A client requests to die at home in a familiar setting, and hospice care is initiated.
Which initial action by a hospice nurse would best support family coping?
Coordinating care when and if the client needs to be readmitted to the hospital.
Provide 24-hour home care to meet the daily basic care needs of the client.
Telling the family about the bereavement visits made after the death of the client.
Explaining the roles of all interdisciplinary team members involved in hospice.
The Correct Answer is D
The scenario requires applying family systems theory and interdisciplinary communication principles within hospice care. Effective coping begins by clarifying the support structure available to the family, necessitating an understanding of how various professional roles function to alleviate the burden of end of life care.
Choice A rationale
Planning for hospital readmission contradicts the primary goal of hospice, which focuses on maintaining a comfortable home death. Focusing on hospitalization initially can create anxiety and undermine the family's confidence in managing the client's care at home.
Choice B rationale
Hospice typically provides intermittent visits rather than continuous 24-hour home care. Suggesting the nurse will meet all daily basic needs is unrealistic and provides false expectations, which can negatively impact the family's long-term ability to cope with caregiving.
Choice C rationale
While bereavement support is a standard component of hospice services, discussing post-death visits during the initial assessment is premature. Families need immediate support strategies and role clarity to manage the active dying process before focusing on aftercare services.
Choice D rationale
Clarifying the roles of the interdisciplinary team empowers the family by identifying specific resources for physical, emotional, and spiritual needs. This foundational knowledge reduces uncertainty, establishes a support network, and is the essential first step in facilitating effective coping.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This clinical presentation requires applying knowledge of Monro-Kellie doctrine and neurological assessment. Understanding how space-occupying lesions like brain tumors affect intracranial dynamics is vital for identifying life-threatening shifts in pressure that manifest as headache, projectile vomiting, and mental status changes.
Choice A rationale
Migraine headaches typically present with unilateral throbbing pain and photophobia but rarely cause sudden, severe altered consciousness in this context. While painful, they do not explain the acute neurological decline associated with a known intracranial tumor.
Choice B rationale
Dehydration usually presents with tachycardia, poor skin turgor, and hypotension. While it can cause lightheadedness or confusion in extreme cases, it does not typically cause the sudden onset of a severe headache and vomiting seen in neurological emergencies.
Choice C rationale
Increased intracranial pressure results from the tumor mass or associated edema. It compresses brain tissue and blood vessels, leading to the classic triad of headache, vomiting, and altered consciousness, signaling a potential brain herniation and neurological crisis.
Choice D rationale
A gastric ulcer causes epigastric pain and potentially hematemesis if perforated. While vomiting may occur, it is unrelated to sudden neurological changes or severe headaches. This diagnosis fails to address the primary intracranial pathology and accompanying mental deficits.
Correct Answer is A
Explanation
Chest tube management for pneumothorax involves monitoring for clinical complications and system patency. This scenario requires applying knowledge of respiratory emergencies, specifically recognizing signs of tension pneumothorax, which is a life threatening complication characterized by shifting of thoracic structures.
Choice A rationale
Tracheal deviation toward the unaffected side signifies a tension pneumothorax. This occurs when intrapleural pressure increases significantly, causing a mediastinal shift that compresses the heart and opposite lung, requiring immediate needle decompression or chest tube adjustment by providers.
Choice B rationale
Eyelets are the drainage holes at the end of the chest tube. If they are not visible, it indicates the tube is correctly positioned within the pleural space. Visible eyelets would suggest the tube has partially dislodged.
Choice C rationale
Crepitus, or subcutaneous emphysema, is a common finding where air leaks into subcutaneous tissues around the insertion site. While it should be monitored and documented, it generally does not require emergency provider notification unless it rapidly expands.
Choice D rationale
Intermittent bubbling in the water seal chamber during exhalation or coughing is expected in a patient with a pneumothorax. It indicates that air is successfully being evacuated from the pleural space into the drainage system.
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