A patient who is terminally ill has been unable to maintain good nutrition because of nausea and anorexia and has lost a great deal of weight. He is now unable to change his position in bed and needs frequent perineal care because of urinary incontinence. The nurse planning his care would include in the plan of care to:

provide laxatives and stool softeners to prevent constipation.

provide him with an air pressure mattress

coax him to eat high-calorie, high-fat food.

contact the primary care provider for an order for tube feeding.

Answer and Explanation

The Correct Answer is B

Provide laxatives and stool softeners to prevent constipation (Option A): While constipation may be a concern for immobile patients, there is no indication in the scenario that the patient is currently experiencing constipation. Therefore, providing laxatives and stool softeners would not be a priority at this time.

Provide him with an air pressure mattress (Option B): This option is appropriate because the patient is immobile and at risk of developing pressure ulcers due to prolonged bed rest. An air pressure mattress helps distribute pressure evenly and reduces the risk of pressure ulcer formation, which is crucial for maintaining skin integrity and preventing complications.

Coax him to eat high-calorie, high-fat food (Option C): Although the patient is experiencing weight loss due to poor nutrition, coaxing him to eat high-calorie, high-fat food may not be appropriate if he is experiencing nausea and anorexia. This approach may exacerbate gastrointestinal symptoms and discomfort.

Contact the primary care provider for an order for tube feeding (Option D): While tube feeding may be considered if the patient is unable to meet his nutritional needs orally, it should not be the first intervention. Before considering tube feeding, other options for improving oral intake and addressing nausea and anorexia should be explored. Additionally, tube feeding may not address the patient's immobility and risk of pressure ulcers. Therefore, providing an air pressure mattress is a more appropriate intervention in this scenario.

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Correct Answer is E

Explanation

A. Anger: Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. The behavior described in the scenario does not express anger towards anyone or anything but rather attempts to negotiate or make deals in hopes of changing the outcome.

B. Acceptance: Acceptance involves coming to terms with the reality of the situation and finding peace with it. The behavior described does not indicate acceptance but rather a desire to alter the situation through bargaining.

C. Depression: Depression involves feelings of sadness, hopelessness, and despair. While the behavior described may indicate emotional distress, it is more reflective of bargaining rather than depression.

D. Denial: Denial is characterized by refusing to accept the reality of the situation. The behavior described involves acknowledging the situation but attempting to change it through bargaining, indicating a stage beyond denial.

E. Bargaining: Bargaining is a stage where individuals attempt to negotiate or make deals to change the outcome of a situation. The behavior described in the scenario, pleading in exchange for a desired outcome, aligns with the bargaining stage of Kübler-Ross's stages of dying.

A. Do not force the client to stay awake B. Administer pain medication by rectal or transdermal when client can no longer swallow C. Position the client on her side D. Offer to turn and reposition client every 2 hours

Correct Answer is ["A","B","C","D"]

Explanation

A. Do not force the client to stay awake: Palliative care focuses on providing comfort and dignity to the patient, and forcing the client to stay awake would not align with this goal. Allowing the client to rest as needed is essential for maintaining comfort during the end-of-life process.

B. Administer pain medication by rectal or transdermal when client can no longer swallow: As the client approaches death, they may lose the ability to swallow oral medications. Administering pain medication rectally or via transdermal patches ensures that the client continues to receive adequate pain relief even when oral intake is no longer possible.

C. Position the client on her side: Positioning the client on her side helps prevent aspiration if there is vomiting and promotes comfort by reducing pressure on bony prominences. This position also facilitates effective airway management and can help alleviate respiratory distress.

D. Offer to turn and reposition client every 2 hours: Turning and repositioning can help prevent pressure ulcers and maintain skin integrity, during the terminal stage of illness. The frequency of turning and repositioning may be adjusted based on the client's comfort and clinical condition.

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Naxlex Comprehensive Predictor Exams

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."

Correct Answer is E

Explanation

A nurse is providing palliative care to a client who is receiving hospice care and is approaching death. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

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 death that occurs under suspicious circumstances should be reported to the

A neighbor who was widowed 2 months ago gives the nurse his wife Helen's gardening books "because the two of you loved flowers." He tries to hold back tears, but begins to cry. To decrease his discomfort, the nurse should say:

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

A terminal patient asks the nurse if he could be given a deliberate overdose of medication that would "end this." According to the Code for Nurses, the nurse's most ethical response would be:

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

A hospice patient is unable to tolerate food or fluids and has advance directives that indicate that he does not want IV fluids or tube feedings if he is unable to take oral feedings. His family is concerned that he will be very uncomfortable without food or fluids. The nurse should tell them that: