ATI LPN
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 16 : End-of-Life Care Questions
Question 1 of 5
The nurse is part of the health care team at an oncology center. A patient has been diagnosed with leukemia and the prognosis is poor, but the patient is not yet aware of the prognosis. How can the bad news best be conveyed to the patient?
Correct Answer: B
Rationale: Communicating about a life-threatening diagnosis should be done in a team setting at eye level with the patient. The family cannot be notified first because that would breach patient confidentiality. The family may be present at the patients request. The appointment should be scheduled when principles can all be in attendance and unrushed.
Question 2 of 5
A patient has just been told that her illness is terminal. The patient tearfully states, I cant believe I am going to die. Why me? What is your best response?
Correct Answer: C
Rationale: The most important intervention the nurse can provide is listening empathetically.
To communicate effectively, the nurse should ask open-ended questions and acknowledge the patients fears. Deflecting the statement or providing false sympathy must be avoided.
Question 3 of 5
The nurse has observed that an older adult patient with a diagnosis of end-stage renal failure seems to prefer to have his eldest son make all of his health care decisions. While the family is visiting, the patient explains to you that this is a cultural practice and very important to him. How should you respond?
Correct Answer: C
Rationale: In this case of a patient who wishes to defer decisions to his son, the nurse can work with the team to negotiate informed consent, respecting the patients right not to participate in decision making and honoring his familys cultural practices.
Question 4 of 5
One aspect of the nurses comprehensive assessment when caring for the terminally ill is the assessment of hope. The nurse is assessing a patient with liver failure for the presence of hope. What would the nurse identify as a hope-fostering category?
Correct Answer: A
Rationale: Hope is a multidimensional construct that provides comfort as a person endures life threats and personal challenges. Uplifting memories are noted as a hope-fostering category, whereas the other listed options are not identified as such.
Question 5 of 5
A medical nurse is providing end-of-life care for a patient with metastatic bone cancer. The nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect, but is now having difficulty swallowing the medication. What should the nurse do?
Correct Answer: A
Rationale: A change in medication route is indicated and must be made by a physicians order. Many pain medications cannot be crushed and given to a patient. Giving the medication with a meal is not going to make it any easier to swallow. Rectal administration may or may not be an option.