Gerontological Nurse Test End-of-Life Care and Palliative Nursing 2

Question 1

A family member asks the nurse why their dying parent is no longer accepting food or water. The most accurate and therapeutic response is:

Accepted Answer

'Decreased intake is a natural part of the dying process and does not cause suffering.'

Answer

Decreased appetite and fluid intake in the active dying phase are normal physiologic changes; the body no longer needs nutrition and forced feeding can increase discomfort.

Question 2

Which pharmacological intervention is most commonly used to manage the death rattle (noisy breathing) in the final hours of life?

Accepted Answer

Glycopyrrolate (Robinul) or hyoscine (scopolamine)

Answer

Anticholinergic agents such as glycopyrrolate or scopolamine reduce secretions causing the death rattle, improving comfort for the patient and reducing distress for families present.

Question 3

A patient at end of life expresses spiritual distress and asks the nurse, 'Why is God doing this to me?' The nurse's most therapeutic response is to:

Accepted Answer

Listen attentively, acknowledge the distress, and offer to arrange a chaplain visit

Answer

Acknowledging spiritual distress and facilitating access to chaplaincy is within nursing scope; imposing theological interpretations or dismissing the concern is inappropriate.

Question 4

Under the Medicare Hospice Benefit in the United States, a patient must have a life expectancy of how long to qualify for hospice enrollment?

Accepted Answer

6 months or less if the disease runs its natural course

Answer

Medicare Hospice Benefit requires physician certification that the patient has a life expectancy of 6 months or less if the terminal illness follows its normal course.

Question 5

The nurse understands that providing adequate opioid analgesia to a dying patient may secondarily hasten death. This ethical concept is known as:

Accepted Answer

The principle of double effect

Answer

The doctrine of double effect justifies an action with a good intended outcome (pain relief) even if a foreseeable but unintended secondary effect (hastened death) may result.

Gerontological Nurse Test Practice Test

Gerontological Nurse Test Practice Test

Gerontological Nurse Test End-of-Life Care and Palliative Nursing 2