A nurse is assessing a patient who is in the active stage of dying.
What are the signs and symptoms of impending death? (Select all that apply)
Mottling of the skin in the lower extremities
Increased blood pressure
Cheyne-Stokes breathing
Warm, dry, and pink skin
Regular respiration
Correct Answer : A,C
Choice A rationale
Mottling of the skin, especially in the lower extremities, is a common sign of impending death. This is due to decreased blood flow and can be a sign that the body is starting to shut down.
Choice B rationale
This statement is incorrect. As a person nears death, their blood pressure typically decreases, not increases.
Choice C rationale
Cheyne-Stokes breathing, which is characterized by a pattern of increasing and decreasing respiration with periods of apnea, is a common symptom in the final stages of life.
Choice D rationale
This statement is incorrect. As a person nears death, their skin may become cool to the touch and may appear pale or mottled.
Choice E rationale
Regular respiration is not typically a sign of impending death. In fact, changes in breathing patterns, such as Cheyne-Stokes breathing, are more common.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Increasing fluid intake can help alleviate constipation. Fluids can soften stool, making it easier to pass.
Choice B rationale
A low-fiber diet can actually contribute to constipation. Fiber adds bulk to the stool and helps it move more quickly through the intestines.
Choice C rationale
While mineral oil can sometimes be used to relieve constipation, it is not typically the first intervention chosen. It can interfere with the absorption of certain nutrients and medications.
Choice D rationale
Cold fluids do not have a significant effect on constipation. While staying hydrated is important, the temperature of the fluids is not typically a factor in constipation.
Correct Answer is D
Explanation
Choice A rationale
Fairness refers to treating all people equally and making decisions without favoritism or prejudice. This is not the most fitting answer because the scenario does not provide information about the nurse treating all patients equally.
Choice B rationale
Confidence in nursing involves trust in one’s abilities and clinical judgment. Although confidence is important in all nursing actions, this scenario does not specifically highlight the nurse’s confidence.
Choice C rationale
Advocacy in nursing refers to the nurse’s role in standing up for the rights and needs of their patient. While notifying the provider could be seen as a form of advocacy, the nurse’s actions in this scenario are more closely aligned with accountability.
Choice D rationale
Accountability in nursing refers to the responsibility of nurses to execute their duties according to standards, being answerable for their actions. In this scenario, the nurse demonstrates accountability by acknowledging the medication error, assessing the patient for any adverse effects, and reporting the incident.
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