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:

the patient has a doctor Who does not tell patients when they have a terminal illness.

the patient is in denial and is unable to consciously admit what he has been told by the doctor.

the patient needs to be told that he doesn’t have long to live so that he can make his final arrangements.

she will have to avoid all conversation that refers to his disease or symptoms so as not to increase his anxiety.

Answer and Explanation

The Correct Answer is B

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.

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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.

A. informing his primary care provider of his desires. B. filing an advance directive with the health care facility. C. including these desires in his will. D. signing a do-not-resuscitate/do-not-intubate (DNR}DNI) request.

Correct Answer is B

Explanation

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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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is B

Explanation

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:

A terminally ill patient and his family have requested hospice care. The nurse clarifies hospice care philosophy as:

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

Breathing called the death rattle is characterized by

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

A terminally ill patient is angry and belligerent. He yells at the nurses and his family for not coming quickly enough when he calls, and he states that he isn't receiving the care he needs. The nurse's most informative response would be: