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 ["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.

A. "l can’t believe that doctor graduated from medical school! He doesn’t know a thing about treating cancer. B. "The doctor has been so good to me. know he has tried everything he can. It is just my time." C. "The doctor says I only have a few months to live, but know he is exaggerating to get me to take my medication,' D. "Even though I am not hurting right now, I don't feel like I have the energy to get Out Of bed."

Correct Answer is C

Explanation

A. "l can’t believe that doctor graduated from medical school! He doesn’t know a thing about treating cancer. This statement expresses frustration or disbelief towards the doctor's competence rather than denial of the terminal diagnosis.

B. "The doctor has been so good to me. know he has tried everything he can. It is just my time." This statement acknowledges the terminal nature of the illness and indicates acceptance rather than denial.

C. "The doctor says I only have a few months to live, but know he is exaggerating to get me to take my medication. This statement suggests denial by questioning the doctor's prognosis and attributing it to an ulterior motive, such as getting the patient to take medication. The client is unable to accept the reality of the limited life expectancy despite being informed by the doctor.

D. "Even though I am not hurting right now, I don't feel like I have the energy to get Out Of bed."

This statement reflects physical symptoms and lack of energy rather than denial of the illness.

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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 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 nurse is caring for a client who has been diagnosed with end-stage liver cancer. Which of the following statements by the client indicates that the client is in the denial phase of the grief process?

Correct Answer is C

Explanation

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

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:

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

A terminally ill patient is experiencing a great deal of dyspnea and noisy, "rattling" rapid respirations. The nurse administers morphine in a very small liquid or intramuscular dose. The purpose of this is to:

A dying patient who verbalizes that he “is ready” is indicating that he is in the following stage.

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:

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. Tells God: "If I quit smoking I can just live until after my daughter's wedding."