ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 10 : End-of-Life Care Questions
Question 1 of 5
The nurse is caring for a client at the end of life. The client is prescribed a regularly scheduled dose of narcotics and a short-acting narcotic for breakthrough pain. Which action should the nurse take when administering narcotics to manage this client's pain?
Correct Answer: B
Rationale: The nurse who is administering narcotics at the end of life still must realize that any side effects must be addressed. In end-of-life care there is no need to assess for signs of drug dependence. The nurse will also reassure the client that frequent use of opioid analgesia will not cause addiction when administered in a life-limiting illness. In this case, dosing will not be restricted and medications will be administered on a routine schedule not a PRN basis. Administering the narcotic on routine schedule around the clock avoids causing intense discomfort followed by a period of heavy sedation.
Question 2 of 5
A nurse is caring for a client who is terminally ill and is inquiring about physician-assisted suicide. Which statement if made by the nurse would correctly inform the client of this practice?
Correct Answer: B
Rationale: Physician-assisted suicide is the practice of providing a means by which a client can end their life. Much controversy exists concerning the practice. California, Vermont, Oregon, Washington, and Montana are the only states that permit physician-assisted suicide. Administering analgesics at a level that renders the client unconscious is referred to as passive euthanasia as it is believed to facilitate death by letting 'nature take its course.' It is different than a provider providing the means for the client to take their own life. The health care provider may provide the means for the client to end their life, but the nurse does not assist the client in the act. Nurse practice prohibit nurses from assisting clients to die. Health care provider-assisted suicide is not considered part of palliative care. Palliative care is an approach that improves the quality of life of those at the end of life. It neither hastens nor postpones death; it provides relief from pain and discomfort, addresses spiritual needs, and provides emotional support to the client and family.
Question 3 of 5
Which cardiovascular findings indicate to the nurse that the condition of the client who is dying is worsening?
Correct Answer: A
Rationale: Earlier, a client with failing cardiac function exhibits a higher pulse as the body attempts to circulate oxygen. Next, cardiac output is decreased due to ineffective filling of the chambers, impairing circulation, and diminishing the heart's own oxygen supply. The heart rate and blood pressure then decrease. Peripheral circulation is impaired with the feet and ankles becoming pale and mottled.
Question 4 of 5
The nurse is caring for a client who is dying in a hospice setting. The family is unsure whether to go home for rest or spend the night with the client. Which body system would the nurse assess to provide the first data on decline?
Correct Answer: B
Rationale: The key word is 'first'. Failing of cardiac functioning is one of the first signs that a condition is worsening. Symptoms within the other systems can also denote deterioration over time.
Question 5 of 5
A nurse is caring for a client whose death is imminent. The family asks the nurse why there is a rattling in their loved one's chest. What information about this process should the nurse convey?
Correct Answer: C
Rationale: Failure of the heart's pumping function causes fluid to collect in the pulmonary circulation. Also, there is an accumulation of secretions in the respiratory tract. Both account for noisy respirations or what is called the 'death rattle.' The client's impaired peripheral circulation causes pallor and cold extremities, not fluid accumulation in the lungs. Decreased perfusion to the kidneys causes urine volume to diminish and toxic waste products to accumulate. It does not cause fluid accumulation in the lungs. Aspiration of oral fluids can occur if the client is able to take fluids. However, a client whose death is imminent is not taking oral fluids.