Chapter 10: End-of-Life Care
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Chapter 10: End-of-Life Care

Priorities in Critical Care Nursing 7th Edition Urden - Stacy - Lough

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Chapter 10: End-of-Life Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. Which of the following statements about comfort care is accurate?
a. Withholding and withdrawing life-sustaining treatment are distinctly different in the eyes of the legal community.
b. Each procedure should be evaluated for its effect on the patient’s comfort before being implemented.
c. Only the patient can determine what constitutes comfort care for him or her.
d. Withdrawing life-sustaining treatments is considered euthanasia in most states.

 

 

ANS:  B

The goal of comfort care is to provide only treatments that do not cause pain or other discomfort to the patient.

 

  1. _____ is a powerful influence when the decision-making process is dealing with recovery or a peaceful death.
a. Hope
b. Religion
c. Culture
d. Ethics

 

 

ANS:  A

Hope is a powerful influence on decision making, and a shift from hope for recovery to hope for a peaceful death should be guided by clinicians with exemplary communication skills. Ethics, religion, and culture can influence the decision process regarding care and end-of-life decisions.

 

  1. The patient’s condition has deteriorated to the point where she can no longer make decisions about her own care. Which of the following nursing interventions would be most appropriate?
a. Obtain a verbal DNR order from the physician.
b. Continue caring for the patient as originally ordered because she obviously wanted this.
c. Consult the hospital attorney for recommendations on how to proceed.
d. Discuss with the family what the patient’s wishes would be if she could make those decisions herself.

 

 

ANS:  D

If the patient is not able to make end-of-life decisions for herself, her family members should be approached to discuss the next steps because they may have insight into what her wishes would be.

 

  1. The two basic ethical principles underlying the provision of health care are
a. beneficence and nonmaleficence.
b. veracity and beneficence.
c. fidelity and nonmaleficence.
d. veracity and fidelity.

 

 

ANS:  A

The two basic ethical principles underlying the provision of health care are beneficence and nonmaleficence.

 

  1. A patient was admitted to the critical care unit several weeks ago with an acute myocardial infarction and subsequently underwent coronary artery bypass grafting surgery. Since a cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram shows no meaningful brain activity. The patient does not have an advance directive. Which of the following statements would be the best way to approach the family regarding his ongoing care?
a. “I will refer this case to the hospital ethics committee, and they will contact you when they have a decision.”
b. “What do you want to do about the patient’s care at this point?”
c. “Dr. Smith believes that there is no hope at this point and recommends DNR status.”
d. “What would the patient want if he knew he were in this situation?”

 

 

ANS:  D

Approaching the family and asking what they know about the patient’s wishes and preferences is the best way to begin this discussion. Emotional support for the patient and the family is important as they discuss advance care planning in the critical care setting.

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