Nokea
Which statements by a patient who is terminally ill give the nurse information relevant to spiritual assessment? (Select all that apply.)
- A. I feel an inner peace with my decision to use hospice services.'
- B. I trust my health care provider to prescribe enough medication to keep me free of pain.'
- C. I have prepared advance directives to spare my children the need to make difficult decisions.'
- D. I plan to use these last weeks to experience the process of dying as fully as I experienced the richness of living.'
- E. Listening to hymns helps deepen my relaxation and the relief I get from my pain medication.'
Correct Answer: A,D,E
Rationale: Spirituality encompasses finding meaning in the process of living and dying, as well as hope and inner peace. Statements A, D, and E reflect these aspects.
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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.
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.
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.
A person whose spouse died 2 years earlier tells friends, 'I think I'm ready to start going out socially, maybe even take someone to dinner.' What does this comment best demonstrate about the individual's state of mind?
- A. Is denying the significance of the loss.
- B. Is in a period of grief resolution.
- C. Is actively working through grief.
- D. Is experiencing intrusion.
Correct Answer: B
Rationale: Toward the end of the grief process, the person renews his or her interest in people and activities. This behavior indicates resolution.
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.