A client requests to die at home in a familiar setting, and hospice care is initiated.
Which initial action by a hospice nurse would best support family coping?
Coordinating care when and if the client needs to be readmitted to the hospital.
Provide 24-hour home care to meet the daily basic care needs of the client.
Telling the family about the bereavement visits made after the death of the client.
Explaining the roles of all interdisciplinary team members involved in hospice.
The Correct Answer is D
The scenario requires applying family systems theory and interdisciplinary communication principles within hospice care. Effective coping begins by clarifying the support structure available to the family, necessitating an understanding of how various professional roles function to alleviate the burden of end of life care.
Choice A rationale
Planning for hospital readmission contradicts the primary goal of hospice, which focuses on maintaining a comfortable home death. Focusing on hospitalization initially can create anxiety and undermine the family's confidence in managing the client's care at home.
Choice B rationale
Hospice typically provides intermittent visits rather than continuous 24-hour home care. Suggesting the nurse will meet all daily basic needs is unrealistic and provides false expectations, which can negatively impact the family's long-term ability to cope with caregiving.
Choice C rationale
While bereavement support is a standard component of hospice services, discussing post-death visits during the initial assessment is premature. Families need immediate support strategies and role clarity to manage the active dying process before focusing on aftercare services.
Choice D rationale
Clarifying the roles of the interdisciplinary team empowers the family by identifying specific resources for physical, emotional, and spiritual needs. This foundational knowledge reduces uncertainty, establishes a support network, and is the essential first step in facilitating effective coping.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Neurological posturing indicates severe brain injury and helps localize the level of damage. Applying knowledge of motor pathway dysfunction, specifically the corticospinal tract, is necessary to distinguish between flexion and extension patterns seen in comatose patients.
Choice A rationale
Decorticate posturing results from damage to the corticospinal tract above the red nucleus. It is characterized by adduction of the arms, internal rotation, and flexion at the elbows, wrists, and fingers, while legs are extended and internally rotated.
Choice B rationale
This description does not match a standard neurological posturing pattern. Rigidity and flexion are seen in decorticate posturing, but "back hunched over" and "supination" of arms are not typical descriptors for these specific upper motor neuron indicators.
Choice C rationale
Supination of the arms is not a component of pathological posturing. Both decorticate and decerebrate posturing typically involve some form of pronation or flexion. Dorsiflexion is also not standard, as plantar flexion is commonly seen in both.
Choice D rationale
This describes decerebrate posturing, which indicates more severe damage to the brainstem or midbrain. It is characterized by rigid extension of the arms and legs, pronation of the arms, and plantar flexion of the feet with outward rotation.
Correct Answer is A
Explanation
The nurse must apply knowledge of surgical decompression and wound care when explaining procedures to family members. Understanding how eschar restricts blood flow and how surgical incisions relieve pressure is critical for communicating the rationale behind life-saving interventions for severe burns.
Choice A rationale
An escharotomy involves making longitudinal incisions through the thick, leathery, necrotic eschar tissue. This relieves the pressure caused by edema in circumferential burns, restoring distal circulation and preventing compartment syndrome in the affected lower extremities.
Choice B rationale
Showering the client to remove dead tissue describes hydrotherapy or mechanical debridement. While this is part of routine burn care for wound cleansing, it does not address the circulatory emergency that necessitates a surgical escharotomy.
Choice C rationale
Grafting healthy skin onto a burned area is known as an autograft. This procedure is performed later in the recovery phase for wound closure and healing, not as an emergency measure to improve immediate limb circulation.
Choice D rationale
The use of specialized enzymes to remove dead tissue is enzymatic debridement. This chemical process is slower and is used to clean the wound bed, whereas an escharotomy is an immediate surgical intervention to restore perfusion..
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