Nokea
After contributing to the care of several patients who died in the hospital, the nurse has identified some lapses in the care that many of these patients received toward the end of their lives. What have research studies identified as a potential deficiency in the care of the dying in hospital settings?
- A. Families needs for information and support often go unmet.
- B. Patients are too sedated to achieve adequate pain control.
- C. Patients are not given opportunities to communicate with caregivers.
- D. Patients are ignored by the care team toward the end of life.
Correct Answer: A
Rationale: Studies have demonstrated that the health care system continues to be challenged when meeting seriously ill patients needs for pain and symptom management and their families needs for information and support. Oversedation, lack of communication, and lack of care are not noted to be deficiencies to the same degree.
You may also like to solve these questions
In the past three to four decades, nursing has moved into the forefront in providing care for the dying. Which phenomenon has most contributed to this increased focus of care of the dying?
- A. Increased incidence of infections and acute illnesses
- B. Increased focus of health care providers on disease prevention
- C. Larger numbers of people dying in hospital settings
- D. Demographic changes in the population
Correct Answer: D
Rationale: The focus on care of the dying has been motivated by the aging of the population, the prevalence of, and publicity surrounding, life-threatening illnesses (e.g., cancer and AIDS), and the increasing likelihood of a prolonged period of chronic illness prior to death. The salience of acute infections, prevention measures, and death in hospital settings are not noted to have had a major influence on this phenomenon.
As the American population ages, nurses expect see more patients admitted to long-term care facilities in need of palliative care. Regulations now in place that govern how the care in these facilities is both organized and reimbursed emphasize what aspect of care?
- A. Ongoing acute care
- B. Restorative measures
- C. Mobility and socialization
- D. Incentives to palliative care
Correct Answer: B
Rationale: Regulations that govern how care in these facilities is organized and reimbursed tend to emphasize restorative measures and serve as a disincentive to palliative care. Long-term care facilities do not normally provide acute care for their patients. Regulations for long-term care facilities do not primarily emphasize mobility and socialization.
The nurse is assessing a 73-year-old patient who was diagnosed with metastatic prostate cancer. The nurse notes that the patient is exhibiting signs of loss, grief, and intense sadness. Based on this assessment data, the nurse will document that the patient is most likely in what stage of death and dying?
- A. Depression
- B. Denial
- C. Anger
- D. Resignation
Correct Answer: A
Rationale: Loss, grief, and intense sadness indicate depression. Denial is indicated by the refusal to admit the truth or reality. Anger is indicated by rage and resentment. Acceptance is indicated by a gradual, peaceful withdrawal from life.
A clinic nurse is providing patient education prior to a patients scheduled palliative radiotherapy to her spine. At the completion of the patient teaching, the patient continues to ask the same questions that the nurse has already addressed. What is the plausible conclusion that the nurse should draw from this?
- A. The patient is not listening effectively.
- B. The patient is noncompliant with the plan of care.
- C. The patient may have a low intelligence quotient or a cognitive deficit.
- D. The patient has not achieved the desired learning outcomes.
Correct Answer: D
Rationale: The nurse should be sensitive to patients ongoing needs and may need to repeat previously provided information or simply be present while the patient and family react emotionally. Telling a patient something is not teaching. If a patient continues to ask the same questions, teaching needs to be reinforced. The patients response is not necessarily suggestive of noncompliance, cognitive deficits, or not listening.
A 66-year-old patient is in a hospice receiving palliative care for lung cancer which has metastasized to the patients liver and bones. For the past several hours, the patient has been experiencing dyspnea. What nursing action is most appropriate to help to relive the dyspnea the patient is experiencing?
- A. Administer a bolus of normal saline, as ordered.
- B. Initiate high-flow oxygen therapy.
- C. Administer high doses of opioids.
- D. Administer bronchodilators and corticosteroids, as ordered.
Correct Answer: D
Rationale: Bronchodilators and corticosteroids help to improve lung function as well as low doses of opioids. Low-flow oxygen often provides psychological comfort to the patient and family. A fluid bolus is unlikely to be of benefit.