CHPNA End-of-Life Care 2 ā Questions and Answers
Question 1: Decreased urine output and dark-colored urine near the end of life usually indicate:
- Kidney infection
- Normal physiological changes as the body shuts down (Correct answer)
- Need for increased IV fluids
- Medication side effects requiring immediate dose change
Correct answer: Normal physiological changes as the body shuts down
As a patient nears death, the kidneys slow down, resulting in decreased and more concentrated (darker) urine output, which is a normal part of the dying process.
Question 2: What does it mean when a hospice patient is in the 'actively dying' phase?
- The patient is agitated and combative
- The patient is in the final hours to days of life with significant physiological changes (Correct answer)
- The patient's condition is improving
- The patient requires surgical intervention
Correct answer: The patient is in the final hours to days of life with significant physiological changes
The 'actively dying' phase refers to the final hours to days before death, characterized by major physiological changes such as changes in breathing, circulation, and consciousness.
Question 3: Hearing is believed to be one of the last senses to fade. How does this affect nursing assistant care?
- The nursing assistant should avoid speaking near the patient
- The nursing assistant should speak softly, identify themselves, and offer comforting words (Correct answer)
- The nursing assistant should increase the TV volume
- It has no effect on care delivery
Correct answer: The nursing assistant should speak softly, identify themselves, and offer comforting words
Because hearing may persist even when the patient is unresponsive, nursing assistants should speak gently, identify themselves, and offer words of comfort to the patient.
Question 4: Which of the following is an appropriate way to support the family during the active dying phase?
- Restrict family visitation to reduce disruption
- Educate the family about what to expect and encourage them to stay if they wish (Correct answer)
- Discourage family from speaking to the patient
- Insist family follow strict hospital routines
Correct answer: Educate the family about what to expect and encourage them to stay if they wish
Educating family about the dying process and encouraging their presence helps reduce fear and allows them to support their loved one during this critical time.
Question 5: What is 'palliative sedation'?
- Sedation to hasten death
- The use of sedative medications to reduce intractable suffering in terminally ill patients near death (Correct answer)
- Routine sedation for all hospice patients
- Sedation used only during procedures
Correct answer: The use of sedative medications to reduce intractable suffering in terminally ill patients near death
Palliative sedation involves administering sedatives to reduce consciousness and relieve refractory suffering in terminally ill patients when other symptom management has failed.
Question 6: Cultural awareness in end-of-life care is important because:
- All patients respond to death the same way
- Cultural beliefs affect how patients and families experience grief, rituals, and death (Correct answer)
- Culture only matters for language barriers
- Cultural differences are irrelevant in medical care
Correct answer: Cultural beliefs affect how patients and families experience grief, rituals, and death
Cultural beliefs, values, and practices strongly influence how patients and families understand death, grieve, and perform ritualsānursing assistants must be respectful and aware.
CHPNA End-of-Life Care 2
Decreased urine output and dark-colored urine near the end of life usually indicate: