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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:

IV fluids or tube feeding would likely make the patient more uncomfortable, and dehydration has been shown to decrease pain and discomfort.

Once the patient is unconscious, his health care proxy can order IV fluids or tube feedings to prevent dehydration.

IV fluids or a tube feeding would make the patient much more comfortable, and they should try to talk him into accepting them.

dehydration is painful, and medication can be given to overcome any pain.

Answer and Explanation

The Correct Answer is A

A. This response aligns with best practices in hospice care, which prioritize comfort and quality of life for terminally ill patients. Dehydration is a common occurrence at the end of life and is generally not associated with discomfort when managed appropriately. IV fluids or tube feedings may cause discomfort, contribute to fluid overload, or lead to complications such as aspiration pneumonia.

B. While the healthcare proxy may have the authority to make decisions on behalf of the patient, the focus should be on honoring the patient's wishes as expressed in advance directives. If the patient has clearly indicated a preference against IV fluids or tube feedings in their advance directives, this should be respected.

C. Encouraging the family to try to talk the patient into accepting IV fluids or tube feedings goes against the principles of patient autonomy and informed decision-making. The decision regarding medical interventions should be based on the patient's preferences and comfort.

D. While dehydration can be uncomfortable in some circumstances, providing adequate symptom management, including pain medication, is essential in hospice care. However, IV fluids or tube feedings are not typically used to manage dehydration in patients who are at the end of life, as they may not improve comfort and can lead to complications.

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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. Make sure the provider has certified the client’s death B. Cleanse the body while adhering to body fluid precautions C. Attach identification tags to the body D. Verify client’s organ and tissue donation status E. Remove medical equipment from the client

Correct Answer is A,D,E,B,C

Explanation

Sequence of Steps:

A. Make sure the provider has certified the client’s death
D. Verify client’s organ and tissue donation status
E. Remove medical equipment from the client
B. Cleanse the body while adhering to body fluid precautions
C. Attach identification tags to the body

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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:

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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

A nurse is providing postmortem care for a client. Identify the sequence of steps the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Correct Answer is A,D,E,B,C

Explanation

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:

Breathing called the death rattle is characterized by

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

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?

A nurse is caring for a client who has a new diagnosis of chronic renal failure. The nurse should recognize which of the following client statements as an indication of anticipatory grief?

The emotional feeling of pain and loss is known as

The focus on quality of life issues is best implemented by: