ADULT HEALTH
1. In the past three to four decades, nursing has moved into the forefront in providing care for
the dying. Which phenomenon has most contributed to this increased focus of care of the
dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on disease prevention
C) Larger numbers of people dying in hospital settings
D) Demographic changes in the population - ANS D
2. A nurse who works in the specialty of palliative care frequently encounters issues and
situations that constitute ethical dilemmas. What issue has most often presented challenging
ethical issues, especially in the context of palliative care? A) The increase in cultural diversity in
the United States B) Staffing shortages in health care and questions concerning quality of care
C) Increased costs of health care coupled with inequalities in access D) Ability of technology to
prolong life beyond meaningful quality of life - ANS D
The nurse is caring for a patient who has been recently diagnosed with late stage pancreatic
cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What is
the most likely psychosocial purpose of this patients strategy? A) The patient may be trying to
protect loved ones from the emotional effects of the illness. B) The patient is being noncompliant
in order to assert power over caregivers. C) The patient may be skeptical of the benefits of the
Western biomedical model of health. D) The patient thinks that treatment does not provide him
comfort. - ANS A
4. A nurse who sits on the hospitals ethics committee is reviewing a complex case that has
many of the hallmarks of assisted suicide. Which of the following would be an example of
assisted suicide? A) Administering a lethal dose of medication to a patient whose death is
imminent B) Administering a morphine infusion without assessing for respiratory depression C)
Granting a patients request not to initiate enteral feeding when the patient is unable to eat D)
Neglecting to resuscitate a patient with a do not resuscitate order - ANS A
5. A medical nurse is providing palliative care to a patient with a diagnosis of end-stage chronic
obstructive pulmonary disease (COPD). What is the primary goal of this nurses care? A) To
improve the patients and familys quality of life Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 320 B) To support aggressive and innovative
treatments for cure C) To provide physical support for the patient D) To help the patient develop
a separate plan with each discipline of the health care team - ANS A
After contributing to the care of several patients who died in the hospital, the nurse has
identified some lapses in the care that many of these patients received toward the end of their
lives. What have research studies identified as a potential deficiency in the care of the dying in
hospital settings? A) Families needs for information and support often go unmet. B) Patients are
too sedated to achieve adequate pain control. C) Patients are not given opportunities to
communicate with caregivers. D) Patients are ignored by the care team toward the end of life. -
ANS A
An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has
asked the nurse about the possibility of hospice care. Which principle is central to a hospice
setting? A) The patient and family should be viewed as a single unit of care. B) Persistent
symptoms of terminal illness should not be treated. C) Each member of the interdisciplinary
,team should develop an individual plan of care. Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 321 D) Terminally ill patients should die in the
hospital whenever possible. - ANS A
A clinic nurse is providing patient education prior to a patients scheduled palliative radiotherapy
to her spine. At the completion of the patient teaching, the patient continues to ask the same
questions that the nurse has already addressed. What is the plausible conclusion that the nurse
should draw from this? A) The patient is not listening effectively. B) The patient is noncompliant
with the plan of care. C) The patient may have a low intelligence quotient or a cognitive deficit.
D) The patient has not achieved the desired learning outcomes. - ANS D
The nurse is part of the health care team at an oncology center. A patient has been diagnosed
with leukemia and the prognosis is poor, but the patient is not yet aware of the prognosis. How
can the bad news best be conveyed to the patient? A) Family should be given the prognosis
first. B) The prognosis should be delivered with the patient at eye level. C) The physician should
deliver the news to the patient alone. D) The appointment should be scheduled at the end of the
day - ANS B
A patient has just been told that her illness is terminal. The patient tearfully states, I cant believe
I am going to die. Why me? What is your best response? A) I know how you are feeling. B) You
have lived a long life. C) This must be very difficult for you. D) Life can be so unfair. - ANS C
The nurse has observed that an older adult patient with a diagnosis of end-stage renal failure
seems to prefer to have his eldest son make all of his health care decisions. While the family is
visiting, the patient explains to you that this is a cultural practice and very important to him. How
should you respond? A) Privately ask the son to allow the patient to make his own health care
decisions. B) Explain to the patient that he is responsible for his own decisions. C) Work with the
team to negotiate informed consent. D) Avoid divulging information to the eldest son - ANS C
One aspect of the nurses comprehensive assessment when caring for the terminally ill is the
assessment of hope. The nurse is assessing a patient with liver failure for the presence of hope.
What would the nurse identify as a hope-fostering category? A) Uplifting memories B) Ignoring
negative outcomes C) Envisioning one specific outcome D) Avoiding an actual or potential
threat - ANS A
A medical nurse is providing end-of-life care for a patient with metastatic bone cancer. The
nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect,
but is now having difficulty swallowing the medication. What should the nurse do? A) Request
the physician to order analgesics by an alternative route. B) Crush the medication in order to aid
swallowing and absorption. C) Administer the patients medication with the meal tray. D)
Administer the medication rectally - ANS A
A 66-year-old patient is in a hospice receiving palliative care for lung cancer which has
metastasized to the patients liver and bones. For the past several hours, the patient has been
experiencing dyspnea. What nursing action is most appropriate to help to relive the dyspnea the
patient is experiencing? Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing
14e (Hinkle 2017) 324 A) Administer a bolus of normal saline, as ordered. B) Initiate high-flow
oxygen therapy. C) Administer high doses of opioids. D) Administer bronchodilators and
corticosteroids, as ordered - ANS D
The nurse is caring for a patient who has terminal lung cancer and is unconscious. Which
assessment finding would most clearly indicate to the nurse that the patients death is imminent?
, A) Mottling of the lower limbs B) Slow, steady pulse C) Bowel incontinence D) Increased
swallowing - ANS A
A patient on the medical unit is dying and the nurse has determined that the familys
psychosocial needs during the dying process need to be addressed. What is a cause of many
patient care dilemmas at the end of life? A) Poor communication between the family and the
care team B) Denial of imminent death on the part of the family or the patient Test Bank -
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 325 C) Limited
visitation opportunities for friends and family D) Conflict between family members - ANS A
The nurse is assessing a 73-year-old patient who was diagnosed with metastatic prostate
cancer. The nurse notes that the patient is exhibiting signs of loss, grief, and intense sadness.
Based on this assessment data, the nurse will document that the patient is most likely in what
stage of death and dying? A) Depression B) Denial C) Anger D) Resignation - ANS A
You are caring for a 50-year-old man diagnosed with multiple myeloma; he has just been told by
the care team that his prognosis is poor. He is tearful and trying to express his feelings, but he is
having difficulty. What should you do first? A) Ask if he would like you to sit with him while he
collects his thoughts. B) Tell him that you will leave for now but will be back shortly. C) Offer to
call pastoral care or a member of his chosen clergy. D) Reassure him that you can understand
how he is feeling - ANS A
The nurse in a pediatric ICU is caring for a child who is dying of sickle cell anemia. The childs
mother has been unable to eat or sleep and can talk only about her impending loss and the guilt
she feels about the childs pain and suffering. What intervention has the highest priority? A)
Allowing the patient to express her feelings without judging her B) Helping the patient to
understand the phases of the grieving process C) Reassuring the patient that the childs death is
not her fault D) Arranging for genetic counseling to inform the patient of her chances of having
another child with the disease - ANS A
You are caring for a patient, a 42-year-old mother of two children, with a diagnosis of ovarian
cancer. She has just been told that her ovarian cancer is terminal. When you admitted this
patient, you did a spiritual assessment. What question would it have been most important for
you to evaluate during this assessment? A) Is she able to tell her family of negative test results?
B) Does she have a sense of peace of mind and a purpose to her life? C) Can she let go of her
husband so he can make a new life? Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 327 D) Does she need time and space to bargain
with God for a cure? - ANS B
A patients rapid cancer metastases have prompted a shift from active treatment to palliative
care. When planning this patients care, the nurse should identify what primary aim? A) To
prioritize emotional needs B) To prevent and relieve suffering C) To bridge between curative
care and hospice care D) To provide care while there is still hope - ANS B
The organization of a patients care on the palliative care unit is based on interdisciplinary
collaboration. How does interdisciplinary collaboration differ from multidisciplinary practice? A) It
is based on the participation of clinicians without a team leader. B) It is based on clinicians of
varied backgrounds integrating their separate plans of care. C) It is based on communication
and cooperation between disciplines. D) It is based on medical expertise and patient preference
with the support of nursing. - ANS C
1. In the past three to four decades, nursing has moved into the forefront in providing care for
the dying. Which phenomenon has most contributed to this increased focus of care of the
dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on disease prevention
C) Larger numbers of people dying in hospital settings
D) Demographic changes in the population - ANS D
2. A nurse who works in the specialty of palliative care frequently encounters issues and
situations that constitute ethical dilemmas. What issue has most often presented challenging
ethical issues, especially in the context of palliative care? A) The increase in cultural diversity in
the United States B) Staffing shortages in health care and questions concerning quality of care
C) Increased costs of health care coupled with inequalities in access D) Ability of technology to
prolong life beyond meaningful quality of life - ANS D
The nurse is caring for a patient who has been recently diagnosed with late stage pancreatic
cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What is
the most likely psychosocial purpose of this patients strategy? A) The patient may be trying to
protect loved ones from the emotional effects of the illness. B) The patient is being noncompliant
in order to assert power over caregivers. C) The patient may be skeptical of the benefits of the
Western biomedical model of health. D) The patient thinks that treatment does not provide him
comfort. - ANS A
4. A nurse who sits on the hospitals ethics committee is reviewing a complex case that has
many of the hallmarks of assisted suicide. Which of the following would be an example of
assisted suicide? A) Administering a lethal dose of medication to a patient whose death is
imminent B) Administering a morphine infusion without assessing for respiratory depression C)
Granting a patients request not to initiate enteral feeding when the patient is unable to eat D)
Neglecting to resuscitate a patient with a do not resuscitate order - ANS A
5. A medical nurse is providing palliative care to a patient with a diagnosis of end-stage chronic
obstructive pulmonary disease (COPD). What is the primary goal of this nurses care? A) To
improve the patients and familys quality of life Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 320 B) To support aggressive and innovative
treatments for cure C) To provide physical support for the patient D) To help the patient develop
a separate plan with each discipline of the health care team - ANS A
After contributing to the care of several patients who died in the hospital, the nurse has
identified some lapses in the care that many of these patients received toward the end of their
lives. What have research studies identified as a potential deficiency in the care of the dying in
hospital settings? A) Families needs for information and support often go unmet. B) Patients are
too sedated to achieve adequate pain control. C) Patients are not given opportunities to
communicate with caregivers. D) Patients are ignored by the care team toward the end of life. -
ANS A
An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has
asked the nurse about the possibility of hospice care. Which principle is central to a hospice
setting? A) The patient and family should be viewed as a single unit of care. B) Persistent
symptoms of terminal illness should not be treated. C) Each member of the interdisciplinary
,team should develop an individual plan of care. Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 321 D) Terminally ill patients should die in the
hospital whenever possible. - ANS A
A clinic nurse is providing patient education prior to a patients scheduled palliative radiotherapy
to her spine. At the completion of the patient teaching, the patient continues to ask the same
questions that the nurse has already addressed. What is the plausible conclusion that the nurse
should draw from this? A) The patient is not listening effectively. B) The patient is noncompliant
with the plan of care. C) The patient may have a low intelligence quotient or a cognitive deficit.
D) The patient has not achieved the desired learning outcomes. - ANS D
The nurse is part of the health care team at an oncology center. A patient has been diagnosed
with leukemia and the prognosis is poor, but the patient is not yet aware of the prognosis. How
can the bad news best be conveyed to the patient? A) Family should be given the prognosis
first. B) The prognosis should be delivered with the patient at eye level. C) The physician should
deliver the news to the patient alone. D) The appointment should be scheduled at the end of the
day - ANS B
A patient has just been told that her illness is terminal. The patient tearfully states, I cant believe
I am going to die. Why me? What is your best response? A) I know how you are feeling. B) You
have lived a long life. C) This must be very difficult for you. D) Life can be so unfair. - ANS C
The nurse has observed that an older adult patient with a diagnosis of end-stage renal failure
seems to prefer to have his eldest son make all of his health care decisions. While the family is
visiting, the patient explains to you that this is a cultural practice and very important to him. How
should you respond? A) Privately ask the son to allow the patient to make his own health care
decisions. B) Explain to the patient that he is responsible for his own decisions. C) Work with the
team to negotiate informed consent. D) Avoid divulging information to the eldest son - ANS C
One aspect of the nurses comprehensive assessment when caring for the terminally ill is the
assessment of hope. The nurse is assessing a patient with liver failure for the presence of hope.
What would the nurse identify as a hope-fostering category? A) Uplifting memories B) Ignoring
negative outcomes C) Envisioning one specific outcome D) Avoiding an actual or potential
threat - ANS A
A medical nurse is providing end-of-life care for a patient with metastatic bone cancer. The
nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect,
but is now having difficulty swallowing the medication. What should the nurse do? A) Request
the physician to order analgesics by an alternative route. B) Crush the medication in order to aid
swallowing and absorption. C) Administer the patients medication with the meal tray. D)
Administer the medication rectally - ANS A
A 66-year-old patient is in a hospice receiving palliative care for lung cancer which has
metastasized to the patients liver and bones. For the past several hours, the patient has been
experiencing dyspnea. What nursing action is most appropriate to help to relive the dyspnea the
patient is experiencing? Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing
14e (Hinkle 2017) 324 A) Administer a bolus of normal saline, as ordered. B) Initiate high-flow
oxygen therapy. C) Administer high doses of opioids. D) Administer bronchodilators and
corticosteroids, as ordered - ANS D
The nurse is caring for a patient who has terminal lung cancer and is unconscious. Which
assessment finding would most clearly indicate to the nurse that the patients death is imminent?
, A) Mottling of the lower limbs B) Slow, steady pulse C) Bowel incontinence D) Increased
swallowing - ANS A
A patient on the medical unit is dying and the nurse has determined that the familys
psychosocial needs during the dying process need to be addressed. What is a cause of many
patient care dilemmas at the end of life? A) Poor communication between the family and the
care team B) Denial of imminent death on the part of the family or the patient Test Bank -
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 325 C) Limited
visitation opportunities for friends and family D) Conflict between family members - ANS A
The nurse is assessing a 73-year-old patient who was diagnosed with metastatic prostate
cancer. The nurse notes that the patient is exhibiting signs of loss, grief, and intense sadness.
Based on this assessment data, the nurse will document that the patient is most likely in what
stage of death and dying? A) Depression B) Denial C) Anger D) Resignation - ANS A
You are caring for a 50-year-old man diagnosed with multiple myeloma; he has just been told by
the care team that his prognosis is poor. He is tearful and trying to express his feelings, but he is
having difficulty. What should you do first? A) Ask if he would like you to sit with him while he
collects his thoughts. B) Tell him that you will leave for now but will be back shortly. C) Offer to
call pastoral care or a member of his chosen clergy. D) Reassure him that you can understand
how he is feeling - ANS A
The nurse in a pediatric ICU is caring for a child who is dying of sickle cell anemia. The childs
mother has been unable to eat or sleep and can talk only about her impending loss and the guilt
she feels about the childs pain and suffering. What intervention has the highest priority? A)
Allowing the patient to express her feelings without judging her B) Helping the patient to
understand the phases of the grieving process C) Reassuring the patient that the childs death is
not her fault D) Arranging for genetic counseling to inform the patient of her chances of having
another child with the disease - ANS A
You are caring for a patient, a 42-year-old mother of two children, with a diagnosis of ovarian
cancer. She has just been told that her ovarian cancer is terminal. When you admitted this
patient, you did a spiritual assessment. What question would it have been most important for
you to evaluate during this assessment? A) Is she able to tell her family of negative test results?
B) Does she have a sense of peace of mind and a purpose to her life? C) Can she let go of her
husband so he can make a new life? Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 327 D) Does she need time and space to bargain
with God for a cure? - ANS B
A patients rapid cancer metastases have prompted a shift from active treatment to palliative
care. When planning this patients care, the nurse should identify what primary aim? A) To
prioritize emotional needs B) To prevent and relieve suffering C) To bridge between curative
care and hospice care D) To provide care while there is still hope - ANS B
The organization of a patients care on the palliative care unit is based on interdisciplinary
collaboration. How does interdisciplinary collaboration differ from multidisciplinary practice? A) It
is based on the participation of clinicians without a team leader. B) It is based on clinicians of
varied backgrounds integrating their separate plans of care. C) It is based on communication
and cooperation between disciplines. D) It is based on medical expertise and patient preference
with the support of nursing. - ANS C
