Question 1

Which of the following is a characteristic of palliative care?&#10;A) It can be used instead of hospice care.&#10;B) It is broader than hospice and end-of-life care.&#10;C) It is a type of care totally unrelated to end-of-life care.&#10;D) It can be offered only after a chronic disease diagnosis.

Accepted Answer

Although palliative care, hospice, and end-of-life care are related, palliative care is the broadest of the three as both a philosophy and system of whole person and family-focused care that can be applied at any time along the health-illness continuum. Palliative care is not used instead of hospice care. It is related to end-of-life care. It can be offered at any time and not just after a chronic disease diagnosis.

Question 2

Which of the following should a nurse explain to a patient who is considering palliative care?&#10;A) &#34;Care is limited to comfort measures.&#34;&#10;B) &#34;It is given in place of other types of care.&#34;&#10;C) &#34;It can be provided in conjunction with curatively focused care.&#34;&#10;D) &#34;You must agree not to be resuscitated when receiving palliative care.&#34;

Accepted Answer

Palliative care can be provided in conjunction with curatively focused care. Palliative care is not limited to comfort measures. It is not given in place of other types of care. The patient does not need to agree not to be resuscitated when receiving palliative care.

Question 3

Which of the following is a characteristic of tertiary palliative care?&#10;A) It is provided in the home.&#10;B) It is used only for specific medical diagnoses.&#10;C) Any nurse can provide this level of palliative care.&#10;D) It is delivered in academic medical centers and focuses on research.

Accepted Answer

Tertiary palliative care is delivered by specially trained providers in academic medical centers and focuses on complex palliative care issues and research. It is not provided in the home and is not used for specific medical diagnoses only. The level of palliative care cannot be provided by any nurse.

Question 4

Which of the following phrases describes the effect that palliative care can have on health promotion?&#10;A) It can maximize the use of health-care dollars.&#10;B) It can prepare the patient for a dignified death.&#10;C) It can support the family after the death of a loved one.&#10;D) It can promote quality of life and well-being across all life stages.

Accepted Answer

Efforts that align palliative care and health promotion can contribute toward meaningful progress in the goal of promoting quality of life and well-being across all life stages. The effect of palliative care in health promotion would not maximize the use of health-care dollars, prepare the patient for a dignified death, or support the family after the death of a loved one.

Question 5

Which of the following should a nurse identify as a goal of advance care planning?&#10;A) Set the stage for the completion of an advance directive&#10;B) Anticipate the amount of money needed to cover end-of-life expenses&#10;C) Direct the health-care provider on the use of medications and treatments&#10;D) Provide care that is consistent with the patient's goals, values, and preferences

Accepted Answer

The goal of advance care planning is to help ensure that people receive medical care that is consistent with their values, goals, and preferences during serious and chronic illness. Preparing to complete an advance directive, anticipating the cost to cover end-of-life expenses, and directing the health-care provider on the use of medications and treatments are not goals of advance care planning.

Question 6

What should a nurse do when incorporating palliative care into health promotion practices?&#10;A) Be a patient advocate&#10;B) Teach family members how to provide care&#10;C) Expect extreme health measures to be discontinued&#10;D) Ask the health-care provider to prescribe palliative care

Accepted Answer

Nurses have the vital role of incorporating palliative care into their health promotion practices through education of themselves and others, practice, collaboration, community engagement, advocacy, and policy-focused activities. Teaching family members how to provide care, expecting extreme health measures to be discontinued, and asking the health-care provider to prescribe palliative care are not measures that the nurse would take when incorporating palliative care into health promotion practice.

Question 7

In which care setting are nurses least likely to participate in advance care planning with their patients?&#10;A) Home care&#10;B) Intensive care unit&#10;C) Medical-surgical unit&#10;D) Preoperative surgical suite

Accepted Answer

Nurses in non-acute-care settings (such as within the community) are less likely to participate in advance care planning with clients than nurses in acute care. Nurses in these studies reported the need for additional education, support from their organizations (including time for client interactions), and resources. Nurses in the intensive care unit, medical-surgical unit, and preoperative surgical suite are more likely to participate in advance care planning with their patients.

Question 8

What should a nurse do to ensure that a patient's goals and wishes for health care are incorporated into a plan of care?&#10;A) Complete a comprehensive assessment.&#10;B) Ask the patient what type of care is desired.&#10;C) Analyze the family's desires for the patient's care needs.&#10;D) Discuss the patient's care needs with the health-care provider.

Accepted Answer

Findings from a comprehensive assessment encompassing the physical, psychological, social, cultural, existential/spiritual, and family concerns of the individual contribute to a plan of care that aligns with the individual's needs, values, and preferences. Asking the patient what type of care is desired, analyzing the family's desires for the patient's care needs, and discussing the patient's care needs with the health-care provider will not ensure that a patient's goals and wishes for health care are incorporated into the plan of care.

Question 9

What should a nurse do to understand a patient's stage of readiness for change in relation to advance care planning?&#10;A) Follow the transtheoretical model.&#10;B) Discuss the patient's readiness for change with the family.&#10;C) Provide the patient with information about advance care planning.&#10;D) Explain to the patient that advance care planning is required for palliative care.

Accepted Answer

The transtheoretical model is a useful tool to understand a client's stage of readiness for change in relation to advance care planning. Discussing the patient with the family, providing the patient with information about advance care planning, and explaining that advance care planning is required for palliative care would not help the nurse understand a patient's stage of readiness for change in relation to advance care planning.

Question 10

Which of the following communication tools can be used to have a sensitive conversation with patients and families about a difficult prognosis?&#10;A) SBAR&#10;B) CAGE&#10;C) SPIKES&#10;D) AUDIT-10

Accepted Answer

SPIKES is a recognized palliative care communication tool used for sensitive conversations with patients and family about a difficult prognosis, such as the worsening of a serious illness. SBAR is a tool to communicate a change in a patient's health status. CAGE is a survey to assess for alcohol use. AUDIT-10 is a tool to assess for substance use.

Deck 22: Health Promotion and Palliative Care