A patient admitted to the nursing home for terminal care is determined that he should not receive extraordinary measures such as resuscitation or the use of a ventilator if he stops breathing, or intravenous (IV) fluids or a feeding tube if he is unable to eat or drink. The nurse explains that these desires can best be honored by:

informing his primary care provider of his desires.

filing an advance directive with the health care facility.

including these desires in his will.

signing a do-not-resuscitate/do-not-intubate (DNR}DNI) request.

Answer and Explanation

The Correct Answer is B

A. Informing his primary care provider of his desires: While it's important for the primary care provider to be aware of the patient's wishes, simply informing the provider may not ensure that these desires are respected in the event of a medical crisis. The primary care provider may not be immediately available during an emergency situation.

B. Filing an advance directive with the health care facility: This is the correct response. Advance directives allow individuals to specify their healthcare preferences in advance, including decisions about life-sustaining treatments such as resuscitation, ventilation, and artificial nutrition and hydration. Filing an advance directive ensures that the patient's wishes are documented and legally binding, providing guidance to healthcare providers in the event that the patient becomes unable to communicate or make decisions.

C. Including these desires in his will: While a will can address matters related to the distribution of assets and property after death, it typically does not cover healthcare decisions or preferences regarding end-of-life care. Healthcare preferences should be documented in an advance directive or similar legal document specifically designed for healthcare decisions.

D. Signing a do-not-resuscitate/do-not-intubate (DNR/DNI) request: While a DNR/DNI request specifies the patient's wishes regarding resuscitation and intubation, it may not cover other aspects of end-of-life care such as the use of IV fluids or feeding tubes. An advance directive provides a more comprehensive framework for expressing end-of-life care preferences beyond just resuscitation and intubation.

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Correct Answer is B

Explanation

A. This option assumes that the doctor does not inform patients about terminal illnesses, which may not necessarily be the case. It is more likely that the patient is in denial rather than the doctor not disclosing the diagnosis.

B. Denial is a common defense mechanism in response to distressing or overwhelming information. The patient's statement suggests denial of the terminal diagnosis despite being informed by the doctor. Denial allows individuals to avoid confronting the reality of their situation and can serve as a protective mechanism to cope with the emotional impact of the diagnosis.

C. While it may be important for the patient to have an understanding of their prognosis in order to make informed decisions and final arrangements, pushing the patient to accept the reality of their terminal illness before they are ready may not be helpful and can cause distress.

D. Avoiding conversation about the disease or symptoms may not address the underlying issue of denial and may hinder open communication between the patient and healthcare team. It is important for the nurse to provide support and opportunities for the patient to discuss their feelings and concerns about their illness, while also respecting their coping mechanisms.

A. Pooling of secretions B. Shallow breathing C. Tachypnea D. Apnea

Correct Answer is A

Explanation

A. Pooling of secretions: The term "death rattle" refers to the sound produced by the pooling of secretions in the throat or airway of a dying person. This accumulation of fluids creates a rattling or gurgling sound during breathing, which is characteristic of the death rattle.

B. Shallow breathing: Shallow breathing refers to breathing that is not deep or full. While shallow breathing may occur in dying individuals, it is not specific to the death rattle.

C. Tachypnea: Tachypnea refers to rapid or fast breathing. While tachypnea may occur in various medical conditions, it is not specific to the death rattle.

D. Apnea: Apnea refers to the cessation or absence of breathing. While apnea may occur in the dying process, it is not specific to the death rattle, which is characterized by the presence of breathing accompanied by the rattling sound caused by secretions.

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Naxlex Comprehensive Predictor Exams

When a patient admitted for terminal care is asked by the admitting nurse, "What has your doctor told you about your illness?" the patient states, "She says that I have a terminal illness, but I know she’s wrong." The nurse recognizes that:

Correct Answer is B

Explanation

Breathing called the death rattle is characterized by

Correct Answer is A

Explanation

The nurse can assess Cheyne-Stokes respiration by its characteristics of respirations that are:

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. pleads "If Mom will just be OK. I'll do my homework every day."

A nurse is assisting with teaching a class about the effects of spirituality for clients who are near the end of life. Which of the following information should the nurse include?

The type of grief that happens before the actual loss is known as:

A 33-year-old patient has been told that her disease is terminal. The patient is crying and states, "l will just be a dependent drain on my family. I hate being a burden to them." The nurse can best respond:

A nurse is caring for a client who has cancer and is receiving palliative care. Which of the following statements should the nurse identify as an indication that the client understands and accepts his prognosis?

The relief of symptoms when a cure is no longer possible is known as:

A death that occurs under suspicious circumstances should be reported to the