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 A

Explanation

A. Listening attentively when the client talks about the past allows the nurse to provide emotional support and validation for the client's feelings of grief. It demonstrates empathy and encourages the client to express their emotions, which can be therapeutic.

B. Telling the client that feelings of grief are a common problem of the aging population may invalidate the client's individual experience and minimize their feelings. Each person's experience of grief is unique, and acknowledging this is important for effective support.

C. Providing activities to distract the client from dwelling on the past may temporarily divert attention but does not address the underlying feelings of grief. Encouraging avoidance of emotions may hinder the client's ability to cope effectively.

D. Comparing the client's experience to that of younger clients who have experienced loss may not be helpful and could potentially minimize the significance of the client's feelings. It is important to focus on the individual client's experience and provide personalized support.

A. Advance directives B. Acceptance C. Hope D. Hospice

Correct Answer is D

Explanation

A. Advance directives: Advance directives are legal documents that allow individuals to specify their preferences for medical treatment and end-of-life care in advance. While advance directives can help ensure that individuals' wishes are respected, they do not directly address the focus on quality of life issues.

B. Acceptance: Acceptance involves coming to terms with the reality of a situation, including one's own mortality. While acceptance can contribute to overall well-being and peace of mind, it is not a comprehensive approach to addressing quality of life issues.

C. Hope: Hope can be an important factor in coping with illness and maintaining quality of life. However, hope alone is not sufficient for implementing a focus on quality of life issues.

D. Hospice: Hospice care is specifically designed to address the physical, emotional, and spiritual needs of individuals with terminal illnesses and their families. Hospice focuses on enhancing quality of life by providing comfort care, symptom management, and psychosocial support. It emphasizes dignity, respect, and compassion at the end of life, making it the best option for implementing a focus on quality of life issues.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an older adult client who expresses feelings of grief for his earlier life. Which of the following actions should the nurse take to help the client cope with his feelings of loss?

Correct Answer is A

Explanation

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

Correct Answer is D

Explanation

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."

The emotional feeling of pain and loss is known as

A nurse in an acute care facility is caring for a preschool-age child who is terminally ill and receiving palliative care. The parents tell the nurse that they have decided to take their child home. Which of the following responses should the nurse make?

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:

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:

When the patient says, "l can die happily if I can live long enough to see my first grandchild that will be born next month." The nurse assesses that this patient is experiencing Kübler Ross's stage of:

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 hospice nurse is caring for a client who is approaching death and has fecal incontinence. Which of the following actions should the nurse take?