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Quizzes > Health & Medicine

End-of-Life Care NCLEX: Tackle end of life NCLEX questions

Quick, free quiz with realistic palliative care NCLEX questions. Instant scoring.

Editorial: Review CompletedCreated By: Jonix CollazoUpdated Aug 27, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art showing palliative care NCLEX quiz with end of life care icons score tracking and expertise boost on dark blue background

Use this End-of-Life Care NCLEX quiz to check your understanding of symptom relief, communication, and ethical basics. Work through realistic items, see your score, and spot topics to review. For more practice, try our death and dying quiz and deepen fundamentals with the palliative care quiz.

What is the primary goal of palliative care?
Cure the disease
Manage pain and improve quality of life
Provide only spiritual support
Prolong life at all costs
Palliative care focuses on relieving pain and other distressing symptoms to improve quality of life rather than curing the underlying illness. The goal is to support patients and families through comprehensive physical, psychosocial, and spiritual care. It can be provided alongside curative treatments at any stage of a serious illness. For more details see .
Which pain assessment tool is most appropriate for a nonverbal patient with advanced dementia?
FLACC Scale
Wong-Baker FACES Pain Scale
PAINAD Scale
Numeric Rating Scale (0 - 10)
The PAINAD (Pain Assessment in Advanced Dementia) scale is designed for patients who cannot verbally communicate their pain levels due to cognitive impairment. It evaluates breathing, vocalization, facial expression, body language, and consolability. Tools like FLACC are more commonly used in pediatric settings. For more information see .
A dying patient consistently refuses oral intake. What is the most appropriate nursing action?
Notify the provider to start IV nutrition
Respect refusal and provide mouth care
Explain that eating will help them get stronger
Force fluids with a feeding tube
In end-of-life care, anorexia and decreased intake are expected physiologic changes. Forcing fluids or nutrition can cause discomfort and distress. Offering mouth care maintains comfort and dignity without imposing unwanted interventions. Further guidance is available at .
Which document legally outlines a patient's preferences for life-sustaining treatments if they lose decision-making capacity?
DNR Order
POLST Form
Living Will
Durable Power of Attorney for Health Care
A living will specifically states a patient's wishes regarding life-sustaining treatments when they cannot communicate. A Durable Power of Attorney for Health Care designates a surrogate decision-maker but does not detail specific treatment preferences. DNR orders apply only to resuscitation efforts. See .
Which position is most effective in relieving dyspnea in an end-of-life patient?
Prone with head turned
Trendelenburg (head down)
Full Fowler's (90° elevation)
Supine with legs elevated
Semi-Fowler's (45° elevation)
Semi-Fowler's position reduces pressure on the diaphragm and improves chest wall expansion, easing breathing efforts. Full Fowler's can cause discomfort and sliding in bed, while Trendelenburg may increase respiratory distress. Positioning should be individualized and comfort-focused. Consult for more details.
A hospice patient on a morphine infusion has a respiratory rate of 7 breaths per minute. What is the nurse's priority action?
Administer naloxone immediately
Increase oxygen flow and call the physician
Decrease the infusion rate and stimulate the patient
Continue monitoring since this is expected
Respiratory depression from opioids should be managed by reducing the dose and providing stimulation to encourage breathing. Immediate naloxone can reverse analgesia and precipitate severe pain. Oxygen alone does not address opioid effect. The NCSBN recommends dose adjustment first; see .
Which opioid analgesic is safest for a patient with end-stage renal disease?
Morphine
Fentanyl
Meperidine
Codeine
Fentanyl is metabolized hepatically and has no active metabolites that accumulate in renal failure. Morphine and codeine produce metabolites that can cause neurotoxicity when excreted poorly. Meperidine's metabolite normeperidine also accumulates and risks seizures. See .
Which clinical sign most reliably indicates that a patient is in the final hours of life?
Elevated body temperature
Mottling of the extremities
Improved appetite
Increased urine output
Mottling of the skin, especially on the knees and feet, reflects decreased perfusion and is a common sign of impending death. Increased urine output and appetite are inconsistent with the dying process. Fever can occur due to infection but is not specific to imminent death. For symptom patterns see .
Which statement best describes hospice care eligibility?
Requires a DNR and DNI order
Must continue all curative treatments
Life expectancy of six months or less if the disease runs its usual course
Available only in an inpatient facility
Hospice is intended for patients with a life expectancy of six months or less when curative treatments are no longer pursued. It can be provided in home or inpatient settings and focuses on comfort rather than cure. A DNR/DNI order is encouraged but not mandatory for eligibility. Further definitions are at .
What should the nurse do first when providing postmortem care?
Ask the family for final view
Document the time of death
Clean and bathe the body
Remove tubing and devices
Caring for the body with dignity includes bathing and grooming before removal of devices or allowing family viewing. Cleaning also helps prevent skin breakdown and odors. Documentation and device removal follow agency policy after the body is prepared. Detailed steps are described at .
Which ethical concept describes administering high-dose opioids for pain control that may unintentionally hasten death?
Doctrine of Double Effect
Principle of Fidelity
Principle of Justice
Principle of Autonomy
The Doctrine of Double Effect permits an action intended to relieve suffering even if it may foreseeably hasten death, provided the intent is not to cause death. It balances beneficence and nonmaleficence in palliative care. Autonomy and other principles guide decision making but do not specifically address unintended outcomes. Read more at .
Which statement accurately distinguishes palliative sedation from euthanasia?
Euthanasia relieves suffering by reducing consciousness
Euthanasia is allowed in all hospice settings
Palliative sedation intentionally hastens death
Palliative sedation aims to relieve refractory symptoms without intent to hasten death
Palliative sedation is used to relieve intractable suffering by reducing consciousness without intent to shorten life. Euthanasia is the intentional act of ending a patient's life. The ethical distinction hinges on intent and proportionality. For guidelines see .
Which medication is most effective in reducing the respiratory secretions known as the 'death rattle'?
Glycopyrrolate
Midazolam
Scopolamine patch
Atropine drops
Glycopyrrolate is an anticholinergic that reduces respiratory tract secretions without crossing the blood - brain barrier. It is often preferred over scopolamine because it causes less sedation. Atropine can be used but may not be as effective subcutaneously. For pharmacologic details see .
Which adjunct medication is most appropriate for managing neuropathic pain in end-of-life care?
Ibuprofen
Acetaminophen
Naloxone
Gabapentin
Gabapentin is a first-line agent for neuropathic pain and can be used alongside opioids for synergistic effect. NSAIDs and acetaminophen are more effective for nociceptive pain. Naloxone reverses opioid effects and is not a pain management drug. Evidence-based guidance is available at .
A patient's advance directive was executed in another state and does not meet your state's requirements. What is the nurse's best action?
Initiate full aggressive treatment until a new directive is completed
Disregard the advance directive and follow default hospital policy
Ask the provider to override the patient's wishes
Contact the patient's designated health care proxy for clarification
When an advance directive is not legally valid in a given jurisdiction, the nurse should work with the designated health care proxy to interpret the patient's wishes. Disregarding it or overriding the patient's intent violates ethical and legal standards. Full treatment until a new directive may not reflect patient preferences. For legal guidance see .
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Study Outcomes

  1. Analyze end-of-life care NCLEX questions -

    Understand patterns and key concepts within common exam items to strengthen test-taking strategies.

  2. Apply evidence-based interventions from palliative care practice questions -

    Demonstrate appropriate nursing actions and protocols in end-of-life scenarios based on current best practices.

  3. Evaluate symptom management techniques in palliative care MCQs quiz -

    Assess pain relief, comfort measures, and holistic care approaches for terminally ill patients.

  4. Integrate ethical and communication principles in end-of-life care -

    Use compassionate dialogue and uphold patient autonomy during end-of-life decision-making.

  5. Identify knowledge gaps through scored feedback from our palliative care quiz -

    Interpret instant quiz results to pinpoint areas requiring further study and reinforce understanding.

  6. Enhance clinical confidence for NCLEX preparedness -

    Utilize performance insights from the end-of-life care NCLEX questions quiz to build competence and reduce exam anxiety.

Cheat Sheet

  1. PQRSTU Pain Assessment Mnemonic -

    The PQRSTU mnemonic (Provocation, Quality, Region, Severity, Timing, Understanding) ensures comprehensive pain assessment, guiding end of life care NCLEX questions on pain management. For example, ask "What makes it better or worse?" for Provocation and "How does it affect your daily activities?" for Understanding. This approach, endorsed by the American Pain Society, boosts accuracy in palliative care MCQs quiz scenarios.

  2. WHO Analgesic Ladder & Opioid Equianalgesic Dosing -

    The WHO three-step analgesic ladder recommends starting with non-opioids, then weak opioids, and finally strong opioids for moderate-to-severe pain. Memorize equianalgesic charts (e.g., morphine 10 mg IV ≈ hydromorphone 1.5 mg IV) to convert safely and prevent overdose. CDC guidelines and palliative care practice questions often test these conversion factors.

  3. Advance Directives and POLST Forms -

    Advance directives and POLST (Physician Orders for Life-Sustaining Treatment) clarify patient wishes and reduce ethical dilemmas in end of life nclex questions. Recall "Living Will" for future care preferences and "Durable Power of Attorney" for decision-making authority if capacity is lost. NIH provides state-specific templates and examples to practice documentation scenarios.

  4. Dyspnea Management with Opioids and Oxygen -

    Low-dose opioids (e.g., morphine 2 - 4 mg PO) reduce the sensation of breathlessness, while low-flow oxygen corrects hypoxemia. Practice palliative care quiz questions on titration: start at 5 mg morphine every 4 hours and adjust by 25 - 50% based on relief and side effects. Guidelines from the American Thoracic Society support this protocol for refractory dyspnea.

  5. SPIKES Protocol for Delivering Bad News -

    Implement the SPIKES framework (Setting, Perception, Invitation, Knowledge, Empathy, Strategy/Summary) to communicate difficult news compassionately, a common scenario in palliative care MCQs quiz. "Perception" involves exploring a patient's understanding before sharing new information, while "Strategy" outlines next steps. This method, endorsed by the National Cancer Institute, ensures clear and empathetic dialogue.

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