C HAPTER 10: E ND - OF -L IFE C ARE
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. A patient was admitted to the critical care unit after having a
cerebrovascular accident (CVA) and m yocardial infarction (MI). The
patient has poor activit y tolerance, falls in and out of consciousness, and
has poor verbal skills. The patient has be en resuscitated four times in the
past 6 hours. The patient does not have advance directives. Famil y
members are at the bedside. Who should the practitioner approach to
discuss decisions of care and possible do -not-resuscitate (DNR) status?
a. Patient
b. Famil y
c. Hospital legal system
d. Hospital ethics committee
ANS: A
Patients’ capacit y for decision -making is limited by illness severit y;
they are too sick or are hampered by the therapies or medications used
to treat them. When decision -making is required, the pati ent is the first
person to be approached.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 151
OBJ: Nursing Process Step: Assessment TOP: End-of-
Life Issues MSC: NC LEX: Psychosocial Integrit y
, 2. Which statement regarding organ donation is accurate?
a. Organ donation is a choice onl y the patient can make for him - or
herself.
b. Hospitals must have written protocols for the identification of
potential organ donors.
c. Organ donation must be requested by the nurse caring for the dying
patient.
d. Individual institutiona l policies govern how organ donation requests
are made.
ANS: B
The Social Securit y Act Section 1138 requires that hospitals have
written protocols for the identification of potential organ donors. The
Joint Commission has a standard on organ donation. Th e nurse must
notify the organ procurement official to approach the famil y with a
donation request.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 156
OBJ: Nursing Process Step: N/A TOP: End-of-Life
Issues MSC: NC LEX: Psychosocial Integrit y
3. Hospice care is an option that should be considered, especially in end -
stage illness. Hospice care can help families with which issue(s)?
a. Organ and tissue donations
b. Symptom management and famil y support
c. Procurement of advance directives and living wills
d. Legal and voluntary euthanasia
ANS: B
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. A patient was admitted to the critical care unit after having a
cerebrovascular accident (CVA) and m yocardial infarction (MI). The
patient has poor activit y tolerance, falls in and out of consciousness, and
has poor verbal skills. The patient has be en resuscitated four times in the
past 6 hours. The patient does not have advance directives. Famil y
members are at the bedside. Who should the practitioner approach to
discuss decisions of care and possible do -not-resuscitate (DNR) status?
a. Patient
b. Famil y
c. Hospital legal system
d. Hospital ethics committee
ANS: A
Patients’ capacit y for decision -making is limited by illness severit y;
they are too sick or are hampered by the therapies or medications used
to treat them. When decision -making is required, the pati ent is the first
person to be approached.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 151
OBJ: Nursing Process Step: Assessment TOP: End-of-
Life Issues MSC: NC LEX: Psychosocial Integrit y
, 2. Which statement regarding organ donation is accurate?
a. Organ donation is a choice onl y the patient can make for him - or
herself.
b. Hospitals must have written protocols for the identification of
potential organ donors.
c. Organ donation must be requested by the nurse caring for the dying
patient.
d. Individual institutiona l policies govern how organ donation requests
are made.
ANS: B
The Social Securit y Act Section 1138 requires that hospitals have
written protocols for the identification of potential organ donors. The
Joint Commission has a standard on organ donation. Th e nurse must
notify the organ procurement official to approach the famil y with a
donation request.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 156
OBJ: Nursing Process Step: N/A TOP: End-of-Life
Issues MSC: NC LEX: Psychosocial Integrit y
3. Hospice care is an option that should be considered, especially in end -
stage illness. Hospice care can help families with which issue(s)?
a. Organ and tissue donations
b. Symptom management and famil y support
c. Procurement of advance directives and living wills
d. Legal and voluntary euthanasia
ANS: B
