Test 4 ( Ch 40)

Question 1

What is the overall objective of hospice service?
a. Relieve symptoms of terminal disease.
b. Educate the patient about the process of death.
c. Keep the patient comfortable as death approaches.
d. Relieve the family of the stress of death.

Answer 1

ANS: C

Question 2

Who was responsible for renewing the hospice philosophy in the 1960s?
a. Cicely Saunders
b. Lillian Wald
c. Dorothea Dix
d. Florence Nightingale

Answer 2

ANS: A

Question 3

The hospice nurse clarifies that hospice service is initiated when what type of treatment is no longer effective?
a. Proactive
b. Palliative
c. Alternative
d. Curative

Answer 3

ANS: D

Question 4

The nurse differentiates between curative and palliative care. What is true of curative treatment?
a. Curative treatment is centered on symptom control.
b. Curative treatment is focused on prolonging life.
c. Curative treatment is not concerned with dying.
d. Curative treatment is the only care covered by health insurance.

Answer 4

ANS: B

Question 5

Because the family is confused about the meaning of palliative care, the hospice nurse needs to explain the focus of care. What is the focus of palliative care?
a. An aggressive approach to prolong life
b. A protocol of pain relief
c. A form of organized care, which relieves the family of responsibility
d. An integrated service of support for alleviation of symptoms

Answer 5

ANS: D

Question 6

The hospice nurse explains that to qualify for admission to a hospice, the attending health care provider must certify that the patient has a life expectancy of fewer than how many months?
a. 2 months
b. 3 months
c. 4 months
d. 6 months

Answer 6

ANS: D

Question 7

The hospice nurse requests that the patient designate a primary caregiver for himself. What is true of the primary caregiver?
a. Must be a relative.
b. Has complete control over the patient’s care.
c. Assumes ongoing responsibility for health maintenance of the patient.
d. Must have power of attorney.

Answer 7

ANS: C

Question 8

Why is it important for the hospice nurse to provide time to confer with the patient and family?
a. To show concern
b. To report changes in the plan of care designed by the team
c. To confirm the ongoing reimbursement
d. To plan for changes in the scope of care

Answer 8

ANS: D

Question 9

The patient informs the hospice nurse, “I’m not sold on this hospice thing. I’m not looking for Jesus, I’m just dying.” What would be the most therapeutic response by thenurse?
a. “Spiritualism is as you define it.”
b. “Rejecting the spiritual aspect of yourself may not be in your best interest.”
c. “Hospice service is about how to make your remaining time meaningful.”
d. “Based on what you say, hospice service may not answer your needs.”

Answer 9

ANS: C

Question 10

What is the role of the hospice medical director?
a. To design and direct the plan of care
b. To evaluate the appropriateness of the care
c. To function as mediator between the team and the attending health care provider
d. To take the place of the patient’s attending health care provider

Answer 10

ANS: C

Question 11

The hospice nurse tells the family that the nurse coordinator, an RN, will visit them. What is the role of the nurse coordinator?
a. Collect initial fees for the hospice service.
b. Officially admit the patient to the hospice service.
c. Assist with accessing community resources.
d. Assist with funeral planning.

Answer 11

ANS: B

Question 12

The social worker evaluates and assesses the psychosocial needs of the patient. To work in a hospice, the social worker must have at least which degree?
a. Associate
b. Bachelor’s
c. Master’s
d. Doctorate

Answer 12

ANS: B

Question 13

The hospice spiritual coordinator can be affiliated with any religion, assists with the spiritual assessment of the patient, and develops the plan of care regarding spiritual matters. To work in a hospice, what degree should the spiritual coordinator possess?
a. Bachelor’s degree
b. Master’s degree
c. Seminary degree
d. Associate degree

Answer 13

ANS: C

Question 14

The hospice nurse introduced the family to the volunteer coordinator who will assign a volunteer to the patient. What can a hospice volunteer do for a patient and caregiver?
a. Give the family respite.
b. Give necessary medication in the absence of the nurse.
c. Be at the family’s disposal 16 hours a week.
d. Bathe the patient.

Answer 14

ANS: A

Question 15

The hospice nurse instructs the family that they have access to a bereavement coordinator who follows the plan of care focused on the caregiver after the death of the patient. For how long of a period of time will the caregiver and family have access to the bereavement coordinator?
a. One week
b. One month
c. One year
d. Two years

Answer 15

ANS: C

Question 16

The hospice nurse instructs the family that they have access to a hospice pharmacist, who is available for consultation on the drugs the hospice patient may be taking. What other role does the hospice pharmacist fill?
a. Administer all drugs necessary for pain alleviation.
b. Evaluate drug interactions with food and other medications.
c. Evaluate the safety of the drug storage in the patient’s home.
d. Monitor drug effectiveness by frequent phone interviews with the family.

Answer 16

ANS: B

Question 17

Who conducts the nutritional assessment at the time of admission to hospice care?
a. Health care provider
b. Hospice nurse
c. Caregiver
d. Unlicensed assistive personnel

Answer 17

ANS: B

Question 18

When a deficiency in nutritional status of a patient is assessed, what action should be taken by the hospice nurse?
a. Make a comprehensive grocery list for the caregiver.
b. Alert the licensed medical nutritionist.
c. Seek culturally appropriate methods to increase nutrition.
d. Instruct the caregiver to give the patient multivitamins.

Answer 18

ANS: B

Question 19

What symptom of hospice patients is the most dreaded and feared, and should be a priority of symptom management?
a. Fear
b. Anger
c. Grief
d. Pain

Answer 19

ANS: D

Question 20

During a pain assessment, the patient tells the nurse that the pain is aching, stabbing, and throbbing. What type of pain is the patient describing?
a. Visceral
b. Neuropathic
c. Somatic
d. Psychogenic

Answer 20

ANS: C

Question 21

What are the drugs of choice when caring for the hospice patient?
a. Nonsteroidal antiinflammatory drugs
b. Anticholinergic drugs
c. Duragesic patches
d. Morphine derivatives

Answer 21

ANS: D

Question 22

The nurse should educate the patient and caregiver that large doses of narcotics are required to control pain. What is the optimal dose for pain medications?
a. The smallest amount possible to achieve some effects
b. The dose that provides pain relief
c. The dose that is not addictive
d. The dose that works for most people

Answer 22

ANS: B

Question 23

The nurse warns that nausea is a common side effect with opioid treatment. What is the best treatment for nausea caused by opioids?
a. Antiemetics
b. Ice chips
c. Dry crackers
d. Ginger ale

Answer 23

ANS: A

Question 24

When educating a patient concerning ways to prevent nausea, the nurse suggests that eating slowly in a pleasant atmosphere will help, as well as taking an antiemetic before meals. How many minutes before meals should the patient take the antiemetic?
a. 10
b. 20
c. 30
d. 60

Answer 24

ANS: C

Question 25

What is the most common problem of the terminally ill patient that is caused by narcotics?
a. Malnutrition
b. Constipation
c. Fluid retention
d. Dehydration

Answer 25

ANS: B

Question 26

The hospice nurse documents an assessment finding of cachexia in the patient record. What does cachexia describe?
a. Deep sleep and unresponsiveness
b. Marked weakness and emaciation
c. Total addiction to opioids d. Renewed energy

Answer 26

ANS: B

Question 27

Which of the following is an expected part of the end-of-dying process?
a. Denial
b. Despair
c. Anorexia
d. Depression

Answer 27

ANS: C

Question 28

Which medication relaxes the patient’s respiratory effort and thus increases the efficiency of the patient’s respiratory status?
a. Aminophylline
b. Theophylline
c. Epinephrine
d. Morphine

Answer 28

ANS: D

Question 29

Why should the hospice nurse delay the use of oropharyngeal suctioning?
a. It will decrease mucus production.
b. It will be uncomfortable for the patient.
c. It is not necessary.
d. It puts the patient at risk for infection.

Answer 29

ANS: B

Question 30

The hospice nurse recommends that the patient prepare the document that provides guidance to the family concerning the patient’s wishes regarding life-support measures and organ donation. What is this document called?
a. Power of attorney
b. Living will
c. Advance directive
d. Conservatorship

Answer 30

ANS: C

Question 31

The hospice nurse instructs caregivers in repositioning the patient because the patient spends most of the time reclining. What problem can this cause?
a. Contractures
b. Pressure injuries
c. Bruising
d. Excoriation

Answer 31

ANS: B