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 C

Explanation

A. Sheriff: The sheriff is responsible for enforcing law and order within a specific jurisdiction and is not typically involved in investigating deaths unless there is suspected criminal activity.

B. Board of death: There is no standard entity known as the "Board of death" in the context of death investigations.

C. Coroner: The coroner is a public official responsible for investigating and determining the cause of deaths that occur under sudden, unexpected, suspicious, or unexplained circumstances. The coroner may conduct autopsies or order further investigations to ascertain the cause and manner of death.

D. Pathologist: A pathologist is a medical professional specializing in the study of disease processes through the examination of tissues and body fluids. While a pathologist may be involved in conducting autopsies and analyzing specimens, they typically work under the direction of the coroner or medical examiner in cases of suspicious deaths.

A. Get him out of bed for an hour in the morning and afternoon and for a short time (15 minutes) before bedtime so that he does not sleep all day and stay awake at night. B. Get him out of bed for 2 hours in the morning and afternoon and for a short time (15 minutes) before bedtime so that he does not sleep all day and Stay awake at night. C. Assess his strength and desire to get out of bed, but permit him to remain in bed if he chooses, because that is his position of comfort. D. Leave him in bed if he wishes, but have him do active exercises of his legs and arms to prevent further muscle weakness.

Correct Answer is C

Explanation

A. and B. Both options involve getting the patient out of bed for specified periods during the day to prevent excessive sleep during the day and wakefulness at night. However, these options may not align with the patient's preferences and comfort.

C. This option respects the patient's autonomy and acknowledges his preference to remain in bed due to feeling tired and weak. It also recognizes that comfort is a priority in end-of-life care. The nurse will assess the patient's strength and desire to get out of bed but will permit him to remain in bed if he chooses, as that is his position of comfort.

D. Leaving the patient in bed while encouraging active exercises may be physically demanding for the patient and may not be appropriate, especially considering the patient's terminal condition and desire to remain in bed.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is C

Explanation

A terminal patient in a skilled nursing home has stated that he does not want to get out of bed, because he is too tired and weak to sit in a chair. He sleeps on and off all day and night, his position is changed every 2 hours, and he is comfortable on his pain regimen. The next day the nurse will:

Correct Answer is C

Explanation

When the patient says, "l can die happily if I can live long enough to see my first grandchild that will be born next month." The nurse assesses that this patient is experiencing Kübler Ross's stage of:

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 in an acute care facility is caring for a preschool-age child who is terminally ill and receiving palliative care. The parents tell the nurse that they have decided to take their child home. Which of the following responses should the nurse make?

The examination of body organs and tissues after death is known as a/an:

The focus on quality of life issues is best implemented by:

Directions: Correlate the behavior with Kübler-Ross's stages of dying from the choices below. "I’ve had stomach problems for years. I don't have cancer."

When the nurse notes an increase in the level of daily function in the terminal patient, the nurse assesses that this patient has reached Kübler Ross's level of: