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9. Chapter 09: Palliative and End of Life Care Test Bank for Lewis Medical Surgical Nursing 11th Edition by Harding
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  • LEWIS MEDICAL SURGICAL NURSING 11TH EDITION
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  • LEWIS MEDICAL SURGICAL NURSING 11TH EDITION

9. Chapter 09: Palliative and End of Life Care Test Bank for Lewis Medical Surgical Nursing 11th Edition by Harding

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  • October 15, 2023
  • 8
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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  • 11th edition by harding
  • chapter 09 palliative and end of life care
  • test bank for lewis medical surgical nursing

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  • LEWIS MEDICAL SURGICAL NURSING 11TH EDITION
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Chapter 09: Palliative and End of Life
Care
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding

MULTIPLE CHOICE
1. The nurse cares for a terminally ill patient who has 20-second periods of apnea
followed by periods of deep and rapid breathing. Which action by the nurse would be
most appropriate?
a. Suction the patient.
b. Administer oxygen via face mask.
c. Place the patient in high Fowlers position.
d. Document the respirations as Cheyne-Stokes.
ANS: D
Cheyne-Stokes respirations are characterized by periods of apnea alternating with
deep and rapid breaths. Cheyne-Stokes respirations are expected in the last days
of life. There is also no need for supplemental oxygen by face mask or suctioning
the patient. Raising the head of the bed slightly and/or turning the patient on the
side may promote comfort. There is no need to place the patient in high Fowlers
position.

DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

2. The nurse cares for an adolescent patient who is dying. The patients parents are
interested in organ donation and ask the nurse how the decision about brain death is
made. Which response by the nurse is most appropriate?
a. Brain death occurs if a person is flaccid and unresponsive.
b. If CPR is ineffective in restoring a heartbeat, the brain cannot function.
c. Brain death has occurred if there is no breathing and certain reflexes are
absent.
d. If respiratory efforts cease and no apical pulse is audible, brain death is
present.
ANS: C
The diagnosis of brain death is based on irreversible loss of all brain functions,
including brainstem functions that control respirations and brainstem reflexes. The
other descriptions describe other clinical manifestations associated with death but
are insufficient to declare a patient brain dead.

DIF: Cognitive Level: Apply (application)

, TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

3. A hospice patient is manifesting a decrease in all body system functions except for a
heart rate of 124 and a respiratory rate of 28. Which statement, if made by the nurse
to the patients family member, is most appropriate?
a. These symptoms will continue to increase until death finally occurs.
b. These symptoms are a normal response before these functions decrease.
c. These symptoms indicate a reflex response to the slowing of other body
systems.
d. These symptoms may be associated with an improvement in the patients
condition.
ANS: B
An increase in heart and respiratory rate may occur before the slowing of these
functions in the dying patient. Heart and respiratory rate typically slow as the
patient progresses further toward death. In a dying patient, high respiratory and
pulse rates do not indicate improvement, and it would be inappropriate for the
nurse to indicate this to the family. The changes in pulse and respirations are not
reflex responses.

DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

4. A patient who has been diagnosed with inoperable lung cancer and has a poor
prognosis plans a trip across the country to settle some issues with sisters and
brothers. The nurse recognizes that the patient is manifesting which psychosocial
response to death?
a. Restlessness
b. Yearning and protest
c. Anxiety about unfinished business
d. Fear of the meaninglessness of ones life
ANS: C
The patients statement indicates that there is some unfinished family business that
the patient would like to address before dying. Restlessness is frequently a
behavior associated with an inability to express emotional or physical distress, but
this patient does not express distress and is able to communicate clearly. There is
no indication that the patient is protesting the prognosis, or that there is any fear
that the patients life has been meaningless.

DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

5. The spouse of a patient with terminal cancer visits daily and cheerfully talks with the
patient about wedding anniversary plans for the next year. When the nurse asks about
any concerns, the spouse says, Im busy at work, but otherwise things are fine. Which

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