Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
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Chapter 9: End-of-Life Care
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | “Most people move on within a few months. You should see a grief counselor.” |
| b. | “Whenever you start to cry, distract yourself from thoughts of your sister.” |
| c. | “You should try not to cry. I’m sure your sister is in a better place now.” |
| d. | “Your feelings are completely normal and may continue for a long time.” |
ANS: D
Frequent crying is not an abnormal response. The nurse should let the client know that this is normal and okay. Although the client may benefit from talking with a grief counselor, it is not unusual for her to still be grieving after a few months. The other responses are not as therapeutic because they justify or minimize the client’s response.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Psychosocial Integrity (Therapeutic Communication)
MSC: Integrated Process: Caring
| a. | “An advance directive will keep my children from selling my home when I’m old.” |
| b. | “An advance directive will be completed as soon as I’m incapacitated and can’t think for myself.” |
| c. | “An advance directive will specify what I want done when I can no longer make decisions about health care.” |
| d. | “An advance directive will allow me to keep my money out of the reach of my family.” |
ANS: C
An advance directive is a written document prepared by a competent individual that specifies what, if any, extraordinary actions a person would want taken when he or she can no longer make decisions about personal health care. It does not address issues such as the client’s residence in his or her own home.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 108
TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Advance Directives) MSC: Integrated Process: Nursing Process (Assessment)
| a. | “Hospice admission has specific criteria. You may not be a viable candidate, so we will look at alternative plans for your discharge.” |
| b. | “Hospice care focuses on a holistic approach to health care. It is designed not to hasten death, but rather to relieve symptoms.” |
| c. | “Hospice care will not help with your symptoms of depression. I will refer you to the facility’s counseling services instead.” |
| d. | “You seem to be experiencing some difficulty with this stage of the grieving process. Let’s talk about your feelings.” |
ANS: B
As both a philosophy and a system of care, hospice care uses an interdisciplinary approach to assess and address the holistic needs of clients and families to facilitate quality of life and a peaceful death. This holistic approach neither hastens nor postpones death but provides relief of symptoms experienced by the dying client.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 108
TOP: Client Needs Category: Psychosocial Integrity (End-of-Life Care)
MSC: Integrated Process: Caring
| a. | Ask the family members to step outside the room so the client cannot hear them. |
| b. | Tell the family that they are being insensitive and their behavior is inappropriate. |
| c. | Recognize that this is a culturally appropriate activity and document it in the chart. |
| d. | Report these activities to the client’s physician and the nursing supervisor. |
ANS: C
American Indians often disperse material possessions before or after death to friends and family members. Recognizing this culturally appropriate activity would not be consistent with removing the family, stopping the activity, or reporting the client’s family’s behaviors.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Psychosocial Integrity (Cultural Diversity)
MSC: Integrated Process: Caring
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