A nurse is assessing a patient who is in the active stage of dying.
What are the signs and symptoms of impending death? (Select all that apply)
Mottling of the skin in the lower extremities
Increased blood pressure
Cheyne-Stokes breathing
Warm, dry, and pink skin
Regular respiration
Correct Answer : A,C
Choice A rationale
Mottling of the skin, especially in the lower extremities, is a common sign of impending death. This is due to decreased blood flow and can be a sign that the body is starting to shut down.
Choice B rationale
This statement is incorrect. As a person nears death, their blood pressure typically decreases, not increases.
Choice C rationale
Cheyne-Stokes breathing, which is characterized by a pattern of increasing and decreasing respiration with periods of apnea, is a common symptom in the final stages of life.
Choice D rationale
This statement is incorrect. As a person nears death, their skin may become cool to the touch and may appear pale or mottled.
Choice E rationale
Regular respiration is not typically a sign of impending death. In fact, changes in breathing patterns, such as Cheyne-Stokes breathing, are more common.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Experiencing poverty can indeed be a source of chronic stress due to the ongoing hardships and struggles associated with financial instability. However, it is not typically classified as an example of acute stress, which is usually associated with a specific event or situation that causes a sudden and intense reaction.
Choice B rationale
Being a victim of a crime is a prime example of an acute stressor. This is because it is a specific event that can cause immediate emotional and physiological reactions. The individual may experience intense feelings of fear, shock, or distress, and these reactions typically occur immediately after the event.
Choice C rationale
Being part of a dysfunctional family can lead to chronic stress due to ongoing family conflicts, communication problems, or other issues. While specific incidents within the family context (like a heated argument) could potentially trigger acute stress responses, the overall experience of living in a dysfunctional family is more commonly associated with chronic stress.
Choice D rationale
Experiencing racism can lead to both acute and chronic stress. Acute stress might occur in response to a specific incident of racial discrimination, while chronic stress could result from living in a society where racism is pervasive. However, without a specific incident mentioned, it is less likely to be considered an example of acute stress compared to being a victim of a crime.
Correct Answer is A
Explanation
Choice A rationale
For a client with Parkinson’s disease who has difficulty swallowing or chewing due to muscle rigidity, semi-solid food with thick liquids can be easier to swallow and reduce the risk of choking.
Choice B rationale
Minced foods and fluid restriction may not provide the necessary nutrients and hydration for a client with Parkinson’s disease.
Choice C rationale
A low-residue diet, which is low in fiber, may not be appropriate for a client with Parkinson’s disease, as constipation is a common symptom of the disease and fiber can help alleviate this.
Choice D rationale
Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract. It is typically reserved for clients who cannot or should not get their nutrition through eating.
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