Nursing Acceleration Challenge Exam I PN Hospice, Palliative Care, and End-of-Life Nursing

Question 1

A patient with terminal cancer is enrolled in hospice. Which statement BEST describes the goal of hospice care?

Accepted Answer

Provide comfort and quality of life when curative treatment is no longer the goal

Answer

Cure the underlying disease through aggressive treatment

Answer

Prolong life as long as possible using all available interventions

Answer

Transfer the patient to a skilled nursing facility for 24-hour monitoring

Question 2

According to Kübler-Ross's five stages of grief, a patient who has just been told she has a terminal diagnosis says, 'The lab must have mixed up my results. I'm going to get a second opinion.' This patient is in which stage?

Accepted Answer

Denial

Answer

Anger

Answer

Bargaining

Answer

Acceptance

Question 3

A terminally ill patient is experiencing Cheyne-Stokes respirations. The family asks what this means. The nurse's BEST response is:

Accepted Answer

'This pattern—cycles of rapid breathing followed by pauses—is a normal sign that death is approaching.'

Answer

'This means the patient needs supplemental oxygen immediately.'

Answer

'We should call the physician to start mechanical ventilation.'

Answer

'This breathing pattern means the patient is in pain and needs more medication.'

Question 4

A patient with a valid advance directive (living will) stating 'no resuscitation' suffers cardiac arrest. A family member demands the nurse perform CPR. The nurse should:

Accepted Answer

Honor the advance directive and do not perform CPR

Answer

Begin CPR because family consent overrides the advance directive

Answer

Contact the physician to obtain a verbal order before deciding

Answer

Perform CPR until the ethics committee can be convened

Question 5

Which comfort measure is the priority nursing intervention for a patient in the active dying phase experiencing air hunger?

Accepted Answer

Administer prescribed low-dose opioids and position the patient upright or on their side

Answer

Initiate mechanical ventilation to normalize oxygen saturation

Answer

Apply a non-rebreather mask at 15 L/min to maximize oxygenation

Answer

Perform chest physiotherapy to clear secretions

Question 6

A nurse is caring for a patient who recently died. The patient's spouse is crying and says, 'I should have been here—I wasn't with him when he died.' Which response by the nurse is most therapeutic?

Accepted Answer

'It sounds like you're feeling guilty. Being with someone you love through this is incredibly hard.'

Answer

'Try not to feel guilty—many patients die when family steps out of the room.'

Answer

'At least he is no longer suffering. That's what matters most.'

Answer

'You can discuss these feelings with the hospital chaplain when you're ready.'