Death and Dying Review

What might a person say or do in the "Denial" stage?

• "No, this can't be happening to me"

• They might accuse the doctor of being incompetent or wrong.

• They might get a second opinion from another doctor.

• They start crying and begging God for his forgiveness.

• They get angry at the doctor and sue him.

Can you get stuck in stages of death?

• Yes, you can

• No, you eventually get over with it.

A patient who has just been diagnosed with a terminal illness tells the nurse, "I can't believe this is happening to me. Why me?" What stage of grief is the patient likely experiencing?

• Anger

• Denial

• Bargaining

• Depression

• Acceptance

Answer explanation

In the denial stage, patients may experience shock, disbelief, and a sense of unreality. They may deny the seriousness of their condition or the fact that they are dying. In this case, the patient's statement of "I can't believe this is happening to me. Why me?" reflects a sense of disbelief and denial, which is common in this stage

A patient who has been diagnosed with a terminal illness tells the nurse, "I'm ready to face whatever comes next. I just want to make the most of the time I have left." What stage of grief is the patient likely experiencing?

• Anger

• Denial

• Bargaining

• Depression

• Acceptance

Answer explanation

Acceptance. In the acceptance stage, patients may come to terms with their situation and start to find peace and meaning in their remaining time. In this case, the patient's statement reflects a sense of acceptance and a desire to make the most of their remaining time.

A patient who has been diagnosed with a terminal illness tells the nurse, "What's the point of trying to enjoy life now? It's all over anyway." What stage of grief is the patient likely experiencing?

• Anger

• Depression

• Denial

• Acceptance

• Bargaining

Answer explanation

Depression. In the depression stage, patients may experience feelings of sadness, hopelessness, and despair. In this case, the patient's statement reflects a sense of depression and a lack of motivation to enjoy life.

Which of the following physical changes are commonly observed by the nurse when assessing a dying patient?

• Decrease blood pressure

• Increased Heart Rate

• Increased urinary output

• Increased Bowel sounds

• Decreased body temperature

Answer explanation

When assessing a dying patient, the nurse may observe a decrease in blood pressure and respiratory rate as the body begins to shut down. The heart rate may slow down or become irregular, but it is not typically increased. Bowel sounds may decrease as the digestive system slows down, and body temperature may fluctuate but is generally not decreased.

A patient with terminal cancer has developed a "death rattle," and the family is distressed by the noise. What should the nurse do?

• Administer a sedative to the patient to reduce the noise

• Explain to the family that the "death rattle" is a normal part of the dying process

• Increase the patient's oxygen flow to reduce the noise

• Provide the family with noise-canceling headphones to wear

Answer explanation

The "death rattle" is a common sound that occurs in the final stages of life when the patient's respiratory secretions pool in the back of the throat. It can be distressing to family members who may interpret it as a sign of suffering, but it is generally not uncomfortable for the patient. Administering a sedative or increasing oxygen flow will not address the issue and may mask other signs of distress. Providing the family with noise-canceling headphones may reduce their discomfort but does not address their concerns. Therefore, the best approach is to educate the family about the normal process of dying and the "death rattle" sound, which can help to alleviate their distress.

Which of the following assessment methods is best for evaluating the level of consciousness in a dying patient who is sleeping?

• performing a sternal rub and checking the patient's reflexes

• Talking loudly in the patient's ear and shaking him

• Opening the patient's eyes and Implementing the Glasgow coma scale

• Speaking softly to the patient and touching him gently

Which of the following statements is the best approach for a nurse to educate family members about mottling and approaching death in a dying patient?

• "Mottling is a sign that the patient is getting better and their blood flow is improving."

• "Mottling is a normal process that occurs as the body shuts down, and it is a sign that death may be near"

• Mottling is a sign that the patient is in pain and needs more pain medication"

• Mottling is a sign that the patient is experiencing an allergic reaction to their medication.

Answer explanation

Mottling is a discoloration of the skin that occurs in the extremities as the body's blood flow decreases and the body begins to shut down. It is a common sign that death may be approaching. Educating family members about this process is important so they can prepare themselves emotionally and mentally.

Which of the following steps is NOT a part of the process of completing post mortem care for a deceased patient?

• Placing the patient in a supine position

• Cleaning and positioning the body appropriately

• Documenting the time of death and any pertinent information

• Administering pain medication to the deceased patient

Answer explanation

The goal of post mortem care is to ensure that the patient is cleaned, positioned appropriately, and documented correctly. Placing the patient in a supine position is important to prevent the pooling of blood in dependent areas, and cleaning the body is necessary for hygiene and to ensure a dignified appearance. If the patient wears dentures keep them in the patient's mouth. Remove all tubes and lines. Documenting the time of death and any pertinent information is important for legal and medical purposes.