TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSING 7TH EDITION BY SOLE" Chapter 4: End-of-Life Care in the Critical Care Unit

Document Content and Description Below

Chapter 4: End-of-Life Care in the Critical Care Unit Test Bank MULTIPLE CHOICE 1. A patient who is undergoing withdrawal of mechanical ventilation appears anxious and agitated. The patient is... on a continuous morphine infusion and has an additional order for lorazepam (Ativan) 1 to 2 mg IV as needed (prn). The patient has received no lorazepam (Ativan) during this course of illness. What is the most appropriate nursing intervention to control agitation? a. Administer fentanyl (Duragesic) 25 mg IV bolus. b. Administer lorazepam (Ativan) 1 mg IV now. c. Increase the rate of the morphine infusion by 50%. d. Request an order for a paralytic agent. ANS: B Lorazepam (Ativan) 1 mg IV is an appropriate loading dose for a patient who is benzodiazepine naïve and experiencing agitation during withdrawal of life support. Fentanyl treats pain and morphine controls pain. Paralytic agents are not warranted. DIF: Cognitive Level: Analysis REF: Figure 4-1 OBJ: Describe nursing interventions to support the patient and family during the end-of-life stage. TOP: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 2. A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has been unresponsive and has required ventilatory support since the time of the stroke. The physician has approached the spouse regarding placement of a permanent feeding tube. The spouse states that the patient never wanted to be kept alive by tubes and personally didn’t want what was being done. After holding a family conference with the spouse, the medical team concurs and the feeding tube is not placed. This situation is an example of: a. euthanasia. b. palliative care. c. withdrawal of life support. d. withholding of life support. ANS: D Because the tube feeding had not been placed in the care of this patient, this scenario is an example of withholding of life support. Withholding of life support does not constitute euthanasia. Withdrawal of life support involves discontinuation of previously established therapies in a terminally ill patient. DIF: Cognitive Level: Analysis REF: p. 40 OBJ: Discuss concepts of end-of-life care, including palliative care; communication and conflict resolution; withholding or withdrawing therapy; and psychological support of the patient, family members, and healthcare providers. TOP: Nursing Process Step: Planning MSC: NCLEX: Safe and Effective Care Environment 3. What were the findings of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT)? a. Clear communication is typical in the relationships between most patients and healthcare providers. b. Critical care units often meet the needs of dying patients and their families. c. Disparities exist between patients' care preferences and actual care provided. d. Pain and suffering of patients at end of life is well controlled in the hospital. 4. A statement that provides a legally recognized description of an individual's desires regarding care at the end of life is a (an): a. advance directive. b. guardianship ad litem. c. healthcare proxy. d. power of attorney. 5. A 65-year-old patient with a history of metastatic lung carcinoma has been unresponsive to chemotherapy. The medical team has determined that there are no additional treatments available that will prolong life or improve the quality of life in any meaningful way. Despite the poor prognosis, the patient continues to receive chemotherapy and full nutrition support. This is an example of what end-of-life concept? a. Medical futility b. Palliative care c. Terminal weaning d. Withdrawal of treatment [Show More]

Last updated: 1 year ago

Preview 1 out of 15 pages