End of Life Care NCLEX
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Question 1 of 5.
The family has requested a client with terminal cancer not be told of the diagnosis. The client tells the nurse, 'I think something is really wrong with me, but the doctor says everything is all right. Do you know if there is something wrong with me?' Which response by the nurse would support the ethical principle of veracity?
A. I think you should talk to your doctor about your concerns.
B. What makes you think something is really wrong?
C. Your family has requested you not be told your diagnosis.
D. The doctor would never tell you incorrect information.
Explanation: Veracity (truth-telling) requires honesty; acknowledging the family's request respects their wishes while addressing the client's question, prompting further discussion. Other responses evade truth.
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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