Chapter 30: Palliative Care

Chapter 30: Palliative Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a patient who just died. Which action should the nurse take first to determine if the patient is an organ or tissue donor?

a.	Delegate the task to nursing assistive personnel (NAP).
b.	Determine the patient’s legal representative.
c.	Request a copy of the patient’s driver’s license.
d.	Ask the spouse to sign an organ donation consent.

 

 

ANS:  B

The nurse needs to determine if patient is an organ/tissue donor. Federal law mandates that family members be given a chance to authorize organ/tissue donation. The nurse should then call the organ/tissue request and procurement team (consult facility policy). Discussing organ donation and obtaining consent are tasks that the nurse cannot delegate because they require clinical judgment and critical thinking skills and are usually done by a special team. A copy of the patient’s driver’s license can be impractical or impossible to obtain soon enough to donate viable organs; generally the family knows the patient’s wishes about organ donation. If the spouse is the patient’s legal representative, he or she can provide consent.

 

DIF:    Cognitive Level: Analyze                REF:   Page 806-807

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

 

2. The family of the patient receiving hospice care is at the bedside expecting an imminent death. They become upset when the patient suddenly becomes restless and disoriented. Which should the nurse implement as the patient advocate?

a.	Apply oxygen with a face mask.
b.	Ask the family to leave the room.
c.	Speak to the patient calmly and softly.
d.	Administer extra pain medication.

 

 

ANS:  C

Restlessness and agitation are common patient assessments as death approaches and are part of the body’s preparation for death. The nurse explains that the upsetting behavior occurs frequently in the dying process and provides actions for the family to implement. For restlessness and agitation, the family can massage the hands or feet or play soothing music. Oxygen by face mask can increase patient distress and impair any ability to communicate. The nurse avoids asking the family to leave the room. The nurse explains that the patient’s behavior is very common, reflective more of the dying process than actual distress. The nurse administers pain medication according to the prescription.

 

DIF:    Cognitive Level: Apply                   REF:   Page 800| Page 801| Page 803

OBJ:   NCLEX: Psychosocial Integrity       TOP:   Nursing Process: Planning

 

3. During postmortem care, the patient’s family says that the patient didn’t have his dentures to place in his mouth. Which action should the nurse take at this time?

a.	Place a rolled-up towel under the patient’s chin.
b.	Stuff the mouth with cotton to maintain the facial contour.
c.	Tell the family to take the dentures to the funeral home.
d.	Ask the family what they want to do about this situation.

 

 

ANS:  A

If there are no dentures to place in the mouth after death, a rolled-up towel will help keep the patient’s mouth positioned appropriately. Cotton is not used by the nurse to maintain the patient’s mouth position. The dentures are easiest to place in the mouth immediately after death. It could be hours to several days until the patient’s body is taken to the funeral home, depending on whether an autopsy is done or not. The nurse should know what to implement regarding this situation.

 

DIF:    Cognitive Level: Comprehend          REF:   Page 808

OBJ:   NCLEX: Psychosocial Integrity       TOP:   Nursing Process: Planning

 

4. The patient is in the final stage of dying. Which action does the nurse implement?

a.	Maintain a darkened, cool room.
b.	Elevate the head of the bed.
c.	Catheterize the patient frequently.
d.	Provide warm, soothing liquids.

 

 

ANS:  B

The nurse elevates the head of the bed as tolerated to facilitate breathing; in addition, the patient looks more comfortable slightly elevated in bed, which can be comforting to the family. The nurse does not alter the temperature of the room. The patient may be more relaxed if the lighting is dim rather than brightly lit. Because urine production slows significantly as death approaches, urinary catheters are usually unnecessary. Patients eat less and less as death approaches; simple items such as ice chips, a teaspoon of tea, or an ice pop are usually sufficient.

 

DIF:    Cognitive Level: Comprehend          REF:   Page 803

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