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:

the patient has a doctor Who does not tell patients when they have a terminal illness.

the patient is in denial and is unable to consciously admit what he has been told by the doctor.

the patient needs to be told that he doesn’t have long to live so that he can make his final arrangements.

she will have to avoid all conversation that refers to his disease or symptoms so as not to increase his anxiety.

Answer and Explanation

The Correct Answer is B

A. This option assumes that the doctor does not inform patients about terminal illnesses, which may not necessarily be the case. It is more likely that the patient is in denial rather than the doctor not disclosing the diagnosis.

B. Denial is a common defense mechanism in response to distressing or overwhelming information. The patient's statement suggests denial of the terminal diagnosis despite being informed by the doctor. Denial allows individuals to avoid confronting the reality of their situation and can serve as a protective mechanism to cope with the emotional impact of the diagnosis.

C. While it may be important for the patient to have an understanding of their prognosis in order to make informed decisions and final arrangements, pushing the patient to accept the reality of their terminal illness before they are ready may not be helpful and can cause distress.

D. Avoiding conversation about the disease or symptoms may not address the underlying issue of denial and may hinder open communication between the patient and healthcare team. It is important for the nurse to provide support and opportunities for the patient to discuss their feelings and concerns about their illness, while also respecting their coping mechanisms.

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Correct Answer is E

Explanation

A. Anger: Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. The behavior described in the scenario does not express anger towards anyone or anything but rather attempts to negotiate or make deals in hopes of changing the outcome.

B. Acceptance: Acceptance involves coming to terms with the reality of the situation and finding peace with it. The behavior described does not indicate acceptance but rather a desire to alter the situation through bargaining.

C. Depression: Depression involves feelings of sadness, hopelessness, and despair. While the behavior described may indicate emotional distress, it is more reflective of bargaining rather than depression.

D. Denial: Denial is characterized by refusing to accept the reality of the situation. The behavior described involves acknowledging the situation but attempting to change it through bargaining, indicating a stage beyond denial.

E. Bargaining: Bargaining is a stage where individuals attempt to negotiate or make deals to change the outcome of a situation. The behavior described in the scenario, pleading in exchange for a desired outcome, aligns with the bargaining stage of Kübler-Ross's stages of dying.

A. Pooling of secretions B. Shallow breathing C. Tachypnea D. Apnea

Correct Answer is A

Explanation

A. Pooling of secretions: The term "death rattle" refers to the sound produced by the pooling of secretions in the throat or airway of a dying person. This accumulation of fluids creates a rattling or gurgling sound during breathing, which is characteristic of the death rattle.

B. Shallow breathing: Shallow breathing refers to breathing that is not deep or full. While shallow breathing may occur in dying individuals, it is not specific to the death rattle.

C. Tachypnea: Tachypnea refers to rapid or fast breathing. While tachypnea may occur in various medical conditions, it is not specific to the death rattle.

D. Apnea: Apnea refers to the cessation or absence of breathing. While apnea may occur in the dying process, it is not specific to the death rattle, which is characterized by the presence of breathing accompanied by the rattling sound caused by secretions.

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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:

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Naxlex Comprehensive Predictor Exams

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. pleads "If Mom will just be OK. I'll do my homework every day."

Correct Answer is E

Explanation

Breathing called the death rattle is characterized by

Correct Answer is A

Explanation

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. "She’ll soon be at peace"

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

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. Tells God: "If I quit smoking I can just live until after my daughter's wedding."

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 provides a back massage as palliative care to an unconscious client who is grimacing and restless. Which of the following indicates a therapeutic response? (Select all that apply.)

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

The nurse is aware that in order to provide effective support to grieving patients and families, the nurse must?