NSG 430 Exam 1: (Latest 2026/2027 Update) Palliative Care, Endocrine,
& Respiratory Emergencies | Q&A | Grade A | 100% Correct (Verified
Answers) – Nursing Program
Subject: NSG 430 – Advanced Medical-Surgical Nursing
Source: NSG 430 Exam Blueprint / 2026-2027 Curriculum
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the definition of palliative care?
Correct Answer: Care or treatment focusing on reducing the severity of symptoms; curative
treatment can be involved
1. Palliative care prioritizes symptom relief (pain, dyspnea, fatigue) while allowing concurrent curative or
life-prolonging treatments.
2. It improves quality of life for patients with serious illnesses regardless of prognosis.
3. Unlike hospice, palliative care does not require forgoing curative therapies.
2. What is the definition of hospice care?
Correct Answer: Treatment of the terminally ill with the goal of helping them to die
comfortably, without pain; curative care is forgone
1. Hospice is a philosophy of care for patients with a prognosis of ≤6 months that focuses on comfort,
dignity, and pain control.
2. Curative treatments are discontinued; the focus shifts entirely to symptom management and psychosocial
support.
3. Hospice can be provided at home, in nursing facilities, or inpatient hospice centers.
3. What are the respiratory physical manifestations of end-of-life (EOL)?
Correct Answer: Cheyne-Stokes respirations, death rattle, terminal secretions, loss of gag
reflex (risk for aspiration)
1. Cheyne-Stokes breathing (crescendo-decrescendo pattern with apnea) indicates brainstem changes near
death.
2. Death rattle from oropharyngeal secretions is managed with positioning and anticholinergics.
3. Loss of gag reflex increases aspiration risk, so avoid oral intake if swallowing impaired.
4. What are the integumentary physical manifestations of end-of-life (EOL)?
Correct Answer: Mottling, cyanosis in nail beds, cold/clammy skin, and "waxlike" skin very
near death
1. Mottling (purplish blotchy skin) results from decreased peripheral perfusion and is an irreversible sign of
approaching death.
2. Cyanosis in nail beds and cold/clammy skin indicate circulatory shutdown.
3. Waxlike skin appearance reflects severe dehydration and loss of tissue turgor in the final hours.
, 5. What is decisional capacity?
Correct Answer: Ability to consent to or refuse care
1. Decisional capacity is a clinical judgment about a patient's ability to understand, appreciate, and
communicate a choice regarding treatment.
2. It can fluctuate over time and must be assessed for each specific decision.
3. Lack of capacity does not mean incompetence; legal determination of incompetence requires formal
adjudication.
6. A patient dies in the hospital. Regarding tissue and organ donation, what is the immediate
nursing action?
Correct Answer: Some used within hours, notify physician immediately
1. Organs for transplantation (heart, liver, kidneys) must be recovered within minutes to hours after death;
prompt notification preserves donation options.
2. The physician or organ procurement organization coordinates donor eligibility and family consent.
3. Tissue (corneas, skin, bone) can be recovered within 24 hours but still requires timely referral.
7. What guides our nursing care at end-of-life?
Correct Answer: Code of Ethics - relieve suffering; Principle of Beneficence - care is provided
to benefit; Standard of Care - define nursing acts that are required for safe and competent
care
1. The ANA Code of Ethics mandates relief of suffering as a fundamental nursing duty.
2. Beneficence requires actions that actively benefit the patient, including pain management and dignity
measures.
3. Standards of Care define safe, competent EOL nursing practice, including symptom assessment and
family support.
8. What assessments are performed in the last hours of life?
Correct Answer: Limit to comfort measures, concerns about pain and respiratory should be
addressed, emotional/comfort support
1. Non-essential assessments (vital signs every hour, blood draws) are discontinued to avoid disturbing the
patient.
2. Priority is recognizing pain (facial grimacing, restlessness) and dyspnea and providing medications
(morphine, atropine).
3. Emotional and spiritual support for family and patient is paramount; involve chaplaincy or bereavement
services.
9. What postmortem care should the nurse provide after a death?
Correct Answer: Close pt's eyes, replace dentures, wash/position body - allow family privacy
1. Closing eyes and placing dentures maintains normal appearance for family viewing and prevents drying
of corneas.
2. Washing and positioning the body in supine with arms extended shows respect and prevents stiffness in
awkward positions.
3. Family should be given time and privacy for rituals, prayer, or saying goodbye before transport to
morgue.
& Respiratory Emergencies | Q&A | Grade A | 100% Correct (Verified
Answers) – Nursing Program
Subject: NSG 430 – Advanced Medical-Surgical Nursing
Source: NSG 430 Exam Blueprint / 2026-2027 Curriculum
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the definition of palliative care?
Correct Answer: Care or treatment focusing on reducing the severity of symptoms; curative
treatment can be involved
1. Palliative care prioritizes symptom relief (pain, dyspnea, fatigue) while allowing concurrent curative or
life-prolonging treatments.
2. It improves quality of life for patients with serious illnesses regardless of prognosis.
3. Unlike hospice, palliative care does not require forgoing curative therapies.
2. What is the definition of hospice care?
Correct Answer: Treatment of the terminally ill with the goal of helping them to die
comfortably, without pain; curative care is forgone
1. Hospice is a philosophy of care for patients with a prognosis of ≤6 months that focuses on comfort,
dignity, and pain control.
2. Curative treatments are discontinued; the focus shifts entirely to symptom management and psychosocial
support.
3. Hospice can be provided at home, in nursing facilities, or inpatient hospice centers.
3. What are the respiratory physical manifestations of end-of-life (EOL)?
Correct Answer: Cheyne-Stokes respirations, death rattle, terminal secretions, loss of gag
reflex (risk for aspiration)
1. Cheyne-Stokes breathing (crescendo-decrescendo pattern with apnea) indicates brainstem changes near
death.
2. Death rattle from oropharyngeal secretions is managed with positioning and anticholinergics.
3. Loss of gag reflex increases aspiration risk, so avoid oral intake if swallowing impaired.
4. What are the integumentary physical manifestations of end-of-life (EOL)?
Correct Answer: Mottling, cyanosis in nail beds, cold/clammy skin, and "waxlike" skin very
near death
1. Mottling (purplish blotchy skin) results from decreased peripheral perfusion and is an irreversible sign of
approaching death.
2. Cyanosis in nail beds and cold/clammy skin indicate circulatory shutdown.
3. Waxlike skin appearance reflects severe dehydration and loss of tissue turgor in the final hours.
, 5. What is decisional capacity?
Correct Answer: Ability to consent to or refuse care
1. Decisional capacity is a clinical judgment about a patient's ability to understand, appreciate, and
communicate a choice regarding treatment.
2. It can fluctuate over time and must be assessed for each specific decision.
3. Lack of capacity does not mean incompetence; legal determination of incompetence requires formal
adjudication.
6. A patient dies in the hospital. Regarding tissue and organ donation, what is the immediate
nursing action?
Correct Answer: Some used within hours, notify physician immediately
1. Organs for transplantation (heart, liver, kidneys) must be recovered within minutes to hours after death;
prompt notification preserves donation options.
2. The physician or organ procurement organization coordinates donor eligibility and family consent.
3. Tissue (corneas, skin, bone) can be recovered within 24 hours but still requires timely referral.
7. What guides our nursing care at end-of-life?
Correct Answer: Code of Ethics - relieve suffering; Principle of Beneficence - care is provided
to benefit; Standard of Care - define nursing acts that are required for safe and competent
care
1. The ANA Code of Ethics mandates relief of suffering as a fundamental nursing duty.
2. Beneficence requires actions that actively benefit the patient, including pain management and dignity
measures.
3. Standards of Care define safe, competent EOL nursing practice, including symptom assessment and
family support.
8. What assessments are performed in the last hours of life?
Correct Answer: Limit to comfort measures, concerns about pain and respiratory should be
addressed, emotional/comfort support
1. Non-essential assessments (vital signs every hour, blood draws) are discontinued to avoid disturbing the
patient.
2. Priority is recognizing pain (facial grimacing, restlessness) and dyspnea and providing medications
(morphine, atropine).
3. Emotional and spiritual support for family and patient is paramount; involve chaplaincy or bereavement
services.
9. What postmortem care should the nurse provide after a death?
Correct Answer: Close pt's eyes, replace dentures, wash/position body - allow family privacy
1. Closing eyes and placing dentures maintains normal appearance for family viewing and prevents drying
of corneas.
2. Washing and positioning the body in supine with arms extended shows respect and prevents stiffness in
awkward positions.
3. Family should be given time and privacy for rituals, prayer, or saying goodbye before transport to
morgue.
