NSG 430
Adult Health Nursing II
NSG 430 Exam 1, 2 & 3
Grand Canyon University
TABLE OF CONTENTS
NSG 430 Exam 1……………….02
NSG 430 Exam 2……………….304
NSG 430 Exam 3……………….600
, NSG 430 Exam 1
1. A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans a trip across the
country to settle some issues with family members. The nurse recognizes that the patient is manifesting which
psychosocial response?
a. Protesting the unfairness of death
b. Anxiety about unfinished business
c. Fear of having lived a meaningless life
d. Restlessness about the uncertain prognosis
Correct Answer: Anxiety about unfinished busi- ness
The patient's statement indicates that there is some unfinished family business that the patient would like to address
before dying.There is no indication that the patient is protesting the prognosis, feels uncertain about the prognosis, or
fears that life has been meaning- less.
2. A patient with terminal cancer is being admitted to a family-centered inpa- tient hospice.The patient's spouse
visits daily and cheerfully talks with the patient about wedding anniversary plans for the next year.When the nurse
asks about any concerns, the spouse says, I'm busy at work, but otherwise things are fine. Which issue would the
nurse identify as a concern in
working with the patient's spouse?
a. Fear
b. Anxiety
c. Hopelessness
d. Difficulty coping
Correct Answer: Difficulty coping
The spouse's behavior and statements indicate the absence of anticipatory grieving, which may lead to impaired
adjustment as the patient progresses toward death. The spouse does not appear to feel fearful, hopeless, or anxious
,3. As the nurse admits a patient in end-stage renal disease to the hospital, the patient tells the nurse, If my heart or
breathing stop, I do not want to be resuscitated. Which action should the nurse take first?
a. Place a Do Not Resuscitate (DNR) notation in the patient's care plan.
b. Invite the patient to add a notarized advance directive in the health record.
c. Advise the patient to designate a person to make future health care deci- sions.
d. Ask if the decision has been discussed with the patient's health care provider.
Correct Answer: Ask if the decision has been discussed with the patient's health care provider.
A health care provider's order should be written describing the actions that the nurses should take if the patient
requires CPR, but the primary right to decide belongs to the patient or family. The nurse should document the patient's
request but does not have the authority to place the DNR order in the care plan until it is prescribed by the HCP. A
notarized advance directive may be completed but is not needed to establish the patient's wishes.The patient
may need a durable power of attorney for health care (or the equivalent), but this
does not address the patient's current concern with possible resuscitation.
4. The nurse is caring for an unresponsive terminally ill patient who has
20-second periods of apnea followed by periods of deep and rapid breathing.Which action would the nurse take?
a. Suction the patient's mouth.
b. Administer oxygen via face mask.
c. Document the patient's respiratory pattern.
d. Place the patient in high Fowler's position.
Correct Answer: Document the patient's respiratory pattern
Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and
rapid breaths.This respiratory pattern is expected in the last days of life and is not position dependent.There is also
no need for supplemental oxygen by face mask or suction- ing the patient.
, 5. The nurse is caring for a dying adolescent patient who is comatose.The patient's parents are interested in organ
donation and ask the nurse how the health care providers determine brain death.Which response by the nurse
accurately describes brain death deter- mination?
a. If CPR does not restore a heartbeat, the brain cannot function any longer.
b. Brain death has occurred if there is not any breathing or brainstem reflexes.
c. Brain death has occurred if a person has flaccid muscles and does not awaken.
d. If respiratory efforts cease and no apical pulse is audible, brain death is present.
Correct Answer: Brain death has occurred if there is not any breathing or brainstem reflexes.
The diagnosis of brain death is based on irreversible loss of all brain functions, including brainstem functions that
control respirations and brainstem reflexes.The other descriptions describe other clinical manifestations associated
with death but are insufficient to declare a patient brain dead.
Adult Health Nursing II
NSG 430 Exam 1, 2 & 3
Grand Canyon University
TABLE OF CONTENTS
NSG 430 Exam 1……………….02
NSG 430 Exam 2……………….304
NSG 430 Exam 3……………….600
, NSG 430 Exam 1
1. A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans a trip across the
country to settle some issues with family members. The nurse recognizes that the patient is manifesting which
psychosocial response?
a. Protesting the unfairness of death
b. Anxiety about unfinished business
c. Fear of having lived a meaningless life
d. Restlessness about the uncertain prognosis
Correct Answer: Anxiety about unfinished busi- ness
The patient's statement indicates that there is some unfinished family business that the patient would like to address
before dying.There is no indication that the patient is protesting the prognosis, feels uncertain about the prognosis, or
fears that life has been meaning- less.
2. A patient with terminal cancer is being admitted to a family-centered inpa- tient hospice.The patient's spouse
visits daily and cheerfully talks with the patient about wedding anniversary plans for the next year.When the nurse
asks about any concerns, the spouse says, I'm busy at work, but otherwise things are fine. Which issue would the
nurse identify as a concern in
working with the patient's spouse?
a. Fear
b. Anxiety
c. Hopelessness
d. Difficulty coping
Correct Answer: Difficulty coping
The spouse's behavior and statements indicate the absence of anticipatory grieving, which may lead to impaired
adjustment as the patient progresses toward death. The spouse does not appear to feel fearful, hopeless, or anxious
,3. As the nurse admits a patient in end-stage renal disease to the hospital, the patient tells the nurse, If my heart or
breathing stop, I do not want to be resuscitated. Which action should the nurse take first?
a. Place a Do Not Resuscitate (DNR) notation in the patient's care plan.
b. Invite the patient to add a notarized advance directive in the health record.
c. Advise the patient to designate a person to make future health care deci- sions.
d. Ask if the decision has been discussed with the patient's health care provider.
Correct Answer: Ask if the decision has been discussed with the patient's health care provider.
A health care provider's order should be written describing the actions that the nurses should take if the patient
requires CPR, but the primary right to decide belongs to the patient or family. The nurse should document the patient's
request but does not have the authority to place the DNR order in the care plan until it is prescribed by the HCP. A
notarized advance directive may be completed but is not needed to establish the patient's wishes.The patient
may need a durable power of attorney for health care (or the equivalent), but this
does not address the patient's current concern with possible resuscitation.
4. The nurse is caring for an unresponsive terminally ill patient who has
20-second periods of apnea followed by periods of deep and rapid breathing.Which action would the nurse take?
a. Suction the patient's mouth.
b. Administer oxygen via face mask.
c. Document the patient's respiratory pattern.
d. Place the patient in high Fowler's position.
Correct Answer: Document the patient's respiratory pattern
Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and
rapid breaths.This respiratory pattern is expected in the last days of life and is not position dependent.There is also
no need for supplemental oxygen by face mask or suction- ing the patient.
, 5. The nurse is caring for a dying adolescent patient who is comatose.The patient's parents are interested in organ
donation and ask the nurse how the health care providers determine brain death.Which response by the nurse
accurately describes brain death deter- mination?
a. If CPR does not restore a heartbeat, the brain cannot function any longer.
b. Brain death has occurred if there is not any breathing or brainstem reflexes.
c. Brain death has occurred if a person has flaccid muscles and does not awaken.
d. If respiratory efforts cease and no apical pulse is audible, brain death is present.
Correct Answer: Brain death has occurred if there is not any breathing or brainstem reflexes.
The diagnosis of brain death is based on irreversible loss of all brain functions, including brainstem functions that
control respirations and brainstem reflexes.The other descriptions describe other clinical manifestations associated
with death but are insufficient to declare a patient brain dead.
