Chapter 40: Psychological Care of Patients with Life-Threatening Illness

Chapter 40: Psychological Care of Patients with Life-Threatening Illness

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is caring for a patient awaiting test results that will indicate whether the patient has cancer. Which communication would be most helpful initially to facilitate a therapeutic nurse-patient relationship?

a.	“I’m sure this must be a difficult time. It may be most helpful for you to focus on the development of new drugs and other therapies.”
b.	“How sad and frightened you must feel right now. Do you have any family or friends that are good support systems for you that I might call?”
c.	“I am trying to imagine how you feel. If you spend this time making sure all your affairs are in order, it will give you more of a sense of control over the situation.”
d.	“This is a time of uncertainty for you and your family. I sense that you are quite anxious and in disbelief. I’d like to talk to you about how you’re feeling.”

 

 

ANS:  D

Between the development of symptoms and a definitive diagnosis, patients and their family members or loved ones have to endure a time of uncertainty. Often the best way to begin the intervention is to tell the person the behavior or emotion that you are observing and give it a name (shock, disbelief, fear, or sadness). It is important to validate and seek the person’s agreement with or refinement of this perception. The correct response “offers self,” a therapeutic communication technique.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 764

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

2. A patient has just been diagnosed with an inoperable brain tumor. Which patient statement about concerns should the nurse expect initially?

a.	“I wish I knew what I did to cause this to happen.”
b.	“I’m very concerned about becoming a burden to my family.”
c.	“If that is the case I would like to look into nursing home placement or hospice care right away.”
d.	“Well, all of us have to die someday. I’ll have to see a lawyer about a will, and I’ll need you to tell me more about advance directives.”

 

 

ANS:  B

Patients and families have concerns immediately after receiving a diagnosis of terminal illness. Concerns frequently include how long people live after diagnosis, emotional effect or inconvenience to family or friends, being a burden, financial concerns, suffering pain or disfigurement, feelings of loss of control, feelings of still having much to do in life, and dying alone.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 765

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

3. A patient with liver failure rings the call bell and tells the nurse, “The lunch is cold, and my sheets are wrinkled. You never seem to have enough help to give me the care I need.” Which intervention should the nurse implement initially?

a.	Listen quietly but attentively until the patient has finished speaking.
b.	Attempt to correct each problem the patient has identified immediately.
c.	Say to the patient, “I’m sorry but please know that the staff is really doing the best they can.”
d.	Promise the patient to share all of the concerns with the unit’s nurse manager on day shift.

 

 

ANS:  A

Ways in which the nurse can respond to patient or family concerns include, among others, listening without interrupting or defending, and providing what is requested if possible. For this reason, the nurse should initially listen to the patient before attempting to correct the perceived problems.

 

DIF:    Cognitive Level: Application           REF:   Text Pages: 762-763

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

4. A patient diagnosed with amyotrophic lateral sclerosis says to the nurse, “I’ve been looking on the Internet to get more information about this disease. Which of the sites has the most reliable information?” Which site would the nurse recommend?

a.	National Institutes of Health (NIH)
b.	Food and Drug Administration (FDA)
c.	Centers for Disease Control and Prevention (CDC)
d.	Occupational Safety and Health Administration (OSHA)

 

 

ANS:  A

The NIH is a reputable and accurate website for obtaining health-related information. The CDC is appropriate for information about communicable diseases. OSHA oversees workplace safety, and the FDA oversees food and drug standards.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 764

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care