CHPNA End-of-Life Care 1 — Questions and Answers
Question 1: Which of the following is a physical sign that death may be approaching within hours to days?
- Increased appetite and energy
- Mottling of the skin, cooling of extremities, and changes in breathing (Correct answer)
- Elevated blood pressure
- Increased urine output
Correct answer: Mottling of the skin, cooling of extremities, and changes in breathing
Mottling (purplish blotchy skin discoloration), cooling of extremities, changes in breathing patterns, and decreased urine output are signs that death is approaching.
Question 2: What is 'mottling' in the context of end-of-life care?
- A rash caused by medication
- Blotchy, purplish discoloration of the skin due to poor circulation (Correct answer)
- Yellowing of the skin
- Swelling of the extremities
Correct answer: Blotchy, purplish discoloration of the skin due to poor circulation
Mottling is a blotchy, irregular purplish discoloration of the skin caused by slowing circulation as the body shuts down, typically starting in the knees and feet.
Question 3: After a patient's death, what is the nursing assistant's first responsibility?
- Contact the funeral home immediately
- Notify the supervising nurse and follow the agency's post-mortem care procedures (Correct answer)
- Remove all equipment from the room
- Inform the insurance company
Correct answer: Notify the supervising nurse and follow the agency's post-mortem care procedures
The nursing assistant should notify the supervising nurse immediately after a patient's death and follow the agency's protocols for post-mortem care.
Question 4: Which of the following is appropriate post-mortem care by the nursing assistant?
- Performing CPR
- Bathing the body, positioning it with dignity, and allowing family time (Correct answer)
- Removing the body immediately
- Administering medications
Correct answer: Bathing the body, positioning it with dignity, and allowing family time
Post-mortem care includes bathing and positioning the body with dignity and respect, and allowing family members time to say goodbye before the body is removed.
Question 5: What is the Kübler-Ross model in relation to end-of-life care?
- A pain assessment tool
- Five stages of grief: denial, anger, bargaining, depression, and acceptance (Correct answer)
- A medication protocol for dying patients
- A physical assessment scale
Correct answer: Five stages of grief: denial, anger, bargaining, depression, and acceptance
Dr. Elisabeth Kübler-Ross described five stages of grief—denial, anger, bargaining, depression, and acceptance—that many dying patients and their families may experience.
Question 6: When a family member is distraught at the bedside of a dying patient, the nursing assistant should:
- Ask them to leave the room
- Offer presence, a calm demeanor, and empathetic support; notify the nurse (Correct answer)
- Tell them to stop crying
- Ignore the behavior
Correct answer: Offer presence, a calm demeanor, and empathetic support; notify the nurse
The nursing assistant should offer compassionate presence and emotional support to distressed family members and notify the nurse for additional support resources.
CHPNA End-of-Life Care 1
Which of the following is a physical sign that death may be approaching within hours to days?