Ch11 Families In Palliative And End-Of-Life Full Test Bank

Chapter 11: Families in Palliative and End-of-Life Care

Multiple Choice:

1. The family of a client with a terminal illness hesitates to agree to palliative care because of not wanting to give up on a possible cure. How should the nurse respond while also including a principle of palliative care?

1. “Most people don’t realize that palliative care means there is no cure.”

2. “There will not be another opportunity if palliative care is refused now.”

3. “The client can continue to receive treatment intended to cure the disease.”

4. “Palliative care and curative treatments cannot be provided at the same time.”

2. The family of a client receiving palliative care for a terminal illness hesitate to call for the nurse because all staff seem to be too busy to address the client’s needs. Which action should the nurse take to improve the connection with the family?

1. Vary the number and type of caregivers who respond to the client’s needs.

2. Enter the room and stand or sit at the bedside to talk with the client and family.

3. Provide the family with reading material that explains the role of palliative care.

4. Attend to infusions and environmental issues while talking with the client and family.

3. The spouse of a client nearing death is concerned because the client’s breathing is “so noisy.” How should the nurse refer to the client’s respiratory status when talking with the spouse?

1. Pneumonia

2. Congestion

3. Death rattle

4. Fluid in the lungs

4. The family of a client nearing end of life asks if they can leave to get dinner. Which client observation causes the nurse to suggest that the family wait a while longer before leaving the client?

1. Cheyne-Stokes respiration pattern

2. Apneic periods of 15 to 30 seconds

3. Shallow respirations at 30 per minute

4. Use of neck and shoulder muscles to breathe

5. A client assigned to a student nurse for care dies shortly after the student completes morning care. What should the nurse do to support the student at this time?

1. Suggest that the student leave the clinical area.

2. Encourage the student to participate in postmortem care.

3. Talk with the student about the experience and answer any questions.

4. Assign the student to another client for the remainder of the clinical day.

Multiple Response:

6. The nurse helps the family decide whether a 13-year-old sibling should be present during the death of a younger brother. Which aspect should the nurse keep in mind when the family is making this decision? Select all that apply.

1. Hospital’s visiting hours policy

2. Reason for the child to be dying

3. Developmental age of the sibling

4. Quality of the relationship between the children

5. Cultural practices within the family regarding death and dying

7. The hospice nurse learns that the spouse of a client with end-stage Alzheimer’s disease has been the primary caregiver without assistance for the past 3 years. What are the risks to this spouse? Select all that apply.

1. Guilt

2. Depression

3. Ambivalence

4. Lack of personal care

5. Feelings of helplessness

8. An interprofessional team meeting is scheduled to discuss the care needs for a client with a terminal illness. What should the nurse expect when participating in this meeting? Select all that apply.

1. Control is centralized.

2. Client goals direct care.

3. Focus is on problem solving.

4. Client’s family can be in attendance.

5. Decisions are made by the team leader.

9. The nurse suspects that a client receiving palliative care is nearing end of life. What did the nurse assess to make this clinical determination? Select all that apply.

1. Sleeping more often

2. Refusing to eat

3. Inability to swallow

4. Asking to talk with a pastor

5. Talking with a deceased spouse

10. The nurse providing palliative care to a client with a terminal illness is experiencing moral distress. Which situation most likely caused the nurse to experience this emotional response? Select all that apply.

1. The nurse continues to provide chemotherapy to the client upon the family’s request.

2. The nurse is unable to relieve dyspnea because of a fear of overmedicating the client.

3. The team members decide to withhold routine fluids unless the client is thirsty.

4. Another health care provider suggested that another course of treatment might “do the trick.”

5. The adult children want everything possible done yet the client is exhausted and wants it to end.

11. The staff development trainer is preparing an educational program for nurses who provide palliative care. Which suggestion should the trainer make to encourage a trusting relationship between the nurse and family? Select all that apply.

1. Maintain a nonjudgmental approach when providing care.

2. Listen to the family’s experience with illness and suffering.

3. Acknowledge the strengths of the individual family members.

4. Encourage the family to take a break and permit the nurse to provide care.

5. Demonstrate compassion by showing an understanding of the family’s suffering.

12. Palliative care can begin as soon as there is a diagnosis of life-limiting illness. What principles of palliative care should guide nursing practice? Select all that apply.

1. The focus of palliative care is on supporting quality of life.

2. Education and support for the family is a high priority.

3. The interprofessional team is there to support the patient and family.

4. It is appropriate for palliative care to be delivered while curative treatments are also in place.

5. Bereavement care is a required component of caring for the family.

13. To provide optional palliative and end-of-life care, nurses need to be aware of their own assumptions and biases about dying and death. Why is it important for the nurse to perform self-reflection? Select all that apply.

1. It may be difficult for the nurse to be with a patient or family who have different beliefs or values than they do.

2. Nurses may feel uncomfortable when they encounter dying and death, no matter how much expertise they have developed.

3. It is important to perform reflection related to how nurses feel about the care settings where hospice is provided.

4. It is important for nurses to explore personal attitudes and assumptions to understand how those might influence their attitudes toward dying and death.

5. It is important to for nurses to explore their beliefs and understanding of the human condition.

14. Bereavement care is a significant component of the hospice plan of care. Which of the following statements about bereavement care are true? Select all that apply.

1. Bereavement support can be provided to any close friend or family member of the patient.

2. Bereavement support includes physical care of the patient.

3. Bereavement support continues to support the family after the death of the patient.

4. Bereavement care includes support and counseling from qualified bereavement experts.

5. Bereavement care may be a time when family members’ suffering increases due to grief.

15. A key principle of palliative care is patient and family-centered care and the awareness that every person has the right to define their family. Select the true statements that apply.

1. Every person has the right to decide who can be involved in their care planning.

2. This philosophy aligns with the concept of chosen family, or family of choice.

3. Chosen families may include partners, spouses, friends, and biological and adopted children.

4. Chosen family members are not required to have biological connections with the patients to participate in care planning.

5. The palliative care team prioritizes care of the patient and the family.