End of Life Care NCLEX Questions
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Question 1 of 5.
The client diagnosed with cancer is unable to attain pain relief despite receiving large amounts of narcotic medications. Which intervention should be included in the plan of care?
A. Ask the HCP to increase the medication.
B. Assess for any spiritual distress.
C. Change the client's position every two (2) hours.
D. Turn on the radio to soothing music.
Explanation: Spiritual distress can exacerbate pain perception; assessing it addresses holistic care, per pain management principles. Increasing medication, repositioning, or music is less targeted.
Question 2 of 5.
The client tells the nurse, 'Every time I come in the hospital you hand me one of these advance directives (AD). Why should I fill one of these out?' Which statement by the nurse is most appropriate?
A. You must fill out this form because Medicare laws require it.
B. An AD lets you participate in decisions about your health care.
C. This paper will ensure no one can override your decisions.
D. It is part of the hospital admission packet and I have to give it to you.
Explanation: Advance directives allow clients to specify their health care preferences, ensuring participation in decisions, per the Patient Self-Determination Act. Medicare requires offering, not completing, ADs; no document guarantees non-override; and packet inclusion is procedural, not the reason.
Question 3 of 5.
The nurse is moving to another state which is part of the multistate licensure compact. Which information regarding ADs should the nurse be aware of when practicing nursing in other states?
A. The laws regarding ADs are the same in all the states.
B. Advance directives can be transferred from state to state.
C. A significant other can sign a loved one's advance directive.
D. Advance directives are state regulated, not federally regulated.
Explanation: ADs are governed by state laws, varying in requirements and execution, not federal regulation. Laws differ, transferability depends on state reciprocity, and significant others cannot sign unless designated.
Question 4 of 5.
The client has just signed an AD at the bedside. Which intervention should the nurse implement first?
A. Notify the client's health-care provider about the AD.
B. Instruct the client to discuss the AD with significant others.
C. Place a copy of the advance directive in the client's chart.
D. Give the original advance directive to the client.
Explanation: Placing a copy in the chart ensures the AD is accessible for care decisions, the first priority. Notifying HCP, discussing with others, or giving the original follows.
Question 5 of 5.
The male client requested a DNR per the AD, and the HCP wrote the order. The client's death is imminent and the client's wife tells the nurse, 'Help him please. Do something. I am not ready to let him go.' Which action should the nurse take?
A. Ask the wife if she would like to revoke her husband's AD.
B. Leave the wife at the bedside and notify the hospital chaplain.
C. Sit with the wife at the bedside and encourage her to say good-bye.
D. Request the client to tell the wife he is ready to die, and don't do anything.
Explanation: Sitting with the wife and encouraging closure supports her emotionally while respecting the DNR. Revoking AD, notifying chaplain, or requesting client communication is inappropriate.
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