NSG PALLIATIVE CARE NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Pain and Symptom Management in Palliative Care
- Psychosocial and Spiritual Care for Patients and Families
- Communication Skills and Advance Care Planning
- Ethical and Legal Issues in End-of-Life Care
- Pharmacology of Palliative Medications
- Pediatric and Geriatric Palliative Care Considerations
- Grief, Bereavement, and Loss Support
- Interdisciplinary Team Collaboration in Palliative Settings
Introduction
This exam assesses comprehensive knowledge and clinical decision-making skills essential for nurses providing palliative care to patients with life-
limiting illnesses. The test evaluates competency across core domains including pain and symptom management, psychosocial support, ethical
decision-making, pharmacological interventions, and interdisciplinary collaboration. Questions are presented in multiple-choice and scenario-
based formats that emphasize real-world application, critical thinking, and professional judgment in diverse clinical settings. Successful
completion demonstrates readiness to deliver high-quality, patient-centered palliative care aligned with current evidence-based practices and
professional standards.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with advanced cancer reports severe pain rated 8/10 despite taking morphine 30 mg orally every 4 hours. The nurse should first:
A. Increase the morphine dose to 45 mg every 4 hours
B. Assess the pain characteristics and current relief level
C. Add a benzodiazepine for pain enhancement
D. Administer a breakthrough dose of fentanyl patch
🟢 B. Assess the pain characteristics and current relief level
,🔴 RATIONALE: Assessment is always the first nursing action before intervention. The nurse must evaluate pain quality, location, intensity,
aggravating/alleviating factors, and current medication effectiveness before adjusting the regimen.
Question 2
Which of the following best describes the primary goal of palliative care?
A. To cure the underlying disease
B. To prolong life at all costs
C. To improve quality of life through symptom relief and support
D. To transition patients exclusively to hospice care
🟢 C. To improve quality of life through symptom relief and support
🔴 RATIONALE: Palliative care focuses on relieving suffering and improving quality of life for patients with serious illnesses, regardless of prognosis
or treatment goals.
Question 3
A family member asks when hospice care becomes appropriate for their loved one. The nurse should explain that hospice is typically indicated when:
A. The patient requests alternative medicine only
B. Life expectancy is estimated at 6 months or less if the disease follows its normal course
C. The patient has mild symptoms manageable at home
D. Chemotherapy side effects become inconvenient
🟢 B. Life expectancy is estimated at 6 months or less if the disease follows its normal course
🔴 RATIONALE: Hospice eligibility generally requires a physician's prognosis of 6 months or less if the illness runs its normal course, focusing on
comfort rather than curative treatment.
Question 4
Which medication is the first-line choice for managing breakthrough cancer pain?
,A. Acetaminophen
B. Immediate-release opioid
C. Long-acting anticonvulsant
D. Topical NSAID
🟢 B. Immediate-release opioid
🔴 RATIONALE: Immediate-release opioids are the standard for breakthrough cancer pain because they act quickly and can be titrated to effect,
unlike long-acting formulations or non-opioids.
Question 5
A patient with terminal illness expresses fear of choking to death. The most appropriate nursing intervention is to:
A. Reassure the patient that this won't happen
B. Ignore the concern as anxiety-related
C. Actively listen and explore the fear while providing accurate information
D. Administer sedation immediately
🟢 C. Actively listen and explore the fear while providing accurate information
🔴 RATIONALE: Therapeutic communication involves active listening, validating concerns, and providing honest information. Dismissing fears or
immediately sedating without assessment is inappropriate.
Question 6
Which symptom is most commonly associated with the "death rattle"?
A. Severe pain
B. Noisy breathing from secretions in the airway
C. Persistent vomiting
D. Extreme agitation
🟢 B. Noisy breathing from secretions in the airway
🔴 RATIONALE: The death rattle is caused by accumulation of secretions in the pharynx and airway when the patient can no longer swallow or
cough effectively near death.
, Question 7
When administering morphine to an elderly patient with renal impairment, the nurse should:
A. Use the standard adult dose
B. Increase the dose due to reduced metabolism
C. Reduce the dose and extend dosing intervals
D. Avoid morphine entirely and use only non-opioids
🟢 C. Reduce the dose and extend dosing intervals
🔴 RATIONALE: Elderly patients with renal impairment have reduced clearance of morphine metabolites, increasing risk of toxicity. Dose reduction
and extended intervals prevent accumulation.
Question 8
A patient with advanced dementia refuses all food and fluids. The family is distressed. The nurse's priority action is to:
A. Force-feed the patient to prevent starvation
B. Start total parenteral nutrition immediately
C. Educate the family about natural dying process and comfort measures
D. Contact ethics committee before any discussion
🟢 C. Educate the family about natural dying process and comfort measures
🔴 RATIONALE: Refusal of food/fluids near end of life is common and natural. Education helps families understand that artificial nutrition may not
improve outcomes and comfort care is priority.
Question 9
Which of the following is a non-pharmacological intervention for managing dyspnea in palliative care?
A. High-dose corticosteroids
B. Fan therapy and positioning
C. Intravenous antibiotics
D. Surgical intervention
🟢 B. Fan therapy and positioning
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Pain and Symptom Management in Palliative Care
- Psychosocial and Spiritual Care for Patients and Families
- Communication Skills and Advance Care Planning
- Ethical and Legal Issues in End-of-Life Care
- Pharmacology of Palliative Medications
- Pediatric and Geriatric Palliative Care Considerations
- Grief, Bereavement, and Loss Support
- Interdisciplinary Team Collaboration in Palliative Settings
Introduction
This exam assesses comprehensive knowledge and clinical decision-making skills essential for nurses providing palliative care to patients with life-
limiting illnesses. The test evaluates competency across core domains including pain and symptom management, psychosocial support, ethical
decision-making, pharmacological interventions, and interdisciplinary collaboration. Questions are presented in multiple-choice and scenario-
based formats that emphasize real-world application, critical thinking, and professional judgment in diverse clinical settings. Successful
completion demonstrates readiness to deliver high-quality, patient-centered palliative care aligned with current evidence-based practices and
professional standards.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with advanced cancer reports severe pain rated 8/10 despite taking morphine 30 mg orally every 4 hours. The nurse should first:
A. Increase the morphine dose to 45 mg every 4 hours
B. Assess the pain characteristics and current relief level
C. Add a benzodiazepine for pain enhancement
D. Administer a breakthrough dose of fentanyl patch
🟢 B. Assess the pain characteristics and current relief level
,🔴 RATIONALE: Assessment is always the first nursing action before intervention. The nurse must evaluate pain quality, location, intensity,
aggravating/alleviating factors, and current medication effectiveness before adjusting the regimen.
Question 2
Which of the following best describes the primary goal of palliative care?
A. To cure the underlying disease
B. To prolong life at all costs
C. To improve quality of life through symptom relief and support
D. To transition patients exclusively to hospice care
🟢 C. To improve quality of life through symptom relief and support
🔴 RATIONALE: Palliative care focuses on relieving suffering and improving quality of life for patients with serious illnesses, regardless of prognosis
or treatment goals.
Question 3
A family member asks when hospice care becomes appropriate for their loved one. The nurse should explain that hospice is typically indicated when:
A. The patient requests alternative medicine only
B. Life expectancy is estimated at 6 months or less if the disease follows its normal course
C. The patient has mild symptoms manageable at home
D. Chemotherapy side effects become inconvenient
🟢 B. Life expectancy is estimated at 6 months or less if the disease follows its normal course
🔴 RATIONALE: Hospice eligibility generally requires a physician's prognosis of 6 months or less if the illness runs its normal course, focusing on
comfort rather than curative treatment.
Question 4
Which medication is the first-line choice for managing breakthrough cancer pain?
,A. Acetaminophen
B. Immediate-release opioid
C. Long-acting anticonvulsant
D. Topical NSAID
🟢 B. Immediate-release opioid
🔴 RATIONALE: Immediate-release opioids are the standard for breakthrough cancer pain because they act quickly and can be titrated to effect,
unlike long-acting formulations or non-opioids.
Question 5
A patient with terminal illness expresses fear of choking to death. The most appropriate nursing intervention is to:
A. Reassure the patient that this won't happen
B. Ignore the concern as anxiety-related
C. Actively listen and explore the fear while providing accurate information
D. Administer sedation immediately
🟢 C. Actively listen and explore the fear while providing accurate information
🔴 RATIONALE: Therapeutic communication involves active listening, validating concerns, and providing honest information. Dismissing fears or
immediately sedating without assessment is inappropriate.
Question 6
Which symptom is most commonly associated with the "death rattle"?
A. Severe pain
B. Noisy breathing from secretions in the airway
C. Persistent vomiting
D. Extreme agitation
🟢 B. Noisy breathing from secretions in the airway
🔴 RATIONALE: The death rattle is caused by accumulation of secretions in the pharynx and airway when the patient can no longer swallow or
cough effectively near death.
, Question 7
When administering morphine to an elderly patient with renal impairment, the nurse should:
A. Use the standard adult dose
B. Increase the dose due to reduced metabolism
C. Reduce the dose and extend dosing intervals
D. Avoid morphine entirely and use only non-opioids
🟢 C. Reduce the dose and extend dosing intervals
🔴 RATIONALE: Elderly patients with renal impairment have reduced clearance of morphine metabolites, increasing risk of toxicity. Dose reduction
and extended intervals prevent accumulation.
Question 8
A patient with advanced dementia refuses all food and fluids. The family is distressed. The nurse's priority action is to:
A. Force-feed the patient to prevent starvation
B. Start total parenteral nutrition immediately
C. Educate the family about natural dying process and comfort measures
D. Contact ethics committee before any discussion
🟢 C. Educate the family about natural dying process and comfort measures
🔴 RATIONALE: Refusal of food/fluids near end of life is common and natural. Education helps families understand that artificial nutrition may not
improve outcomes and comfort care is priority.
Question 9
Which of the following is a non-pharmacological intervention for managing dyspnea in palliative care?
A. High-dose corticosteroids
B. Fan therapy and positioning
C. Intravenous antibiotics
D. Surgical intervention
🟢 B. Fan therapy and positioning
