Palliative Care and Pain Management at the End of Life ___________________________________________
23. ]When managing dyspnea in patients with terminal illness, A) nonpharmacologic interventions are generally ineffective. B) the first step is treatment of symptoms rather than underlying cause. C) evidence supports the use of opioids for patients with advanced lung disease. D) providing supplemental oxygen should be the primary approach, even in patients without hypoxemia.
29. Which of the following is NOT a precipitating factor of delirium at the end of life? A) Overhydration
B) Decreased sensory input C) Psychotropic medications D) A change in environment
30. Of the following, which has been shown to be bothersome to the greatest proportion of individuals receiving palliative care? A) Relationships B) Loss of function and normalcy C) Concerns about the dying process and death D) Emotional, spiritual, existential, or non-specific distress 31. Which of the following is TRUE regarding anxiety at the end of life? A) Anxiety is rarely a side effect of a medication. B) Pharmacologic approaches are essential for managing anxiety. C) Anxiety manifests itself through only psychological and cognitive signs. D) None of the above
24. Which of the following is TRUE regarding constipation in the end of life?
A) Constipation should be reassessed at least every three days. B) Polyethylene glycol and lactulose improve stool frequency. C) Assessment includes determining what herbal remedies the patient may be taking. D) All of the above 25. Which of the following antiemetic agents is recommended for uremia-induced nausea in people with end-stage chronic kidney disease?
32. Which of the following is FALSE regarding depression at the end of life?
A) Haloperidol B) Ondansetron C) Metoclopramide D) Hyoscine hydrobromide
A) Polypharmacy can increase the risk of depression. B) Cognitive therapy alone is recommended as treatment. C) Distraction therapy has been effective for mild-to- moderate depression. D) A diagnosis requires at least five depression-related symptoms within a two-week period. 33. Which of the following is FALSE regarding spiritual needs of patients at the end of life? A) Spiritual care is well-defined. B) Spirituality is considered to be separate from religious faith. C) Spirituality has a strong protective effect against end-of- life distress. D) Greater spiritual well-being has been associated with decreased anxiety and depression among people with advanced disease.
26. The most widely used appetite enhancer for patients with life-limiting disease is A) ondansetron.
B) dexamethasone. C) megestrol acetate. D) None of the above
27. Among terminally ill patients, the highest rates of diarrhea have been associated with A) cancer.
B) HIV/AIDS. C) heart failure. D) end-stage renal disease.
28. The most common contributor to sleep disturbances in patients at the end of life is A) dyspnea. B) hot flashes.
34. Which of the following measures are appropriate for managing the so-called “death rattle?”
A) Oropharyngeal suction B) Laying the patient supine C) Anticholinergic medications D) All of the above
C) uncontrolled pain. D) nocturnal hypoxia.
Self-Assessment questions continue on next page
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MDCA1525
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