Palliative Care and End-of-Life Care

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Hospice care differs from palliative care in that:

It is not covered by insurance

Supports patients and families through both the dying and the bereavement process

It cannot be provided in the nursing home

The majority of those admitted to hospice die within 7 days

____ 2. Evidence reflects the primary obstacle to implementing palliative care in the long-term care setting include all of the following except:

Inadequate communication between decision makers

Failure to recognize futile treatments

Lack of advance directives

Lack of sufficient staff

____ 3. The most prevalent symptom in end-of-life care includes all of the following except:

Lower extremity weakness

Pain

Dyspnea

Delirium

____ 4. Pain at the end of life is most often due to all of the following except:

Musculoskeletal disorders

Headache

Cancer pain

Neuropathic pain

____ 5. The strongest level of evidence reflects the absolute contraindication for NSAID use exists with:

Chronic kidney disease

Peptic ulcer disease

Heart disease

Liver disease

____ 6. The drug specific for severe opioid-induced constipation is:

Lactulose

Ducolax

Mineral oil

Methylnaltrexone

____ 7. Pharmacological interventions for dyspnea include all of the following except:

Antitussives

Inhaled anesthetics

Sedatives

Anxiolytics

____ 8. Delirium is typically characterized by all of the following except:

Inattention

Hyperactive level of psychomotor activity

Disorganized thinking

Altered level of consciousness

____ 9. The first step in treating delirium is to:

Give low-dose Haldol if the patient has psychosis

Identify the cause

Provide reality orientation

Use side rails and/or wrist restraints to keep the patient safe

____ 10. The majority of patients enrolled in hospice care die:

In a nursing home

In the hospital

In an inpatient hospice facility

At home

____ 11. A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea) is:

Morphine

Methadone

Gabapentin

Lorazepam

____ 12. The tasks of grieving include all of the following except:

Acknowledge the reality of death

Work through the pain of grief

Begin to disengage

Restructure relationships

____ 13. The best description of complicated grief is:

Chronic, delayed, exaggerated, masked, or disenfranchised

Experience of shock during notification of the death

When grief is actually experienced before the death of a loved one

A physical illness develops soon after death of a loved one

____ 14. All of the following statements are true about interventions in working with the bereaved except:

Allow the active expression of grief

There is strong evidence behind recommended interventions

Staff attending memorial services support the family

Provide both emotional and spiritual support

____ 15. The highest level of evidence to support interventions at the end of life is with:

Opioids for pain control

Hyocsyamine for respiratory secretions

Stimulant laxatives for treating constipation

Opioids for dyspnea

____ 16. The highest level of evidence with the use of adjuvant analgesics is with:

Tricyclic antidepressants avoided due to high adverse events

Therapeutic trials before discontinuing drugs

Patient with fibromyalgia are candidates for adjuvant analgesics

Neuropathic pain patients are candidates for adjuvant analgesia