GNA - Geriatric Nursing Assistant End-of-Life Care Questions and Answers — Questions and Answers
Question 1: Which of the following BEST describes the primary philosophy of hospice care?
- To aggressively treat the resident's illness and prolong life at all costs.
- To focus on comfort, dignity, and quality of life when a cure is not possible. (Correct answer)
- To provide curative treatments only in a specialized hospital setting.
- To assist the family with legal and financial matters after the resident's death.
Correct answer: To focus on comfort, dignity, and quality of life when a cure is not possible.
Hospice care is a philosophy of care that centers on providing comfort (palliative care), supporting dignity, and maximizing the quality of life for a person with a terminal illness, rather than seeking a cure. [8, 18, 29] It addresses the physical, emotional, and spiritual needs of the resident and their family. [4, 18]
Question 2: A GNA is caring for a resident who is actively dying. Which of the following are common physical signs that death is approaching?
- Increased appetite and high energy levels.
- Warm, pink skin and a strong, regular pulse.
- Irregular breathing patterns (like Cheyne-Stokes) and mottling of the skin. (Correct answer)
- Clear, loud speech and increased interest in social activities.
Correct answer: Irregular breathing patterns (like Cheyne-Stokes) and mottling of the skin.
As the body's systems begin to shut down, circulation slows, causing a blotchy, purplish discoloration of the skin called mottling, particularly in the extremities. [6, 11] Breathing patterns often become irregular, with periods of rapid breathing followed by periods of no breathing (apnea), a pattern known as Cheyne-Stokes respirations. [10, 15] The other options describe signs of health and vitality.
Question 3: When providing postmortem care for a resident who has just passed away, what is a primary responsibility of the GNA?
- Completing the official death certificate for the facility's records.
- Informing the resident's family members of the death.
- Treating the body with dignity while performing a final bath and positioning. (Correct answer)
- Removing all intravenous lines and medical tubing from the body.
Correct answer: Treating the body with dignity while performing a final bath and positioning.
The GNA's role in postmortem care is to treat the deceased with respect and dignity. [1, 2] This includes gently bathing the body, dressing it in a clean gown, and placing it in a natural, dignified position before family viewing or transport. [5, 23] Notifying the family, completing the death certificate, and removing medical tubing are tasks performed by the licensed nurse or physician. [1, 5]
Question 4: A resident receiving end-of-life care tells the GNA, "I'm so scared of dying." What is the MOST therapeutic response from the GNA?
- "Don't be scared, we will take great care of you."
- "Would you like to talk about what is making you feel scared?" (Correct answer)
- "We all have to go sometime. You should try not to think about it."
- "I will let the nurse know so they can talk to you about it."
Correct answer: "Would you like to talk about what is making you feel scared?"
The most therapeutic response is one that acknowledges the resident's feelings and provides an open-ended invitation for them to express themselves further. [3, 19] This demonstrates active listening and empathy. Providing false reassurance (A), dismissing their feelings (C), or immediately deferring to the nurse (D) closes off communication and fails to provide immediate emotional support. [19, 20]
Question 5: A resident has a legal document that outlines their wishes for medical treatment, such as the use of life-sustaining measures, in case they become unable to make decisions for themselves. This document is known as:
- A last will and testament.
- An informed consent form.
- An advance directive. (Correct answer)
- A facility incident report.
Correct answer: An advance directive.
An advance directive is a legal document, such as a living will or a durable power of attorney for health care, that allows a person to state their preferences for end-of-life medical care. [27, 34, 36] A last will and testament deals with property after death, while informed consent is for specific procedures, and an incident report documents unexpected events.
Question 6: A GNA is caring for an unconscious resident who is near death and has a dry mouth with crusted lips. Which comfort measure is most appropriate for the GNA to perform?
- Gently apply a moisturizing swab to the resident's lips and inside of the mouth. (Correct answer)
- Attempt to give the resident small sips of water from a cup.
- Ignore the dry mouth since the resident is unconscious.
- Use a hard-bristled toothbrush to scrub the resident's teeth and gums.
Correct answer: Gently apply a moisturizing swab to the resident's lips and inside of the mouth.
Frequent oral care is a critical comfort measure for a dying resident, as a dry mouth can cause significant discomfort. [29, 35] Using a soft, moisturizing swab is the safest and most effective way to provide this care. [24] Giving fluids by mouth to an unconscious person creates a high risk of aspiration, and it is wrong to assume an unconscious person feels no discomfort. [29]
GNA - Geriatric Nursing Assistant End-of-Life Care Questions and Answers
Which of the following BEST describes the primary philosophy of hospice care?