181-193
End-of-Life Care Quiz
Test your knowledge on the management of pain and symptoms for patients in palliative care. This quiz covers essential concepts in treating patients with metastatic cancer and their end-of-life needs.
- 12 questions focusing on pain management, opioid use, and symptom control.
- Ideal for healthcare professionals seeking to enhance their knowledge in palliative care.
A 90-year-old male with a history of metastatic lung cancer is admitted to hospice. You agree to follow the patient. The following week the hospice nurse calls you because the patient is complaining of significant dyspnea. His oxygen saturation is 91% on room air. A physical examination reveals diminished but otherwise clear breath sounds. Which one of the following is the treatment of choice for this patient's dyspnea?
A) Oxygen
B) Albuterol in normal saline by nebulizer
C) Prednisone orally
D) Morphine sulfate sublingually
E) Lorazepam (Ativan) orally
The son of a 76-year-old female with metastatic cancer calls you stating that the patient is having uncontrollable nausea. She takes long-acting morphine for pain and he has already tried giving her promethazine and ondansetron (Zofran) without significant benefit. She has been able to drink fluids, but feels “full” and has not eaten more than a few bites of food each day. She has not been vomiting and her urine output has been normal. However, the son reports that she has not had a bowel movement in about 5 days, which he assumes is due to her low intake of food. Which one of the following would be most appropriate at this point?
A) Increasing the dosage of oral morphine
B) Initiating subcutaneous hydration
C) Assessing for possible fecal impaction
D) Inserting a nasogastric tube
E) Suggesting oral or inhaled marijuana
The following drugs are not included in step I WHO analytic ladder
A. Paracetamol
B. Codeine
C. Declofenac
D. Ibuprofen
First line drug for opioid induced nausea and vomiting:
A. Haloperidol
B. Prokinetic agents(Metoclopramide)
C. 5HT3 Antagonists
D. Steroids
The single MOST IMPORTANT feature that defines opioid drug addiction (Psychological dependence) is:
A. An increasing need for the drug over time
B. Complaint of pain exceeding that expected for a given medical problem
C. Development of withdrawal when the drug is stopped
D. Evidence of adverse life consequences from drug use
Factors that contribute, with pain, to suffering at the end of life include:
A. Depression
B. Joy
C. Poor communications
D. Good family relationships L
The most appropriate definition of pain is
A. Unpleasant sensation associated always with demontrable tissue injury
B. Unpleasant sensation described in terms of tissue injury, not always demontrable
C. Unpleasant sensation measured objectively
D. Unpleasant sensation that is only physical
Morphine causes pain relief by
A. Mu receptor agonist action
B. Prostaglandin mediated analgesic action
C. Nerve ablation
D. NMDA recptor block
Mu receptor is locaterd in the following places
A. GIT
B. Peripheral tissue
C. Posterior column
D. All of the above
Side effects of morphine include all except
A. neurotoxicity
B. constipation
C. insomnia
D. vomiting
The half life of oral morphine syrup is
A. 3-5 hours
B. 1-2 hours
C. 8-10 hours
D. 12 hours
The half life of SR morphine is
A. 8-12 H
B. 12-24 H
C. 4-6 H
D. None of the above
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