End of Life Care NCLEX
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Question 1 of 5.
The client has been declared brain dead and is an organ donor. The nurse is preparing the wife of the client to enter the room to say good-bye. Which information is most important for the nurse to discuss with the wife?
A. Inform the wife the client will still be on the ventilator.
B. Instruct the wife to only stay a few minutes at the bedside.
C. Tell the wife it is all right to talk to the client.
D. Allow another family member to go in with the wife.
Explanation: Informing the wife about the ventilator prepares her for the client's appearance, reducing distress, a priority for organ donors. Time limits, talking, or companions are secondary.
Question 2 of 5.
In which client situation would the AD be consulted and used in decision making?
A. The client diagnosed with Guillain-Barré who is on a ventilator.
B. The client with a C6 spinal cord injury in the rehabilitation unit.
C. The client in end-stage renal disease who is in a comatose state.
D. The client diagnosed with cancer who has Down syndrome.
Explanation: ADs are consulted when a client cannot make decisions, such as in a comatose state (end-stage renal disease). Ventilated, rehab, or Down syndrome clients may still have decision-making capacity.
Question 3 of 5.
The client with an AD tells the nurse, 'I have changed my mind about my AD. I really want everything possible done if I am near death since I have a grandchild.' Which action should the nurse implement?
A. Notify the health information systems department to talk to the client.
B. Remove the AD from the client's chart and shred the document.
C. Inform the client he or she has the right to revoke the AD at any time.
D. Explain this document cannot be changed once it is signed.
Explanation: Clients can revoke ADs at any time, per legal rights. Notifying health information, shredding without process, or claiming unchangeability is incorrect.
Question 4 of 5.
The client asks the nurse, 'When will the durable power of attorney for health care take effect?' On which scientific rationale would the nurse base the response?
A. It goes into effect when the client needs someone to make financial decisions.
B. It will be effective when the client is under general anesthesia during surgery.
C. The client must say it is all right for it to become effective and enforced.
D. It becomes valid only when the clients cannot make their own decisions.
Explanation: A durable power of attorney for health care activates when the client is incapacitated, per legal standards. Financial decisions, anesthesia, or client permission are incorrect triggers.
Question 5 of 5.
The nurse is aware the Patient Self-Determination Act of 1991 requires the health-care facility to implement which action?
A. Make available an AD on admission to the facility.
B. Assist the client with legally completing a will.
C. Provide ethically and morally competent care to the client.
D. Discuss the importance of understanding consent forms.
Explanation: The Patient Self-Determination Act mandates offering AD information on admission for Medicare/Medicaid facilities. Wills, ethical care, and consent forms are unrelated.
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