Chapter 43 Flashcards
A terminally ill client states to the nurse, “My situation is hopeless; I have no control over anything.” The nurse
implements which of the following interventions to enable hope for the client?
A) State to the client, “We have explored all treatment options.”
B) Encourage the client to discuss his feelings.
C) Sit in a chair next to the client.
D) Hold the client’s hand.
E) Withhold information about disease progression
B) Encourage the client to discuss his feelings.
C) Sit in a chair next to the client.
D) Hold the client’s hand.
Measures to establish rapport with the client (e.g., providing time and physical contact by sitting in a chair next to the client; holding the client’s hand) should be utilized. The client should be encouraged to express his feelings. The nurse avoids language that would extinguish hope as in the statement, “We have explored all treatment options.” The nurse should provide information about the progress of the disease.
Which one of the following statements accurately describes the process known as grief reaction?
A) Reactions to grief and dying are different.
B) Reactions to grief are similar for all people.
C) Reactions to grief follow all stages of the grieving process.
D) Reactions to grief may differ from client to family
D) Reactions to grief may differ from client to family
Reactions to grief and dying are similar. The stages of these reactions overlap and vary among individuals. One person may skip a reaction stage, whereas another may repeat an earlier stage. Each person is different, and clients and family members may be at different reaction stages. More important than the actual stages of any given grief reaction is the idea that grief is a process that varies from person to person.
A dying client is crying. She states, Why me, Lord?” and “I can’t pray.” What would be an appropriate nursing diagnosis based on this data? A) Psycho-spiritual distress B) Low self esteem C) Ineffective coping D) Knowledge deficit related to praying
A) Psycho-spiritual distress
Spiritual needs must be included in the plan of care for the dying client. Verbal cues to psycho-spiritual distress include
inability to pray and lack of inability to forgive one’s self.
A woman has had a breast removed to treat cancer. What type of loss will she most likely experience? A) Actual loss B) Perceived loss C) Maturational loss D) Anticipatory loss
A) Actual loss
Loss occurs when a valued person, object, or situation is changed or made inaccessible so that its value is diminished or
removed. Actual loss can be recognized by others as well as by the person sustaining the loss.
According to the Harvard University Medical School committee, what function must be irreversibly lost to define death? A) Respiratory functions B) Reflexes C) Consciousness D) Brain function
D) Brain function
A Harvard University Medical School committee added that the nonreversible loss of brain function, accompanied by the more traditional signs, should be the definitive definition of death.
A nurse is developing a plan of care for a dying client. Which of the following physiologic basic human needs should be addressed? A) Personal hygiene B) Rsk for infection C) Family support D) Spirituality
A) Personal hygiene
Physiologic care of the dying client involves meeting physical needs such as personal hygiene, pain control, nutritional
and fluid needs, movement, elimination, and respiratory care.
Although all of the following are factors that affect grief, which one is most likely to influence a person’s expression of grief? A) Socioeconomic factors B) Cultural influences C) Religious influences D) Cause of death
B) Cultural influences
Both the physical and emotional manifestations of grief may be culturally influenced. Culture also influences a person’s
expression of grief.
A nurse is caring for a young client who is dying of renal failure. What should the nurse do when caring for the dying client’s family members?
A) Inform the family that the client may soon be out of danger
B) Request the family members not to talk about death to the client
C) Inform the family members that it is time to bid farewell to the client
D) Provide respite care to the client’s family members
C) Inform the family members that it is time to bid farewell to the client
The nurse should ask the family members to meet the client so that they can have a chance to say a final goodbye. The nurse should not provide any false hope to the client’s family by telling them that the client may soon be out of danger.
The nurse should not ask the client’s family members to avoid talking about death, because the client would want to know that he or she is loved and will be missed by the family. Respite care is usually provided when the client is resting or out of danger
An appropriate nursing diagnosis for the family of a client dying of cancer, whose members have expressed sorrow over
the forthcoming loss, would be …
A) Anticipatory grieving related to loss of family member, as evidenced by sorrow
B) Dysfunctional grieving related to the loss of family member, as manifested by behaviors indicating anxiety
C) Potential for grieving related to loss of family member and sorrow
D) Dysfunctional grieving related to future loss of family member, manifested by family’s developmental regression
A) Anticipatory grieving related to loss of family member, as evidenced by sorrow
Anticipatory grieving comprises the intellectual and emotional responses and behaviors by which individuals, families,
and communities work through the process of modifying self-concept based on the perception of loss.
A client asks a nurse to explain a living will. What is the nurse’s best answer?
A) It specifies who will inherit the client’s estate.
B) It determines an individual’s quality of life.
C) It lists specific instructions for health care provisions.
D) It identifies a trusted person to make health care decisions.
C) It lists specific instructions for health care provisions.
A living will is a type of written advance directive that provides specific instructions about the kinds of health care that should be provided or foregone in particular situations.
The husband of a client who died of breast cancer is still grieving for his wife two years later. What type of grief is he experiencing? A) Unresolved B) Situational C) Inhibited D) Maturational
A) Unresolved
Unresolved grief is abnormal or distorted; it may be either unresolved or inhibited. In unresolved grief, a person may have trouble expressing feelings of loss or may deny them; unresolved grief also describes a state of bereavement that extends over a lengthy period. With inhibited grief, a person suppresses feelings of grief and may instead manifest somatic (body) symptoms, such as abdominal pain or heart palpitations.
The nurse is giving palliative care to a client with a diagnosis of COPD. What is the goal of palliative care?
A) Improve the client’s and family’s quality of life.
B) Support aggressive treatment for cure.
C) Provide physical support for the client.
D) The client may develop a separate plan with each discipline of the health care team
A) Improve the client’s and family’s quality of life.
The goal of palliative care is to improve the client’s and the family’s quality of life. The support should include the
patient’s physical, emotional, and spiritual well-being. Each discipline should contribute to a single care plan that
addresses the needs of the client and family. Options B, C and D are incorrect; the goal of palliative care is not
aggressive support for curing the client. Providing physical support for the client is also not the goal of palliative care.
Separate plans of care developed by the client with each discipline of the health care team are not the goal of palliative
care.
A terminally ill client, in severe pain, asks a nurse to help her die. What must the nurse consider morally, ethically, and
professionally before answering the client?
A) ANA Code for Nurses, ethical and professional standards
B) Own personal moral and ethical values and standards
C) Hospital or agency procedures and protocols
D) Medical Code of Ethics, belief in active euthanasia
A) ANA Code for Nurses, ethical and professional standards
The ANA Code of Ethics, the ethical traditions and goals of the nursing profession, and nursing’s covenant with society, all affirm that it is a violation for nurses to participate in assisting in a suicide and active euthanasia (assisting a client to die).
A man is diagnosed with terminal kidney failure. His wife demonstrates loss and grief behaviors. What type of loss is the wife experiencing? A) Maturational loss B) Anticipatory loss C) Dysfunctional grieving D) Bereavement
B) Anticipatory loss
Anticipatory loss occurs when a person displays loss and grief behaviors for a loss that has yet to take place. It is often seen in the families of clients with serious or life-threatening illnesses, and serves to lessen the effect of the actual loss of
a family member.
A dying client is undergoing terminal weaning. What is the purpose of this intervention?
A) To manage the symptoms of the illness
B) To prepare for resuscitation of the client
C) To initiate life-sustaining measures for the client
D) To gradually withdraw mechanical ventilation
D) To gradually withdraw mechanical ventilation
Terminal weaning is the gradual withdrawal of mechanical ventilation from a client with a terminal illness or an irreversible condition with a poor prognosis
