End-Of-Life Care, Family Support - NCLEX-PN
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Which opioid adverse effect requires routine prevention in end-of-life care?
Which opioid adverse effect requires routine prevention in end-of-life care?
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Constipation. Opioids commonly cause constipation due to slowed gastrointestinal motility, necessitating prophylactic measures like stool softeners.
Constipation. Opioids commonly cause constipation due to slowed gastrointestinal motility, necessitating prophylactic measures like stool softeners.
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What is the best nursing action to relieve dry mouth in a dying patient?
What is the best nursing action to relieve dry mouth in a dying patient?
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Provide frequent oral care and moisten lips and mucosa. Dry mouth in dying patients results from dehydration or medications, and regular hydration and care prevent discomfort and complications.
Provide frequent oral care and moisten lips and mucosa. Dry mouth in dying patients results from dehydration or medications, and regular hydration and care prevent discomfort and complications.
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Which intervention is most appropriate for dyspnea at end of life?
Which intervention is most appropriate for dyspnea at end of life?
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Position upright and give prescribed opioids and oxygen as ordered. Dyspnea management focuses on reducing air hunger through positioning and pharmacological support to enhance comfort.
Position upright and give prescribed opioids and oxygen as ordered. Dyspnea management focuses on reducing air hunger through positioning and pharmacological support to enhance comfort.
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Which medication class is commonly used to reduce terminal secretions?
Which medication class is commonly used to reduce terminal secretions?
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Anticholinergics (for example, glycopyrrolate or scopolamine). Anticholinergics dry up excessive secretions by blocking acetylcholine, commonly used to manage noisy breathing in terminal phases.
Anticholinergics (for example, glycopyrrolate or scopolamine). Anticholinergics dry up excessive secretions by blocking acetylcholine, commonly used to manage noisy breathing in terminal phases.
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What is the best nursing response to the “death rattle” in a dying patient?
What is the best nursing response to the “death rattle” in a dying patient?
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Reposition and provide oral suction only if secretions are in the mouth. The death rattle is caused by accumulated secretions; interventions minimize distress without invasive measures unless necessary.
Reposition and provide oral suction only if secretions are in the mouth. The death rattle is caused by accumulated secretions; interventions minimize distress without invasive measures unless necessary.
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Which change in breathing pattern is common near death and may include apnea?
Which change in breathing pattern is common near death and may include apnea?
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Cheyne–Stokes respirations. Cheyne-Stokes breathing reflects central nervous system changes near death, characterized by cycles of deep breaths and apnea.
Cheyne–Stokes respirations. Cheyne-Stokes breathing reflects central nervous system changes near death, characterized by cycles of deep breaths and apnea.
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Which action best supports patient autonomy when discussing end-of-life choices?
Which action best supports patient autonomy when discussing end-of-life choices?
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Provide clear information and honor the patient’s informed decisions. Autonomy respects the patient's right to self-determination, ensuring decisions are based on accurate information and consent.
Provide clear information and honor the patient’s informed decisions. Autonomy respects the patient's right to self-determination, ensuring decisions are based on accurate information and consent.
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What does a Do-Not-Resuscitate (DNR) order direct the nurse to withhold?
What does a Do-Not-Resuscitate (DNR) order direct the nurse to withhold?
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CPR and advanced resuscitation if cardiac or respiratory arrest occurs. A DNR order specifies withholding resuscitative efforts to align with patient wishes against prolonging suffering.
CPR and advanced resuscitation if cardiac or respiratory arrest occurs. A DNR order specifies withholding resuscitative efforts to align with patient wishes against prolonging suffering.
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Which treatment is still appropriate for a patient with a DNR order?
Which treatment is still appropriate for a patient with a DNR order?
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Comfort measures and medically indicated treatments not involving CPR. DNR orders limit only resuscitation, allowing other interventions to maintain comfort and treat symptoms.
Comfort measures and medically indicated treatments not involving CPR. DNR orders limit only resuscitation, allowing other interventions to maintain comfort and treat symptoms.
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What is the nurse’s first action when a family asks to stop life support?
What is the nurse’s first action when a family asks to stop life support?
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Clarify goals and verify the patient’s wishes and legal decision-maker. Withdrawing life support requires ethical and legal confirmation of patient directives and surrogate authority.
Clarify goals and verify the patient’s wishes and legal decision-maker. Withdrawing life support requires ethical and legal confirmation of patient directives and surrogate authority.
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Which document names a health care proxy to make decisions if the patient cannot?
Which document names a health care proxy to make decisions if the patient cannot?
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Durable power of attorney for health care. This legal instrument appoints a surrogate to advocate for the patient's preferences when they lack capacity.
Durable power of attorney for health care. This legal instrument appoints a surrogate to advocate for the patient's preferences when they lack capacity.
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What is the nurse’s priority if an advance directive is found in the chart?
What is the nurse’s priority if an advance directive is found in the chart?
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Ensure the care plan aligns with the documented wishes. Advance directives guide care to respect patient values, preventing conflicts and ensuring ethical practice.
Ensure the care plan aligns with the documented wishes. Advance directives guide care to respect patient values, preventing conflicts and ensuring ethical practice.
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Which statement best reflects therapeutic communication with a grieving family?
Which statement best reflects therapeutic communication with a grieving family?
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Use silence and open-ended prompts; acknowledge feelings. Therapeutic communication fosters emotional expression and validation, aiding families in processing grief.
Use silence and open-ended prompts; acknowledge feelings. Therapeutic communication fosters emotional expression and validation, aiding families in processing grief.
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Which response is best when a family member says, “This is all my fault”?
Which response is best when a family member says, “This is all my fault”?
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“You are feeling guilty. Tell me more about what you are thinking.”. Acknowledging guilt encourages exploration of emotions, promoting coping and reducing isolation in grief.
“You are feeling guilty. Tell me more about what you are thinking.”. Acknowledging guilt encourages exploration of emotions, promoting coping and reducing isolation in grief.
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What is the nurse’s best action immediately after a patient is pronounced dead?
What is the nurse’s best action immediately after a patient is pronounced dead?
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Provide privacy, support the family, and begin postmortem care per policy. Post-death actions prioritize dignity, family support, and adherence to institutional protocols for care.
Provide privacy, support the family, and begin postmortem care per policy. Post-death actions prioritize dignity, family support, and adherence to institutional protocols for care.
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Which finding requires reporting before postmortem care due to legal implications?
Which finding requires reporting before postmortem care due to legal implications?
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Unexplained injury or death that may require medical examiner notification. Legal requirements mandate reporting suspicious circumstances to ensure investigation and prevent oversight.
Unexplained injury or death that may require medical examiner notification. Legal requirements mandate reporting suspicious circumstances to ensure investigation and prevent oversight.
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Which option best defines palliative care in end-of-life nursing?
Which option best defines palliative care in end-of-life nursing?
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Care focused on comfort and quality of life; may occur with curative care. Palliative care aims to alleviate suffering and improve well-being for patients with serious illnesses, integrating with curative treatments when appropriate.
Care focused on comfort and quality of life; may occur with curative care. Palliative care aims to alleviate suffering and improve well-being for patients with serious illnesses, integrating with curative treatments when appropriate.
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What is the primary goal of hospice care for a terminally ill patient?
What is the primary goal of hospice care for a terminally ill patient?
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Comfort-focused care when cure is not expected. Hospice emphasizes symptom management and emotional support for patients with limited life expectancy, shifting from aggressive treatments to comfort.
Comfort-focused care when cure is not expected. Hospice emphasizes symptom management and emotional support for patients with limited life expectancy, shifting from aggressive treatments to comfort.
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Which option best defines anticipatory grief for family members?
Which option best defines anticipatory grief for family members?
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Grief experienced before the actual death occurs. Anticipatory grief allows family members to process emotions in advance, often triggered by the impending loss of a loved one.
Grief experienced before the actual death occurs. Anticipatory grief allows family members to process emotions in advance, often triggered by the impending loss of a loved one.
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Which term describes grief that lasts longer and impairs functioning?
Which term describes grief that lasts longer and impairs functioning?
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Complicated grief. Complicated grief involves intense, persistent symptoms that disrupt daily life, requiring professional intervention beyond normal grieving.
Complicated grief. Complicated grief involves intense, persistent symptoms that disrupt daily life, requiring professional intervention beyond normal grieving.
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Which finding is most consistent with disenfranchised grief?
Which finding is most consistent with disenfranchised grief?
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Grief not socially recognized or supported. Disenfranchised grief occurs when societal norms minimize the loss, leading to isolation and unsupported mourning.
Grief not socially recognized or supported. Disenfranchised grief occurs when societal norms minimize the loss, leading to isolation and unsupported mourning.
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Which sign most strongly suggests decreased perfusion in the actively dying patient?
Which sign most strongly suggests decreased perfusion in the actively dying patient?
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Mottling and cool extremities. Mottling and coolness indicate circulatory shutdown as the body prioritizes vital organs in the dying process.
Mottling and cool extremities. Mottling and coolness indicate circulatory shutdown as the body prioritizes vital organs in the dying process.
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