BIOLOGY 102 Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition CHAPTER 5

Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Priscilla LeMon

CHAPTER 5

Chapter 5

1. The hospice nurse is working with the family of a 30-year-old client who is dying. The client voices concerns about how her death will be perceived by her 7-year-old child. What advice from the nurse would be most beneficial? 

1. Advise the client that children that age emotionally distance themselves from the death.

2. Explain to the client that children of this age recognize death is permanent.

3. Encourage the client to begin to prepare the child by explaining that death is permanent, as the child fears separation, and might lack comprehension of permanent separation.

4. Advise the client that children at this age fear death.

2. A client has reported to the physician’s office with complaints of an inability to sleep at night. During the data collection, the client reports her estranged husband died a little over a year ago. She states “I am not sure why this is so difficult, I really couldn’t stand him near the end.” Which response by the nurse is most appropriate?

1. “You seem angry.”

2. “You should contact a therapist.”

3. “Sometimes a rocky relationship with someone at the time of their death can impact your ability to grieve.”

4. “You are just entering the grief process, things will get better.”

3. After suffering a massive cerebral hemorrhage, a client of American Indian descent is not expected to survive. The family arrives at the hospital. In conversation with the family, they report they observe most of their religious and cultural traditions. Which of the following interventions by the nursing staff would be most appropriate?

1. Offer the family a private room to sit together.

2. Discourage the family from sitting with their loved one prior to death.

3. Discuss the possibility of transferring the client home for the death.

4. Encourage the family to assist in the care of the dying client.

4. A competent elderly client has a living will. The living will expressed the desire to avoid resuscitation and heroic life support measures. The family members are not supportive of this directive. Which of the following actions by the nursing staff is most appropriate?

1. Contact the Social Services department.

2. Notify the hospital attorney.

3. Place the document on the chart.

4. Explain to the client that the conflict could invalidate the document.

5. At the time of admission, the client is asked if he has a healthcare directive. The client reports that his daughter will be allowed to make health-related decisions if he becomes incapacitated. Based upon your knowledge, the client has a/n:

1. Living will.

2. Healthcare surrogate.

3. Durable power of attorney.

4. Advanced directive.

6. While preparing for the discharge of an elderly, terminally ill client, the family asks for information concerning the most appropriate time to become involved with a hospice agency. What action by the nurse is most correct?

1. Assist the family with making contact with hospice at this time.

2. Determine the client’s expected life expectancy to gauge when the contact should be made.

3. Encourage the family to “hold off” making the contact until death is very close.

4. Determine what expectations the family has of the hospice agency.

7. The client is diagnosed with Huntington’s disease. While at a follow-up visit with the physician, the client breaks down and questions her ability to cope with the situation. What response by the nurse will be most beneficial to the client?

1. “You are certainly facing a difficult road ahead.”

2. “Unfortunately, your prognosis is bleak.”

3. “How have other members of your family coped with this diagnosis?”

4. “You should contact a support group.”

8. The client, age 20, dies after an unsuccessful resuscitation attempt. What nursing action is indicated first?

1. Notify the funeral home.

2. Document the time of death.

3. Contact the physician.

4. Contact the orderly for transport to the morgue.

9. The client has been diagnosed with chronic sorrow related to her husband’s recent diagnosis of terminal cancer. Which action by the nurse would be most helpful to the client?

1. Question the client about her knowledge of cancer treatment options.

2. Question the client about her husband’s prognosis.

3. Determine the means used by the client to cope with loss in the past.

4. Encourage the client to identify potential sources of emotional support.

10. A client hospitalized for diagnostic testing reports an intense fear of being found to have a terminal condition. What response by the nurse will be most therapeutic?

1. “There is no indication you are going to die.”

2. “I am not sure why you feel that way.”

3. “What has your doctor told you about your condition?”

4. “What types of symptoms lead you to feel this way?”

11. A group of students is attending an in-service about do-not-resuscitate orders. Which of the following statements by one of the students indicate the need for further teaching? Select all that apply.

1. “Do-not-resuscitate orders are a form of euthanasia.”

2. “My nursing license will not be in jeopardy if I follow do-not resuscitate orders.”

3. “If a client does not have completed do-not-resuscitate orders, I can just participate in a ‘slow code’.”

4. “Do-not-resuscitate orders may be rescinded if the client wishes.”