Health Care > EXAM > Palliative Care at End of Life Test Bank (All)
Palliative Care at End of Life Test Bank MULTIPLE CHOICE 1. The nurse cares for a terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Wh... ich action by the nurse would be most appropriate? a. Suction the patient. b. Administer oxygen via face mask. c. Place the patient in high Fowler’s position. d. Document the respirations as Cheyne-Stokes. ANS: D Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and rapid breaths. Cheyne-Stokes respirations are expected in the last days of life. There is also no need for supplemental oxygen by face mask or suctioning the patient. Raising the head of the bed slightly and/or turning the patient on the side may promote comfort. There is no need to place the patient in high Fowler’s position. DIF: Cognitive Level: Apply (application) REF: 142-143 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 2. The nurse cares for an adolescent patient who is dying. The patient’s parents are interested in organ donation and ask the nurse how the decision about brain death is made. Which response by the nurse is most appropriate? a. “Brain death occurs if a person is flaccid and unresponsive.” b. “If CPR is ineffective in restoring a heartbeat, the brain cannot function.” c. “Brain death has occurred if there is no breathing and certain reflexes are absent.” d. “If respiratory efforts cease and no apical pulse is audible, brain death is present.” ANS: C The diagnosis of brain death is based on irreversible loss of all brain functions, including brainstem functions that control respirations and brainstem reflexes. The other descriptions describe other clinical manifestations associated with death but are insufficient to declare a patient brain dead. DIF: Cognitive Level: Apply (application) REF: 142 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 3. A hospice patient is ma [Show More]
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