Chapter 17 End-of-Life Care

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Chapter 17  End-of-Life Care

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. In the past three to four decades, nursing has moved into the forefront in providing care for the dying. Which phenomenon has lead to this increased focus by nursing on the care of the dying?
A) Decreased publicity surrounding life-threatening illness

B) Focus of health care providers on prevention C) Larger number of people dying in the hospital D) Demographic changes in the population

Ans: D
Chapter: 17
Client Needs: D-1
Cognitive Level: Comprehension
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 1
Page and Header: 396, Nursing and End-of-Life Care

Feedback: The focus on care of the dying has been motivated by the aging population and the prevalence of and publicity surrounding life-threatening illness, such as cancer and AIDS. This makes option A incorrect. Option B is incorrect because prevention is only one focus of the

nursing profession, and it is not a phenomenon. Option C is incorrect; nowhere in the scenario does it cite a larger number of people dying in the hospital.

2. Ethical issues have been raised within hospitals regarding patient care. Ethical committees have been formed to address these numerous ethical issues. As health care professionals, nurses are often members of these ethical committees. What issue has raised the most troubling ethical issues?

A) The increase in cultural diversity
B) Staffing shortages in health care and questions concerning quality of care C) The increased cost of health care
D) The ability of technology to prolong life beyond meaningful quality of life

Ans: D
Chapter: 17
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Page and Header: 396, Nursing and End-of-Life Care

Feedback: The application of technology to prolong life has raised several ethical issues. The major question is, Because we can prolong life through increasingly sophisticated technology, does it necessarily follow that we must do so? Technologic advances have prolonged life for many. The ability of technology to prolong life beyond the point that some would consider meaningful has raised some troubling ethical issues. Option A is incorrect; the increase in cultural diversity has not raised ethical issues in health care. Option B is incorrect; the ethical issue here is, how many patients can we provide optimal care for with a less-than-optimal number of staff? This is not the most troubling ethical issue we face. Option C is incorrect; the increased cost of health care is definitely an issue in today’s health care arena, but it is not the most troubling ethical issue we face.

3. You are caring for a patient who has been recently diagnosed with a terminal disease. This patient refuses to accept the diagnosis and refuses to comply with treatment. What is the psychosocial purpose of this strategy?
A) The patient is trying to protect loved ones from the emotional effects of the illness.

B) The patient is being noncompliant.
C) The patient is afraid of treatment.
D) The patient understands that treatment will have no benefit.

Ans: A
Chapter: 17
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 9
Page and Header: 397, Nursing and End-of-Life Care

Feedback: Patients who are characterized as being in denial may be using this strategy to preserve important interpersonal relationships, to protect others from the emotional effects of their illness, and to protect themselves because of fears of abandonment. Option B is incorrect; yes, the patient is being noncompliant, but this option does not answer the question being asked. Option C is incorrect; the patient may be afraid of treatment; however, this does not answer the question being asked. Option D is incorrect; a patient in denial would not fully understand that treatment will have no benefit.

4. Assisted suicide is expressly prohibited under statutory or common law in the overwhelming majority of states. Yet public support for physician-assisted suicide has resulted in a number of state ballot initiatives. The issue of assisted suicide is opposed by nursing and medical organizations as a violation of the ethical traditions of nursing and medicine. Which of the following would be an example of assisted suicide?

A) Administering a lethal dose of medication
B) Administering a morphine infusion
C) Granting a patient’s request not to initiate enteral feeding when the patient is unable to eat D) Neglecting to resuscitate a patient with a “do not resuscitate” status

Ans: A
Chapter: 17
Client Needs: D-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Page and Header: 398, Nursing and End-of-Life Care

Feedback: Assisted suicide refers to providing another person the means to end his or her own life. This is not to be confused with the ethically and legally supported practices of withholding or withdrawing medical treatment in accordance with the wishes of the terminally ill individual. Options B, C, and D are incorrect answers as they do not fit the definition of assisted suicide.

5. You are the nurses giving palliative care to a patient with a diagnosis of COPD. What is the goal of palliative care?
A) To improve the patient’s and family’s quality of life
B) To support aggressive treatment for cure

C) To provide physical support for the patient
D) To help the patient develop a separate plan with each discipline of the health care team

Ans: A
Chapter: 17
Client Needs: D-1
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Caring
Objective: 2
Page and Header: 398, Settings for End-of-Life Care

Feedback: The goal of palliative care is to improve the patient’s and the family’s quality of life. The support should include the patient’s physical, emotional, and spiritual well-being. Each discipline should contribute to a single care plan that addresses the needs of the patient and family. Options B, C, and D are incorrect; the goal of palliative care is not aggressive support for curing the patient. Providing physical support for the patient is also not the goal of palliative care. Palliative care does not strive to achieve separate plans of care developed by the patient with each discipline of the health care team.

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