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Which actions by a nurse contribute to protecting the rights of patients who are terminally ill? (Select all that apply.)
- A. Maintain hope for a positive prognosis.
- B. Hug the patient when sadness is expressed.
- C. Offer choices that promote personal control.
- D. Provide interventions that convey respect.
- E. Support the patient's quest for spiritual growth.
Correct Answer: C,D,E
Rationale: The answers support the rights of the individual who is dying. Offering choices, providing respectful interventions, and supporting spiritual growth respect the patient's autonomy and dignity.
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The partner of a patient in hospice care angrily tells the nurse, 'The care provided by the aide and other family members is inadequate, so I must do everything myself. Can't anyone do anything right?' How best should the palliative care nurse respond?
- A. Providing teaching about anticipatory grieving
- B. Assigning new personnel to the patient's care
- C. Arranging hospitalization for the patient
- D. Refer the partner for crisis counseling
Correct Answer: A
Rationale: The behaviors described in this scenario are consistent with anticipatory grieving. The spouse needs to be taught about the process of anticipatory grieving.
A nurse manager notices that a staff member spends minimal time with a patient diagnosed with AIDS who is terminally ill. The patient says, 'I'm having intense emotional reactions to this illness. Sometimes I feel angry, but other times I feel afraid or abandoned.' The nurse manager can correctly hypothesize that the most likely reason for the staff member's avoidance is triggered by what?
- A. Fear of infection transmission.
- B. Feelings of inadequacy in dealing with complex emotional needs.
- C. Belief that the patient needs time alone with family and friends.
- D. Knowledge that the patient's former lifestyle included high-risk behaviors.
Correct Answer: B
Rationale: Many nurses tend to be more comfortable with meeting physical needs than in focusing on complex emotional needs.
A nurse talks with a person whose spouse died suddenly while jogging. Which is the appropriate statement for the nurse?
- A. At least your spouse did not suffer.'
- B. It's better to go quickly as your spouse did.'
- C. The loss of your spouse must be very painful for you.'
- D. You'll begin to feel better after you get over the shock.'
Correct Answer: C
Rationale: The most helpful responses by others validate the bereaved person's experience of loss. Avoid banalities; they increase the individual's sense of isolation.
Children of a widowed parent confer with the nurse; their surviving parent repeatedly relates the details of finding the deceased parent not breathing, performing cardiopulmonary resuscitation, going to the hospital by ambulance, and seeing the pronouncement of death. The family asks, 'What can we do?' How should the nurse best counsel the family?
- A. Encouraging them to share their own feelings with the surviving parent and ask for the retelling to stop
- B. Support the ideas that retelling the story should be limited to once daily to avoid unnecessary stimulation
- C. Share with them that retelling memories is to be expected as part of the aging process
- D. Reassure them that repeating the story is a helpful and a necessary part of grieving
Correct Answer: D
Rationale: Nurses are encouraged to tell bereaved patients that telling the personal story of loss as many times as needed is acceptable and healthy.
After the death of his wife, a man tells the nurse, 'I can't live without her. She was my whole life.' Which is the nurse's most therapeutic reply?
- A. Each day will get a little better.'
- B. Her death is a terrible loss for you.'
- C. Remember, she's no longer suffering.'
- D. Your friends will help you cope with this.'
Correct Answer: B
Rationale: The correct response demonstrates the use of reflection, a therapeutic communication technique. A statement that validates the bereaved person's loss is more helpful than clich?©s and it signifies understanding.