Death & Dying
1. The nurse cares for a terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid
breathing. Which
... [Show More] action by the nurse would be most appropriate?
a. Suction the patient.
b. Administer oxygen via face mask.
c. Place the patient in high Fowlers position.
d. Document the respirations as Cheyne-Stokes.
ANS: D
Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and rapid breaths. Cheyne-
Stokes respirations are expected in the last days of life. There is also no need for supplemental oxygen by face mask or
suctioning the patient. Raising the head of the bed slightly and/or turning the patient on the side may promote comfort.
There is no need to place the patient in high Fowlers position.
2. The nurse cares for an adolescent patient who is dying. The patients parents are interested in organ donation and ask
the nurse how the decision about brain death is made. Which response by the nurse is most appropriate?
a. Brain death occurs if a person is flaccid and unresponsive.
b. If CPR is ineffective in restoring a heartbeat, the brain cannot function.
c. Brain death has occurred if there is no breathing and certain reflexes are absent.
d. If respiratory efforts cease and no apical pulse is audible, brain death is present.
ANS: C
The diagnosis of brain death is based on irreversible loss of all brain functions, including brainstem functions that control
respirations and brainstem reflexes. The other descriptions describe other clinical manifestations associated with death
but are insufficient to declare a patient brain dead.
3. A hospice patient is manifesting a decrease in all body system functions except for a heart rate of 124 and a
respiratory rate of 28. Which statement, if made by the nurse to the patients family member, is most appropriate?
a. These symptoms will continue to increase until death finally occurs.
b. These symptoms are a normal response before these functions decrease.
c. These symptoms indicate a reflex response to the slowing of other body systems.
d. These symptoms may be associated with an improvement in the patients condition.
ANS: B
An increase in heart and respiratory rate may occur before the slowing of these functions in the dying patient. Heart and
respiratory rate typically slow as the patient progresses further toward death. In a dying patient, high respiratory and
pulse rates do not indicate improvement, and it would be inappropriate for the nurse to indicate this to the family. The
changes in pulse and respirations are not reflex responses. [Show Less]