Death & Dying- Chap 13 MS, Chap 16-17 skills book, chap 28 fundamentals

Question 1

The patient has a history of terminal cancer but is being admitted for treatment of a pressure ulcer. The patient’s wife has been caring for him at home and refuses to discuss admission to a nursing home. The wife looks extremely tired and is near the point of exhaustion. What could the nurse suggest?

a. A consult for hospice care
b. Continuing with the plan of care as is
c. That the doctor order the patient into a nursing home
d. That the wife stay away while the patient is hospitalized

Answer 1

ANS: A

Question 2

The patient is being admitted to the hospital for injuries received when a hurricane destroyed her home. She is upset from the loss of her home and possessions. What type of loss is this considered?

a. Necessary loss
b. Maturational loss
c. Situational loss
d. Perceived loss

Answer 2

ANS: C

Question 3

The nurse recognizes that anticipatory grieving can be most beneficial for a patient or family because it can:

a. be done in a private setting.
b. be discussed with other individuals.
c. promote separation of the ill patient from the family.
d. allow time for the process of grief.

Answer 3

ANS: D

Question 4

4. The nurse is preparing to assist the patient at the end stage of her life. To provide comfort for the patient in response to anticipated symptom development, the nurse plans to:

a. decrease the patient’s fluid intake.
b. limit the use of pain medication.
c. provide larger meals with more seasoning.
d. determine patient wishes and select appropriate therapies.

Answer 4

ANS: D

Question 5

A nurse-initiated or independent activity for promotion of respiratory function in a terminally ill patient is to:

a. limit PO fluid intake.
b. position the patient in semi-Fowler’s or Fowler’s position.
c. reduce narcotic analgesic use.
d. administer bronchodilators.

Answer 5

ANS: B

Question 6

A nurse-initiated or independent activity for promotion of respiratory function in a terminally ill patient is to:

a. limit PO fluid intake.
b. position the patient in semi-Fowler’s or Fowler’s position.
c. reduce narcotic analgesic use.
d. administer bronchodilators.

Answer 6

ANS: B

Question 7

When caring for a patient who is an appropriate candidate for organ or tissue donation, the nurse knows that requests for donation are:

a. required by state law.
b. the total responsibility of the survivors.
c. a possible inclusion in the advance directive.
d. made only by the physician.

Answer 7

ANS: C

Question 8

When caring for a patient who is an appropriate candidate for organ or tissue donation, the nurse knows that requests for donation are:

a. required by state law.
b. the total responsibility of the survivors.
c. a possible inclusion in the advance directive.
d. made only by the physician.

Answer 8

ANS: C

Question 9

The patient is on a ventilator and has a heartbeat but has been declared “brain dead.” The family has agreed to organ donation. The nurse realizes that which of the following organ donations would require that the patient be left on life support?

a. Eyes
b. Bone
c. Kidney
d. Skin

Answer 9

ANS: C

Question 10

An appropriate technique for the nurse to implement when caring for a patient’s body after death is to:

a. remove the patient’s ID band and put a new gown on the patient.
b. cover the patient with a sheet and transfer him or her to the morgue.
c. inquire about particular cultural or spiritual practices.
d. remove tubes and lines if the patient is to be autopsied.

Answer 10

ANS: C

Question 11

An appropriate technique for the nurse to implement when caring for a patient’s body after death is to:

a. remove the patient’s ID band and put a new gown on the patient.
b. cover the patient with a sheet and transfer him or her to the morgue.
c. inquire about particular cultural or spiritual practices.
d. remove tubes and lines if the patient is to be autopsied.

Answer 11

ANS: C

Question 12

After the death of a patient and before other nursing interventions are implemented, the nurse should:

a. place the patient in a supine position and elevate the head of the bed 30 degrees.
b. wait an hour to prepare the patient for viewing.
c. place the patient in a side-lying position to allow drainage.
d. exclude the family while the body is being prepared.

Answer 12

ANS: A

Question 13

After the death of a patient and before other nursing interventions are implemented, the nurse should:

a. place the patient in a supine position and elevate the head of the bed 30 degrees.
b. wait an hour to prepare the patient for viewing.
c. place the patient in a side-lying position to allow drainage.
d. exclude the family while the body is being prepared.

Answer 13

ANS: A

Question 14

Before allowing the family of a deceased patient to view the body, the nurse should:

a. insert the patient’s dentures.
b. lower the head of the bed.
c. fold the arms and hands over the chest.
d. leave all of the old dressings and tape in place.

Answer 14

ANS: A

Question 15

Before allowing the family of a deceased patient to view the body, the nurse should:

a. insert the patient’s dentures.
b. lower the head of the bed.
c. fold the arms and hands over the chest.
d. leave all of the old dressings and tape in place.

Answer 15

ANS: A

Question 16

A new staff member is working with a patient who is dying. A nurse evaluates that this new employee requires additional teaching when he or she is observed:

a. limiting the family’s visiting hours.
b. staying with the patient and family as much as possible.
c. finding a quiet place for family members to gather.
d. asking the family if they would like to help with preparing the body.

Answer 16

ANS: A

Question 17

A new staff member is working with a patient who is dying. A nurse evaluates that this new employee requires additional teaching when he or she is observed:

a. limiting the family’s visiting hours.
b. staying with the patient and family as much as possible.
c. finding a quiet place for family members to gather.
d. asking the family if they would like to help with preparing the body.

Answer 17

ANS: A

Question 18

The patient was a practicing Hindu when he died. Knowing this, the nurse realizes that:

a. the body should be covered with a cotton sheet.
b. anointing of the sick is performed even after death.
c. family members often prefer to wash the body after death.
d. the body should be buried within 24 hours.

Answer 18

ANS: C

Question 19

For a patient in the final stages of dying, a nurse expects to:

a. keep the patient’s room cool.
b. avoid catheterizing the patient.
c. elevate the head of the bed as tolerated.
d. encourage the patient to eat and drink more.

Answer 19

ANS: C

Question 20

For a patient in the final stages of dying, a nurse expects to:

a. keep the patient’s room cool.
b. avoid catheterizing the patient.
c. elevate the head of the bed as tolerated.
d. encourage the patient to eat and drink more.

Answer 20

ANS: C

Question 21

Hospice care can be provided in which of the following settings? (Select all that apply.)

a. Home
b. Free-standing hospice facilities
c. Extended care facilities
d. Acute care facilities

Answer 21

ALL OF THE ABOVE

Question 22

Hospice care can be provided in which of the following settings? (Select all that apply.)

a. Home
b. Free-standing hospice facilities
c. Extended care facilities
d. Acute care facilities

Answer 22

ALL OF THE ABOVE

Question 23

Hospice benefits include which of the following? (Select all that apply.)

a. Respite for family caregivers
b. Hospitalization for acute symptom management
c. Emotional and psychological support
d. Financial assistance and funeral arrangement

Answer 23

ANS: ABC

Question 24

The World Health Organization (2002) defines ___________ as an “approach that improves the quality of life of individuals and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychological, and spiritual problems.”

Answer 24

Palliative Care

Question 25

The World Health Organization (2002) defines ___________ as an “approach that improves the quality of life of individuals and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychological, and spiritual problems.”

Answer 25

Palliative Care

Question 26

_____________ helps people live as well as possible through the dying process.

Answer 26

Hospice

Question 27

___________________ specify medical interventions that the patient does not want in certain situations, such as mechanical ventilation, and are used to communicate the care a patient wants, for example, pain relief to the fullest extent possible.

Answer 27

Advanced directives

Question 28

Nurses provide _______________ that is defined as care of the body after death in a manner consistent with the patient’s religious and cultural beliefs

Answer 28

Postmortem care

Question 29

Nurses provide _______________ that is defined as care of the body after death in a manner consistent with the patient’s religious and cultural beliefs

Answer 29

Postmortem care

Question 30

A person experiences an actual _________ when an object or a person can no longer be felt, heard, or experienced.

Answer 30

Loss

Question 31

A person experiences an actual _________ when an object or a person can no longer be felt, heard, or experienced.

Answer 31

Loss

Question 32

The irreversible absence of all brain function is termed ______________.

Answer 32

Brain death

Question 33

An _______________ is the surgical dissection of a body after death.

Answer 33

Autopsy

Question 34

The patient was brought into the emergency department with a cardiac arrest after suffering multiple gunshot wounds. The patient did not survive even after multiple attempts at resuscitation. The nurse is preparing the body for transport to the morgue by completing hospital procedures for __________________.

Answer 34

Autopsy

Question 35

The patient was brought into the emergency department with a cardiac arrest after suffering multiple gunshot wounds. The patient did not survive even after multiple attempts at resuscitation. The nurse is preparing the body for transport to the morgue by completing hospital procedures for __________________.

Answer 35

Autopsy

Question 36

The nurse is aware that normal flora that does not cause disease but does prevent disease-causing microorganisms from reproducing is known as:

a. sebum.
b. the epidermis.
c. resident bacteria.
d. the dermis.

Answer 36

ANS: C

Question 37

In relation to hygiene and the acute care setting, the nurse knows that which of the following statements is true?

a. The disposable bath is a less desirable form of bathing than the traditional basin bath.
b. The disposable bath is a more desirable form of bathing than the traditional basin bath.
c. The disposable bath is more desirable for patients who can bathe independently.
d. The disposable bath is not an acceptable form of bathing in the acute care setting.

Answer 37

ANS: B

Question 38

In relation to hygiene and the acute care setting, the nurse knows that which of the following statements is true?

a. The disposable bath is a less desirable form of bathing than the traditional basin bath.
b. The disposable bath is a more desirable form of bathing than the traditional basin bath.
c. The disposable bath is more desirable for patients who can bathe independently.
d. The disposable bath is not an acceptable form of bathing in the acute care setting.

Answer 38

ANS: B

Question 39

The nurse is caring for a ventilated patient in the ICU who has just undergone coronary artery bypass. The nurse is concerned that the patient may be at risk for ventilator-acquired pneumonia (VAP). What step will she take to minimize this risk?

a. Not provide oral hygiene because this may cause bacterial contamination of the airway.
b. Be careful not to use chlorhexidine in oral care because it provides a medium for bacterial growth.
c. Not use chlorhexidine in oral care because it enhances the rate at which VAP develops.
d. Include the use of a chlorhexidine rinse as part of oral hygiene to delay the development of VAP.

Answer 39

ANS: D

Question 40

The nurse is caring for a ventilated patient in the ICU who has just undergone coronary artery bypass. The nurse is concerned that the patient may be at risk for ventilator-acquired pneumonia (VAP). What step will she take to minimize this risk?

a. Not provide oral hygiene because this may cause bacterial contamination of the airway.
b. Be careful not to use chlorhexidine in oral care because it provides a medium for bacterial growth.
c. Not use chlorhexidine in oral care because it enhances the rate at which VAP develops.
d. Include the use of a chlorhexidine rinse as part of oral hygiene to delay the development of VAP.

Answer 40

ANS: D

Question 41

The nurse plans to give the patient a therapeutic bath. Which of the following is considered therapeutic?

a. Bed bath
b. Sponge bath at the sink
c. Sitz bath
d. Bag bath

Answer 41

ANS: C

Question 42

The nurse plans to give the patient a therapeutic bath. Which of the following is considered therapeutic?

a. Bed bath
b. Sponge bath at the sink
c. Sitz bath
d. Bag bath

Answer 42

ANS: C

Question 43

What should the nurse do before starting a patient’s bed bath?

a. Lower the bed.
b. Offer the bedpan or urinal.
c. Partially undress the patient.
d. Place the head of the bed in high-Fowler’s position.

Answer 43

ANS: B

Question 44

The nurse is preparing to provide a complete bed bath to a patient who has a running IV. She places a bath blanket over the patient and:

a. removes the gown from the arm with the IV first.
b. removes the gown from the arm without the IV first.
c. removes the gown after the bath to keep the patient warm.
d. readjusts the IV rate before removing the gown.

Answer 44

ANS: B

Question 45

The nurse is preparing to provide a complete bed bath to a patient who has a running IV. She places a bath blanket over the patient and:

a. removes the gown from the arm with the IV first.
b. removes the gown from the arm without the IV first.
c. removes the gown after the bath to keep the patient warm.
d. readjusts the IV rate before removing the gown.

Answer 45

ANS: B

Question 46

While washing the patient’s face, the nurse should:

a. wash the eyes using soap and warm water.
b. wash the eyes from outer canthus to inner canthus.
c. wash the eyes with plain warm water.
d. use the same portion of the washcloth.

Answer 46

ANS: C

Question 47

When bathing a patient, which sequence is the correct approach to use?

a. Wash the feet after the legs.
b. Wash the eyes after the face.
c. Wash the legs before the abdomen.
d. Wash the back area before the extremities.

Answer 47

ANS: A

Question 48

What should hygienic care of the patient with dry skin include?

a. Use of moisturizers
b. Use of ultraviolet light
c. Application of antiseptic lotion
d. Lowering of bath water temperature

Answer 48

ANS: A

Question 49

What should hygienic care of the patient with dry skin include?

a. Use of moisturizers
b. Use of ultraviolet light
c. Application of antiseptic lotion
d. Lowering of bath water temperature

Answer 49

ANS: A

Question 50

While giving the patient a bed bath, the nurse notices a reddened area on the patient’s coccyx. The nurse should:

a. decrease the temperature of the bath water.
b. massage the reddened area to decrease the redness.
c. apply topical moisturizing agents to the area.
d. ignore the redness because it will return to normal soon.

Answer 50

ANS: C

Question 51

The optimal position for a female patient for the provision of perineal care is:

a. prone.
b. side-lying.
c. high-Fowler’s.
d. dorsal recumbent.

Answer 51

ANS: D

Question 52

While evaluating the hygienic care practices of a female patient, the nurse recognizes that additional instruction is necessary if the patient:

a. washes the perineal area from back to front.
b. washes the labia majora before the labia minora.
c. avoids tension on the indwelling catheter.
d. uses separate sections of the washcloth for each cleansing stroke.

Answer 52

ANS: A

Question 53

In providing perineal care for a male patient, the nurse realizes that the patient has not been circumcised. The nurse should:

a. retract the foreskin after care has been completed.
b. place the patient in prone position.
c. replace the foreskin to its natural position after care has been provided.
d. have the patient adduct his legs.

Answer 53

ANS: C

Question 54

The home care nurse is getting ready to help the patient prepare a tub bath. What should the nurse be sure to do?

a. Instruct the patient to use safety bars.
b. Use the patient’s favorite bath oil for aroma therapy.
c. Instruct the patient to stay in the tub no longer than 30 minutes.
d. Check on the patient every 20 minutes.

Answer 54

ANS: A

Question 55

When teaching parents how to provide oral care to their child, the nurse instructs them to:

a. give bottles with juice at bedtime.
b. begin dental visits after the child is 8 years old.
c. allow the preschool child to floss his teeth without parental supervision.
d. limit snacks to three or four per day.

Answer 55

ANS: D

Question 56

The nurse is about to provide oral hygiene to an unconscious patient. To do so, she places the patient in which position?

a. Fowler’s
b. Semi-Fowler’s
c. Sims’
d. Supine

Answer 56

ANS: C

Question 57

A nurse recognizes that a shampoo may be contraindicated for a bed-bound patient with:

a. heart disease.
b. diabetes mellitus.
c. a neck injury.
d. a bleeding disorder.

Answer 57

ANS: C

Question 58

Shaving with a disposable razor is contraindicated for a patient with:

a. heart disease.
b. diabetes mellitus.
c. a head injury.
d. a bleeding disorder.

Answer 58

ANS: D

Question 59

Shaving with a disposable razor is contraindicated for a patient with:

a. heart disease.
b. diabetes mellitus.
c. a head injury.
d. a bleeding disorder.

Answer 59

ANS: D

Question 60

When evaluating the shaving of a patient done by a family member, the nurse determines that the technique is done appropriately when:

a. long strokes are used.
b. the razor is held at a 45-degree angle to the skin.
c. shaving is done against the direction of hair growth.
d. a cool cloth is used on the skin before the shave.

Answer 60

ANS: B

Question 61

The nurse is providing nail care for the patient who wants his fingernails “done.” The nurse should:

a. clip the fingernails gently to prevent injury.
b. clean under the nails using an orange stick.
c. soak the fingernails no longer than 10 minutes.
d. clean under the nails using the end of a cotton swab.

Answer 61

ANS: C

Question 62

The nurse assesses the patient’s skin and notices an abrasion. Which of the following best describes this type of skin abnormality?

a. A papulopustular skin eruption
b. Rough texture on the skin surface
c. Erythema and scaly, oozing areas
d. A scraping away of the epidermis

Answer 62

ANS: D

Question 63

The nurse is caring for a gentleman who has dry skin. When the following interventions are compared, which would be most appropriate for this patient?

a. Limiting the frequency of bathing
b. Using a fat-free soap for washing
c. Using warm water and moisturizers
d. Bathing with hot water to increase blood flow

Answer 63

ANS: C

Question 64

The patient confides in the nurse that she is bothered by the fact that she has alopecia. How should the nurse respond to this information?

a. Shave hair off of the affected area.
b. Use permethrin (Nix).
c. Offer the patient access to scarves or wigs.
d. Place a drop of oil on the area.

Answer 64

ANS: C

Question 65

The patient requires postural drainage three times a day. Which of the following bed positions would be most appropriate for this task?

a. Fowler’s position
b. Trendelenburg’s position
c. Reverse Trendelenburg’s position
d. Semi-Fowler’s position

Answer 65

ANS: B

Question 66

The skin, the largest human body organ, protects us from heat, light, injury, and infection and does which of the following? (Select all that apply.)

a. Helps regulate body temperature
b. Stores water, vitamin D, and fat
c. Helps to sense pain
d. Prevents the entry of bacteria

Answer 66

ALL OF THE ABOVE

Question 67

Critically ill patients on a ventilator are at risk for ventilator-associated pneumonia (VAP). Sources of VAP include: (Select all that apply.)

a. bacteria in the oral pharynx.
b. dental plaque.
c. chlorhexidine rinses.
d. frequent oral hygiene.

Answer 67

ANS: AB

Question 68

Critically ill patients on a ventilator are at risk for ventilator-associated pneumonia (VAP). Sources of VAP include: (Select all that apply.)

a. bacteria in the oral pharynx.
b. dental plaque.
c. chlorhexidine rinses.
d. frequent oral hygiene.

Answer 68

ANS: AB

Question 69

When taking a shower in the home setting, the patient at risk for falls may benefit from: (Select all that apply.)

a. installation of grab bars.
b. adhesive strips applied to the tub floor.
c. addition of a shower chair or stool.
d. a hydraulic lift.

Answer 69

A, B, C

Question 70

Patients at greatest risk for developing serious foot problems include those with: (Select all that apply.)

a. peripheral neuropathy.
b. peripheral vascular disease.
c. pancreatitis.
d. diabetes.

Answer 70

A, B, D

Question 71

Patients at greatest risk for developing serious foot problems include those with: (Select all that apply.)

a. peripheral neuropathy.
b. peripheral vascular disease.
c. pancreatitis.
d. diabetes.

Answer 71

A, B, D

Question 72

The development of diabetic foot ulcers is dependent on which of the following? (Select all that apply.)

a. Peripheral neuropathy
b. Tissue ischemia
c. Trauma to the foot
d. Pain in the affected extremity

Answer 72

A, B, C

Question 73

A patient is admitted with the diagnosis of pediculosis capitis (head lice). Proper treatment for this condition would include which of the following? (Select all that apply.)

a. Use of medicated shampoo or permethrin (Nix)
b. Use of products containing lindane
c. Combing the hair with a nit comb for 2 to 3 days after treatment
d. Washing linens in cold water for 30 minutes

Answer 73

A, C

Question 74

The ____________ is the largest human organ.

Answer 74

Skin

Question 75

The first line of defense against external injury and infection contains several thin layers of cells undergoing different stages of maturation. This first line of defense is known as the _______.

Answer 75

Epidermis

Question 76

_________________ provides an acidic coating to protect the epidermis against penetration from chemicals and microorganisms; it also minimizes loss of water and plasma proteins.

Answer 76

Sebum

Question 77

________________ removes sweat, oil, dirt and bacteria and helps maintain skin integrity.

Answer 77

Bathing

Question 78

The act of chewing is also known as ________________.

Answer 78

Mastication

Question 79

______________ are mucous membranes with underlying supportive tissue that encircle the neck of erupted teeth to hold them in place.

Answer 79

Gingivae

Question 80

Regular oral hygiene is necessary to maintain the integrity of tooth surfaces and to prevent gum inflammation known as ____________.

Answer 80

Gingivitis

Question 81

Tissue that surrounds the fingernail, slowly grows over the nail, and must be regularly pushed back with a soft nail brush is known as the __________________.

Answer 81

Cuticle

Question 82

Many foot ulcers are due to repeat trauma over time, often caused by ________________.

Answer 82

Poorly fitting shoes

Question 83

________________ is defined as excessive growth of body and facial hair.

Answer 83

Hirsutism

Question 84

_____________ is balding patches in the periphery of the hairline.

Answer 84

Alopecia