Chapter 16: Palliative Care

Chapter 16: Palliative Care

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The patient has a history of terminal cancer but is being admitted for treatment of a pressure ulcer. The patient’s wife has been caring for him at home and refuses to discuss admission to a nursing home. The wife looks extremely tired and is near the point of exhaustion. What could the nurse suggest?

ANS:  A

Hospice benefits include respite for family caregivers. The current plan of care may be the reason for the decubiti and may lead to the patient’s wife’s becoming ill. Palliative and hospice care place a primary focus on the patient’s values, quality of life, and care preferences.

DIF:    Cognitive Level: Application           REF:   Text reference: p. 375

OBJ:   Describe hospice care.                     TOP:   Respite Care

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

2. The patient is being admitted to the hospital for injuries received when a hurricane destroyed her home. She is upset from the loss of her home and possessions. What type of loss is this considered?

ANS:  C

Situational losses include loss from sudden, unpredictable external events such as a hurricane that destroys one’s home or city. Necessary losses, such as leaving friends after high school graduation, are a natural part of life. Such losses usually are replaced by something different or better. Some necessary losses are more difficult and never seem acceptable, such as the loss of a loved one through death. Life goes on, but replacements for these losses do not appear. Maturational losses include changes that occur as a part of normal life development. For instance, a parent feels loss when a child marries and moves away from home. Perceived losses are interpreted uniquely by the individual and often are not obvious to others. For example, one person perceives failure to get into a preferred college as a loss of all opportunity, while another person views the same experience as a relief.

DIF:    Cognitive Level: Comprehension     REF:   Text reference: p. 378

OBJ:   Discuss principles of palliative care.                                  TOP:   Loss

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Physiological Integrity

3. The nurse recognizes that anticipatory grieving can be most beneficial for a patient or family because it can:

ANS:  D

The benefit of anticipatory grief is that it allows for a gradual disengagement from the loss. Anticipatory grief may help people move through the stages of grief, allowing time to grieve in private, to discuss the anticipated loss with others, and then to “let go” of the loved one.

DIF:    Cognitive Level: Comprehension     REF:   Text reference: p. 378

OBJ:   Identify the nurse’s role in assisting patients and families in grief and at the end of life.

TOP:   Grief              KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity

4. The nurse is preparing to assist the patient at the end stage of her life. To provide comfort for the patient in response to anticipated symptom development, the nurse plans to:

ANS:  D

Have the patient identify what she wants to accomplish, and use strategies to conserve energy for meeting those goals. This provides the patient with a sense of well-being and purpose to meet important personal goals. Decreasing the patient’s fluid intake may make the terminally ill patient more prone to dehydration and constipation. The nurse should take measures to help maintain oral intake, such as administering antiemetics, applying topical analgesics to oral lesions, and offering ice chips. The use of analgesics should not be limited. Controlling the terminally ill patient’s level of pain is a primary concern in promoting comfort. Nausea, vomiting, and anorexia may increase the terminally ill patient’s likelihood of inadequate nutrition. The nurse should serve smaller portions and bland foods, which may be more palatable.

DIF:    Cognitive Level: Analysis

REF:   Text reference: p. 373|Text reference: p. 376|Text reference: pp. 383-384

OBJ:   Identify the nurse’s role in assisting patients and families in grief and at the end of life.

TOP:   Caring for the Dying Patient            KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity