Chapter 10: End-of-Life Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The Patient Self-Determination Act is a federal law that supports the patient’s right to:

a.	receive fair and equal treatment under the law.
b.	obtain maximum health care benefits from third-party payers.
c.	control treatment in the future, even if unable to effectively communicate.
d.	exclude family members from decision making related to treatments.

 

ANS:   C

The Patient Self-Determination Act supports the patient’s right to control future treatment in the event that the individual cannot speak for himself or herself.

 

DIF:    Cognitive Level: Comprehension       REF:    107

OBJ:    Nursing Process: Implementation       TOP:    End-of-Life Care

MSC:   NCLEX: Safe and Effective Care Environment: Management of Care

 

2. The patient’s family is struggling to make decisions related to treatments for the critically ill patient. They ask the nurse about the difference between “withholding” and “withdrawing” life support. The nurse will tell them:

a.	“Morally they are the same, but legally withdrawal is more difficult to support.”
b.	“Legally they are on the same level, but morally it is indefensible to withdraw treatment.”
c.	“Withdrawal is a legal issue and withholding is a moral one.”
d.	“Morally and legally they are considered to be equal.”

 

ANS:   D

Withholding and withdrawing are considered to be morally and legally equivalent.

 

DIF:    Cognitive Level: Comprehension       REF:    107

OBJ:    Nursing Process: Implementation       TOP:    End-of-Life Care

MSC:   NCLEX: Safe and Effective Care Environment: Management of Care

 

3. The patient’s husband is terrified by the prospect of removing life-sustaining treatments from the patient. He asks why anyone would do that. The nurse explains:

a.	“It is to save you money so you won’t have such a large financial burden.”
b.	“It will preserve limited resources for the hospital so other patients may benefit from them.”
c.	“It is to discontinue treatments that are not helping your wife and may be very uncomfortable for her.”
d.	“We have done all we can for your wife and any more treatment would be futile.”

 

ANS:   C

The goal of withdrawal of life-sustaining treatments is to remove treatments that are not beneficial and may be uncomfortable.

 

DIF:    Cognitive Level: Application REF:    107

OBJ:    Nursing Process: Implementation       TOP:    End-of-Life Care

MSC:   NCLEX: Safe and Effective Care Environment: Management of Care

 

4. All of the patient’s children are distressed by the possibility of removing life-support treatments from their father. The most upset tells the nurse, “This is the same as killing him! I thought you were supposed to help him!” The nurse explains to the family:

a.	“This is a process of allowing your father to die naturally after the injuries that he sustained in a serious accident.”
b.	“The hospital would never allow us to do that kind of thing.”
c.	“Let’s talk about this calmly and I will explain why assisted suicide is appropriate in this case.”
d.	“He’s lived a long and productive life.”

 

ANS:   A

Forgoing life-sustaining treatments is not the same as active euthanasia or assisted suicide. Killing is an action causing another’s death, whereas allowing dying is avoiding any intervention that interferes with a natural death following illness or trauma.

 

DIF:    Cognitive Level: Application REF:    107

OBJ:    Nursing Process: Implementation       TOP:    End-of-Life Care

MSC:   NCLEX: Safe and Effective Care Environment: Management of Care

 

5. To forestall any unwanted resuscitation after life-sustaining treatments have been withdrawn, the nurse should make sure that:

a.	do-not-resuscitate (DNR) orders are written before discontinuation of the treatments.
b.	the family is not allowed to visit until the death occurs.
c.	DNR orders are written as soon as possible after the discontinuation of the treatments.
d.	the change-of-shift report includes the information that the patient is not to be resuscitated.

 

ANS:   A

DNR orders should be written before withdrawal of life support; this will prevent any unfortunate errors in unwanted resuscitation during the time period between initiation of withdrawal and the actual death.

 

DIF:    Cognitive Level: Application REF:    108

OBJ:    Nursing Process: Implementation       TOP:    End-of-Life Care

MSC:   NCLEX: Safe and Effective Care Environment: Management of Care