On learning that the illness is terminal, a patient insists the test results must be wrong and seeks another opinion, behavior that fits the grief stage of denial.
Missing Word
denial
Denial is the stage of grief marked by difficulty accepting the situation. Seeking another opinion and doubting the results are typical, and the nurse responds with patience rather than confrontation.
Category: Grief and Psychosocial Care
Question 2
A dying patient snaps at the nurses, resents a healthy sibling and keeps asking, "Why me?", behavior typical of the grief stage of anger.
Missing Word
anger
Anger is the stage of grief marked by resentment, rage or envy, often voiced as "Why me?" and aimed at family, staff, caregivers or God. The nurse recognizes it as part of grieving, listens without taking it personally and keeps offering support.
Category: Grief and Psychosocial Care
Question 3
Promising to change in exchange for enough time to see a grandchild graduate is typical of bargaining, a stage in which patients plead for more time.
Missing Word
bargaining
Bargaining is the stage of grief in which a person pleads for more time to reach a milestone, often through promises to God. It reflects an attempt to regain some control.
Category: Grief and Psychosocial Care
Question 4
Near the end of life, a patient who has said goodbye to loved ones calmly tells the family, "I have had a good life, and I am ready," showing the grief stage of acceptance.
Missing Word
acceptance
Acceptance is the stage of grief in which the person is at peace and can acknowledge that the life has been well lived. Grief stages follow no fixed order and a person can return to earlier ones, so the nurse keeps assessing and supporting the patient and family.
Category: Grief and Psychosocial Care
Question 5
A dying patient becomes withdrawn and tearful and speaks with deep sadness about the losses ahead, behavior typical of the grief stage of depression.
Missing Word
depression
In this stage of grief the person feels a deep sadness about the losses to come. The nurse listens, encourages the patient to share feelings and avoids false cheerfulness, because sadness about an approaching death is an expected part of grieving.
Category: Grief and Psychosocial Care
Question 6
The period after a loss during which grief is felt and mourning is expressed is called bereavement.
Missing Word
bereavement
Bereavement is the period of time in which a person grieves and mourns a loss. Hospice support for families continues through this period after the death.
Category: Grief and Psychosocial Care
Question 7
In Cheyne-Stokes breathing, which often appears as death nears, cycles of deepening and then shallower breaths alternate with periods of apnea, when breathing stops altogether.
Missing Word
apnea
Apnea is the absence of breathing. Cheyne-Stokes breathing is a late sign of approaching death, and families are told that it is usually not distressing to the patient.
Category: Signs of Approaching Death
Question 8
In the middle stage of dying, the patient drinks less and circulation slows, so the kidneys produce less urine, an expected change the nurse prepares the family to see.
Missing Word
urine
Decreased urine output is a mid-stage sign of approaching death, along with weakness, more sleep and cool, mottled skin. Families who know to expect it are less likely to treat it as an emergency.
Category: Signs of Approaching Death
Question 9
The member of the palliative care team who addresses spiritual and existential concerns, whatever the patient's faith, and can help with advance care planning is the chaplain.
Missing Word
chaplain
A chaplain provides emotional and spiritual support for patients of any faith or none. Chaplains visit the patient, help with advance care planning and often continue to support the family after the death.
Category: Palliative and Hospice Care
Question 10
In a dying patient, dyspnea, the uncomfortable sensation of breathlessness, often brings on anxiety, which in turn makes breathing feel even harder.
Missing Word
dyspnea
Dyspnea is the subjective feeling of being short of breath. Because it and anxiety feed each other, care targets both, using positioning, relaxation, oxygen and prescribed medications.
Category: Symptom Management
Question 11
Directing air across the patient's face with a small handheld fan can ease the sensation of breathlessness without any medication.
Missing Word
fan
A fan moving cool air across the face is a simple nondrug measure that changes the perception of breathlessness. Opening a window and raising the head of the bed work in a similar way.
Category: Symptom Management
Question 12
Comfort-focused care for a person nearing the end of life who has chosen to stop treatment aimed at curing the disease is called hospice.
Missing Word
hospice
Hospice is comfort-focused care for people nearing the end of life who have stopped treatment aimed at cure. Palliative care, by contrast, can be given alongside curative treatment at any stage of a serious illness.
Category: Palliative and Hospice Care
Question 13
Medicare, the federal health insurance program that covers most older adults, has an end-of-life benefit that pays for comfort care from an interdisciplinary team at home or in a facility.
Missing Word
Medicare
Medicare is the federal health insurance program for most older adults, and its hospice benefit covers the team's services, medications and equipment related to the terminal illness. Medicaid, a joint federal and state program based on income, is a separate program.
Category: Palliative and Hospice Care
Question 14
The goal of palliative care is the best possible quality of life while preserving dignity, the inherent worth that entitles every person to be treated with respect.
Missing Word
dignity
Dignity is a person's inherent worth and the right to be treated with respect. Preserving it, along with quality of life, is a central aim of palliative and end-of-life care.
Category: Palliative and Hospice Care
Question 15
Low fluid intake, reduced activity and opioid pain medications make constipation common near the end of life, so the nurse monitors bowel patterns as part of comfort care.
Missing Word
constipation
Constipation is infrequent or difficult passage of stool. Near the end of life, low intake, immobility and pain medications all contribute, so bowel patterns are assessed regularly.
Category: Symptom Management