Palliative & End-of-Life - 2026 Nursing Protocols: Exam 1 -
Questions with Correct Answers
100 questions
1. Nurses advocate for patients in palliative care by:
A. Making decisions on behalf of competent patients
B. Ensuring patient preferences are known and respected and that symptoms are addressed
C. Withholding information
D. Following family wishes over the patient's stated wishes
Correct Answer: B. Ensuring patient preferences are known and respected and that symptoms
are addressed
Rationale: Advocacy centers the patient's voice. Competent patients make their own decisions.
2. A key principle of palliative care is that the unit of care is:
A. The patient's disease only
B. The hospital
C. The insurance plan
D. The patient and family together
Correct Answer: D. The patient and family together
Rationale: Families experience the illness alongside patients and need support. Care is not
disease-centered.
,3. The National Consensus Project Clinical Practice Guidelines for Quality Palliative Care (4th
edition) organize care into:
A. Two domains only
B. Eight domains, including physical, psychological, social, spiritual, cultural, ethical and
end-of-life care
C. Billing categories
D. Hospital departments
Correct Answer: B. Eight domains, including physical, psychological, social, spiritual, cultural,
ethical and end-of-life care
Rationale: The domains are structure and processes; physical; psychological and psychiatric;
social; spiritual, religious and existential; cultural; care of the patient nearing the end of life; and
ethical and legal aspects. They guide high-quality care in all settings.
4. The End-of-Life Nursing Education Consortium (ELNEC) is:
A. A hospice billing program
B. A medication
C. A government regulation
D. A national education initiative to improve palliative and end-of-life care by nurses
Correct Answer: D. A national education initiative to improve palliative and end-of-life care by
nurses
Rationale: ELNEC trains nurses and educators in core palliative care competencies. It is not a
billing program, drug or regulation.
,5. Palliative care has been shown to:
A. Increase suffering
B. Increase costs in all cases
C. Have no measurable benefit
D. Improve symptom burden, patient and family satisfaction and reduce unwanted
hospitalizations
Correct Answer: D. Improve symptom burden, patient and family satisfaction and reduce
unwanted hospitalizations
Rationale: Evidence supports benefits for patients, families and health systems. It does not
increase suffering.
6. Elisabeth Kübler-Ross contributed to end-of-life care by:
A. Founding the first US hospice
B. Creating the Medicare hospice benefit
C. Developing opioid conversion tables
D. Describing patients' emotional responses to dying in On Death and Dying (1969)
Correct Answer: D. Describing patients' emotional responses to dying in On Death and Dying
(1969)
Rationale: Her work encouraged open discussion of dying. Her stages are not a fixed sequence
and are now viewed more flexibly.
7. Palliative care teams support families after the patient's death through:
A. No further contact
B. Bereavement follow-up and resources
C. Billing for services
D. Legal advice only
Correct Answer: B. Bereavement follow-up and resources
Rationale: Bereavement support is a core element, particularly in hospice. It continues after
death.
, 8. Deprescribing in advanced serious illness involves:
A. Stopping all medications at once
B. Adding medications for every possible condition
C. Stopping medications whose burdens outweigh benefits given the patient's goals and
prognosis, such as some preventive drugs
D. Never reviewing medications
Correct Answer: C. Stopping medications whose burdens outweigh benefits given the
patient's goals and prognosis, such as some preventive drugs
Rationale: Reducing pill burden and side effects supports comfort, and studies show some
drugs, such as statins, can be stopped safely near the end of life. Symptom-relieving drugs
continue.
9. To be eligible for the Medicare Hospice Benefit, a patient must:
A. Have cancer
B. Be bedbound
C. Be certified as terminally ill with a life expectancy of 6 months or less if the illness runs its
normal course, and elect hospice care
D. Have a prognosis of less than 1 week
Correct Answer: C. Be certified as terminally ill with a life expectancy of 6 months or less if the
illness runs its normal course, and elect hospice care
Rationale: Eligibility depends on prognosis and the patient's election, not diagnosis or
functional status alone. Many hospice patients have non-cancer diagnoses.
10. A face-to-face encounter by a hospice physician or nurse practitioner is required:
A. Only at admission
B. Never
C. Only after death
D. Before the third benefit period and each subsequent recertification
Correct Answer: D. Before the third benefit period and each subsequent recertification
Rationale: The encounter supports recertification by documenting continued eligibility. It is not
required only at admission.
Questions with Correct Answers
100 questions
1. Nurses advocate for patients in palliative care by:
A. Making decisions on behalf of competent patients
B. Ensuring patient preferences are known and respected and that symptoms are addressed
C. Withholding information
D. Following family wishes over the patient's stated wishes
Correct Answer: B. Ensuring patient preferences are known and respected and that symptoms
are addressed
Rationale: Advocacy centers the patient's voice. Competent patients make their own decisions.
2. A key principle of palliative care is that the unit of care is:
A. The patient's disease only
B. The hospital
C. The insurance plan
D. The patient and family together
Correct Answer: D. The patient and family together
Rationale: Families experience the illness alongside patients and need support. Care is not
disease-centered.
,3. The National Consensus Project Clinical Practice Guidelines for Quality Palliative Care (4th
edition) organize care into:
A. Two domains only
B. Eight domains, including physical, psychological, social, spiritual, cultural, ethical and
end-of-life care
C. Billing categories
D. Hospital departments
Correct Answer: B. Eight domains, including physical, psychological, social, spiritual, cultural,
ethical and end-of-life care
Rationale: The domains are structure and processes; physical; psychological and psychiatric;
social; spiritual, religious and existential; cultural; care of the patient nearing the end of life; and
ethical and legal aspects. They guide high-quality care in all settings.
4. The End-of-Life Nursing Education Consortium (ELNEC) is:
A. A hospice billing program
B. A medication
C. A government regulation
D. A national education initiative to improve palliative and end-of-life care by nurses
Correct Answer: D. A national education initiative to improve palliative and end-of-life care by
nurses
Rationale: ELNEC trains nurses and educators in core palliative care competencies. It is not a
billing program, drug or regulation.
,5. Palliative care has been shown to:
A. Increase suffering
B. Increase costs in all cases
C. Have no measurable benefit
D. Improve symptom burden, patient and family satisfaction and reduce unwanted
hospitalizations
Correct Answer: D. Improve symptom burden, patient and family satisfaction and reduce
unwanted hospitalizations
Rationale: Evidence supports benefits for patients, families and health systems. It does not
increase suffering.
6. Elisabeth Kübler-Ross contributed to end-of-life care by:
A. Founding the first US hospice
B. Creating the Medicare hospice benefit
C. Developing opioid conversion tables
D. Describing patients' emotional responses to dying in On Death and Dying (1969)
Correct Answer: D. Describing patients' emotional responses to dying in On Death and Dying
(1969)
Rationale: Her work encouraged open discussion of dying. Her stages are not a fixed sequence
and are now viewed more flexibly.
7. Palliative care teams support families after the patient's death through:
A. No further contact
B. Bereavement follow-up and resources
C. Billing for services
D. Legal advice only
Correct Answer: B. Bereavement follow-up and resources
Rationale: Bereavement support is a core element, particularly in hospice. It continues after
death.
, 8. Deprescribing in advanced serious illness involves:
A. Stopping all medications at once
B. Adding medications for every possible condition
C. Stopping medications whose burdens outweigh benefits given the patient's goals and
prognosis, such as some preventive drugs
D. Never reviewing medications
Correct Answer: C. Stopping medications whose burdens outweigh benefits given the
patient's goals and prognosis, such as some preventive drugs
Rationale: Reducing pill burden and side effects supports comfort, and studies show some
drugs, such as statins, can be stopped safely near the end of life. Symptom-relieving drugs
continue.
9. To be eligible for the Medicare Hospice Benefit, a patient must:
A. Have cancer
B. Be bedbound
C. Be certified as terminally ill with a life expectancy of 6 months or less if the illness runs its
normal course, and elect hospice care
D. Have a prognosis of less than 1 week
Correct Answer: C. Be certified as terminally ill with a life expectancy of 6 months or less if the
illness runs its normal course, and elect hospice care
Rationale: Eligibility depends on prognosis and the patient's election, not diagnosis or
functional status alone. Many hospice patients have non-cancer diagnoses.
10. A face-to-face encounter by a hospice physician or nurse practitioner is required:
A. Only at admission
B. Never
C. Only after death
D. Before the third benefit period and each subsequent recertification
Correct Answer: D. Before the third benefit period and each subsequent recertification
Rationale: The encounter supports recertification by documenting continued eligibility. It is not
required only at admission.
