Chapter 7--Palliative Care

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Chapter 7--Palliative Care MULTIPLE CHOICE 1. The nurse believes that a client is eligible as a participant for The National Hospice Reimbursement Act of 1986. This act mandated that: 1. clien ... ts with terminal illnesses are reimbursed. 2. a physician must order hospice to be reimbursed. 3. to receive reimbursement that client must be eligible for Medicare. 4. to receive benefits, the physician must certify that the client has a limited life expectancy of 6 months or less. PTS: 1 DIF: Analyze REF: History and Overview of Hospice Care 2. After a Native American client has died, the family begins the practice of purifying the body. The nurse realizes that the deceased client may stay with the family for what period of time? 1. 12 hours 2. 24 hours 3. 36 hours 4. 48 hours PTS: 1 DIF: Analyze REF: Table 7-1 Cultural Considerations Related to Dying 3. A client is receiving care for symptoms; however, the treatment will not alter the course of the disease. This client is receiving which type of care? 1. Hospital-based 2. Managed 3. Palliative 4. Therapeutic PTS: 1 DIF: Analyze REF: Overview of Palliative Care 4. A client diagnosed with a terminal illness is receiving an opioid/acetaminophen combination for pain control. The nurse realizes this client is being managed at which step of the World Health Organization approach to pain management? 1. Step 1 2. Step 2 3. Step 3 4. Step 4 PTS: 1 DIF: Analyze REF: Figure 7-2 Conceptual Model of Ladder Approach to Pain Management 5. A dying client is surrounded by family and friends at home. The hospice nurse talks with the spouse of the dying client to ensure that everything the family needs during this time is being done. The nurse is providing support to: 1. the client. 2. the bereaved. 3. ensure compliance with the hospice rules and regulations. 4. determine if the spouse understands that the client is dying. PTS: 1 DIF: Analyze REF: Role of the Hospice and Palliative Care Nurse 6. A client of the Hispanic culture is nearing death and the family requests that the client be prepared for discharge. The nurse realizes that the reason the family and client want to return home is because: 1. individuals within this culture do not trust hospital caregivers. 2. the family wants to have a spiritual healer care for the client. 3. it is bad luck to die in the hospital. 4. the spirit may get lost if the client dies in the hospital, and it will not be able to find its way home. PTS: 1 DIF: Analyze REF: Table 7-1 Cultural Considerations Related to Dying 7. During the period of time when a client diagnosed with a terminal illness became comatose, a health care proxy made decisions about the client’s care. When the client regained consciousness a few days later, the nurse consulted whom regarding the client’s ongoing care decisions? 1. The client 2. The health care proxy 3. The client’s family 4. The client’s physician PTS: 1 DIF: Apply REF: Ethics in Practice: Legal and Ethical Considerations Related to Dying 8. The nurse is concerned that the spouse of a terminally ill client is experiencing Anticipatory Grieving when which of the following is assessed? 1. Confidence in the ability to care for the ill client at home 2. Expressing anger about the client’s pending death and crying throughout the day 3. Large social support system 4. Knowledge of equipment function PTS: 1 DIF: Analyze REF: Nursing Diagnoses 9. The nurse administers additional intravenous medication to a hospice client with uncontrollable pain. After receiving the additional medication, the client demonstrates apneic periods and bradycardia. Which of the following does this nurse’s actions suggest? 1. Euthanasia 2. Assisted suicide 3. Double effect 4. Malpractice . PTS: 1 DIF: Analyze REF: Managing Pain 10. A client with a terminal illness was ingesting morphine sulfate 10 mg by mouth every 6 hours for pain. To ensure that the client receives the same degree of pain control when delivering the same medication through the intravenous route, which of the following should the nurse do? 1. Provide morphine sulfate 10 mg intravenous every 6 hours. 2. Provide morphine sulfate 20 mg intravenous every 4 hours. 3. Provide a different medication since morphine sulfate cannot be given through the intravenous route. 4. Consult a dose equivalent table to determine the dose of morphine sulfate the client will need through the intravenous route. PTS: 1 DIF: Apply REF: Managing Pain 11. A terminally ill client is experiencing nausea. Which of the following interventions can be used to help the client at this time? 1. Administer diphenhydramine (Benadryl) as prescribed. 2. Provide three regular meals. 3. Limit mouth care. 4. Restrict iced fluids. PTS: 1 DIF: Apply REF: Managing Loss of Appetite, Constipation, Nausea, and Vomiting 12. A terminally ill client is more alert and talkative, and she is requesting specific foods to eat. The nurse should caution the family regarding the client’s behavior because this could indicate: 1. total remission of the disease process. 2. final surprising rally before retreating. 3. the client is cured of the terminal illness. 4. the client was misdiagnosed. PTS: 1 DIF: Apply REF: Providing Care in the Active Phase of Dying 13. The nurse is concerned that a hospice client is approaching death when which of the following is assessed? 1. Respiratory rate 16 and regular 2. Blood pressure 110/60 mmHg 3. Restlessness, irritability, and anxiety 4. Periods of wakefulness are greater than periods of sleep PTS: 1 DIF: Analyze REF: Table 7-2 Physiology of Dying MULTIPLE RESPONSE 1. The nurse is discussing end-of-life wishes with a client and his family. Since the client is not sure of what type of care he wants, the nurse provides the document “Five Wishes” because this document provides which of the following types of information? (Select all that apply.) 1. What the client wants his loved ones to know 2. The level of comfort that the client wants 3. Comments and ideas for health care providers 4. The person designated by the client to make health care decisions 5. The kinds of medical treatment that the client wants or does not want 6. The way in which the client wants to be treated PTS: 1 DIF: Apply REF: Role of the Hospice and Palliative Care Nurse 2. The nurse is making a home visit to a client receiving hospice care. Which of the following symptoms will the nurse assess in the client during the visit? (Select all that apply.) 1. Aggression 2. Anxiety 3. Confusion 4. Depression 5. Increased appetite 6. Urinary continence PTS: 1 DIF: Apply REF: Assessment of the Patient Receiving Hospice and Palliative Care 3. The nurse, assessing pain in a client receiving hospice care, uses the ABCDE model to guide pain management. Which of the following is a part of this pain management approach? (Select all that apply.). 1. Ask about the pain regularly. 2. Believe the patient and family in their reports of pain. 3. Confront the patient if you believe pain control was not achieved. 4. Deliver interventions only when requested. 5. Enable the patient to control her course of pain management to the greatest extent possible. 6. Utilize complementary alternative medicine approaches first. PTS: 1 DIF: Apply REF: Box 7-2 ABCDE Guide to Pain Assessment 4. The nurse is providing a terminally ill client with morphine for pain control. In addition to this medication, which of the following can be provided to enhance analgesic effect? (Select all that apply.) 1. Antihypertensive 2. Antidepressant 3. Antibiotic 4. Antiemetic 5. Anticonvulsant 6. Corticosteroid PTS: 1 DIF: Apply REF: Managing Pain 5. A client with a terminal illness refuses pain medication. The nurse realizes that the client may decline pain medication for which of the following reasons? (Select all that apply.) 1. Fear that the pain means the disease is worse 2. Insufficient health plan benefits to pay for the medication 3. Cultural background prevents the use of pain medication 4. Fear of becoming addicted to pain medication 5. Fear of side effects 6. Concern about being labeled as a “bad” client PTS: 1 DIF: Analyze REF: Box 7-4 Barriers to Pain Management [Show More]

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