NR 443 CHAPTER 24: LOSS, DEATH, AND
END-OF-LIFE CARE
Chapter 24: Loss, Death, and End-of-Life Care
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. How should a nurse position the body after the death of a patient?
a. Prone
b. Supine
c. On the side
d. In Fowler position
ANS: B
The body should be placed in the supine position, with the arms at the sides or with the
hands across the abdomen.
DIF: Cognitive Level: Knowledge REF: p. 377-378 OBJ: 1
TOP: Positioning after Death KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. According to Strauss and Glaser, three states of awareness of terminal illness have been
identified. What do these states include?
a. Denial, anger, and depression
b. Shock, yearning, and anguish
c. Avoidance, confrontation, and accommodation
d. Closed awareness, mutual pretense, and open awareness
ANS: D
Strauss and Glaser have identified three states of awareness: closed awareness, mutual
pretense, and open awareness.
DIF: Cognitive Level: Knowledge REF: p. 378 OBJ: 2
TOP: Awareness of Terminal Illness KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. When planning the care of a patient who is terminally ill, a nurse should include the
prevention of pain and relief from discomfort. What should the nurse implement when
administering pain medication?
a. Narcotics have the potential for addiction.
b. Pain medication must be given before the pain becomes unbearable.
c. Pain medication should be given no more often than every 6 hours.
d. Narcotics must be given as needed only.
ANS: B
Pain control must be consistent to provide constant relief rather than waiting until the pain is
unbearable and then trying to relieve it. Addiction to narcotics is of little concern.
, DIF: Cognitive Level: Application REF: p. 372-373 OBJ: 5
TOP: Pain Control KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
4. What is one of the most important interventions for a nurse to implement when caring for
a patient who is terminally ill?
a. Touching and listening to the patient
b. Encouraging the patient to express any regrets
c. Assessing for signs and symptoms of impending death
d. Talking to the patient about how other patients have handled the dying process
ANS: A
The simple presence of someone provides support and comfort. Neither words nor actions
are necessary unless the patient requires something. Holding hands, touching, and listening
are quality nursing responses.
DIF: Cognitive Level: Application REF: p. 373 OBJ: 5
TOP: Fear of Loneliness KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
5. A nurse is assessing a patient who is terminally ill for clinical signs of impending death.
What should the nurse expect when assessing the patient’s respirations?
a. Deep, clear breath sounds
b. Noisy, wet-sounding respirations
c. Even, unlabored respirations
d. Shallow, clear breath sounds
ANS: B
Breathing may sound wet and noisy. Noisy, wet-sounding respirations, termed the death
rattle, are a response based on mouth breathing and accumulation of mucus in the upper
airways.
DIF: Cognitive Level: Comprehension REF: p. 373 OBJ: 2
TOP: Respiratory Changes KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. What is believed to be the last sense to remain intact during the death process?
a. Touch
b. Sight
c. Smell
d. Hearing
ANS: D
Hearing is commonly believed to be the last sense to remain intact during the death
process.
DIF: Cognitive Level: Knowledge REF: p. 373 OBJ: 4
TOP: Sensory Changes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
END-OF-LIFE CARE
Chapter 24: Loss, Death, and End-of-Life Care
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. How should a nurse position the body after the death of a patient?
a. Prone
b. Supine
c. On the side
d. In Fowler position
ANS: B
The body should be placed in the supine position, with the arms at the sides or with the
hands across the abdomen.
DIF: Cognitive Level: Knowledge REF: p. 377-378 OBJ: 1
TOP: Positioning after Death KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. According to Strauss and Glaser, three states of awareness of terminal illness have been
identified. What do these states include?
a. Denial, anger, and depression
b. Shock, yearning, and anguish
c. Avoidance, confrontation, and accommodation
d. Closed awareness, mutual pretense, and open awareness
ANS: D
Strauss and Glaser have identified three states of awareness: closed awareness, mutual
pretense, and open awareness.
DIF: Cognitive Level: Knowledge REF: p. 378 OBJ: 2
TOP: Awareness of Terminal Illness KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. When planning the care of a patient who is terminally ill, a nurse should include the
prevention of pain and relief from discomfort. What should the nurse implement when
administering pain medication?
a. Narcotics have the potential for addiction.
b. Pain medication must be given before the pain becomes unbearable.
c. Pain medication should be given no more often than every 6 hours.
d. Narcotics must be given as needed only.
ANS: B
Pain control must be consistent to provide constant relief rather than waiting until the pain is
unbearable and then trying to relieve it. Addiction to narcotics is of little concern.
, DIF: Cognitive Level: Application REF: p. 372-373 OBJ: 5
TOP: Pain Control KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
4. What is one of the most important interventions for a nurse to implement when caring for
a patient who is terminally ill?
a. Touching and listening to the patient
b. Encouraging the patient to express any regrets
c. Assessing for signs and symptoms of impending death
d. Talking to the patient about how other patients have handled the dying process
ANS: A
The simple presence of someone provides support and comfort. Neither words nor actions
are necessary unless the patient requires something. Holding hands, touching, and listening
are quality nursing responses.
DIF: Cognitive Level: Application REF: p. 373 OBJ: 5
TOP: Fear of Loneliness KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
5. A nurse is assessing a patient who is terminally ill for clinical signs of impending death.
What should the nurse expect when assessing the patient’s respirations?
a. Deep, clear breath sounds
b. Noisy, wet-sounding respirations
c. Even, unlabored respirations
d. Shallow, clear breath sounds
ANS: B
Breathing may sound wet and noisy. Noisy, wet-sounding respirations, termed the death
rattle, are a response based on mouth breathing and accumulation of mucus in the upper
airways.
DIF: Cognitive Level: Comprehension REF: p. 373 OBJ: 2
TOP: Respiratory Changes KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. What is believed to be the last sense to remain intact during the death process?
a. Touch
b. Sight
c. Smell
d. Hearing
ANS: D
Hearing is commonly believed to be the last sense to remain intact during the death
process.
DIF: Cognitive Level: Knowledge REF: p. 373 OBJ: 4
TOP: Sensory Changes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
