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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:

"Bringing on your death in this manner would be a subject you should discuss with your family and primary care provider."

"Let me have a while to consider your request."

"I cannot ethically give you a deliberate overdose."

"I can contact the primary care provider and request an order for a drug that could be used as you request"

Answer and Explanation

The Correct Answer is C

"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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Correct Answer is B

Explanation

A. Final: This option does not correspond to any stage of the grieving process or Kubler-Ross's stages of dying.

B. Acceptance: In Kubler-Ross's stages of dying, acceptance is the final stage. When a dying patient verbalizes that they are "ready," it suggests they have reached a level of acceptance regarding their impending death.

C. Bargaining: Bargaining is a stage where individuals attempt to negotiate or make deals to change the outcome of their situation. It typically occurs before acceptance in the stages of dying.

D. Denial: Denial is one of the initial stages where individuals refuse to accept the reality of their situation. It does not correspond to a dying patient indicating they are "ready."

A. IV fluids or tube feeding would likely make the patient more uncomfortable, and dehydration has been shown to decrease pain and discomfort. B. Once the patient is unconscious, his health care proxy can order IV fluids or tube feedings to prevent dehydration. C. IV fluids or a tube feeding would make the patient much more comfortable, and they should try to talk him into accepting them. D. dehydration is painful, and medication can be given to overcome any pain.

Correct Answer is A

Explanation

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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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is B

Explanation

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:

Correct Answer is A

Explanation

Breathing called the death rattle is characterized by

Nurses may have a difficult time dealing with patient deaths if they

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:

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."

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. "I'm going after that company for using that chemical on the field next door. "

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