Chapter 15: End-of-Life Care
Williams: Basic Geriatric Nursing, 8th Edition
MULTIPLE CHOICE
1. The distraught wife of a terminally ill patient reports to the nurse, “My husband has not
been shaved, and he has that miserable gown on instead of his own pajamas. Don’t you
people care about things like that?” What would be the best response of the nurse?
a. “I delayed his morning care because he was sleeping comfortably. I’ll complete
his care now that he’s awake.”
b. “We’re running late today and I have six other patients to care for. What do you
want?”
c. “Of course we care! Someone will come to do his care before lunch.”
d. “I’m sorry you feel we’re doing such a poor job. I’m doing my best.”
ANS: A
Listening to criticism without defensiveness and giving a prompt response to requests
with an explanation shows the nurse’s concern for meeting the needs of the dying
person and of the distressed family members.
PTS: 1 DIF: 5 REF: p. 266 OBJ: 4
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation NOT:
Applying
2. The nurse becomes tearful at the death of a patient. Which response would be the most
appropriate response of the nurse?
a. Leave the room so that the family will not witness the unprofessional behavior.
b. Touch the hand of the daughter and say, “We’ll miss your dad.”
, c. Become occupied with rearranging a floral bouquet until emotions are under
control.
d. Ask family members to leave the room so the post mortem care can be provided.
ANS: B
Showing that the nurse is experiencing a loss also helps the family deal with their
grief. Showing empathetic emotion is not unprofessional.
PTS: 1 DIF: 5 REF: pp. 266-267 OBJ: 4
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation NOT:
Applying
3. Which sign is a cardiovascular sign of impending death?
a. Cheyne-Stokes respiration
b. Bounding pulse
c. Cyanosis of the extremities
d. Increased blood pressure
ANS: C
As death approaches, there is vasoconstriction to the extremities to keep blood going
to the heart and brain. This causes cyanosis in the extremities. Decreased blood
pressure and a weak pulse are often seen in the dying person. Cheyne-Stokes
respirations are changes seen in the respiratory system.
PTS: 1 DIF: 4 REF: p. 271 OBJ: 6
TOP: Cardiovascular Changes of Approaching Death
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation NOT:
Applying
, 4. What is the objective of pain control for the patient who is dying?
a. Keep the patient unconscious and relaxed to avoid the perception of pain.
b. Delay medication until the patient reports that the pain is intense.
c. Find a control level that reduces pain but allows the patient to interact.
d. Eradicate pain completely.
ANS: C
Finding a level of pain control that allows the patient to participate in care and
communicate with family is the goal of pain control. Analgesics given before pain
becomes intense can keep pain at a moderate level. Completely eradicating pain is not
realistic.
PTS: 1 DIF: 4 REF: p. 269 OBJ: 6
TOP: Pain Control KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation NOT:
Understanding
5. A patient who is dying is receiving 2 mg of morphine sulfate every hour. The patient’s
family member is worried about oversedation. The nurse will explain that this small dose
of morphine is given to control which symptom?
a. Dyspnea
b. Pain
c. Hallucinations
d. Fatigue
ANS: A
Administering frequent, small doses of morphine sulfate is standard protocol to
reduce end-of-life air hunger.
PTS: 1 DIF: 3 REF: pp. 271-272 OBJ: 6
Williams: Basic Geriatric Nursing, 8th Edition
MULTIPLE CHOICE
1. The distraught wife of a terminally ill patient reports to the nurse, “My husband has not
been shaved, and he has that miserable gown on instead of his own pajamas. Don’t you
people care about things like that?” What would be the best response of the nurse?
a. “I delayed his morning care because he was sleeping comfortably. I’ll complete
his care now that he’s awake.”
b. “We’re running late today and I have six other patients to care for. What do you
want?”
c. “Of course we care! Someone will come to do his care before lunch.”
d. “I’m sorry you feel we’re doing such a poor job. I’m doing my best.”
ANS: A
Listening to criticism without defensiveness and giving a prompt response to requests
with an explanation shows the nurse’s concern for meeting the needs of the dying
person and of the distressed family members.
PTS: 1 DIF: 5 REF: p. 266 OBJ: 4
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation NOT:
Applying
2. The nurse becomes tearful at the death of a patient. Which response would be the most
appropriate response of the nurse?
a. Leave the room so that the family will not witness the unprofessional behavior.
b. Touch the hand of the daughter and say, “We’ll miss your dad.”
, c. Become occupied with rearranging a floral bouquet until emotions are under
control.
d. Ask family members to leave the room so the post mortem care can be provided.
ANS: B
Showing that the nurse is experiencing a loss also helps the family deal with their
grief. Showing empathetic emotion is not unprofessional.
PTS: 1 DIF: 5 REF: pp. 266-267 OBJ: 4
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation NOT:
Applying
3. Which sign is a cardiovascular sign of impending death?
a. Cheyne-Stokes respiration
b. Bounding pulse
c. Cyanosis of the extremities
d. Increased blood pressure
ANS: C
As death approaches, there is vasoconstriction to the extremities to keep blood going
to the heart and brain. This causes cyanosis in the extremities. Decreased blood
pressure and a weak pulse are often seen in the dying person. Cheyne-Stokes
respirations are changes seen in the respiratory system.
PTS: 1 DIF: 4 REF: p. 271 OBJ: 6
TOP: Cardiovascular Changes of Approaching Death
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation NOT:
Applying
, 4. What is the objective of pain control for the patient who is dying?
a. Keep the patient unconscious and relaxed to avoid the perception of pain.
b. Delay medication until the patient reports that the pain is intense.
c. Find a control level that reduces pain but allows the patient to interact.
d. Eradicate pain completely.
ANS: C
Finding a level of pain control that allows the patient to participate in care and
communicate with family is the goal of pain control. Analgesics given before pain
becomes intense can keep pain at a moderate level. Completely eradicating pain is not
realistic.
PTS: 1 DIF: 4 REF: p. 269 OBJ: 6
TOP: Pain Control KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation NOT:
Understanding
5. A patient who is dying is receiving 2 mg of morphine sulfate every hour. The patient’s
family member is worried about oversedation. The nurse will explain that this small dose
of morphine is given to control which symptom?
a. Dyspnea
b. Pain
c. Hallucinations
d. Fatigue
ANS: A
Administering frequent, small doses of morphine sulfate is standard protocol to
reduce end-of-life air hunger.
PTS: 1 DIF: 3 REF: pp. 271-272 OBJ: 6
