Palliative & End-of-Life - 2026 Nursing Protocols: Exam 3 -
Questions with Correct Answers
100 questions
1. The World Health Organization describes palliative care as an approach that:
A. Hastens death
B. Improves quality of life of patients and families facing life-threatening illness through
prevention and relief of suffering, including physical, psychosocial and spiritual problems
C. Postpones death at all costs
D. Focuses only on physical pain
Correct Answer: B. Improves quality of life of patients and families facing life-threatening
illness through prevention and relief of suffering, including physical, psychosocial and
spiritual problems
Rationale: WHO emphasizes holistic relief of suffering for patients and families, neither
hastening nor postponing death. Physical pain is only one component.
2. Palliative care should be introduced to patients as:
A. Giving up on treatment
B. Only for the last hours of life
C. An extra layer of support focused on comfort and quality of life
D. A replacement for the primary team
Correct Answer: C. An extra layer of support focused on comfort and quality of life
Rationale: Framing palliative care positively reduces fear. It works alongside the primary team.
,3. Patient- and family-centered care in palliative care means:
A. Care is guided by the values, preferences and goals of the patient and family
B. Care follows only institutional routines
C. Families are excluded from decisions
D. Clinicians choose all treatments
Correct Answer: A. Care is guided by the values, preferences and goals of the patient and
family
Rationale: Shared decision-making respects what matters most to patients and families.
Excluding them violates the principle.
4. A patient newly diagnosed with advanced heart failure who is still receiving disease-directed
therapy may benefit from:
A. Waiting until death is imminent
B. Immediate hospice enrollment regardless of prognosis
C. No supportive care
D. A palliative care consultation for symptom management and goals-of-care support
Correct Answer: D. A palliative care consultation for symptom management and goals-of-care
support
Rationale: Palliative care is appropriate early in serious illness, alongside treatment. Hospice
depends on prognosis and goals.
5. Palliative care can be provided in which settings?
A. Only hospitals
B. Only hospices
C. Hospitals, clinics, nursing homes, homes and hospices
D. Only intensive care units
Correct Answer: C. Hospitals, clinics, nursing homes, homes and hospices
Rationale: Community-based palliative care allows patients to receive support where they live.
It is not limited to one setting.
,6. Primary palliative care refers to:
A. Basic palliative skills, such as symptom management and goals-of-care discussions, provided
by all clinicians
B. Care provided only by board-certified palliative specialists
C. Care provided only in hospice
D. Care provided only by chaplains
Correct Answer: A. Basic palliative skills, such as symptom management and goals-of-care
discussions, provided by all clinicians
Rationale: All nurses and clinicians should provide basic palliative care, with specialists
consulted for complex needs. It is not limited to specialists or hospice.
7. The patient's goals of care refer to:
A. The hospital's financial goals
B. The nurse's shift goals
C. What the patient hopes to achieve with treatment, based on their values and priorities
D. Only discharge dates
Correct Answer: C. What the patient hopes to achieve with treatment, based on their values
and priorities
Rationale: Clarifying goals guides treatment choices, such as prioritizing comfort or longevity.
Institutional or staff goals are separate.
8. Specialty palliative care consultation is most appropriate when a patient has:
A. A mild headache
B. A routine postoperative course
C. No symptoms or concerns
D. Complex, refractory symptoms or difficult family conflicts about goals of care
Correct Answer: D. Complex, refractory symptoms or difficult family conflicts about goals of
care
Rationale: Specialists help with challenging situations that exceed primary palliative skills.
Routine needs can be met by the primary team.
, 9. Documentation in hospice should support eligibility by describing:
A. Decline in function, weight, symptoms and other indicators of disease progression
B. Only the patient's favorite foods
C. Only family names
D. Only vital signs
Correct Answer: A. Decline in function, weight, symptoms and other indicators of disease
progression
Rationale: Clear documentation of decline supports recertification and quality care. Single data
points are insufficient.
10. Since October 1, 2025, Medicare-certified hospices collect patient assessment data using:
A. The OASIS tool
B. The Hospice Outcomes and Patient Evaluation (HOPE) tool, which replaced the Hospice Item
Set
C. The MDS
D. No assessment tool
Correct Answer: B. The Hospice Outcomes and Patient Evaluation (HOPE) tool, which replaced
the Hospice Item Set
Rationale: HOPE is part of the Hospice Quality Reporting Program and collects data at
admission, update visits and discharge. OASIS and MDS are used in home health and nursing
homes.
Questions with Correct Answers
100 questions
1. The World Health Organization describes palliative care as an approach that:
A. Hastens death
B. Improves quality of life of patients and families facing life-threatening illness through
prevention and relief of suffering, including physical, psychosocial and spiritual problems
C. Postpones death at all costs
D. Focuses only on physical pain
Correct Answer: B. Improves quality of life of patients and families facing life-threatening
illness through prevention and relief of suffering, including physical, psychosocial and
spiritual problems
Rationale: WHO emphasizes holistic relief of suffering for patients and families, neither
hastening nor postponing death. Physical pain is only one component.
2. Palliative care should be introduced to patients as:
A. Giving up on treatment
B. Only for the last hours of life
C. An extra layer of support focused on comfort and quality of life
D. A replacement for the primary team
Correct Answer: C. An extra layer of support focused on comfort and quality of life
Rationale: Framing palliative care positively reduces fear. It works alongside the primary team.
,3. Patient- and family-centered care in palliative care means:
A. Care is guided by the values, preferences and goals of the patient and family
B. Care follows only institutional routines
C. Families are excluded from decisions
D. Clinicians choose all treatments
Correct Answer: A. Care is guided by the values, preferences and goals of the patient and
family
Rationale: Shared decision-making respects what matters most to patients and families.
Excluding them violates the principle.
4. A patient newly diagnosed with advanced heart failure who is still receiving disease-directed
therapy may benefit from:
A. Waiting until death is imminent
B. Immediate hospice enrollment regardless of prognosis
C. No supportive care
D. A palliative care consultation for symptom management and goals-of-care support
Correct Answer: D. A palliative care consultation for symptom management and goals-of-care
support
Rationale: Palliative care is appropriate early in serious illness, alongside treatment. Hospice
depends on prognosis and goals.
5. Palliative care can be provided in which settings?
A. Only hospitals
B. Only hospices
C. Hospitals, clinics, nursing homes, homes and hospices
D. Only intensive care units
Correct Answer: C. Hospitals, clinics, nursing homes, homes and hospices
Rationale: Community-based palliative care allows patients to receive support where they live.
It is not limited to one setting.
,6. Primary palliative care refers to:
A. Basic palliative skills, such as symptom management and goals-of-care discussions, provided
by all clinicians
B. Care provided only by board-certified palliative specialists
C. Care provided only in hospice
D. Care provided only by chaplains
Correct Answer: A. Basic palliative skills, such as symptom management and goals-of-care
discussions, provided by all clinicians
Rationale: All nurses and clinicians should provide basic palliative care, with specialists
consulted for complex needs. It is not limited to specialists or hospice.
7. The patient's goals of care refer to:
A. The hospital's financial goals
B. The nurse's shift goals
C. What the patient hopes to achieve with treatment, based on their values and priorities
D. Only discharge dates
Correct Answer: C. What the patient hopes to achieve with treatment, based on their values
and priorities
Rationale: Clarifying goals guides treatment choices, such as prioritizing comfort or longevity.
Institutional or staff goals are separate.
8. Specialty palliative care consultation is most appropriate when a patient has:
A. A mild headache
B. A routine postoperative course
C. No symptoms or concerns
D. Complex, refractory symptoms or difficult family conflicts about goals of care
Correct Answer: D. Complex, refractory symptoms or difficult family conflicts about goals of
care
Rationale: Specialists help with challenging situations that exceed primary palliative skills.
Routine needs can be met by the primary team.
, 9. Documentation in hospice should support eligibility by describing:
A. Decline in function, weight, symptoms and other indicators of disease progression
B. Only the patient's favorite foods
C. Only family names
D. Only vital signs
Correct Answer: A. Decline in function, weight, symptoms and other indicators of disease
progression
Rationale: Clear documentation of decline supports recertification and quality care. Single data
points are insufficient.
10. Since October 1, 2025, Medicare-certified hospices collect patient assessment data using:
A. The OASIS tool
B. The Hospice Outcomes and Patient Evaluation (HOPE) tool, which replaced the Hospice Item
Set
C. The MDS
D. No assessment tool
Correct Answer: B. The Hospice Outcomes and Patient Evaluation (HOPE) tool, which replaced
the Hospice Item Set
Rationale: HOPE is part of the Hospice Quality Reporting Program and collects data at
admission, update visits and discharge. OASIS and MDS are used in home health and nursing
homes.
