A patient who is terminally ill has been unable to maintain good nutrition because of nausea and anorexia and has lost a great deal of weight. He is now unable to change his position in bed and needs frequent perineal care because of urinary incontinence. The nurse planning his care would include in the plan of care to:

provide laxatives and stool softeners to prevent constipation.

provide him with an air pressure mattress

coax him to eat high-calorie, high-fat food.

contact the primary care provider for an order for tube feeding.

Answer and Explanation

The Correct Answer is B

Provide laxatives and stool softeners to prevent constipation (Option A): While constipation may be a concern for immobile patients, there is no indication in the scenario that the patient is currently experiencing constipation. Therefore, providing laxatives and stool softeners would not be a priority at this time.

Provide him with an air pressure mattress (Option B): This option is appropriate because the patient is immobile and at risk of developing pressure ulcers due to prolonged bed rest. An air pressure mattress helps distribute pressure evenly and reduces the risk of pressure ulcer formation, which is crucial for maintaining skin integrity and preventing complications.

Coax him to eat high-calorie, high-fat food (Option C): Although the patient is experiencing weight loss due to poor nutrition, coaxing him to eat high-calorie, high-fat food may not be appropriate if he is experiencing nausea and anorexia. This approach may exacerbate gastrointestinal symptoms and discomfort.

Contact the primary care provider for an order for tube feeding (Option D): While tube feeding may be considered if the patient is unable to meet his nutritional needs orally, it should not be the first intervention. Before considering tube feeding, other options for improving oral intake and addressing nausea and anorexia should be explored. Additionally, tube feeding may not address the patient's immobility and risk of pressure ulcers. Therefore, providing an air pressure mattress is a more appropriate intervention in this scenario.

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Correct Answer is E

Explanation

A. Anger: Anger involves feelings of frustration, resentment, or hostility towards the situation or others. The statement does not express anger but rather a refusal to accept the possibility of a serious illness.

B. Depression: Depression is characterized by feelings of sadness, hopelessness, and despair. While the statement may reflect concern, it does not indicate depressive symptoms.

C. Acceptance: Acceptance is characterized by coming to terms with one's impending death or loss. The statement does not indicate acceptance of the possibility of having cancer.

D. Bargaining: Bargaining involves attempting to negotiate or make deals to change the outcome of a situation. The statement does not suggest bargaining behavior.

E. Denial: Denial is the initial stage where individuals refuse to accept the reality of their situation. The statement "I've had stomach problems for years. I don't have cancer." suggests a refusal to accept the possibility of having cancer despite ongoing health issues. Therefore, it correlates with denial.

A. "Bringing on your death in this manner would be a subject you should discuss with your family and primary care provider." B. "Let me have a while to consider your request." C. "I cannot ethically give you a deliberate overdose." D. "I can contact the primary care provider and request an order for a drug that could be used as you request"

Correct Answer is C

Explanation

"Bringing on your death in this manner would be a subject you should discuss with your family and primary care provider" (Option A): While discussing end-of-life wishes with family and healthcare providers is important, this response does not directly address the ethical issue at hand. It may be appropriate to encourage open communication and advance care planning, but administering a deliberate overdose is not ethically permissible.

"Let me have a while to consider your request" (Option B): Delaying a response to the patient's request for deliberate overdose could potentially lead to confusion and distress for the patient. Additionally, this response does not address the ethical concerns raised by the request.

"I cannot ethically give you a deliberate overdose" (Option C): This response aligns with the ethical principle of nonmaleficence, which obligates healthcare providers to avoid causing harm to patients. Administering a deliberate overdose to hasten death would violate this principle and go against the nurse's ethical obligations.

"I can contact the primary care provider and request an order for a drug that could be used as you request" (Option D): This response suggests a willingness to facilitate the patient's request for deliberate overdose, which is not ethically permissible. Administering a drug with the intention of ending a patient's life is contrary to the ethical principles of beneficence and nonmaleficence.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Directions: Correlate the behavior with Kübler-Ross's stages of dying from the choices below. "I’ve had stomach problems for years. I don't have cancer."

Correct Answer is E

Explanation

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:

Correct Answer is C

Explanation

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

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 emotional feeling of pain and loss is known as

A terminally ill patient and his family have requested hospice care. The nurse clarifies hospice care philosophy as:

A terminally ill patient is angry and belligerent. He yells at the nurses and his family for not coming quickly enough when he calls, and he states that he isn't receiving the care he needs. The nurse's most informative response would be:

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.)

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

An oncologist has recommended that a hospice patient receives palliative radiation to reduce the pain of bony metastases. The patient reacts with anger, saying, "l don't want any more treatments that don't cure my cancer!" The hospice nurse tells the patient that the use of radiation: