NCLEX, ATI, & HESI Exam Bank: Palliative and End-of-Life Nursing Care – Compassion, Symptom Control & Ethics

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Comprehensive Exam Bank on Nursing in Palliative and End-of-Life
Care: Compassionate Support, Symptom Relief, and Ethical
Decision-Making




Table of Contents

Topic 1: Principles and Foundations of Palliative and End-of-Life Nursing Care..............................2
Topic 2: Pain and Symptom Management in Terminal Illness.......................................................10
Topic 3: Communication, Family Support, and Grief Management..............................................18
Topic 4: Ethical and Legal Issues in Palliative and End-of-Life Care...............................................27
Topic 5: Psychosocial and Spiritual Care in Palliative Nursing.......................................................35
Topic 6: Pharmacologic Interventions in Palliative Care................................................................43
Topic 7: Psychosocial Challenges and Family Dynamics in Palliative Care.....................................51
Topic 8: Symptom Management and Comfort Measures..............................................................60
Topic 9: Communication and Advance Care Planning...................................................................68
Topic 10: Ethical and Legal Issues in Palliative Care.......................................................................76

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Topic 1: Principles and Foundations of
Palliative and End-of-Life Nursing Care



Question 1:
Which of the following best describes the primary goal of palliative care?
A. To cure the patient’s underlying illness
B. To prolong life at all costs
C. To relieve suffering and improve quality of life
D. To withhold all treatments that are not curative

Correct Answer: C
Rationale: Palliative care focuses on relieving pain and distressing
symptoms, while enhancing quality of life for patients and families,
regardless of the stage of the disease or need for other therapies.




Question 2:
In palliative care, which interdisciplinary team member primarily assists with
the patient’s spiritual needs?
A. Case manager
B. Chaplain or spiritual counselor
C. Occupational therapist
D. Clinical pharmacist

Correct Answer: B
Rationale: A chaplain or spiritual counselor is trained to address spiritual or
existential concerns, a vital component of holistic palliative care.

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Question 3:
Which of the following best defines hospice care?
A. Curative treatment provided in an ICU
B. End-of-life care for patients with a prognosis of six months or less
C. Psychological therapy for terminal patients
D. In-home nursing care for chronic disease

Correct Answer: B
Rationale: Hospice is a type of palliative care for patients typically in the
final six months of life, focusing on comfort rather than curative treatment.




Question 4:
What ethical principle is upheld when a nurse respects a patient’s wish to
stop chemotherapy and receive comfort care only?
A. Beneficence
B. Justice
C. Autonomy
D. Nonmaleficence

Correct Answer: C
Rationale: Autonomy is the right of individuals to make decisions about
their own healthcare based on their values and beliefs.




Question 5:
Which statement about the difference between palliative and curative care is
most accurate?
A. Palliative care is only offered after curative options have failed
B. Palliative care can be provided alongside curative treatments
C. Curative care focuses on symptoms, not underlying disease
D. Palliative care does not involve medication management

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Correct Answer: B
Rationale: Palliative care may be integrated with curative treatments to
manage symptoms and enhance patient comfort during illness.




Question 6:
What is the most appropriate nursing intervention for managing refractory
pain in a palliative patient?
A. Administer a mild analgesic
B. Consult with the team about initiating palliative sedation
C. Delay medications to assess baseline pain
D. Encourage use of ice packs

Correct Answer: B
Rationale: For refractory symptoms unrelieved by standard treatments,
palliative sedation may be considered ethically and clinically appropriate.




Question 7:
Which patient scenario most clearly demonstrates the principle of
beneficence?
A. The nurse provides CPR despite a DNR
B. The nurse discontinues all medications
C. The nurse advocates for increased morphine to control severe
pain
D. The nurse ignores the patient’s spiritual distress

Correct Answer: C
Rationale: Beneficence involves actively doing good, such as relieving
suffering by advocating for adequate pain management.