Palliative & End-of-Life - 2026 Nursing Protocols: Practice Test
1 (Units 1-7) - Questions with Correct Answers
100 questions
1. A common barrier to timely palliative care referral is:
A. Too many palliative specialists
B. The misconception that palliative care is only for the dying or means giving up
C. Patients requesting too much information
D. Excessive funding
Correct Answer: B. The misconception that palliative care is only for the dying or means giving
up
Rationale: Many patients and clinicians equate palliative care with hospice. Education about its
role improves earlier referral.
2. The CAPC (Center to Advance Palliative Care) primarily:
A. Licenses hospice nurses
B. Regulates opioid prescribing
C. Provides tools, training and technical assistance to expand palliative care programs
D. Pays hospice claims
Correct Answer: C. Provides tools, training and technical assistance to expand palliative care
programs
Rationale: CAPC supports organizations in building and improving palliative care. Licensing,
regulation and payment are handled elsewhere.
,3. The nurse's role in palliative care includes:
A. Making all decisions for the patient
B. Assessing and managing symptoms, advocating for patient preferences, educating and
supporting families
C. Avoiding discussions about prognosis in all cases
D. Focusing only on medication administration
Correct Answer: B. Assessing and managing symptoms, advocating for patient preferences,
educating and supporting families
Rationale: Nurses spend the most time with patients and families and are key advocates and
educators. Decisions belong to patients and surrogates.
4. Social workers on the palliative care team commonly help with:
A. Prescribing opioids
B. Psychosocial assessment, family dynamics, advance care planning and access to resources
C. Performing surgery
D. Giving IV medications
Correct Answer: B. Psychosocial assessment, family dynamics, advance care planning and
access to resources
Rationale: Social workers address emotional, practical and financial needs. Prescribing and
procedures are outside their role.
5. Telehealth in palliative care can:
A. Replace all in-person care
B. Be used only in hospitals
C. Eliminate the need for teams
D. Expand access, especially for rural and homebound patients
Correct Answer: D. Expand access, especially for rural and homebound patients
Rationale: Virtual visits support symptom management and family meetings. Some needs still
require in-person care.
,6. A palliative performance status decline, such as spending more time in bed, may signal:
A. Improvement
B. Normal aging only
C. A need for more aggressive treatment in all cases
D. Disease progression and a need to revisit goals of care
Correct Answer: D. Disease progression and a need to revisit goals of care
Rationale: Functional decline is an important prognostic indicator and prompt for planning. It
does not automatically mean more aggressive treatment.
7. Continuity of care across settings in palliative care is supported by:
A. Clear communication, documented goals and portable orders such as POLST
B. Leaving decisions to each new team without information
C. Avoiding documentation
D. Restarting discussions from scratch at each transition
Correct Answer: A. Clear communication, documented goals and portable orders such as
POLST
Rationale: Transitions are high-risk times, and shared information prevents unwanted
treatments. Lack of documentation causes errors.
8. Palliative care screening criteria in hospitals often include:
A. Being under 30 years old
B. Elective surgery
C. Frequent admissions, uncontrolled symptoms, functional decline and complex care needs
D. Normal laboratory values
Correct Answer: C. Frequent admissions, uncontrolled symptoms, functional decline and
complex care needs
Rationale: Triggers help identify patients with unmet needs. Age, elective surgery and normal
labs are not triggers.
, 9. Spiritual care in palliative care is the responsibility of:
A. All team members, with chaplains providing specialized spiritual care
B. Only chaplains
C. Only physicians
D. No one
Correct Answer: A. All team members, with chaplains providing specialized spiritual care
Rationale: Nurses can screen for spiritual distress and provide presence, with referral to
chaplains for complex needs. Spiritual care is shared.
10. The family in palliative care is defined as:
A. Only legally married spouses
B. Only biological relatives
C. Only those living in the same house
D. Those the patient identifies as family, including biological, legal and chosen relationships
Correct Answer: D. Those the patient identifies as family, including biological, legal and
chosen relationships
Rationale: Respecting the patient's definition of family ensures the right people are involved.
Restrictive definitions exclude important supporters.
11. The phrase "hope for the best, prepare for the worst" in palliative care communication
means:
A. Supporting hopes while also planning for possible decline
B. Avoiding all planning
C. Taking away hope
D. Giving false reassurance
Correct Answer: A. Supporting hopes while also planning for possible decline
Rationale: Balancing hope and preparation allows patients to plan without losing hope. False
reassurance and removing hope are harmful.
1 (Units 1-7) - Questions with Correct Answers
100 questions
1. A common barrier to timely palliative care referral is:
A. Too many palliative specialists
B. The misconception that palliative care is only for the dying or means giving up
C. Patients requesting too much information
D. Excessive funding
Correct Answer: B. The misconception that palliative care is only for the dying or means giving
up
Rationale: Many patients and clinicians equate palliative care with hospice. Education about its
role improves earlier referral.
2. The CAPC (Center to Advance Palliative Care) primarily:
A. Licenses hospice nurses
B. Regulates opioid prescribing
C. Provides tools, training and technical assistance to expand palliative care programs
D. Pays hospice claims
Correct Answer: C. Provides tools, training and technical assistance to expand palliative care
programs
Rationale: CAPC supports organizations in building and improving palliative care. Licensing,
regulation and payment are handled elsewhere.
,3. The nurse's role in palliative care includes:
A. Making all decisions for the patient
B. Assessing and managing symptoms, advocating for patient preferences, educating and
supporting families
C. Avoiding discussions about prognosis in all cases
D. Focusing only on medication administration
Correct Answer: B. Assessing and managing symptoms, advocating for patient preferences,
educating and supporting families
Rationale: Nurses spend the most time with patients and families and are key advocates and
educators. Decisions belong to patients and surrogates.
4. Social workers on the palliative care team commonly help with:
A. Prescribing opioids
B. Psychosocial assessment, family dynamics, advance care planning and access to resources
C. Performing surgery
D. Giving IV medications
Correct Answer: B. Psychosocial assessment, family dynamics, advance care planning and
access to resources
Rationale: Social workers address emotional, practical and financial needs. Prescribing and
procedures are outside their role.
5. Telehealth in palliative care can:
A. Replace all in-person care
B. Be used only in hospitals
C. Eliminate the need for teams
D. Expand access, especially for rural and homebound patients
Correct Answer: D. Expand access, especially for rural and homebound patients
Rationale: Virtual visits support symptom management and family meetings. Some needs still
require in-person care.
,6. A palliative performance status decline, such as spending more time in bed, may signal:
A. Improvement
B. Normal aging only
C. A need for more aggressive treatment in all cases
D. Disease progression and a need to revisit goals of care
Correct Answer: D. Disease progression and a need to revisit goals of care
Rationale: Functional decline is an important prognostic indicator and prompt for planning. It
does not automatically mean more aggressive treatment.
7. Continuity of care across settings in palliative care is supported by:
A. Clear communication, documented goals and portable orders such as POLST
B. Leaving decisions to each new team without information
C. Avoiding documentation
D. Restarting discussions from scratch at each transition
Correct Answer: A. Clear communication, documented goals and portable orders such as
POLST
Rationale: Transitions are high-risk times, and shared information prevents unwanted
treatments. Lack of documentation causes errors.
8. Palliative care screening criteria in hospitals often include:
A. Being under 30 years old
B. Elective surgery
C. Frequent admissions, uncontrolled symptoms, functional decline and complex care needs
D. Normal laboratory values
Correct Answer: C. Frequent admissions, uncontrolled symptoms, functional decline and
complex care needs
Rationale: Triggers help identify patients with unmet needs. Age, elective surgery and normal
labs are not triggers.
, 9. Spiritual care in palliative care is the responsibility of:
A. All team members, with chaplains providing specialized spiritual care
B. Only chaplains
C. Only physicians
D. No one
Correct Answer: A. All team members, with chaplains providing specialized spiritual care
Rationale: Nurses can screen for spiritual distress and provide presence, with referral to
chaplains for complex needs. Spiritual care is shared.
10. The family in palliative care is defined as:
A. Only legally married spouses
B. Only biological relatives
C. Only those living in the same house
D. Those the patient identifies as family, including biological, legal and chosen relationships
Correct Answer: D. Those the patient identifies as family, including biological, legal and
chosen relationships
Rationale: Respecting the patient's definition of family ensures the right people are involved.
Restrictive definitions exclude important supporters.
11. The phrase "hope for the best, prepare for the worst" in palliative care communication
means:
A. Supporting hopes while also planning for possible decline
B. Avoiding all planning
C. Taking away hope
D. Giving false reassurance
Correct Answer: A. Supporting hopes while also planning for possible decline
Rationale: Balancing hope and preparation allows patients to plan without losing hope. False
reassurance and removing hope are harmful.
