Ch. 13 Med-Surg: Palliative and End-of-Life
Care EXAM QUESTIONS VERIFIED
ANSWERS LATEST UPDATE 2025/2026
In recent 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 - CORRECT ANSWERS D. Demographic changes in
the population
Rationale: The focus on care of the dying has been motivated by the aging of the population, the
prevalence of, and publicity surrounding, life-threatening illnesses (e.g., cancer and AIDS), and the
increasing likelihood of a prolonged period of chronic illness prior to death. The salience of acute
infections, prevention measures, and death in hospital settings are not noted to have had a major
influence on this phenomenon.
P 368
Which issue has most often presented challenging ethical issues, especially in the context of palliative
care?
A. Increased cultural diversity 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 - CORRECT ANSWERS
D. Ability of technology to prolong life beyond meaningful quality of life
Rationale: The application of technology to prolong life has raised several ethical issues.The major
question is, "Because we can prolong life through increasingly sophisticated technology, does it
necessarily follow that we must do so?" The increase in cultural diversity has not raised ethical issues in
health care. Similarly, costs and staffing issues are relevant, but not central to the most common ethical
issues surrounding palliative care.
P 389
,The nurse is assessing a client whose spouse died 16 months ago. The client tells the nurse about joining
a hiking group, volunteering as a college mentor, and thinking about dating again. The nurse determines
that the client is in which stage of Rando's processes of mourning?
A. Reinvestment
B. Recognition of the loss
C. Recollection and reexperiencing the deceased D. Relinquishing old attachments to the deceased -
CORRECT ANSWERS A. Reinvestment
Rationale: Rando identified six processes of mourning that involve the detachment from ties that bind
the mourner to the deceased and learning to live in a world without the deceased. By engaging in new
activities and forming emotional attachments to new people, the client is reinvesting in a life without
the spouse. Recognizing the loss refers to acknowledging the death of the spouse. Recollection and
reexperiencing involve reviewing and reminiscing about the deceased spouse and the relationship.
Relinquishing old attachments to the spouse involves letting go of the attachment to an old way of life.
P 385
A nurse who sits on the hospital's ethics committee is reviewing a complex case that has many of the
characteristics of assisted suicide. Which of the following would be an example of assisted suicide? A.
Administering a lethal dose of medication to a client whose death is imminent
B. Administering a morphine infusion without assessing for respiratory depression
C. Granting a client's request not to initiate enteral feeding when the client is unable to eat
D. Neglecting to resuscitate a client with a "do not resuscitate" order - CORRECT ANSWERS A.
Administering a lethal dose of medication to a client whose death is imminent
Rationale: Assisted suicide refers to providing another person the means to end his or her own life. This
is not to be confused with the ethically and legally supported practices of withholding or withdrawing
medical treatment in accordance with the wishes of the terminally ill individual. The other listed options
do not fit this accepted definition of assisted suicide.
P 387
A medical nurse is providing palliative care to a client with a diagnosis of end-stage chronic obstructive
pulmonary disease (COPD). What is the primary goal of this nurse's care?
, A. To improve the client's and family's quality of life
B. To support aggressive and innovative treatments for cure C. To provide physical support for the client
D. To help the client develop a separate plan with each discipline of the health care team - CORRECT
ANSWERS A. To improve the client's and family's quality of life
Rationale: The goal of palliative care is to improve the client's and the family's quality of life. The support
should include the client's physical, emotional, and spiritual well-being. Each discipline should contribute
to a single care plan that addresses the needs of the client and family. The goal of palliative care is not
aggressive support for curing the client. Providing physical support for the client is also not the goal of
palliative care. Palliative care does not strive to achieve separate plans of care developed by the client
with each discipline of the health care team.
P 368
After caring for several clients who died in the hospital, the nurse has identified some lapses in the care
that many of these clients 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. The perception that palliative care constitutes "giving up."
B. Clients are too sedated to achieve adequate pain control.
C. Clients are not given opportunities to communicate with caregivers.
D. Clients are ignored by the care team toward the end of life. - CORRECT ANSWERS A. The
perception that palliative care constitutes "giving up."
Rationale: One of the principal objections to palliative care is that palliative care is equated with "giving
up." Oversedation, lack of communication, and lack of care are not noted to be deficiencies to the same
degree.
P 389
An adult oncology client has a diagnosis of bladder cancer with metastasis and the client has asked the
nurse about the possibility of hospice care. Which principle is central to a hospice setting?
A. The client 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.
Care EXAM QUESTIONS VERIFIED
ANSWERS LATEST UPDATE 2025/2026
In recent 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 - CORRECT ANSWERS D. Demographic changes in
the population
Rationale: The focus on care of the dying has been motivated by the aging of the population, the
prevalence of, and publicity surrounding, life-threatening illnesses (e.g., cancer and AIDS), and the
increasing likelihood of a prolonged period of chronic illness prior to death. The salience of acute
infections, prevention measures, and death in hospital settings are not noted to have had a major
influence on this phenomenon.
P 368
Which issue has most often presented challenging ethical issues, especially in the context of palliative
care?
A. Increased cultural diversity 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 - CORRECT ANSWERS
D. Ability of technology to prolong life beyond meaningful quality of life
Rationale: The application of technology to prolong life has raised several ethical issues.The major
question is, "Because we can prolong life through increasingly sophisticated technology, does it
necessarily follow that we must do so?" The increase in cultural diversity has not raised ethical issues in
health care. Similarly, costs and staffing issues are relevant, but not central to the most common ethical
issues surrounding palliative care.
P 389
,The nurse is assessing a client whose spouse died 16 months ago. The client tells the nurse about joining
a hiking group, volunteering as a college mentor, and thinking about dating again. The nurse determines
that the client is in which stage of Rando's processes of mourning?
A. Reinvestment
B. Recognition of the loss
C. Recollection and reexperiencing the deceased D. Relinquishing old attachments to the deceased -
CORRECT ANSWERS A. Reinvestment
Rationale: Rando identified six processes of mourning that involve the detachment from ties that bind
the mourner to the deceased and learning to live in a world without the deceased. By engaging in new
activities and forming emotional attachments to new people, the client is reinvesting in a life without
the spouse. Recognizing the loss refers to acknowledging the death of the spouse. Recollection and
reexperiencing involve reviewing and reminiscing about the deceased spouse and the relationship.
Relinquishing old attachments to the spouse involves letting go of the attachment to an old way of life.
P 385
A nurse who sits on the hospital's ethics committee is reviewing a complex case that has many of the
characteristics of assisted suicide. Which of the following would be an example of assisted suicide? A.
Administering a lethal dose of medication to a client whose death is imminent
B. Administering a morphine infusion without assessing for respiratory depression
C. Granting a client's request not to initiate enteral feeding when the client is unable to eat
D. Neglecting to resuscitate a client with a "do not resuscitate" order - CORRECT ANSWERS A.
Administering a lethal dose of medication to a client whose death is imminent
Rationale: Assisted suicide refers to providing another person the means to end his or her own life. This
is not to be confused with the ethically and legally supported practices of withholding or withdrawing
medical treatment in accordance with the wishes of the terminally ill individual. The other listed options
do not fit this accepted definition of assisted suicide.
P 387
A medical nurse is providing palliative care to a client with a diagnosis of end-stage chronic obstructive
pulmonary disease (COPD). What is the primary goal of this nurse's care?
, A. To improve the client's and family's quality of life
B. To support aggressive and innovative treatments for cure C. To provide physical support for the client
D. To help the client develop a separate plan with each discipline of the health care team - CORRECT
ANSWERS A. To improve the client's and family's quality of life
Rationale: The goal of palliative care is to improve the client's and the family's quality of life. The support
should include the client's physical, emotional, and spiritual well-being. Each discipline should contribute
to a single care plan that addresses the needs of the client and family. The goal of palliative care is not
aggressive support for curing the client. Providing physical support for the client is also not the goal of
palliative care. Palliative care does not strive to achieve separate plans of care developed by the client
with each discipline of the health care team.
P 368
After caring for several clients who died in the hospital, the nurse has identified some lapses in the care
that many of these clients 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. The perception that palliative care constitutes "giving up."
B. Clients are too sedated to achieve adequate pain control.
C. Clients are not given opportunities to communicate with caregivers.
D. Clients are ignored by the care team toward the end of life. - CORRECT ANSWERS A. The
perception that palliative care constitutes "giving up."
Rationale: One of the principal objections to palliative care is that palliative care is equated with "giving
up." Oversedation, lack of communication, and lack of care are not noted to be deficiencies to the same
degree.
P 389
An adult oncology client has a diagnosis of bladder cancer with metastasis and the client has asked the
nurse about the possibility of hospice care. Which principle is central to a hospice setting?
A. The client 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.
