Palliative & End-of-Life - 2026 Nursing Protocols: Midterm
Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. Palliative care is best described as:
A. Care provided only in the last days of life
B. Care that requires stopping all curative treatment
C. Care limited to patients with cancer
D. Specialized care focused on relieving suffering and improving quality of life for people with
serious illness, at any stage and alongside curative treatment
Correct Answer: D. Specialized care focused on relieving suffering and improving quality of
life for people with serious illness, at any stage and alongside curative treatment
Rationale: Palliative care is based on need, not prognosis, and can be given with
disease-directed therapy. It is not limited to the final days or to cancer.
2. Research by Temel and colleagues (2010) in metastatic non-small cell lung cancer found that
early palliative care:
A. Shortened survival
B. Had no effect
C. Improved quality of life and mood and was associated with less aggressive end-of-life care
and longer median survival
D. Increased depression
Correct Answer: C. Improved quality of life and mood and was associated with less aggressive
end-of-life care and longer median survival
Rationale: This landmark trial supported integrating palliative care early in serious illness. It did
not show harm.
,3. Self-care for palliative care nurses is important because:
A. Nurses are unaffected by patient deaths
B. It is optional and has no impact
C. It interferes with patient care
D. Repeated exposure to suffering and death can lead to compassion fatigue and burnout
Correct Answer: D. Repeated exposure to suffering and death can lead to compassion fatigue
and burnout
Rationale: Supporting nurse well-being sustains compassionate care. Ignoring it leads to
burnout and turnover.
4. The best time to introduce palliative care is:
A. At diagnosis of a serious illness or when symptom burden increases
B. Only in the last week of life
C. After all treatments fail
D. Never, unless the patient asks
Correct Answer: A. At diagnosis of a serious illness or when symptom burden increases
Rationale: Early integration leads to better outcomes. Waiting until the end limits benefits.
5. Dame Cicely Saunders is recognized for:
A. Developing the five stages of grief
B. Inventing morphine
C. Creating Medicare
D. Founding the modern hospice movement and describing the concept of total pain
Correct Answer: D. Founding the modern hospice movement and describing the concept of
total pain
Rationale: Saunders founded St. Christopher's Hospice in London in 1967 and described pain as
physical, emotional, social and spiritual. Kübler-Ross described grief stages.
,6. A nurse explaining palliative care to a patient who is afraid it means "giving up" should say:
A. "It means we are stopping all treatment"
B. "It is only for people who are dying today"
C. "Palliative care focuses on your comfort and goals and can be given alongside your
treatments"
D. "It replaces your doctors"
Correct Answer: C. "Palliative care focuses on your comfort and goals and can be given
alongside your treatments"
Rationale: Accurate explanation reduces misconceptions and encourages acceptance. The
other statements are inaccurate.
7. The Hospice and Palliative Nurses Association (HPNA) supports nurses by:
A. Providing standards, education and advocacy for hospice and palliative nursing practice
B. Licensing all nurses
C. Paying hospice claims
D. Regulating pharmacies
Correct Answer: A. Providing standards, education and advocacy for hospice and palliative
nursing practice
Rationale: HPNA advances the specialty through education, standards and policy work.
Licensing and payment are not its role.
8. The "surprise question" used to identify patients who may benefit from palliative care asks:
A. Will this patient survive surgery?
B. Does the patient like surprises?
C. Would I be surprised if this patient died in the next 12 months?
D. Has the patient been to the hospital before?
Correct Answer: C. Would I be surprised if this patient died in the next 12 months?
Rationale: A "no" answer suggests a patient may benefit from palliative care and advance care
planning. It is a screening tool, not a precise predictor.
, 9. An important competency for all nurses caring for seriously ill patients is:
A. Avoiding difficult conversations
B. Performing palliative sedation independently
C. Basic communication skills for discussing goals, prognosis and emotions
D. Prescribing opioids
Correct Answer: C. Basic communication skills for discussing goals, prognosis and emotions
Rationale: Communication is central to palliative care. Sedation and prescribing require orders
and specialized protocols.
10. Palliative care principles apply to:
A. Only older adults
B. Patients of all ages, including children and infants
C. Only adults with cancer
D. Only patients in hospice
Correct Answer: B. Patients of all ages, including children and infants
Rationale: Pediatric and perinatal palliative care address the needs of young patients and
families. It is not limited by age.
11. The interdisciplinary palliative care team typically includes:
A. Only physicians
B. Only nurses
C. Physicians or advanced practice providers, nurses, social workers, chaplains and others such
as pharmacists and volunteers
D. Only family members
Correct Answer: C. Physicians or advanced practice providers, nurses, social workers,
chaplains and others such as pharmacists and volunteers
Rationale: Addressing physical, emotional, social and spiritual needs requires multiple
disciplines. Single-discipline care cannot meet all needs.
Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. Palliative care is best described as:
A. Care provided only in the last days of life
B. Care that requires stopping all curative treatment
C. Care limited to patients with cancer
D. Specialized care focused on relieving suffering and improving quality of life for people with
serious illness, at any stage and alongside curative treatment
Correct Answer: D. Specialized care focused on relieving suffering and improving quality of
life for people with serious illness, at any stage and alongside curative treatment
Rationale: Palliative care is based on need, not prognosis, and can be given with
disease-directed therapy. It is not limited to the final days or to cancer.
2. Research by Temel and colleagues (2010) in metastatic non-small cell lung cancer found that
early palliative care:
A. Shortened survival
B. Had no effect
C. Improved quality of life and mood and was associated with less aggressive end-of-life care
and longer median survival
D. Increased depression
Correct Answer: C. Improved quality of life and mood and was associated with less aggressive
end-of-life care and longer median survival
Rationale: This landmark trial supported integrating palliative care early in serious illness. It did
not show harm.
,3. Self-care for palliative care nurses is important because:
A. Nurses are unaffected by patient deaths
B. It is optional and has no impact
C. It interferes with patient care
D. Repeated exposure to suffering and death can lead to compassion fatigue and burnout
Correct Answer: D. Repeated exposure to suffering and death can lead to compassion fatigue
and burnout
Rationale: Supporting nurse well-being sustains compassionate care. Ignoring it leads to
burnout and turnover.
4. The best time to introduce palliative care is:
A. At diagnosis of a serious illness or when symptom burden increases
B. Only in the last week of life
C. After all treatments fail
D. Never, unless the patient asks
Correct Answer: A. At diagnosis of a serious illness or when symptom burden increases
Rationale: Early integration leads to better outcomes. Waiting until the end limits benefits.
5. Dame Cicely Saunders is recognized for:
A. Developing the five stages of grief
B. Inventing morphine
C. Creating Medicare
D. Founding the modern hospice movement and describing the concept of total pain
Correct Answer: D. Founding the modern hospice movement and describing the concept of
total pain
Rationale: Saunders founded St. Christopher's Hospice in London in 1967 and described pain as
physical, emotional, social and spiritual. Kübler-Ross described grief stages.
,6. A nurse explaining palliative care to a patient who is afraid it means "giving up" should say:
A. "It means we are stopping all treatment"
B. "It is only for people who are dying today"
C. "Palliative care focuses on your comfort and goals and can be given alongside your
treatments"
D. "It replaces your doctors"
Correct Answer: C. "Palliative care focuses on your comfort and goals and can be given
alongside your treatments"
Rationale: Accurate explanation reduces misconceptions and encourages acceptance. The
other statements are inaccurate.
7. The Hospice and Palliative Nurses Association (HPNA) supports nurses by:
A. Providing standards, education and advocacy for hospice and palliative nursing practice
B. Licensing all nurses
C. Paying hospice claims
D. Regulating pharmacies
Correct Answer: A. Providing standards, education and advocacy for hospice and palliative
nursing practice
Rationale: HPNA advances the specialty through education, standards and policy work.
Licensing and payment are not its role.
8. The "surprise question" used to identify patients who may benefit from palliative care asks:
A. Will this patient survive surgery?
B. Does the patient like surprises?
C. Would I be surprised if this patient died in the next 12 months?
D. Has the patient been to the hospital before?
Correct Answer: C. Would I be surprised if this patient died in the next 12 months?
Rationale: A "no" answer suggests a patient may benefit from palliative care and advance care
planning. It is a screening tool, not a precise predictor.
, 9. An important competency for all nurses caring for seriously ill patients is:
A. Avoiding difficult conversations
B. Performing palliative sedation independently
C. Basic communication skills for discussing goals, prognosis and emotions
D. Prescribing opioids
Correct Answer: C. Basic communication skills for discussing goals, prognosis and emotions
Rationale: Communication is central to palliative care. Sedation and prescribing require orders
and specialized protocols.
10. Palliative care principles apply to:
A. Only older adults
B. Patients of all ages, including children and infants
C. Only adults with cancer
D. Only patients in hospice
Correct Answer: B. Patients of all ages, including children and infants
Rationale: Pediatric and perinatal palliative care address the needs of young patients and
families. It is not limited by age.
11. The interdisciplinary palliative care team typically includes:
A. Only physicians
B. Only nurses
C. Physicians or advanced practice providers, nurses, social workers, chaplains and others such
as pharmacists and volunteers
D. Only family members
Correct Answer: C. Physicians or advanced practice providers, nurses, social workers,
chaplains and others such as pharmacists and volunteers
Rationale: Addressing physical, emotional, social and spiritual needs requires multiple
disciplines. Single-discipline care cannot meet all needs.
