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Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test
Bank
Chapter 17Question 1
Type: MCSA
The nurse interacts with clients experiencing loss in a variety of settings, and understands that the most traumaticgrieving is usually associated with
1. Loss of safety or freedom
2. Divorce
. Empty nesting
!. Loss of life as you have nown it
Corre"t #ns$er: !
Rationa%e 1" #hen lives are affected $y civil or national strife, they may grieve the loss of safety, freedom, or
democracy%
Rationa%e 2" Divorce is a situational loss of a valued relationship%
Rationa%e " Maturational loss, such as changing life roles causes people to experience grief%
Rationa%e !" The most traumatic grieving is usually associated with the loss of one&s own life 'as you have nowit( or that of a loved one%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
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Question 2
Type: MCSA
As the nurse counsels the parents of a child who has lost a si$ling, an appropriate comment would $e
1. -Allowing children to decide how to participate in funerals will help them in the grieving process.
2. -Children are permanently scarred $y loss.
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. -Children need to go to funerals to help them get over loss.
!. -Children get over loss $est $y going to therapy.
Corre"t #ns$er: 4
Rationa%e 1" Allowing children to mae decisions a$out participating in funerals will help them process the even
Rationa%e 2" Children are resilient, $ut will learn to live with the loss%
Rationa%e " Children may or may not need to go to the funeral to process the loss5 they should $e allowed to
mae the decision themselves%
Rationa%e !" Children and adolescents may process $est with a variety of approaches, such as play, art, dance,music%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrityC%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
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Question
Type: MCMA
The nurse understands that culture and religious traditions and practices"
*tandard Tet: Select all that apply%
1. Should $e supported $y the healthcare team
2. 6ften determine expression of grief
. Encourage outward expressions of grief
!. Are diverse in the 1nited States
/. /e7uire individuali)ed care
Corre"t #ns$er: 4,0,!,8
Rationa%e 1" Supporting these traditions comfort survivors%
Rationa%e 2" The customs of the culture help people cope with death, dying, and the grieving process%
Rationa%e " Expressions of grief vary from culture to culture, from stoic to demonstrative%
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Rationa%e !" The 1nited States has a diverse num$er of cultures in $oth clients and nursing staff%
Rationa%e /" +ndividuali)ed care $y nurses ensure maximum support for clients and their families%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
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Question !
Type: MCSA
The nurse woring with a group of students whose friend committed suicide distinguishes $etween the stages of
grief each student is exhi$iting% The nurse identifies a student as $eing in denial when she says
1. -She was so sad.
2. -She ran away.
. 9+f we tell you how we feel, can we leave:.
!. -+ don&t want to $e here.
Corre"t #ns$er: 0
Rationa%e 1" +dentifying the sadness is a sign of acceptance%
Rationa%e 2" The client refuses to $elieve that the loss is happening%
Rationa%e " This is an example of $argaining%
Rationa%e !" The student who says something lie this is expressing anger%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question /
Type: MCMA
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#hen leading a support group for clients who have lost a lim$, the nurse explains the following as $eing element
in the grief process"
*tandard Tet: Select all that apply%
1. ot everyone goes through the stages of grief in the same order
2. 6nce a person experiences a stage of grief, he or she moves on to the next stage
. The client can expect to reach the acceptance stage within ; months
!. Counseling may $e necessary of the depression stage is not experienced within ; months
/. The amount of time a person spends in each stage differs from person to person
Corre"t #ns$er: 4,8
Rationa%e 1" Those experiencing grief will process the event in their own order%
Rationa%e 2" +ndividuals may move $ac and forth $etween stages%
Rationa%e " *eople may need profession counseling if they do not experience the 8 stages within ; months of a
grief event%
Rationa%e !" The depression stage needs to $e wored through as part of the grief process%
Rationa%e /" The grieving client will move $etween the stages of grief at own pace%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ingC%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
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Question 0
Type: MCMA
The nurse descri$es #olfelt&s mourner&s needs to a widow as including"
*tandard Tet: Select all that apply%
1. A support person who will encourage her to <get over& the grief 7uicly
2. The need to allow oneself periods of time to feel the grief completely
. The need to find reasons for going on with life
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!. The need to acnowledge the reality of the loved one&s death
/. Maintaining a relationship with the deceased person as part of the past
Corre"t #ns$er: 0,=,!,8
Rationa%e 1" Seeing mourning as something to -get over. leads to repression rather than resolution of grief%
Rationa%e 2" Allowing oneself to feel the pain followed $y periods of not dwelling in the grief will assist insuccessful resolution of grief%
Rationa%e " The grieving person will need to create a new self>identity that does not include the deceased%
Rationa%e !" The grieving person needs to acnowledge the reality of the death in order to recover%
Rationa%e /" The mourner needs to maintain the relationship as part of the past in order to $e open to newexperiences in the future%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
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Question 7
Type: MCMA
A client is seen in the family practice clinic after losing 48 pounds ? months after the death of her mother% The
nurse 7uestions the client regarding the loss% #hich of the following reported $ehaviors may indicate complicated
grieving:
*tandard Tet: Select all that apply%
1. Living in the past
2. Self>isolation
. Shoc
!. /ead@usting her routine
/. olding on to the grief
Corre"t #ns$er: 4,0,8
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Rationa%e 1" A client who is not maing new memories $y ? months after the loss may $e at ris for complicatedgrieving%
Rationa%e 2" The client who reports loss of interest in outside activities and relationships may $e experiencing
complicated grieving%
Rationa%e " Shoc is usually experienced during the initial stages of grief%
Rationa%e !" The client who is read@usting her routine to incorporate the new reality is showing signs ofsuccessful resolution of grief%
Rationa%e /" The client who is holding on to her grief ? months after the loss may $e experiencing complicated
grieving%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis)earning -ut"ome:
Question
Type: MCMA
#hen caring for client&s who have experience paralysis due to acute spinal cord in@ury, the nurse remem$ers
guidelines that may help those who are grieving"
*tandard Tet: Select all that apply%
1. Taling will help the mourner heal
2. Brief may $ring mixed emotions
. Brieving taes a great deal of energy
!. Brief is a process
/. *owerful surges of grief are dysfunctional
Corre"t #ns$er:4,0,=,!
Rationa%e 1" Taling with supportive others will help with the resolution of the grieving process%
Rationa%e 2" Brief may $ring feelings that may seem inappropriate5 the mourner needs to find listeners who will
accept feelings without @udgment%
Rationa%e " The mourner needs to rest and eat well>$alanced meals%
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Rationa%e !" Brief is not an event5 it will tae time to resolve%
Rationa%e /" *owerful surges of grief are normal and natural%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
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Question
Type: MCMA
urses are re7uired to $e familiar with facility policies, including those regarding directives and medical orders%
The *atient Self>Determination Act of 44 re7uires all healthcare facilities receiving Medicare and Medicaid
reim$ursement to"
*tandard Tet: Select all that apply%
1. As clients whether they have advance directives
2.
. *rovide written information to clients a$out their right to declare personal wishes a$out treatment
!. Mae certain that clients have an advance directive in place
/. +nform clients of their right to refuse medical treatment
Corre"t #ns$er: 4,0,=,8
Rationa%e 1" All facilities are re7uired to either chec the client&s chart or as clients whether they have advance
directives%
Rationa%e 2" All facilities and healthcare staff are re7uired to recogni)e and a$ide $y advance directives%
Rationa%e " All facilities must provide, in writing, information to clients a$out their right to mae treatmentdecisions%
Rationa%e !" All facilities are re7uired to as, $ut clients are not re7uired to have an advance directive in place%
Rationa%e /" All facilities are re7uired to provide written information to clients a$out their right to refuse medica
treatment%
&%o'a% Rationa%e:
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Cogniti(e )e(e%: /emem$ering
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
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Question 13
Type: MCSA
The nurse understands that the living will
1. *rovide specific instructions a$out what medical treatment the client chooses to omit or refuse
2. +s the same as a healthcare proxy
. *rovides for a designated person to see that the client&s wishes are honored when the client can no longer spea
for him
!. /e7uires a physician&s order
Corre"t #ns$er: 4
Rationa%e 1" The living will is referenced $efore C*/, intu$ation or $reathing support are $egun, so that specificinstructions from the client are followed%
Rationa%e 2" A healthcare proxy is also nown as a dura$le power of attorney%
Rationa%e " A dura$le power of attorney provides for a designated person to see that the client&s wishes are
honored when the client can no longer spea for him>or herself%
Rationa%e !" A do not resuscitate 'D/( order re7uires a physician order%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
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Question 11Type: MCSA
#hen reviewing a client&s chart prior to $eginning care, the nurse notes a do not resuscitate order on file% This
order
1. *revents the client from receiving anti$iotics
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2. *revents the client from receiving + fluids
. *revents interventions the client does not wish to have performed when death approaches
!. *revents surgery from $eing performed
Corre"t #ns$er: =
Rationa%e 1" A D/ generally prevents resuscitation in the event of respiratory or cardiac arrest, $ut does not prohi$it the administration of anti$iotics%
Rationa%e 2" The D/ would prevent C*/, $ut not + fluids, unless specified in a -comfort measures only.
order%
Rationa%e " The D/ generally prevents the initiation of resuscitation measures in the event of a respiratory or
cardiac arrest%
Rationa%e !" The D/ does not prevent surgery from $eing performed%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
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Question 12
Type: MCMA
The hospice nurse is discussing indications of death with a client&s family% +ndications of clinical death include"
*tandard Tet: Select all that apply%
1. Total lac of response to external stimuli
2. +na$ility to $reathe independently
. A$sent reflexes
!. o voluntary muscular movement
/. +na$ility to open eyes
Corre"t #ns$er: 4,=,!
Rationa%e 1" Total lac of response to external stimuli is one clinical indication of death%
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Rationa%e 2" +na$ility to $reathe independently is not a clinical indication of death $y itself%
Rationa%e " A$sent reflexes indicate destruction of $rain function%
Rationa%e !" o voluntary muscular movement is a clinical indication of death, especially when $reathing is
a$sent%
Rationa%e /" +na$ility to open eyes is not a clinical indication of death $y itself%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question 1
Type: MCSA
A 4 year old client is admitted to the emergency room after a severe motor vehicle accident% The client&s driver&
license has an organ donation code specified% The nurse explains to the family that
1. The client will have organs harvested within 0! hours
2. The client must experience heart>lung death $efore organs can $e harvested
. The client is too young to $ecome an organ donor
!. The presence of two electroencephalograms showing no $rain activity over 0! hours is re7uired prior todeclaration of death
Corre"t #ns$er: !
Rationa%e 1" The client will not have the organ donation process started without specific criteria $eing met%
Rationa%e 2" Specific criteria must $e met prior to the client $eing declared dead5 with artificial life support, the
client may not have heart>lung death%
Rationa%e " The client is of age to $ecome an organ donor%
Rationa%e !" The presence of two EEBs showing no $rain activity over 0! hours is re7uired $efore the client may $e declared dead, and organ or tissue donation process can $egin%
&%o'a% Rationa%e:
Cogniti(e )e(e%: /emem$ering
C%ient Need: *sychosocial +ntegrity
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C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question 1!
Type: MCSA
The nurse notes the term palliative management on a client&s chart, and recogni)es that the treatment goals
1. Are to let the client die peacefully
2. Are to optimi)e 7uality of life
. Depend on the results of tests
!. Are to mae sure the client gets plenty of fluids to stay hydrated
Corre"t #ns$er: 0
Rationa%e 1" *alliative care may $e instituted for clients who are not terminally ill%
Rationa%e 2" The goals of palliative management is to optimi)e 7uality of life, with providing relief from
suffering rather than curing a disease%
Rationa%e " Diagnostic tests and other invasive procedures are minimi)ed, unless they are liely to alleviatesymptoms, or provide information that will facilitate symptom management%
Rationa%e !" Clients eat if they are hungry and drin if they are thirsty5 feeding and fluids are not forced%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" *lanning
)earning -ut"ome:
Question 1/
Type: MCMA
The home health nurse is explaining the principles of palliative care to the client and the family% These principlesinclude"
*tandard Tet: Select all that apply%
1. either hastening nor prolonging death
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2. 1se of heroic treatment measures is discouraged
. *ain medication is given on a strict schedule
!. The hopes and desires of the family are fulfilled as much as possi$le
/. eeding and fluids are not forced
Corre"t #ns$er: 4,0,8
Rationa%e 1" Death is regarded as a natural process that is not prolonged or hastened%
Rationa%e 2" The use of heroic measures is discouraged, with the client usually having a do not resuscitate order
in place%
Rationa%e " The client is the expert on whether pain is ade7uately relieved, and the right dose is the dose that provides pain relief without unaccepta$le side effects%
Rationa%e !" Care is individuali)ed to meet the emotional, social, spiritual, and existential needs of the client%
Rationa%e /" The clients eat if they are hungry, and drin if they are thirsty5 food and fluids are not forced%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" *lanning
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Question 10Type: MCSA
As the family of a client with a terminal illness weighs the options of future care, the nurse explains the differenc
$etween hospice care and palliative care as follows"
1. The focus of hospice care is to prolong life
2. All hospice care is palliative, $ut not all palliative care is hospice
. *alliative care is provided for terminally ill clients with a prognosis of ; months or less survival time
!. ospice care is never provided in a hospital
Corre"t #ns$er: 0
Rationa%e 1" The focus of hospice is to improve the 7uality of life, rather than to prolong it%
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Rationa%e 2" *alliative care may $e provided to clients who are not terminal, however hospice is provided forterminally ill clients, and incorporates the holistic concepts of palliative management%
Rationa%e " ospice care is provided for terminally ill clients with a prognosis of ; months or less survival time
Rationa%e !" ospice care can $e provided in many settings, included a hospital%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 17
Type: MCMA
The nurse is reviewing the terminally ill client&s chart and notes a referral for hospice care% Characteristics of
hospice care include"
*tandard Tet: Select all that apply%
1. Medicare pays an all inclusive $enefit related to the terminal illness or symptom management
2. Care is delivered $y an interdisciplinary team
. A nurse can mae a referral for hospice care
!. Clients may have Medicare claims denied if they live longer than ; months
/. ospice care can $e carried out in a variety of settings
Corre"t #ns$er: 4,0,8
Rationa%e 1" Medicare pays an all>inclusive $enefit that provides the client with dura$le medical e7uipment, and
all medication and treatment related to the terminal illness and symptom management%
Rationa%e 2" The interdisciplinary hospice team consists of the dying person, family and caregivers, physicians,
nurses, aides, chaplains, social worers, $ereavement specialists and volunteers%
Rationa%e " Entrance or admission into a hospice program re7uires a physician&s certification of terminal illness
Rationa%e !" Medicare claims are not denied, as long as clients continue to meet the Medicare -conditions of
participation. in a hospice%
Rationa%e /" ospice care is commonly carried out in the client&s home or an extended care facility5 independent
hospice and hospital $ased palliative care units are $ecoming more widely availa$le%%
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&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 1Type: SEF
The hospice movement was founded in the 03th century% *lace the following in se7uence from earliest to most
recent events
*tandard Tet: Clic and drag the options $elow to move them up or down%
Choi"e 1. Canadian *alliative Care Association
Choi"e 2. Gale>ew aven ospital ospice
Choi"e . London hospice
Choi"e !. Medicare ospice $enefit
Choi"e /.
Corre"t #ns$er: =,0,!,4
Rationa%e 1" The Canadian *alliative Care Association was founded in 44 to promote the hospice care
movement%
Rationa%e 2" Modern>day hospice came to the 1nited States in 4H! with the opening of a hospice unit at Gale> ew aven ospital in Connecticut%
Rationa%e " The hospice movement was founded in London in 4;H%
Rationa%e !" The enactment of the Medicare ospice $enefit occurred in 4?=%
Rationa%e /"
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
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Question 1
Type: MCMA
The L*IL can provide care for the client and family when in hospice care $y"
*tandard Tet: Select all that apply%
1. *roviding comfort assistance
2. Jeeping the family informed a$out the client&s status
. /einforcing information that the family mem$ers may not have $een a$le to a$sor$
!. Leaving the client alone, and not $othering them
/. Encouraging the client to ver$ali)e positive expectations for the future
Corre"t #ns$er: 4,0,=,8
Rationa%e 1" The nurse cares for the family $y providing comfort assistance to the client%
Rationa%e 2" Jeeping the family informed a$out the client&s status and letting them now what changes indicate
impending death will help the family and client cope%
Rationa%e " Moderate to severe anxiety interferes with comprehension, learning, and memory%
Rationa%e !" *ersonal care should $e given to the client as any client5 clients wishes should $e respected%
Rationa%e /" Encouraging the client to ver$ali)e positive expectations for the future will eep the daily focus
positive%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 23
Type: MCMA
The nurse caring for the terminally ill client and the family collects data a$out loss and grieving during the
admission interview% +nformation important to collect includes"
*tandard Tet: Select all that apply%
1. *revious losses/amont, iedringhous, Comprehensive Nursing Care 0nd Edition 1pdate Test 2an
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2. Awareness of approaching loss
. ow grief was handled previously
!. Medications $eing taen for coping
/. istory of alcohol a$use
Corre"t #ns$er: 4,0,=,!
Rationa%e 1" Assessing previous loss is important to determine coping techni7ues%
Rationa%e 2" The level of awareness of the approaching loss is important when planning care and communicating
with caregivers%
Rationa%e " A history of previous difficulty with loss will assist the nurse in planning care for the client andfamily%
Rationa%e !" Jnowledge of the use of drugs, such as anxiolytics, will assist the nurse in caring for the client and
family%
Rationa%e /" Asing the client or family a$out alcohol a$use would not $e appropriate at the admission interview
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 21
Type: MCSA
#hen o$serving the terminally ill client and family are interacting, the nurse hears the client&s daughter say, -
when you get $etter, we&ll go shopping%. This is an example of
1. Closed awareness
2. 6pen pretense
. 6pen awareness
!. Mutual pretense
Corre"t #ns$er: !
Rationa%e 1" +n closed awareness, the client and family are unaware of impending death%
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Rationa%e 2" 6pen pretense is not a level of awareness%
Rationa%e " +n open awareness, the client and others now a$out the impending death, and feel comforta$lediscussing it even though it is difficult%
Rationa%e !" +n mutual pretense, the client, family, and health personnel now that the prognosis is terminal5
however they do not tal a$out it, and try not to raise the su$@ect%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 22
Type: MCMA
The hospice nurse is teaching the family of a terminally ill client the signs of approaching death, including
*tandard Tet: Select all that apply%
1. Loss of muscle tone
2. 2ounding pulse
. Decreased urinary output
!. oisy respirations
/. Sta$le $lood pressure
Corre"t #ns$er: 4,=,!
Rationa%e 1" Loss of muscle tone, including incontinence, constipation, nausea may $e a sign of approachingdeath%
Rationa%e 2" The pulse may $ecome slow, wea, or thready as death approaches%
Rationa%e " 1rinary output usually decreases as death approaches%
Rationa%e !" oisy respirations, decreased or irregular respirations may $e a sign of approaching death%
Rationa%e /" 2lood pressure may decrease as circulation slows%
&%o'a% Rationa%e:
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Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 2
Type: MCMA
The nurse identifies actions that may assist the family of the terminally ill client including"
*tandard Tet: Select all that apply%
1. Suggesting placement in a hospice unit instead of home care
2. Allowing family to visit ad li$
. /einforcing information that family mem$ers may not have a$sor$ed
!. /eorient the client who is hallucinating
/. As direct 7uestions a$out needs
Corre"t #ns$er: 0,=,!,8
Rationa%e 1" Clients and family wishes regarding hospice care need to $e respected%
Rationa%e 2" amily mem$ers should not $e limited to regular visiting hours%
Rationa%e " Moderate to severe anxiety that may $e part of confronting death interferes with comprehension,learning, and memory%
Rationa%e !" Dying clients may hallucinate, and this experience should $e treated with respect%
Rationa%e /" The nurse should not assume client or family needs5 direct 7uestions are the appropriate way to
determine needs%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 2!
Type: MCSA
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The ma@or nursing responsi$ility for clients who are dying is
1. To maintain the client&s comfort and dignity
2. To assist the client to a peaceful death
. To maintain a sense of hopefulness
!. To help the family accept the death
Corre"t #ns$er: 0
Rationa%e 1" Maintaining the client&s comfort and dignity is a nursing responsi$ility for all clients, including thedying person%
Rationa%e 2" Assisting the client to a peaceful death, using the Dying *erson&s 2ill of /ights as a guide%
Rationa%e " Maintaining a sense of hopefulness with the client helps the client to mae peace with their death $u
is not the ma@or nursing responsi$ility for the dying client%
Rationa%e !" The nurse assists the client and family in accepting the death, $ut is not the ma@or nursingresponsi$ility%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question 2/
Type: MCMA
The terminally ill client is crying as the family leaves the room% The nurse identifies the following nursing
diagnoses as liely reasons for the clients tears"
*tandard Tet: Select all that apply%
1. ear
2. opelessness
. *owerlessness
!. /is for Caregiver /ole Strain
/. Brieving
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Corre"t #ns$er: 4,0,=,8
Rationa%e 1" The client may fear $eing alone when the family leaves%
Rationa%e 2" The client may feel a sense of hopelessness at the terminal diagnosis%
Rationa%e " The client may feel powerless over the situation%
Rationa%e !" The client will not $e at ris for caregiver role strain5 the family is at ris%
Rationa%e /" The client may $e grieving the impending death, loss of health, leaving family5 these potential
reasons need to $e verified%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question 20
Type: MCMA
The nurse acnowledges and respects the terminal client&s right to approach death in his or her own way $y"
*tandard Tet: Select all that apply%
1. Active listening
2. Allowing the client to mae treatment decisions
. Allowing the client to maintain self>care duties as possi$le
!. Allowing the client to express emotions without @udgment
/. Telling the client that a positive attitude is more helpful than crying
Corre"t #ns$er: 4,0,=,!
Rationa%e 1" Active listing shows respect for the client&s feelings and actions%
Rationa%e 2" Allowing the client to mae treatment decisions will increase emotional comfort%
Rationa%e " Allowing the client to maintain self care activities as desired will maintain the dignity and autonomy
Rationa%e !" Active listening, and presencing will assist the client in retaining individuality and autonomy%
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Rationa%e /" /especting the client&s right to express emotions without expectations or @udgment includes allowinand encouraging the client to grieve impending or actual losses%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis)earning -ut"ome:
Question 27
Type: MCSA
The elderly wife of a hospice client has reported experiencing difficulty sleeping, and a decreased appetite% The
priority nursing diagnosis most liely to apply is
1. Brieving
2. ear
. /is for Caregiver /ole Strain
!. +nterrupted family process
Corre"t #ns$er: =
Rationa%e 1" The client may $e grieving, however this is not the priority diagnosis%
Rationa%e 2" The wife may $e afraid of the impending death, however this is not the priority diagnosis%
Rationa%e " The wife is reporting symptoms common to caregiver role strain%
Rationa%e !" The wife is not reporting symptoms that would point at this diagnosis%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis)earning -ut"ome:
Question 2
Type: MCMA
#hen planning care with clients who are confronting a loss or death, the nurse remem$ers to"
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*tandard Tet: Select all that apply%
1. Treat the client as a living human $eing until death
2. Allow the client to participate in decisions concerning care
. Assist the client with pain control
!. Discuss negative changes in the condition with the family so the client will maintain hope
/. Answer the client&s 7uestions honestly
Corre"t #ns$er: 4,0,=
Rationa%e 1" The client should $e cared for as all clients, with respect, compassion and competence%
Rationa%e 2" The client is a$le to mae decisions a$out ADLs, food choices, etc% in order to maintain dignity%
Rationa%e " The client has the right to $e free from pain%
Rationa%e !" All changes in condition need to $e discussed with the client first, if conscious%
Rationa%e /" Client 7uestions should $e answered honestly, even if the answers are difficult%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question 2
Type: MCMA
ursing interventions for the physiological needs of the client $y"
*tandard Tet: Select all that apply%
1. Administering pain medication
2. Assisting with ADLs
. orcing fluids
!. Allowing unlimited visitors
/. Maintaining respiratory status
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Corre"t #ns$er: 4,0,8
Rationa%e 1" elping the client to control pain is a $asic nursing intervention%
Rationa%e 2" Assisting with ADLs and position changes addresses the comfort needs of the client%
Rationa%e " 6ffering fluids, and supporting nutrition needs without pressure is an appropriate nursing
intervention%
Rationa%e !" Monitoring the client for sensory overload, including too many visitors, is a nursing intervention tha
meets the physiological needs of dying clients%
Rationa%e /" Maintaining respiratory status is a $asic nursing intervention%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
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Question 3
Type: MCMA
ursing interventions that are appropriate for supporting the client and family during the grieving process include
*tandard Tet: Select all that apply%
1. Encourage the family to participate in physical care of dying person
2. Tell children exactly what to expect when visiting
. Mae sure the client doesn&t have to mae any decisions
!. 1se communication techni7ues such as evaluating and analy)ing
/. 1se communication techni7ues such as 7uestioning, paraphrasing and clarifying
Corre"t #ns$er: 4,0,8
Rationa%e 1" Assisting the dying person may relieve anxiety and reduce the feeling of helplessness%
Rationa%e 2" +t may $e unsettling for a child to see an unresponsive person or loved one attached to medicale7uipment5 having information ahead of time will mae the situation less frightening%
Rationa%e " +nvolvement in decision maing is empowering and helps the client $egin to organi)e the
experience%
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Rationa%e !" Evaluating and analy)ing are less helpful in allowing clients to explore their own feelings%
Rationa%e /" These techni7ues, in addition to active and attentive listening, allow clients to explore their ownfeelings%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrityC%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 1
Type: MCSA
A client who was widowed 4? months ago is seen in the internal medicine office% She mentions that she started
crying when she came across a picture of her late hus$and% An appropriate response for the nurse would $e"
1. -+t seems to $e a long time for you to still $e crying% ave you considered counseling:.
2. -+t is very normal for anniversaries, pictures and holidays to trigger feelings of loss%.
. -Do you have a pet: *ets often can help people move on from a loss%.
!. -Are you eeping $usy: Gou need to develop new interests to eep from crying.
Corre"t #ns$er: 0
Rationa%e 1" This response does not acnowledge the client&s feelings%
Rationa%e 2" Events such as holidays and anniversaries can trigger painful feelings of loss, and are not indicativeof complicated grieving%
Rationa%e " This response does not acnowledge the client&s feelings%
Rationa%e !" This response does not acnowledge the clients feelings, and sends the message that crying is not
accepta$le%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
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Question 2
Type: MCMA
The family of the dying client ass the nurse if there are any complementary therapies that might help the client
with the fear and anxiety $eing experienced% The nurse explains the following complementary and alternative
medicine techni7ues as possi$ly helpful"
*tandard Tet: Select all that apply%
1. +maging
2. Medication
. *hysical therapy
!. Music
/. Meditation
Corre"t #ns$er: 4,!,8
Rationa%e 1" +maging is a techni7ues designed to replace unpleasant thoughts and feelings with positive ones%
Rationa%e 2" Medication is not a CAM therapy%
Rationa%e " *hysical therapy is not a CAM therapy%
Rationa%e !" Music therapy is classified under mind>$ody medicine, and may encourage relaxation and pain
relief%
Rationa%e /" Meditation and prayer are classified as mind>$ody medicine, and may encourage relaxation and painrelief%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question
Type: MCMA
The nurse explains the clinical signs of death for the client who is not on artificial life support as including"
*tandard Tet: Select all that apply%
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1. Cessation of apical pulse
2. Cessation of respirations
. Cessation of $lood pressure
!. Total lac of response to external stimuli
/. A$sence of electric currents from the $rain
Corre"t #ns$er: 4,0,=
Rationa%e 1" Traditional clinical signs of death included cessation of apical pulse%
Rationa%e 2" Traditional clinical signs of death included cessation of respirations%
Rationa%e " Traditional clinical signs of death included cessation of $lood pressure%
Rationa%e !" Total lac of response to external stimuli is included in the parameters for clinical death in the case
of the client having artificial means to maintain respiration and $lood%
Rationa%e /" A$sence of electric currents from the $rain are included in the clinical indications of death in the
case of the client having artificial means to maintain respiration and $lood%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *hysiological +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question !
Type: MCSA
The nurse explains the traditional clinical signs of death as $eing referred to as
1. 2rain death
2. eart>lung death
. Cere$ral death
!. Clinical death
Corre"t #ns$er: 0
Rationa%e 1" The traditional signs of death are not referred to as $rain death%
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Rationa%e 2" The traditional clinical signs of death are also referred to as heart>lung death%
Rationa%e " The traditional clinical signs of death are not referred to as cere$ral death%
Rationa%e !" The traditional clinical signs of death are not referred to as clinical death%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstandingC%ient Need: *hysiological +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question /
Type: MCSA
The nurse who wors with the organ donation team explains the definition of death prior to tissue harvesting as
$eing"
1. A$sence of reflexes
2. Total lac of response to external stimuli
. *resence of two EEBs showing no $rain activity
!. o voluntary muscular movement
Corre"t #ns$er: =
Rationa%e 1" A$sence of reflexes is an indication of clinical death $ut not an accepta$le indication of death%
Rationa%e 2" Total lac of response to external stimuli is not an accepta$le indication of death to proceed with
organ harvesting%
Rationa%e " The presence of two EEBs showing no $rain activity over 0!>hour period is re7uired $efore the
client may $e declared dead and organ or tissue donation process can $egin%
Rationa%e !" o voluntary muscular movement is not an accepta$le indication of death to proceed with organ
harvesting%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *hysiological +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
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Question 0
Type: MCSA
The nurse who holds $ac from clients emotionally is exhi$iting
1. *resencing
2. Distancing
. Summari)ing
!. Denial
Corre"t #ns$er: 0
Rationa%e 1" *resencing is the act of $eing availa$le and with clients%
Rationa%e 2" Distancing is an unconscious response of professionals in which they hold $ac emotionally from
clients, especially dying client%
Rationa%e " Summari)ing is a communication techni7ue to verify understanding of an interaction%
Rationa%e !" Denial is refusing to $elieve that the loss is happening%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 7
Type: MCSA
Caring for sic and dying clients without maintaining $alance in the nurse&s personal life puts the nurse at ris for
1. Depression
2. Distancing
. Compassion fatigue
!. Coping
Corre"t #ns$er: =
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Rationa%e 1" The nurse who cares for sic and dying clients is at ris for other emotional im$alance%
Rationa%e 2" Distancing is prevalent when the client is unaware of the diagnosis and can enhance loneliness andfear in the client%
Rationa%e " Compassion fatigue may occur if the nurse gives and gives without maintaining his or her own well
$eing%
Rationa%e !" Coping is a positive response%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question
Type: MCMA
Characteristics of nurses who successful care for clients in hospice include"
*tandard Tet: Select all that apply%
1. Discipline
2. Dedication
. Compassion
!. Distancing
/. *ower
Corre"t #ns$er: 4,0,=
Rationa%e 1" The nurse must $e a$le to prioriti)e care, and remem$er that client and family emotions are notdirected at the nurse, $ut at the loss%
Rationa%e 2" Caring for hospice clients and their families re7uires dedication to the process and the people, as the
end result is loss%
Rationa%e " The needs of the dying client and his or her family include emotional support, and allowing them toexpress feelings, as well as providing a calm presence%
Rationa%e !" Distancing may assist the nurse in staying unemotional, $ut is not the hallmar of a successful
hospice professional %
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Rationa%e /" *ower is not a characteristic of a hospice nurse%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question
Type: MCMA
ospice nurses who identify the $eginnings of compassion fatigue in their $ehavior can"
*tandard Tet: Select all that apply%
1. Attend memorial services for their clients
2. Allow themselves to cry
. Tae a leave of a$sence
!. Distance themselves from their clients
/. Tae a wal
Corre"t #ns$er: 4,0,8
Rationa%e 1" Attending services may assist nurses with closure for the loss%
Rationa%e 2" /ecogni)ing one&s grief is a healthy way do process loss%
Rationa%e " Taing a leave of a$sence does not assist in processing the grief%
Rationa%e !" Distancing from clients does not assist the client, and does not allow for emotional $alance in the
nurse&s life%
Rationa%e /" Taing care of oneself physically is a step towards $alance %
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
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Question !3
Type: MCMA
The nurse identifies the challenge of $eing a hospice nurse as including"
*tandard Tet: Select all that apply%
1. 2eing empathetic
2. 2eing mentally healthy
. 2eing spiritually healthy
!. 2eing professionally healthy
/. 2eing self>protective
Corre"t #ns$er: 4,0,=
Rationa%e 1" The nurse must $e empathetic with the client and family in order to assist them with death anddying%
Rationa%e 2" The nurse must $e mentally healthy, aware of sadness or depression in self in order to $e effectivewith the client and family%
Rationa%e " The nurse must $e aware of his or her own views a$out death and dying in order to affectively care
for the dying client and family%
Rationa%e !" *rofessional health is not one of the challenges for the hospice nurse%
Rationa%e /" Self>protection will not assist the nurse in caring for the dying client and family%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question !1
Type: MCSA
The nurse interacts with clients experiencing loss in a variety of settings, and understands that the most traumaticgrieving is usually associated with"
1. Loss of safety or freedom%
2. Divorce%
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. Empty nesting%
!. Loss of life as you have nown it%
Corre"t #ns$er: !
Rationa%e 1" #hen lives are affected $y civil or national strife, clients might grieve the loss of safety, freedom, o
democracy%
Rationa%e 2" Divorce is a situational loss of a valued relationship%
Rationa%e " Maturational loss, such as changing life roles, causes people to experience grief%
Rationa%e !" The most traumatic grieving is usually associated with the loss of one&s own life 'as you have nowit( or that of a loved one%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrityC%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !2
Type: MCSA
As the nurse counsels the parents of a child who has lost a si$ling, an appropriate comment would $e"
1. -Allowing children to decide how to participate in funerals will help them in the grieving process%.
2. -Children are permanently scarred $y loss%.
. -Children need to go to funerals to help them get over loss%.
!. -Children get over loss $est $y going to therapy%.
Corre"t #ns$er: 4
Rationa%e 1" Allowing children to mae decisions a$out participating in funerals will help them process the even
Rationa%e 2" Children are resilient, and will learn to live with the loss%
Rationa%e " Children might not need to go to the funeral to process the loss5 they should $e allowed to mae thedecision themselves%
Rationa%e !" Children and adolescents might process $est with a variety of approaches, such as play, art, dance,
and music%
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&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !Type: MCMA
The nurse understands that cultural and religious traditions and practices"
*tandard Tet: Select all that apply%
1. Should $e supported $y the healthcare team%
2. 6ften determine expression of grief%
. Encourage outward expressions of grief%
!. Are diverse in the 1nited States%
/. /e7uire individuali)ed care%
Corre"t #ns$er: 4,0,!,8
Rationa%e 1" Supporting these traditions comforts survivors%
Rationa%e 2" The customs of the culture help people cope with death, dying, and the grieving process%
Rationa%e " Expressions of grief vary from culture to culture, from stoic to demonstrative%
Rationa%e !" The 1nited States has a diverse num$er of cultures among $oth clients and nursing staff%
Rationa%e /" +ndividuali)ed care $y nurses ensures maximum support for clients and their families%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !!
Type: MCSA
The nurse woring with a group of students whose friend committed suicide distinguishes $etween the stages of
grief each student is exhi$iting% The nurse identifies a student as $eing in denial when she says"
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1. -She was so sad%.
2. -She ran away%.
. 9+f we tell you how we feel, can we leave:.
!. -+ don&t want to $e here%.
Corre"t #ns$er: 0
Rationa%e 1" +dentifying the sadness is a sign of acceptance%
Rationa%e 2" The client refuses to $elieve that the loss is happening%
Rationa%e " This is an example of $argaining%
Rationa%e !" The student who says something lie this is expressing anger%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !/
Type: MCMA
#hen leading a support group for clients who have lost a lim$, the nurse lists the following as elements in the
grief process"
*tandard Tet: Select all that apply%
1. ot everyone goes through the stages of grief in the same order%
2. 6nce a person experiences a stage of grief, he moves on to the next stage%
. The client can expect to reach the acceptance stage within ; months%
!. Counseling might $e necessary if the depression stage is not experienced within ; months%
/. The amount of time spent in each stage differs from person to person%
Corre"t #ns$er: 4,8
Rationa%e 1" Those experiencing grief will process the event in their own order%
Rationa%e 2" +ndividuals might move $ac and forth $etween stages%
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Rationa%e " *eople might need professional counseling if they do not experience the five stages within ; monthsof a grief event%
Rationa%e !" The depression stage needs to $e wored through as part of the grief process%
Rationa%e /" The grieving client will move $etween the stages of grief at his own pace%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !0
Type: MCMA
The nurse descri$es #olfelt&s mourner&s needs to a widow as including"
*tandard Tet: Select all that apply%
1. A support person who will encourage her to <get over& the grief 7uicly%
2. The need to allow oneself periods of time to feel the grief completely%
. The need to find reasons for going on with life%
!. The need to acnowledge the reality of the loved one&s death%
/. Maintaining a relationship with the deceased person as part of the past%
Corre"t #ns$er: 0,=,!,8
Rationa%e 1" Seeing mourning as something to -get over. leads to repression rather than resolution of grief%
Rationa%e 2" Allowing oneself to feel the pain followed $y periods of not dwelling on the grief will assist in
successful resolution of grief%
Rationa%e " The grieving person will need to create a new self>identity that does not include the deceased%
Rationa%e !" The grieving person needs to acnowledge the reality of the death in order to recover%
Rationa%e /" The mourner needs to maintain the relationship as part of the past in order to $e open to newexperiences in the future%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
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C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !7
Type: MCMA
A client is seen in the family practice clinic after losing 48 pounds ? months after the death of her mother% The
nurse 7uestions the client regarding the loss% #hich of the following reported $ehaviors might indicatecomplicated grieving:
*tandard Tet: Select all that apply%
1. Living in the past
2. Self>isolation
. Shoc
!. /ead@usting her routine
/. olding on to the grief
Corre"t #ns$er: 4,0,8
Rationa%e 1" A client who is not maing new memories $y ? months after the loss might $e at ris for
complicated grieving%
Rationa%e 2" The client who reports loss of interest in outside activities and relationships might $e experiencingcomplicated grieving%
Rationa%e " Shoc is usually experienced during the initial stages of grief%
Rationa%e !" The client who is read@usting her routine to incorporate the new reality is showing signs of
successful resolution of grief%
Rationa%e /" The client who is holding on to her grief ? months after the loss might $e experiencing complicatedgrieving%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ingC%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !
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Type: MCMA
#hen caring for clients who have experienced paralysis due to acute spinal cord in@ury, the nurse remem$ers thefollowing guidelines that might help those who are grieving"
*tandard Tet: Select all that apply%
1. Taling will help the mourner heal%
2. Brief can $ring mixed emotions%
. Brieving taes a great deal of energy%
!. Brief is a process%
/. *owerful surges of grief are dysfunctional%
Corre"t #ns$er: 4,0,=,!
Rationa%e 1" Taling with supportive others will help with the resolution of the grieving process%
Rationa%e 2" Brief can $ring feelings that might seem inappropriate5 the mourner needs to find listeners who will
accept feelings without @udgment%
Rationa%e " The mourner needs to rest and eat well>$alanced meals%
Rationa%e !" Brief is not an event5 it will tae time to resolve%
Rationa%e /" *owerful surges of grief are normal and natural%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question !
Type: MCSA
The nurse understands that the living will"
1. *rovides specific instructions a$out what medical treatment the client chooses to omit or refuse%
2. +s the same as a healthcare proxy%
. *rovides for a designated person to see that the client&s wishes are honored when the client no longer can spea
for him%
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!. /e7uires a physician&s order%
Corre"t #ns$er: 4
Rationa%e 1" The living will is referenced $efore C*/, intu$ation, or $reathing support is $egun, so that specificinstructions from the client are followed%
Rationa%e 2" A healthcare proxy is also nown as a dura$le power of attorney%
Rationa%e " A dura$le power of attorney provides for a designated person to see that the client&s wishes are
honored when the client no longer can spea for herself%
Rationa%e !" A do not resuscitate 'D/( order re7uires a physician order%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment)earning -ut"ome:
Question /3
Type: MCSA
#hen reviewing a client&s chart prior to $eginning care, the nurse notes a do not resuscitate order on file% Thisorder"
1. *revents the client from receiving anti$iotics%
2. *revents the client from receiving + fluids%
. *revents interventions the client does not wish to have performed when death approaches%
!. *revents surgery from $eing performed%
Corre"t #ns$er: =
Rationa%e 1" A D/ generally prevents resuscitation in the event of respiratory or cardiac arrest, $ut does not
prohi$it the administration of anti$iotics%
Rationa%e 2" The D/ would prevent C*/, $ut not + fluids, unless specified in a -comfort measures only.
order%
Rationa%e " The D/ generally prevents the initiation of resuscitation measures in the event of a respiratory or
cardiac arrest%
Rationa%e !" The D/ does not prevent surgery from $eing performed%
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&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question /1Type: MCMA
The hospice nurse is discussing indications of death with a client&s family% +ndications of clinical death include"
*tandard Tet: Select all that apply%
1. Total lac of response to external stimuli%
2. +na$ility to $reathe independently%
. A$sent reflexes%
!. o voluntary muscular movement%
/. +na$ility to open the eyes%
Corre"t #ns$er: 4,=,!
Rationa%e 1" Total lac of response to external stimuli is one clinical indication of death%
Rationa%e 2" +na$ility to $reathe independently is not a clinical indication of death $y itself%
Rationa%e " A$sent reflexes indicate destruction of $rain function%
Rationa%e !" Total lac of voluntary muscular movement is a clinical indication of death, especially when $reathing is a$sent%
Rationa%e /" +na$ility to open the eyes is not a clinical indication of death $y itself%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Analy)ing
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question /2
Type: MCSA
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A 4>year>old client is admitted to the Emergency Department after a severe motor vehicle accident% The client&sdriver&s license has an organ donation code specified% The nurse explains to the family that"
1. The client will have organs harvested within 0! hours%
2. The client must experience heartKlung death $efore organs can $e harvested%
. The client is too young to $ecome an organ donor%
!. The presence of two electroencephalograms showing no $rain activity over 0! hours is re7uired prior to
declaration of death%
Corre"t #ns$er: !
Rationa%e 1" The client will not have the organ donation process started without specific criteria $eing met%
Rationa%e 2" Specific criteria must $e met prior to the client&s $eing declared dead5 with artificial life support, the
client might not have heart>lung death%
Rationa%e " The client is of age to $ecome an organ donor%
Rationa%e !" The presence of two EEBs showing no $rain activity over 0! hours is re7uired $efore the client may $e declared dead and organ or tissue donation process can $egin%
&%o'a% Rationa%e:
Cogniti(e )e(e%: /emem$ering
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question /
Type: MCSA
The nurse notes the term palliative management on a client&s chart, and recogni)es that the treatment goal"
1. +s to let the client die peacefully%
2. +s to optimi)e 7uality of life%
. Depends on the results of tests%
!. +s to mae sure the client gets plenty of fluids to stay hydrated%
Corre"t #ns$er: 0
Rationa%e 1" *alliative care may $e instituted for clients who are not terminally ill%
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Rationa%e 2" The goal of palliative management is to optimi)e 7uality of life, providing relief from sufferingrather than curing a disease%
Rationa%e " Diagnostic tests and other invasive procedures are minimi)ed, unless they are liely to alleviate
symptoms, or provide information that will facilitate symptom management%
Rationa%e !" Clients eat if they are hungry and drin if they are thirsty5 feeding and fluids are not forced%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" *lanning
)earning -ut"ome:
Question /!
Type: MCMA
The home health nurse is explaining the principles of palliative care to the client and the family% These principles
include"
*tandard Tet: Select all that apply%
1. either hastening nor prolonging death%
2. 1se of heroic treatment measures is discouraged%
. *ain medication is given on a strict schedule%
!. The hopes and desires of the family are fulfilled as much as possi$le%
/. eeding and fluids are not forced%
Corre"t #ns$er: 4,0,8
Rationa%e 1" Death is regarded as a natural process that is not prolonged or hastened%
Rationa%e 2" The use of heroic measures is discouraged, with the client usually having a do not resuscitate orderin place%
Rationa%e " The client is the expert on whether pain is ade7uately relieved, and the right dose is the dose that
provides pain relief without unaccepta$le side effects%
Rationa%e !" Care is individuali)ed to meet the emotional, social, spiritual, and existential needs of the client%
Rationa%e /" The clients eat if they are hungry, and drin if they are thirsty5 food and fluids are not forced%
&%o'a% Rationa%e:
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Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" *lanning
)earning -ut"ome:
Question //
Type: MCSAAs the family of a client with a terminal illness weighs the options of future care, the nurse explains the differenc
$etween hospice care and palliative care as follows"
1. The focus of hospice care is to prolong life%
2. All hospice care is palliative, $ut not all palliative care is hospice%
. *alliative care is provided for terminally ill clients with a prognosis of ; months or less survival time%
!. ospice care is never provided in a hospital%
Corre"t #ns$er: 0
Rationa%e 1" The focus of hospice is to improve the 7uality of life, rather than to prolong it%
Rationa%e 2" *alliative care may $e provided to clients who are not terminal5 however, hospice is provided for
terminally ill clients, and incorporates the holistic concepts of palliative management%
Rationa%e " ospice care is provided for terminally ill clients with a prognosis of ; months or less survival time
Rationa%e !" ospice care can $e provided in many settings, including a hospital%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question /0
Type: MCMAThe nurse is reviewing the terminally ill client&s chart, and notes a referral for hospice care% Characteristics of
hospice care include"
*tandard Tet: Select all that apply%
1. Medicare pays an all>inclusive $enefit related to the terminal illness or symptom management%
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2. Care is delivered $y an interdisciplinary team%
. A nurse can mae a referral for hospice care%
!. Clients can have Medicare claims denied if they live longer than ; months%
/. ospice care can $e carried out in a variety of settings%
Corre"t #ns$er: 4,0,8
Rationa%e 1" Medicare pays an all>inclusive $enefit that provides the client with dura$le medical e7uipment and
all medication and treatment related to the terminal illness and symptom management%
Rationa%e 2" The interdisciplinary hospice team consists of the dying person, family and caregivers, physicians,nurses, aides, chaplains, social worers, $ereavement specialists, and volunteers%
Rationa%e " Entrance or admission into a hospice program re7uires a physician&s certification of terminal illness
Rationa%e !" Medicare claims are not denied as long as clients continue to meet the Medicare -conditions of
participation. in a hospice%
Rationa%e /" ospice care is commonly carried out in the client&s home or an extended care facility5 independenthospice and hospital>$ased palliative care units are $ecoming more widely availa$le%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question /7
Type: SEF
The hospice movement was founded in the 03th century% *lace the following in se7uence from earliest to mostrecent developments"
*tandard Tet: Clic and drag the options $elow to move them up or down%
Choi"e 1. Canadian *alliative Care Association
Choi"e 2. GaleKew aven ospital ospice
Choi"e . London hospice
Choi"e !. Medicare ospice $enefit
Corre"t #ns$er: !,0,4,=
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Rationa%e 1" The Canadian *alliative Care Association was founded in 44 to promote the hospice caremovement%
Rationa%e 2" Modern>day hospice came to the 1nited States in 4H! with the opening of a hospice unit at GaleK
ew aven ospital in Connecticut%
Rationa%e " The hospice movement was founded in London in 4;H%
Rationa%e !" The enactment of the Medicare ospice $enefit occurred in 4?=%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question /
Type: MCMAThe L*IL can provide care for the client and family when in hospice care $y"
*tandard Tet: Select all that apply%
1. *roviding comfort assistance%
2. Jeeping the family informed a$out the client&s status%
. /einforcing information that the family mem$ers might not have $een a$le to a$sor$%
!. Leaving the client alone, and not $othering her%
/. Encouraging the client to ver$ali)e positive expectations for the future%
Corre"t #ns$er: 4,0,=,8
Rationa%e 1" The nurse cares for the family $y providing comfort assistance to the client%
Rationa%e 2" Jeeping the family informed a$out the client&s status and letting them now what changes indicate
impending death will help the family and client cope%
Rationa%e " Moderate>to>severe anxiety interferes with comprehension, learning, and memory%
Rationa%e !" *ersonal care should $e given to the client, as any client wishes should $e respected%
Rationa%e /" Encouraging the client to ver$ali)e positive expectations for the future will eep the daily focus
positive%
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&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question /Type: MCMA
The nurse caring for the terminally ill client and the family collects data a$out loss and grieving during theadmission interview% +nformation important to collect includes"
*tandard Tet: Select all that apply%
1. *revious losses%
2. Awareness of approaching loss%
. ow grief was handled previously%
!. Medications $eing taen for coping%
/. istory of alcohol a$use%
Corre"t #ns$er: 4,0,=,!
Rationa%e 1" Assessing previous loss is important to determine coping techni7ues%
Rationa%e 2" The level of awareness of the approaching loss is important when planning care and communicating
with caregivers%
Rationa%e " A history of previous difficulty with loss will assist the nurse in planning care for the client and
family%
Rationa%e !" Jnowledge of the use of drugs, such as anxiolytics, will assist the nurse in caring for the client andfamily%
Rationa%e /" Asing the client or family a$out alcohol a$use would not $e appropriate at the admission interview
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
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Question 03
Type: MCSA
#hen o$serving the terminally ill client and family interacting, the nurse hears the client&s daughter say, -#hen
you get $etter, we&ll go shopping%. This is an example of"
1. Closed awareness%
2. 6pen pretense%
. 6pen awareness%
!. Mutual pretense%
Corre"t #ns$er: !
Rationa%e 1" +n closed awareness, the client and family are unaware of impending death%
Rationa%e 2" 6pen pretense is not a level of awareness%
Rationa%e " +n open awareness, the client and others now a$out the impending death, and feel comforta$lediscussing it even though it is difficult%
Rationa%e !" +n mutual pretense, the client, family, and health personnel now that the prognosis is terminal5however, they do not tal a$out it, and they try not to raise the su$@ect%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation)earning -ut"ome:
Question 01
Type: MCMA
The hospice nurse is teaching the family of a terminally ill client the signs of approaching death, including"
*tandard Tet: Select all that apply%
1. Loss of muscle tone%
2. 2ounding pulse%
. Decreased urinary output%
!. oisy respirations%
/. Sta$le $lood pressure%
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Corre"t #ns$er: 4,=,!
Rationa%e 1" Loss of muscle tone, including incontinence5 constipation5 and nausea can $e signs of approachingdeath%
Rationa%e 2" The pulse can $ecome slow, wea, or thready as death approaches%
Rationa%e " 1rinary output usually decreases as death approaches%
Rationa%e !" oisy, decreased, or irregular respirations can $e a sign of approaching death%
Rationa%e /" 2lood pressure can decrease as circulation slows%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 02
Type: MCMA
The nurse identifies actions that might assist the family of the terminally ill client, including"
*tandard Tet: Select all that apply%
1. Suggesting placement in a hospice unit instead of home care%
2. Allowing family to visit ad li$%
. /einforcing information that family mem$ers might not have a$sor$ed%
!. /eorienting the client who is hallucinating%
/. Asing direct 7uestions a$out needs%
Corre"t #ns$er: 0,=,!,8
Rationa%e 1" Client and family wishes regarding hospice care need to $e respected%
Rationa%e 2" amily mem$ers should not $e limited to regular visiting hours%
Rationa%e " Moderate>to>severe anxiety that can $e part of confronting death interferes with comprehension,
learning, and memory%
Rationa%e !" Dying clients can hallucinate, and this experience should $e treated with respect%
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Rationa%e /" The nurse should not assume client or family needs5 direct 7uestions are the appropriate way todetermine needs%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation)earning -ut"ome:
Question 0
Type: MCSA
The ma@or nursing responsi$ility for clients who are dying is"
1. To maintain the client&s comfort and dignity%
2. To assist the client to a peaceful death%
. To maintain a sense of hopefulness%
!. To help the family accept the death%
Corre"t #ns$er: 0
Rationa%e 1" Maintaining the client&s comfort and dignity is a nursing responsi$ility for all clients, including the
dying person%
Rationa%e 2" Assist the client to a peaceful death, using the Dying *erson&s 2ill of /ights as a guide%
Rationa%e " Maintaining a sense of hopefulness with the client helps the client to mae peace with his death $utis not the ma@or nursing responsi$ility for the dying client%
Rationa%e !" The nurse assists the client and family in accepting the death, $ut this is not the ma@or nursing
responsi$ility%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question 0!
Type: MCMA
The terminally ill client is crying as the family leaves the room% The nurse identifies the following nursingdiagnoses as liely reasons for the client&s tears"
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*tandard Tet: Select all that apply%
1. ear
2. opelessness
. *owerlessness
!. /is for Caregiver /ole Strain
/. Brieving
Corre"t #ns$er: 4,0,=,8
Rationa%e 1" The client might fear $eing alone when the family leaves%
Rationa%e 2" The client might feel a sense of hopelessness at the terminal diagnosis%
Rationa%e " The client might feel powerless over the situation%
Rationa%e !" The client will not $e at ris for caregiver role strain5 the family is at ris%
Rationa%e /" The client might $e grieving the impending death, loss of health, and leaving family5 these potential
reasons need to $e verified%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis)earning -ut"ome:
Question 0/
Type: MCMA
The nurse acnowledges and respects the terminal client&s right to approach death in her own way through"
*tandard Tet: Select all that apply%
1. Active listening%
2. Allowing the client to mae treatment decisions%
. Allowing the client to maintain self>care duties as possi$le%
!. Allowing the client to express emotions without @udgment%
/. Telling the client that a positive attitude is more helpful than crying%
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Corre"t #ns$er: 4,0,=,!
Rationa%e 1" Active listing shows respect for the client&s feelings and actions%
Rationa%e 2" Allowing the client to mae treatment decisions will increase emotional comfort%
Rationa%e " Allowing the client to maintain self>care activities as desired will maintain dignity and autonomy%
Rationa%e !" Active listening and presencing will assist the client in retaining individuality and autonomy%
Rationa%e /" /especting the client&s right to express emotions without expectations or @udgment includes allowin
and encouraging the client to grieve impending or actual losses%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question 00
Type: MCSA
The elderly wife of a hospice client has reported experiencing difficulty sleeping and a decreased appetite% The
priority nursing diagnosis most liely to apply is"
1. Brieving%
2. ear%
. /is for Caregiver /ole Strain%
!. +nterrupted amily *rocess%
Corre"t #ns$er: =
Rationa%e 1" The client might $e grieving5 however, this is not the priority diagnosis%
Rationa%e 2" The wife might $e afraid of the impending death5 however, this is not the priority diagnosis%
Rationa%e " The wife is reporting symptoms common to caregiver role strain%
Rationa%e !" The wife is not reporting symptoms that would point to this diagnosis%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
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C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question 07
Type: MCMA
#hen planning care with clients who are confronting a loss or death, the nurse remem$ers to"
*tandard Tet: Select all that apply%
1. Treat the client as a living human $eing until death%
2. Allow the client to participate in decisions concerning care%
. Assist the client with pain control%
!. Discuss negative changes in the condition with the family so the client will maintain hope%
/. Answer the client&s 7uestions honestly%
Corre"t #ns$er: 4,0,=
Rationa%e 1" The client should $e cared for as all clients are cared for, with respect, compassion, and competence
Rationa%e 2" The client is a$le to mae decisions a$out ADLs, food choices, etc% in order to maintain dignity%
Rationa%e " The client has the right to $e free from pain%
Rationa%e !" All changes in condition need to $e discussed with the client first, if conscious%
Rationa%e /" Client 7uestions should $e answered honestly, even if the answers are difficult%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Diagnosis
)earning -ut"ome:
Question 0
Type: MCMA
ursing interventions for the physiological needs of the client include"
*tandard Tet: Select all that apply%
1. Administering pain medication%
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2. Assisting with ADLs%
. orcing fluids%
!. Allowing unlimited visitors%
/. Maintaining respiratory status%
Corre"t #ns$er: 4,0,8
Rationa%e 1" elping the client to control pain is a $asic nursing intervention%
Rationa%e 2" Assisting with ADLs and position changes addresses the comfort needs of the client%
Rationa%e " 6ffering fluids and supporting nutrition needs without pressure are appropriate nursing
interventions%
Rationa%e !" Monitoring the client for sensory overload, including too many visitors, is a nursing intervention tha
meets the physiological needs of dying clients%
Rationa%e /" Maintaining respiratory status is a $asic nursing intervention%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 0Type: MCMA
ursing interventions that are appropriate for supporting the client and family during the grieving process include
*tandard Tet: Select all that apply%
1. Encourage the family to participate in the physical care of the dying person%
2. Tell children exactly what to expect when visiting%
. Mae sure the client doesn&t have to mae any decisions%
!. 1se communication techni7ues such as evaluating and analy)ing%
/. 1se communication techni7ues such as 7uestioning, paraphrasing, and clarifying%
Corre"t #ns$er: 4,0,8
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Rationa%e 1" Assisting the dying person can relieve anxiety and reduce the feeling of helplessness%
Rationa%e 2" +t might $e unsettling for a child to see an unresponsive person or loved one attached to medicale7uipment5 having information ahead of time will mae the situation less frightening%
Rationa%e " +nvolvement in decision maing is empowering, and helps the client $egin to organi)e the
experience%
Rationa%e !" Evaluating and analy)ing are less helpful in allowing clients to explore their own feelings%
Rationa%e /" These techni7ues, in addition to active and attentive listening, allow clients to explore their ownfeelings%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 73
Type: MCSA
A client who was widowed 4? months ago is seen in the internal medicine office% She mentions that she started
crying when she came across a picture of her late hus$and% An appropriate response for the nurse would $e"
1. -+t seems to $e a long time for you to still $e crying% ave you considered counseling:.
2. -+t is very normal for anniversaries, pictures, and holidays to trigger feelings of loss%.
. -Do you have a pet: *ets often can help people move on from a loss%.
!. -Are you eeping $usy: Gou need to develop new interests to eep from crying%.
Corre"t #ns$er: 0
Rationa%e 1" This response does not acnowledge the client&s feelings%
Rationa%e 2" Events such as holidays and anniversaries can trigger painful feelings of loss, and are not indicative
of complicated grieving%
Rationa%e " This response does not acnowledge the client&s feelings%
Rationa%e !" This response does not acnowledge the clients feelings, and sends the message that crying is notaccepta$le%
&%o'a% Rationa%e:
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Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 71
Type: MCMA
The family of the dying client ass the nurse whether there are any complementary therapies that might help theclient with the fear and anxiety the client is experiencing% The nurse explains the following complementary andalternative medicine techni7ues as potentially helpful"
*tandard Tet: Select all that apply%
1. +maging
2. Medication
. *hysical therapy
!. Music
/. Meditation
Corre"t #ns$er: 4,!,8
Rationa%e 1" +maging is a techni7ue designed to replace unpleasant thoughts and feelings with positive ones%
Rationa%e 2" Medication is not a CAM therapy%
Rationa%e " *hysical therapy is not a CAM therapy%
Rationa%e !" Music therapy is classified under mindK$ody medicine, and can encourage relaxation and pain relie
Rationa%e /" Meditation and prayer are classified as mindK$ody medicine, and can encourage relaxation and painrelief%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 72
Type: MCMA
The nurse lists the clinical signs of death for the client who is not on artificial life support, including"
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*tandard Tet: Select all that apply%
1. Cessation of apical pulse%
2. Cessation of respirations%
. Cessation of $lood pressure%
!. Total lac of response to external stimuli%
/. A$sence of electric currents from the $rain%
Corre"t #ns$er: 4,0,=
Rationa%e 1" Traditional clinical signs of death include cessation of apical pulse%
Rationa%e 2" Traditional clinical signs of death include cessation of respirations%
Rationa%e " Traditional clinical signs of death include cessation of $lood pressure%
Rationa%e !" Total lac of response to external stimuli is included in the parameters for clinical death in the case
of the client utili)ing artificial means to maintain respiration and $lood%
Rationa%e /" A$sence of electric currents from the $rain is included in the clinical indications of death in the case
of the client utili)ing artificial means to maintain respiration and $lood%
&%o'a% Rationa%e:
Cogniti(e )e(e%: Applying
C%ient Need: *hysiological +ntegrity
C%ient Need *u':Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question 7
Type: MCSA
The nurse reefers to the traditional clinical signs of death as"
1. 2rain death%
2. eartKlung death%
. Cere$ral death%
!. Clinical death%
Corre"t #ns$er: 0
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Rationa%e 1" The traditional signs of death are not referred to as $rain death%
Rationa%e 2" The traditional clinical signs of death are also referred to as heartKlung death%
Rationa%e " The traditional clinical signs of death are not referred to as cere$ral death%
Rationa%e !" The traditional clinical signs of death are not referred to as clinical death%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *hysiological +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question 7!
Type: MCSA
The nurse who wors with the organ donation team explains the definition of death prior to tissue harvesting as
$eing"
1. A$sence of reflexes%
2. Total lac of response to external stimuli%
. *resence of two EEBs showing no $rain activity%
!. o voluntary muscular movement%
Corre"t #ns$er: =
Rationa%e 1" A$sence of reflexes is an indication of clinical death $ut not an accepta$le indication of death fororgan harvesting%
Rationa%e 2" Total lac of response to external stimuli is not an accepta$le indication of death to proceed with
organ harvesting%
Rationa%e " The presence of two EEBs showing no $rain activity over a 0!>hour period is re7uired $efore theclient may $e declared dead and the organ or tissue donation process may $egin%
Rationa%e !" Lac of voluntary muscular movement is not an accepta$le indication of death to proceed with orga
harvesting%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *hysiological +ntegrity
C%ient Need *u':
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Nursing+ntegrated Con"epts: ursing *rocess" Assessment
)earning -ut"ome:
Question 7/
Type: MCSA
The nurse who holds $ac from clients emotionally is exhi$iting"
1. *resencing%
2. Distancing%
. Summari)ing%
!. Denial%
Corre"t #ns$er: 0
Rationa%e 1" *resencing is the act of $eing availa$le and with clients%
Rationa%e 2" Distancing is an unconscious response of professionals in which they hold $ac emotionally fromclients, especially dying clients%
Rationa%e " Summari)ing is a communication techni7ue to verify understanding of an interaction%
Rationa%e !" Denial is refusing to $elieve that the loss is happening%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 70
Type: MCSA
Caring for sic and dying clients without maintaining $alance in the nurse&s personal life puts the nurse at ris for
1. Depression%
2. Distancing%
. Compassion fatigue%
!. Coping%
Corre"t #ns$er: =
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Rationa%e 1" The nurse who cares for sic and dying clients is at ris for other emotional im$alance%
Rationa%e 2" Distancing is prevalent when the client is unaware of the diagnosis, and can enhance loneliness andfear in the client%
Rationa%e " Compassion fatigue can occur if the nurse gives and gives without maintaining her own well>$eing%
Rationa%e !" Coping is a positive response%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 77
Type: MCMA
Characteristics of nurses who successfully care for clients in hospice include"
*tandard Tet: Select all that apply%
1. Discipline%
2. Dedication%
. Compassion%
!. Distancing%
/. *ower%
Corre"t #ns$er: 4,0,=
Rationa%e 1" The nurse must $e a$le to prioriti)e care and remem$er that client and family emotions are not
directed at the nurse, $ut at the loss%
Rationa%e 2" Caring for hospice clients and their families re7uires dedication to the process and the people, as the
end result is loss%
Rationa%e " The needs of the dying client and his family include emotional support, and allowing them toexpress feelings, as well as providing a calm presence%
Rationa%e !" Distancing can assist the nurse in staying unemotional, $ut is not the hallmar of a successful
hospice professional %
Rationa%e /" *ower is not a characteristic of a hospice nurse%
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&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 7Type: MCMA
ospice nurses who identify the $eginnings of compassion fatigue in their $ehavior can"
*tandard Tet: Select all that apply%
1. Attend memorial services for their clients%
2. Allow themselves to cry%
. Tae a leave of a$sence%
!. Distance themselves from their clients%
/. Tae a wal%
Corre"t #ns$er: 4,0,8
Rationa%e 1" Attending services can assist nurses with closure for the loss%
Rationa%e 2" /ecogni)ing one&s grief is a healthy way to process loss%
Rationa%e " Taing a leave of a$sence does not assist in processing the grief%
Rationa%e !" Distancing from clients does not assist the client, and does not allow for emotional $alance in thenurse&s life%
Rationa%e /" Taing care of oneself physically is a step towards $alance%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrity
C%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
Question 7
Type: MCMA
The nurse identifies the challenges of $eing a hospice nurse as including"
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*tandard Tet: Select all that apply%
1. 2eing empathetic%
2. 2eing mentally healthy%
. 2eing spiritually healthy%
!. 2eing professionally healthy%
/. 2eing self>protective%
Corre"t #ns$er: 4,0,=
Rationa%e 1" The nurse must $e empathetic with the client and family in order to assist them with death and
dying%
Rationa%e 2" The nurse must $e mentally healthy, aware of sadness or depression in himself, in order to $e
effective with the client and family%
Rationa%e " The nurse must $e aware of his own views a$out death and dying in order to affectively care for the
dying client and family%
Rationa%e !" *rofessional health is not one of the challenges for the hospice nurse%
Rationa%e /" Self>protection will not assist the nurse in caring for the dying client and family%
&%o'a% Rationa%e:
Cogniti(e )e(e%: 1nderstanding
C%ient Need: *sychosocial +ntegrityC%ient Need *u':
Nursing+ntegrated Con"epts: ursing *rocess" +mplementation
)earning -ut"ome:
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