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 A

Explanation

A. Depression: The statement expresses feelings of hopelessness, which is characteristic of depression. Depression is a stage in Kübler-Ross's model where individuals may experience sadness, despair, and a sense of loss.

B. Anger: While hopelessness can sometimes lead to feelings of anger, the statement primarily conveys a sense of despair rather than anger towards the situation.

C. Bargaining: Bargaining involves attempting to negotiate or make deals to change the outcome of a situation. The statement does not suggest bargaining behavior.

D. Acceptance: Acceptance is characterized by coming to terms with one's impending death or loss. The statement does not indicate acceptance of the situation.

E. Denial: Denial is the initial stage where individuals refuse to accept the reality of their situation. The statement acknowledges the reality of the situation (Mom's condition) rather than denying it.

A. The respiratory rate increases B. The shoulders droop C. The facial muscles relax D. The client draws his legs up into a fetal position E. The pulse is within the expected range

Correct Answer is ["B","C","E"]

Explanation

A. The respiratory rate increasing may indicate discomfort or agitation rather than a therapeutic response to the massage.

B. The shoulders drooping may indicate relaxation, a release of tension and potentially improved comfort.

C. The relaxation of facial muscles indicates a therapeutic response to the back massage, as it suggests the client is experiencing relief from tension or discomfort.

D. Drawing the legs up into a fetal position may indicate discomfort or agitation rather than a therapeutic response to the massage.

E. The pulse remaining within the expected range suggests that the client is not experiencing undue stress or discomfort in response to the massage, indicating a therapeutic response.

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Naxlex Comprehensive Predictor Exams

Directions: Correlate the behavior with Kübler-Ross's stages of dying from the choices below. "l feel so hopeless about Mom's condition. "

Correct Answer is A

Explanation

A nurse provides a back massage as palliative care to an unconscious client who is grimacing and restless. Which of the following indicates a therapeutic response? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

Nurses may have a difficult time dealing with patient deaths if they

A patient tells the nurse during an admission interview that his wife "went on to her reward." The nurse assesses that this statement is an indication that the patient:

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:

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:

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

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. "I'm going after that company for using that chemical on the field next door. "

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

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."