Question 1

The tasks of grieving include all of the following except:&#10;A) Acknowledge the reality of death&#10;B) Work through the pain of grief&#10;C) Begin to disengage&#10;D) Restructure relationships

Accepted Answer

Disengaging is not typically considered a task of grieving; instead, grieving involves acknowledging the loss, working through the pain, and restructuring relationships.

Question 2

The drug specific for severe opioid-induced constipation is:&#10;A) Lactulose&#10;B) Ducolax&#10;C) Mineral oil&#10;D) Methylnaltrexone

Accepted Answer

The drug specific for severe opioid-induced constipation is Methylnaltrexone, an opioid antagonist that acts solely on the gut receptors to reduce constipation without reversing the analgesic effects of opioids in the brain. Lactulose, Ducolax, and mineral oil are not specific for opioid-induced constipation and may have limited efficacy or unwanted side effects in this context.

Question 3

The highest level of evidence with the use of adjuvant analgesics is with:&#10;A) Tricyclic antidepressants avoided due to high adverse events&#10;B) Therapeutic trials before discontinuing drugs&#10;C) Patient with fibromyalgia are candidates for adjuvant analgesics&#10;D) Neuropathic pain patients are candidates for adjuvant analgesia

Accepted Answer

The highest level of evidence with the use of adjuvant analgesics is in the treatment of neuropathic pain. This has been demonstrated in numerous randomized controlled trials and systematic reviews. Options A, B, and C are not relevant to the question and are therefore incorrect.

Question 4

Hospice care differs from palliative care in that:&#10;A) It is not covered by insurance&#10;B) Supports patients and families through both the dying and the bereavement process&#10;C) It cannot be provided in the nursing home&#10;D) The majority of those admitted to hospice die within 7 days

Accepted Answer

Hospice care provides support for patients and families through the dying process, but also provides bereavement support after the patient has passed. Palliative care primarily focuses on relieving symptoms and improving quality of life for patients with serious illnesses, but does not necessarily involve end-of-life care or bereavement support. Options A, C, and D are all incorrect as hospice care is typically covered by insurance, can be provided in various settings including nursing homes, and patients can receive hospice care for longer than 7 days.

Question 5

Pain at the end of life is most often due to all of the following except:&#10;A) Musculoskeletal disorders&#10;B) Headache&#10;C) Cancer pain&#10;D) Neuropathic pain

Accepted Answer

Headache is less commonly a cause of pain at the end of life compared to musculoskeletal disorders, cancer pain, and neuropathic pain, which are more prevalent in terminal conditions.

Question 6

The strongest level of evidence reflects the absolute contraindication for NSAID use exists with:&#10;A) Chronic kidney disease&#10;B) Peptic ulcer disease&#10;C) Heart disease&#10;D) Liver disease

Accepted Answer

The answer of The strongest level of evidence reflects the...

Question 7

Pharmacological interventions for dyspnea include all of the following except:&#10;A) Antitussives&#10;B) Inhaled anesthetics&#10;C) Sedatives&#10;D) Anxiolytics

Accepted Answer

The answer of Pharmacological interventions for dyspnea include all of...

Question 8

The first step in treating delirium is to:&#10;A) Give low-dose Haldol if the patient has psychosis&#10;B) Identify the cause&#10;C) Provide reality orientation&#10;D) Use side rails and/or wrist restraints to keep the patient safe

Accepted Answer

Identifying the cause of delirium is essential in order to appropriately treat and manage it. Treatment will then depend on the underlying cause. Giving medications such as Haldol or using restraints should not be the first line of treatment and can potentially worsen delirium. Reality orientation may be helpful in some cases, but again, identifying and treating the underlying cause is essential.

Question 9

The majority of patients enrolled in hospice care die:&#10;A) In a nursing home&#10;B) In the hospital&#10;C) In an inpatient hospice facility&#10;D) At home

Accepted Answer

The majority of patients enrolled in hospice care die at home, surrounded by their loved ones and with the support of hospice care providers. This is often a preferred option for patients and families who want to spend their final moments together in the comfort of their own home. However, patients may also choose to receive hospice care in a nursing home or inpatient hospice facility, and some may still pass away in the hospital.

Question 10

The most prevalent symptom in end-of-life care includes all of the following except:&#10;A) Lower extremity weakness&#10;B) Pain&#10;C) Dyspnea&#10;D) Delirium

Accepted Answer

Lower extremity weakness is not typically a prevalent symptom in end-of-life care. The most common symptoms include pain, dyspnea, and delirium.

Question 11

A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea)is:&#10;A) Morphine&#10;B) Methadone&#10;C) Gabapentin&#10;D) Lorazepam

Accepted Answer

The answer of A drug that can be used to...

Question 12

Evidence reflects the primary obstacle to implementing palliative care in the long-term care setting include all of the following except:&#10;A) Inadequate communication between decision makers&#10;B) Failure to recognize futile treatments&#10;C) Lack of advance directives&#10;D) Lack of sufficient staff

Accepted Answer

The answer of Evidence reflects the primary obstacle to implementing...

Question 13

Delirium is typically characterized by all of the following except:&#10;A) Inattention&#10;B) Hyperactive level of psychomotor activity&#10;C) Disorganized thinking&#10;D) Altered level of consciousness

Accepted Answer

The answer of Delirium is typically characterized by all of...

Question 14

The highest level of evidence to support interventions at the end of life is with:&#10;A) Opioids for pain control&#10;B) Hyocsyamine for respiratory secretions&#10;C) Stimulant laxatives for treating constipation&#10;D) Opioids for dyspnea

Accepted Answer

The answer of The highest level of evidence to support...

Question 15

The best description of complicated grief is:&#10;A) Chronic,delayed,exaggerated,masked,or disenfranchised&#10;B) Experience of shock during notification of the death&#10;C) When grief is actually experienced before the death of a loved one&#10;D) A physical illness develops soon after death of a loved one

Accepted Answer

The answer of The best description of complicated grief is:&#10;A)...

Question 16

All of the following statements are true about interventions in working with the bereaved except:&#10;A) Allow the active expression of grief&#10;B) There is strong evidence behind recommended interventions&#10;C) Staff attending memorial services support the family&#10;D) Provide both emotional and spiritual support

Accepted Answer

The answer of All of the following statements are true...

Deck 19: Palliative Care and End-Of-Life Care