Exam #3

A nurse interviews an 82-year-old resident of a long-term care facility who says that she has never gotten over the death of her son 20 years ago. She reports that her life fell apart after that and she never again felt like herself or was able to enjoy life. What type of grief is this woman experiencing?

• Somatic

• Anticipatory

• Unresolved

• Inhibited

A home health care nurse has been visiting a patient with AIDS who says, “I’m no longer afraid of dying. I think I’ve made my peace with everyone, and I’m actually ready to move on.” This reflects the patient’s progress to which stage of death and dying?

• Acceptance

• Anger

• Bargaining

• Denial

A nurse is visiting a patient with pancreatic cancer who is dying at home. During the visit, he breaks down and cries, and tells the nurse that it is unfair that he should have to die now when he’s finally made peace with his family. Which response by the nurse would be most appropriate?

• “You can’t be feeling this way. You know you are going to die.”

• “It does seem unfair. Tell me more about how you are feeling.”

• “You’ll be all right; who knows how much time any of us has.”

• “Tell me about your pain. Did it keep you awake last night?”

A patient tells a nurse that he would like to appoint his daughter to make decisions for him should he become incapacitated. What should the nurse suggest he prepare?

• POLST Form

• Durable Power of Attorney for Health Care

• Living Will

• Allow Natural Death Form

A hospice nurse is caring for a patient who is terminally ill and who is on a ventilator. After a restless night, the patient hands the nurse a note with the request: “Please help me end my suffering.” Which response by a nurse would best reflect adherence to the position of the American Nurses Association (ANA) regarding assisted suicide?

• The nurse promises the patient that he or she will do everything possible to keep the patient comfortable but cannot administer an injection or overdose to cause the patient’s death.

• The nurse tells the patient that under no condition can he be removed from the ventilator because this is active euthanasia and is expressly forbidden by the Code for Nurses.

• After exhausting every intervention to keep a dying patient comfortable, the nurse says, “I think you are now at a point where I’m prepared to do what you’ve been asking me. Let’s talk about when and how you want to die.”

• The nurse responds: “I’m personally opposed to assisted suicide, but I’ll find you a colleague who can help you.”

A nurse is caring for terminally ill patients in a hospital setting. Which nursing action describes appropriate end-of-life care?

• To eliminate confusion, the nurse takes care not to speak too much when caring for a comatose patient.

• The nurse sits on the side of the bed of a dying patient, holding the patient’s hand, and crying with the patient.

• The nurse refers a counselor to the daughter of a dying patient who is complaining about the care associated with artificially feeding her father.

• The nurse tells a dying patient to sit back and relax and performs patient hygiene for the patient because it is easier than having the patient help.

A nurse is providing postmortem care. Which nursing action violates the standards of caring for the body after a patient has been pronounced dead and is not scheduled for an autopsy?

• The nurse leaves the patient in a sitting position while the family visits.

• The nurse places identification tags on both the shroud and the ankle.

• The nurse removes soiled dressings and tubes.

• The nurse makes sure a death certificate is issued and signed.

The family of a patient who has just died asks to be alone with the body and asks for supplies to wash the body. The nurse providing care knows that the mortician usually washes the body. Which response would be most appropriate?

• Inform the family that there is no need for them to wash the body since the mortician typically does this.

• Explain that hospital policy forbids their being alone with the deceased patient and that hospital supplies are to be used only by hospital personnel.

• Give the supplies to the family but maintain a watchful eye to make sure that nothing unusual happens.

• Provide the requested supplies, checking if this request is linked to their religious or cultural customs and asking if there is anything else you can do to help.

A 70-year-old patient who has had a number of strokes refuses further life-sustaining interventions, including artificial nutrition and hydration. She is competent, understands the consequences of her actions, is not depressed, and persists in refusing treatment. Her health care provider is adamant that she cannot be allowed to die this way, and her daughter agrees. An ethics consult has been initiated. Who would be the appropriate decision maker?

• The patient

• The patient's daughter

• The patient's health care provider

• The ethics consult team

A nurse is caring for a terminally ill patient during the 11 PM to 7 AM shift. The patient says, “I just can’t sleep. I keep thinking about what my family will do when I am gone.” What response by the nurse would be most appropriate?

• “Oh, don’t worry about that now. You need to sleep.”

• “What seems to be concerning you the most?”

• “I have talked to your wife and she told me she will be fine.”

• “I’m not qualified to advise you, I suggest you discuss this with your wife.”