death is
imminent
B. Administering a morphine infusion without assessing for respiratory
depression
C. Granting a client's request not to initiate enteral feeding when the
client is unable to eat
D. Neglecting to resuscitate a client with a "do not resuscitate" order -
ANSWER A. Administering a lethal dose of medication to a client whose
death is imminent
Rationale: 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.
P 387
, A medical nurse is providing palliative care to a client with a diagnosis of
end-stage chronic obstructive pulmonary disease (COPD). What is the
primary goal of this nurse's care?
A. To improve the client's and family's quality of life
B. To support aggressive and innovative treatments for cure C. To
provide physical support for the client
D. To help the client develop a separate plan with each discipline of the
health care team - ANSWER A. To improve the client's and family's
quality of life
Rationale: The goal of palliative care is to improve the client's and the
family's quality of life. The support should include the client's physical,
emotional, and spiritual well-being. Each discipline should contribute to a
single care plan that addresses the needs of the client and family. The
goal of palliative care is not aggressive support for curing the client.
Providing physical support for the client is also not the goal of palliative
care. Palliative care does not strive to achieve separate plans of care
developed by the client with each discipline of the health care team.
P 368
After caring for several clients who died in the hospital, the nurse has
identified some lapses in the care that many of these clients 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. The perception that palliative care constitutes "giving up."
B. Clients are too sedated to achieve adequate pain control.
C. Clients are not given opportunities to communicate with caregivers.
D. Clients are ignored by the care team toward the end of life. -
ANSWER A. The perception that palliative care constitutes "giving up."
Rationale: One of the principal objections to palliative care is that
palliative care is equated with "giving up." Oversedation, lack of
communication, and lack of care are not noted to be deficiencies to the
same degree.
P 389
An adult oncology client has a diagnosis of bladder cancer with
metastasis and the client has asked the nurse about the possibility of
hospice care. Which principle is central to a hospice setting?
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