Question

A client asks the RN about the purpose of an advance directive. What is the RN’s most appropriate response?

“It allows you to document your wishes about your health care.”

“It provides instructions for your care, should you become terminally ill.”

“It is a document that identifies post mortem preferences.”

“It will allow the hospital to choose a health care proxy on your behalf.”

The daughter of a client who is dying and unconscious, asks what she can do to make her father feel better. What is the appropriate response for the RN?

“You can talk to your father and hold his hand.”

“It is important that you focus on your healing now.”

“There is nothing more to do now.”

“Think about what he would want for his funeral arrangements.”

By which client statement does the RN determine the patient is ready to enter the hospice level of care?

“I want to make the best of my remaining days.”

“I don’t have a strong support system.”

“I want to put my affairs in order.”

“I heard about a new drug treatment.”

The hospice RN has been working with a dying woman and her spouse for four months. Both have been freely verbalizing concerns and supporting one another. The spouse was stoic and showed no expression of sadness or grief after hearing the “bad news” from the health care provider. How would the RN interpret this response?

Cultural belief to accept hardships without complaint.

The spouse is not comprehending the illness severity.

Confusion concerning the circumstances of the diagnosis.

Ambivalence about the spouse’s relationship with the dying woman.

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The parents of a terminally ill three-year-old are in the acceptance stage of grief. What will be the RN’s primary plan during this time?

Call a religious leader to visit

Offer support and encouragement.

Encourage a positive outlet for emotions.

Limit visitation to family.

The RN and a nursing assistive personnel (NAP) are caring for a client who is comatose and has a Do Not Attempt Resuscitation (DNAR) order. Which statement by the NAP indicates an understanding of patient’s resuscitation status?

“Tell me what part of the emergency care you want me to do.”

DNAR means that we will limit care.”

“If this patient stops breathing the healthcare provider will put him on a respirator.”

“If the patient’s heart stops we will not begin cardiopulmonary resuscitation (CPR).”

The RN is supervising a home health aide who is providing daily care for a patient who is receiving hospice care and is anorexic. Which statement by the home health aide indicates additional teaching is necessary?

“I will have food available whenever the patient is hungry.”

“I will make sure the patient eats from each food group at every meal.”

“I will position the patient to eat sitting upright.”

“I will ask if the patient needs pain medications before meals.”

While the RN is providing after-death care the patient’s spouse runs into the room crying out “He is gone!” and lays across the body. The adult children try to pull the spouse away. What is the most appropriate action for the RN?

Acknowledge the loss and be present.

Find the pastoral care staff.

Allow the children to assist the grieving parent.

Seek the social worker to see the spouse.

The RN is caring for a patient who is dying and has secretions in the back of her throat that rattle. The family asks the RN what can be done to make their family member more comfortable. Which actions would the RN perform? Select all that apply.

Position patient on in a side lying position.

Administer scopolamine (Transderm Scop) patch.

Administer an expectorant medication.

Reposition the patient in high Fowlers.

Inform the family this is part of the dying process.

The RN is caring for a patient who had a diagnostic procedure scheduled to rule out a terminal illness. The patient begins crying and says, “Will God help me?”. Which of the following should the RN do first?

Make a pastoral care referral.

Be present for the patient.

Refer the patient to a social worker.

Initiate a prayer with the patient.

An 8-year-old child with cancer asks the RN what it feels like to die. What is the appropriate response by the RN?

“You have to talk to your parents about that.”

“It is similar to going to sleep.”

“Angels come and bring you to heaven.”

“Why are you asking about dying?”

The nursing assistive personnel (NAP) asks the RN to describe the goal of palliative care for terminally ill patients. What is the RN’s appropriate response?

“Palliative care provides pain relief and symptom management.”

“Palliative care is focused on prolonging the patient’s life.”

“Palliative care prevents the removal of life sustaining treatments”

“Palliative care reduces and manages costs and payments.”

The student nurse asks the RN instructor what it means when health care providers discuss extraordinary treatments. Which is the appropriate description of extraordinary treatments?

“Treatments and medications that offer little hope for curing or improving the patient’s condition.”

“Alternative way of providing care to terminally ill patients where palliative care is used.”

“Administering a lethal agent to end a patient’s life for reasons of mercy.”

“Documentation of patient’s desires for end of life care with appointment of surrogate.”

Which statement by the patient indicates the RN should provide teaching regarding the Patient Self Determination Act?

“If I appoint a durable power of attorney, that person can make decisions for me if I am unable to communicate my wishes.”

“A Physician Orders for Life-Sustaining Treatment (POLST) for must be completed for every health care facility I transfer to.”

“An Advance Directive can be completed

Answer 1

1) advance directives helps you to document your wishes about health care.

2) the nurse can say "you can talk to your father and hold his hands".

3) I want to make the best of my remaining days.

4) cultural belief to answer hardship without complain

5) offer support and encouragement.

6) if the patients heart stops we will not provide cardio pulmonary resuscitation.

7) I will make sure the patient eats from every food group.

8) allow the children to assist the grieving parent.

9) administration of expectorant

Fowlers position.