Question

The term ‘palliative care’, when used in relation to making health care decisions, takes into perspective all of the following except:

1. The experience of pain is subjective
2. Family and carers need to be supported through the grieving process as well
3. Having a discussion with a person who is in palliative care about where they wish to die
4. Patients have to stay in a hospital to get effective pain relief

Palliative care should include all of the following principals except:

a. It is only relevant for cancer patients

b. It provides relief from pain and other distressing symptoms

c. It should neither hasten nor postpone death

d. It enhances quality of life

When a person is dying the nurse should:

a. Understand the person’s wishes and support the person to die with dignity

b. Ask to look after other patients as this person has no hope of cure and is wasting their time and skills

c. Ignore the family and carers as they are not the patient

d. Delay giving pain medication as they could become addicted

Morphine is a common pain-relieving medication in palliative care. Which of the following statements is false?

a. People should wait until their pain is severe to take morphine so it will be effective when it is really needed

b. The experience of pain is subjective

c. An overdose of morphine may inhibit normal respiratory function

d. Give morphine as charted and have the dose reviewed if needed to manage pain

Cultural factors that may impede nursing care include:

a. Language barriers that inhibit effective communication

b. Lack of understanding regarding religious or spiritual needs

c. Personal bias or preconceived beliefs about other cultures

d. All of the above

Breakthrough pain occurs:

a.   When a patient is on a therapeutic level of pain management and is comfortable

b.   As a result of nausea and vomiting

c. In between regular intervals of pain relief and requires additional pain relief titrated to the patient’s level of comfort

d. As a result of administering too much analgesia

Answer 1

1. The term palliative care, when used in relation to making health care decisions , takes into perspective ,except

ANS: Answer is option d. Patient does not have to in hospital for effective pain management.Palliative care can be provided in home settings also.

All other statements are correct regarding the palliative care.

2.Palliative care should include all the following principals except:

ANS: Here answer is option a. Palliative here is not exclusively for cancer patients. It is for all patients with terminal illness.

All other statements are principals of palliative care.

3.When a person is dying the nurse should

ANS:Here answer is option a. Nurse should understant patients wishes and support the person to die with dignity.

All other options are incorrect.Other options are opposite to what a nurse is supposed to do while caring for dying patients.

4 False statement regarding morphine

ANS:Here answer is option a. People shouldn't have to wait to take morphine, until their pain is severe for effectiveness.

Other options are correct. Pain is subjective,overdose causes respiratory depression. Morphine should be administered according to physician's order and the dose to be reviewed for effectiveness.

5.Cultural factors that impede nursing care

ANS:Here answer is option d. All the given statements are correct. Language barriers, religious and siritual needs,personal bias all are cultural factors that impede nursing care.

6.Breakthrough pain occurs

ANS: Here option is b.Breakthrough pain is a sudden ,brief flare up of pain .This may be caused by certain activities such as vomiting,coughing ,eating,defecation etc.

Option c is also correct. Breakthrough pain also occurs when the dose of pain medication that patient is taking wears off.And breakthrough pain is treated with short acting opioid that is 5 to 20 %of the dose you normally take for chronic pain

Other options a and d are incorrect.