Chapter 07: End-of-Life Care Test Bank Medical Surgical Nursing 9th Edition Ignatavicius Workman

MULTIPLE CHOICE 1. A nurse cares for a dying client. Which manifestation of dying should the nurse treat first? a. Anorexia b. Pain c. Nausea d. Hair loss ANS: B Only symptoms that cause distress for a dying client should be treated. Such symptoms include pain, nausea and vomiting, dyspnea, and agitation. These problems interfere with the clients comfort. Even when symptoms, such as anorexia or hair loss, disturb the family, they should be treated only if the client is distressed by their presence. The nurse should treat the clients pain first. DIF: Applying/Application REF: 109 KEY: End-of-life care| advance directives MSC: Integrated Process: Caring NOT: Client Needs Category: Psychosocial Integrity 2. A nurse plans care for a client who is nearing end of life. Which question should the nurse ask when developing this clients plan of care? a. Is your advance directive up to date and notarized? b. Do you want to be at home at the end of your life? c. Would you like a physical therapist to assist you with range-of-motion activities? d. Have your children discussed resuscitation with your health care provider? ANS: B When developing a plan of care for a dying client, consideration should be given for where the client wants to die. Advance directives do not need to be notarized. A physical therapist would not be involved in end-of-life care. The client should discuss resuscitation with the health care provider and children; do-not-resuscitate status should be the clients decision, not the familys decision. DIF: Applying/Application REF: 106 KEY: End-of-life care| advance directives MSC: Integrated Process: Caring NOT: Client Needs Category: Psychosocial Integrity 3. A nurse is caring for a client who has lung cancer and is dying. Which prescription should the nurse question? a. Morphine 10 mg sublingual every 6 hours PRN for pain level greater than 5 b. Albuterol (Proventil) metered dose inhaler every 4 hours PRN for wheezes c. Atropine solution 1% sublingual every 4 hours PRN for excessive oral secretions d. Sodium biphosphate (Fleet) enema once a day PRN for impacted stool ANS: A Pain medications should be scheduled around the clock to maintain comfort and prevent reoccurrence of pain. The other medications are appropriate for this client. DIF: Applying/Application REF: 108 KEY: End-of-life care| pharmacologic pain management MSC: Integrated Process: Nursing Process: Planning NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies 4. A client tells the nurse that, even though it has been 4 months since her sisters death, she frequently finds herself crying uncontrollably. How should the nurse respond? a. Most people move on within a few months. You should see a grief counselor. b. Whenever you start to cry, distract yourself from thoughts of your sist