Palliative Care Nursing Quality Care to the End of Life 5th Edition Matzo Test Bank CHAPTER 1 Palliative Care Nursing Multiple Choice
- The majority of hospice care is provided in which setting?
- Hospitals
- Private residences
- Jails
- PC clinics
Answer: B
Rationale: While hospice occurs in many different settings such as acute care hospital units, PC clinics or ambulatory settings, private practices, and prisons, most hospice care is provided in private residences such as nursing homes, homes, and residential facilities.
- Which entity is the first professional organization for excellence in the practice of hospice
- National Board for Certification of Hospice and Palliative Nurses (NBCHPN)
- Hospice and Palliative Nurses Foundation (HPNF)
- Advancing Expert Care (AEC)
- Hospice and Palliative Care Nurses Association (HPNA)
nursing?
Answer: D
Rationale: Incorporated in 1987, the Hospice Nurses Association (HNA) became the first professional nursing organization dedicated to promoting excellence in the practice of hospice nursing. NBCHN is the National Board for Certification of Hospice and Palliative Nurses. HPNF is the Hospice and Palliative Nurses Foundation. In 2014, the HPNA came together with the Hospice and Palliative Nurses Foundation (HPNF) and the Hospice and Palliative Credentialing Center (HPCC) to form a partnership with a synergized mission. The three distinct organizations form Advancing Expert Care (AEC).
- In 1995, SUPPORT investigators came to which conclusion?
- Patients with end-of-life care felt they had adequate communication with their healthcare
- Patients with end of life care were requesting less-aggressive medical treatments.
- Dying patients require an individual and collective commitment from healthcare
- Dying patients were reporting moderate levels of pain and needed little increase in
providers.
providers.
medication.
Answer: C
Rationale: The “Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment” (SUPPORT; SUPPORT Study Investigators, 1995) investigators believed that improving the end-of-life care for patients required an individual and collective commitment of healthcare providers and that the caregiving processes needed to be reshaped. SUPPORT findings indicated a lack of communication between patients and their providers, particularly 1 / 4
related to EOL preferences, aggressiveness of medical treatments, and a high level of reported pain by seriously ill and dying patients.
- Which type of disease is a leading cause of death today?
- Infectious
- Autoimmune
- Chronic
- Acute
Answer: C
Rationale: People today are living much longer than those of previous eras. The leading causes of death have changed from primarily infectious diseases to chronic illnesses. In 2014, the 10 leading causes of death were heart disease, cancer, chronic lower respiratory diseases, unintentional injuries, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease, and suicide. These 10 causes of death accounted for 74% of the 2.6 million deaths in 2014.
- What is the purpose of the eight domains of palliative care?
- To reflect national guidelines for quality palliative care
- To correlate palliative care with hospice parameters
- To determine nursing school palliative care learning objectives
- To educate physicians on the benefits of a palliative care
Answer: A
Rationale: The domains of quality palliative care are designed to complement the process of improving PC quality. The qualifications of caregivers are determined by the organizations that grant professional credentials and programmatic accreditation. As a specialty organization, the Hospice and Palliative Care Nurses Association has identified the scope and standards of hospice and palliative care nursing and the competencies at all levels of nursing practice, specifically nursing assistants, licensed vocational nurses, professional registered nurses, and advanced practice nurses.
- In addition to the nurse, which professionals are core members of the palliative care team?
- Dietician and physical therapist
- Physician and pharmacist
- Physician and nursing assistant
- Physician and social worker
Answer: D
Rationale: At the very minimum, the interprofessional team includes the physician, nurse, social worker, and clergy. While physical therapists, dieticians, and nursing assistants can play significant roles in the patient’s care, they are not considered part of the minimal team. 2 / 4
- What is the last step in the advanced practice nurse’s standards for development and
- Planning
- Consultation
- Diagnosis
- Evaluation
implementation of a plan of care?
Answer: D
Rationale: A specific notation of standards applies only to the advanced practice nurse, especially when creating a plan of care for the patient. The steps involved are assessment, diagnosis, outcome identification, planning, implementation, coordination of care, health teaching and health promotion, consultation, prescriptive authority and treatment, and evaluation.
- Which situation shows a nurse demonstrating competency in collaboration when providing
- Checking current research on effective pain management when determining the care plan
- Consulting with a dietician when determining the meal plan for a patient with end-stage
- Providing a list of caregiver support groups to a patient's family members
- Reflecting on actions taken in a care situation and how they may be improved
palliative care?
for an end-of-life patient
renal failure
Answer: B
Rationale: Interprofessional collaborative practice involves different types of health professionals working together with patients, families, and communities to deliver best practices and best patient outcomes. Practicing evidence-based nursing, being knowledgeable regarding resources to assist patients and families, and evaluating care are nursing competencies but does not reflect interprofessional collaboration.
- What is the core principle of palliative care?
- Patient’s family involvement is approved by the healthcare provider.
- Patient’s care depends primarily on the disease involved.
- Patient and healthcare provider are the unit of care.
- Patient and family are the unit of care.
Answer: D
Rationale: A core principle of palliative care across the entire disease spectrum and in all settings is that the patient and family constitute the unit of care. The patient and family, rather than the disease, are the primary focus of care. Family-centered care forms the foundation of palliative care philosophy; it addresses the meaning of disease, suffering, life, and death within the context of each family unit.
- Physical, psychological, spiritual, and social dimensions are part of which conceptual model?
- Whole-person suffering
- Calkin model of advanced nursing practice
- Systems approach
- Clinical ethics 3 / 4
Answer: A
Rationale: Dame Cicely Saunder is the founder of St. Christopher’s Hospice in London. She developed a conceptual model of “whole-person” suffering that has four dimensions: physical, psychological, spiritual, and social. Suffering affects each domain of the bio–psycho–social– spiritual aspects of care. This forms the basis for the description of palliative care nursing practice.
Short Answer
- What is the difference between palliative care and hospice care?
Model Answer: While there are similarities between palliative care and hospice care, palliative care involves identifying and preventing serious, chronic, or life-threatening illness, and is used along with measures to reverse the illness or prolong life. The focus is pain and symptom relief for the patient, comfort measures, and management of physical, psychological, or spiritual issues that the patient may experience during the illness trajectory.Palliative care was built on the foundation of Hospice care which is holistic, comprehensive care of the patient and family with serious, life-threatening, and progressive illness. The difference is that patients may be enrolled in Hospice, as a Medicare benefit, only during that last six months before death. Palliative and Hospice care exist on the same continuum of care with palliative care offered earlier in the illness experience. If a patient decides not to enroll in Hospice, Palliative care can also continue through the death of the patient and into the bereavement period of families.
- Describe three factors that drew national attention to palliative care as it was first emerging
as a care specialty.
Model Answer: Billings and Block (1997) identified forces that increased national attention on palliative care. These included growing interest in death and dying; development of hospice programs; increasing integration of pain and symptom management into conventional care; concern about the high cost of dying; increased national focus on pain management; greater attention in medicine to caring rather than curing; national debates on physician-assisted suicide and euthanasia. All of these forces led to increased demand for expert, comprehensive palliative and hospice care.
- What are at least four standards of nursing practice?
Model Answer: The standards of nursing practice, which are the foundations of palliative care and hospice nursing, include providing age-appropriate and culturally, ethnically, and spiritually sensitive care and support; maintaining a safe environment; educating patients and families to identify appropriate settings and treatment options; assuring continuity of care and transitioning to the next appropriate setting; coordinating care across settings and among caregivers; managing information and protecting confidentiality; communicating promptly and effectively.
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