Chapter 7--Palliative Care

Chapter 7–Palliative Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse believes that a client is eligible as a participant for The National Hospice Reimbursement Act of 1986. This act mandated that:

1.	clients with terminal illnesses are reimbursed.
2.	a physician must order hospice to be reimbursed.
3.	to receive reimbursement that client must be eligible for Medicare.
4.	to receive benefits, the physician must certify that the client has a limited life expectancy of 6 months or less.

 

 

ANS:  4

The Medicare hospice benefit is a reimbursement benefit for those with a prognosis of 6 months or less to live (certified by a physician). The act does not mandate reimbursement to clients with terminal illnesses, physicians do not have to order hospice for reimbursement, nor does a client have to be eligible for Medicare for hospice eligibility.

 

PTS:   1                    DIF:    Analyze         REF:   History and Overview of Hospice Care

 

2. After a Native American client has died, the family begins the practice of purifying the body. The nurse realizes that the deceased client may stay with the family for what period of time?

1.	12 hours
2.	24 hours
3.	36 hours
4.	48 hours

 

 

ANS:  3

Native Americans believe that the soul departs from the body 36 hours after death. The family may want the body to remain at the place of death for this period. The other choices are incorrect lengths of time according to Native American culture.

 

PTS:   1                    DIF:    Analyze

REF:   Table 7-1 Cultural Considerations Related to Dying

 

3. A client is receiving care for symptoms; however, the treatment will not alter the course of the disease. This client is receiving which type of care?

1.	Hospital-based
2.	Managed
3.	Palliative
4.	Therapeutic

 

 

ANS:  3

Palliative care, or “comfort” care, is directed at providing relief to a terminally ill client through symptom and pain relief. The goal is not curative. Care for symptoms that will not alter the course of the disease does not need to be provided in the hospital. Managed care is guided through the direction of a primary care physician. Therapeutic is a type of care that focuses on a specific treatment for a health problem.

 

PTS:   1                    DIF:    Analyze         REF:   Overview of Palliative Care

 

4. A client diagnosed with a terminal illness is receiving an opioid/acetaminophen combination for pain control. The nurse realizes this client is being managed at which step of the World Health Organization approach to pain management?

1.	Step 1
2.	Step 2
3.	Step 3
4.	Step 4

 

 

ANS:  2

The World Health Organization approach to pain management involves three steps. Step 1: Clients are treated with around-the-clock doses of nonopioids. Step 2: The use of opioid/acetaminophen combinations are used to treat mild to moderate pain. Step 3: Strong opioids are used. There is no Step 4 in the World Health Organization’s approach to pain management.

 

PTS:   1                    DIF:    Analyze

REF:   Figure 7-2 Conceptual Model of Ladder Approach to Pain Management

 

5. A dying client is surrounded by family and friends at home. The hospice nurse talks with the spouse of the dying client to ensure that everything the family needs during this time is being done. The nurse is providing support to:

1.	the client.
2.	the bereaved.
3.	ensure compliance with the hospice rules and regulations.
4.	determine if the spouse understands that the client is dying.

 

 

ANS:  2

Supporting the family’s rituals and cultural practices gives structure to support the bereaved through this painful process when people are vulnerable and feel off balance. The nurse is not providing support to the client. The nurse is not providing support to ensure compliance with the hospice rules and regulations. The nurse is also not providing support to determine if the spouse understands that the client is dying.

 

PTS:   1                    DIF:    Analyze         REF:   Role of the Hospice and Palliative Care Nurse