Nokea
A patients daughter has asked the nurse about helping him end his terrible suffering. The nurse is aware of the ANA Position Statement on Assisted Suicide, which clearly states that nursing participation in assisted suicide is a violation of the Code for Nurses. What does the Position Statement further stress?
- A. Educating families about the moral implications of assisted suicide
- B. Identifying patient and family concerns and fears
- C. Identifying resources that meet the patients desire to die
- D. Supporting effective means to honor the patients desire to die
Correct Answer: B
Rationale: The ANA Position Statement further stresses the important role of the nurse in supporting effective symptom management, contributing to the creation of environments for care that honor the patients and familys wishes, as well as identifying their concerns and fears. Discussion of moral implications would normally be beyond the purview of the nurse.
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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?
- A. Request the physician to order analgesics by an alternative route.
- B. Crush the medication in order to aid swallowing and absorption.
- C. Administer the patients medication with the meal tray.
- D. Administer the medication rectally.
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.
A medical nurse is providing palliative care to a patient with a diagnosis of end-stage chronic obstructive pulmonary disease (COPD). What is the primary goal of this nurses care?
- A. To improve the patients and familys quality of life
- B. To support aggressive and innovative treatments for cure
- C. To provide physical support for the patient
- D. To help the patient develop a separate plan with each discipline of the health care team
Correct Answer: A
Rationale: The goal of palliative care is to improve the patients and the familys quality of life. The support should include the patients physical, emotional, and spiritual well-being. Each discipline should contribute to a single care plan that addresses the needs of the patient and family. The goal of palliative care is not aggressive support for curing the patient. Providing physical support for the patient is also not the goal of palliative care. Palliative care does not strive to achieve separate plans of care developed by the patient with each discipline of the health care team.
A patient with end-stage heart failure has participated in a family meeting with the interdisciplinary team and opted for hospice care. On what belief should the patients care in this setting be based?
- A. Meaningful living during terminal illness requires technologic interventions.
- B. Meaningful living during terminal illness is best supported in designated facilities.
- C. Meaningful living during terminal illness is best supported in the home.
- D. Meaningful living during terminal illness is best achieved by prolonging physiologic dying.
Correct Answer: C
Rationale: The hospice movement in the United States is based on the belief that meaningful living is achievable during terminal illness and that it is best supported in the home, free from technologic interventions to prolong physiologic dying.
A hospice nurse is caring for a 22-year-old with a terminal diagnosis of leukemia. When updating this patients plan of nursing care, what should the nurse prioritize?
- A. Interventions aimed at maximizing quantity of life
- B. Providing financial advice to pay for care
- C. Providing realistic emotional preparation for death
- D. Making suggestions to maximize family social interactions after the patients death
Correct Answer: C
Rationale: Hospice care focuses on quality of life, but, by necessity, it usually includes realistic emotional, social, spiritual, and financial preparation for death. Financial advice and actions aimed at post-death interaction would not be appropriate priorities.
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?
- A. Helping the family to understand why the patient needs to be sedated
- B. Making arrangements to promptly move the patient to an acute-care facility
- C. Explaining to the family that death is near and the patient needs around-the-clock nursing care
- D. Teaching family members how to interact with, and ensure safety for, the patient with impaired cognition
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.