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Test 8: Palliative care

  1. What is palliative care?
    • Primary care provided at a local clinic
    • Poor care which is offered when the facilities and staff are not available to provide good care
    • Care that aims at curing the patient
    • Care that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness
  2. What is the main aim of palliative care?
    • To improve the quality of life and relieve symptoms
    • To save money by keeping the patient out of hospital
    • To remove the responsibility from the family by hospitalising the patient
    • To transfer care from doctors to nurses
  3. What is terminal care?
    • Care that addresses the needs of the patient and family when you think the patient is dying
    • Care which is aimed at speeding up the dying process
    • Care that is provided on the day before a patient is discharged home from hospital
    • Care that is given in a final attempt to cure the illness
  4. How do you gain a patient’s trust?
    • By giving clear, strict instructions
    • By promising that they will get better
    • By good communication
    • By bringing them sweets or small presents
  5. It is best to start a conversation by:
    • Discussing the role of religion in palliative care
    • Telling the patient about your experience with palliative care
    • Talking about current news items on TV
    • Asking the patient about their family or interests
  6. Pain is best assessed by:
    • Asking the patient to describe their pain
    • Counting the number of pain tablets remaining in the bottle
    • Taking the patient’s pulse and temperature
    • Speaking to the family
  7. If possible, pain medication should be given by:
    • Applying an anti-inflammatory skin patch
    • Slow intravenous injection
    • Mouth
    • Rectal suppositories
  8. The best medication for mild to moderate pain is:
    • Morphine
    • Aspirin
    • Paracetamol (Panado)
    • Steroids
  9. Ibuprofen (Brufen) for pain:
    • Should be given once a day
    • Has an added effect if given with paracetamol
    • Is of little value as it is an anti-inflammatory
    • Is usually used for severe pain
  10. How frequently should oral morphine be given?
    • Four hourly
    • Six hourly
    • Eight hourly
    • Whenever the patient has pain
  11. How should the dose of morphine be increased if the pain is not controlled?
    • Double the dose
    • Give the doses more frequently
    • Take the medication in small sips over half an hour
    • Calculate the new daily dose by adding the previous day’s regular doses to the extra doses needed
  12. How should the medication be given if the patient has difficulty swallowing tablets?
    • Pass a nasogastric tube to give crushed tablets
    • Use a liquid medication
    • Give the medication by intramuscular injection
    • Use a syringe driver to give the medication by continuous intravenous infusion
  13. How should a fungating wound be cleaned?
    • With soap and water
    • With surgical spirits
    • With a saline or metronidazole (Flagyl) solution
    • Mercurochrome or gentian violet
  14. Bedsores are caused by?
    • Pressure on the skin and underlying tissues
    • Malignant secondary deposits
    • Infection with Staphylococcus
    • Fungal infections
  15. Bedsores can be prevented by:
    • Prophylactic antibiotics
    • Keeping the patients nursed on their back
    • Local antifungal cream
    • Turning patients at least every 2 hours
  16. Constipation is best prevented with?
    • Regular enemas
    • Laxatives twice a day
    • Adding fruit and fibre to the diet
    • Not eating between meals
  17. Patients with breathlessness should be nursed:
    • Lying flat on their backs
    • In the semi-Fowler’s position
    • Sitting upright
    • Lying on their left side
  18. What may help nausea?
    • Drink water with meals
    • Eat more fatty foods
    • Stay in bed
    • Have frequent small snacks
  19. Psychosocial problems:
    • Should only be managed by a social worker
    • Can often be improved by a primary care nurse
    • Are best ignored as they usually cannot be solved
    • Are uncommon in patients if they are cared for in hospital
  20. Which topics are best not discussed when counselling a patient?
    • The financial implications to the family
    • Sexuality
    • Spiritual needs
    • The patient should feel free to discuss any concern