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Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 16 : End-of-Life Care Questions
Question 1 of 5
As a staff member in a local hospice, a nurse deals with death and dying on a frequent basis. Where would be the safe venue for the nurse to express her feelings of frustration and grief about a patient who has recently died?
Correct Answer: B
Rationale: In hospice settings, where death, grief, and loss are expected outcomes of patient care, interdisciplinary colleagues rely on each other for support, using meeting time to express frustration, sadness, anger, and other emotions; to learn coping skills from each other; and to speak about how they were affected by the lives of those patients who have died since the last meeting. Public settings are inappropriate places to express frustration about the death of a patient.
Question 2 of 5
A hospice nurse is well aware of how difficult it is to deal with others pain on a daily basis. This nurse should put healthy practices into place to guard against what outcome?
Correct Answer: C
Rationale: Well before the nurse exhibits symptoms of stress or burnout, he or she should acknowledge the difficulty of coping with others pain on a daily basis and put healthy practices in place that guard against emotional exhaustion. Emotional exhaustion is more likely to have deleterious effects than inefficiency, social withdrawal, or weight gain, though these may signal emotional exhaustion.
Question 3 of 5
The hospice nurse is caring for a 45-year-old mother of three young children in the patients home. During the most recent visit, the nurse has observed that the patient has a new onset of altered mental status, likely resulting from recently diagnosed brain metastases. What goal of nursing interventions should the nurse identify?
Correct Answer: D
Rationale: Nursing interventions should be aimed at accommodating the change in the patients status and maintaining her safety. The scenario does not indicate the need either to sedate the patient or to move her to an acute-care facility. If the family has the resources, there is no need to bring in nurses to be with the patient around-the-clock, and the scenario does not indicate that death is imminent.
Question 4 of 5
You are caring for a patient who has just been told that his illness is progressing and nothing more can be done for him. After the physician leaves, the patient asks you to stay with him for a while. The patient becomes tearful and tries several times to say something, but cannot get the words out. What would be an appropriate response for you to make at this time?
Correct Answer: B
Rationale: Prompt gently: Do you need more time to think about this? Giving advice is inappropriate and it is obvious from the scenario that the patient has something to say. Referring to other patients negates the patients feelings at this time.
Question 5 of 5
A patient who is receiving care for osteosarcoma has been experiencing severe pain since being diagnosed. As a result, the patient has been receiving analgesics on both a scheduled and PRN basis. For the past several hours, however, the patients level of consciousness has declined and she is now unresponsive. How should the patients pain control regimen be affected?
Correct Answer: A
Rationale: Pain should be aggressively treated, even if dying patients become unable to verbally report their pain. There is no need to forego the IV route. There is no specific need to discontinue the pain control regimen or reduce dosages.