Palliative & End-of-Life - 2026 Nursing Protocols: Exam 2 -
Questions with Correct Answers
100 questions
1. Cultural humility in palliative care involves:
A. Assuming all members of a culture have the same beliefs
B. Ignoring cultural factors
C. Applying one's own values to all patients
D. Ongoing self-reflection and learning from each patient about their beliefs and preferences
Correct Answer: D. Ongoing self-reflection and learning from each patient about their beliefs
and preferences
Rationale: Each patient's preferences may differ from cultural generalizations. Humility and
curiosity guide individualized care.
2. A goal of palliative care is to:
A. Shorten life
B. Avoid all medications
C. Help patients live as well as possible for as long as possible
D. Replace all medical specialists
Correct Answer: C. Help patients live as well as possible for as long as possible
Rationale: Palliative care supports comfort, function and meaning. It does not intend to shorten
life or replace other care.
,3. According to WHO, among people worldwide who need palliative care:
A. Nearly all receive it
B. Only a small proportion, about 14 percent, currently receive it, with most need in low- and
middle-income countries
C. Most live in high-income countries
D. Need is limited to cancer patients
Correct Answer: B. Only a small proportion, about 14 percent, currently receive it, with most
need in low- and middle-income countries
Rationale: Limited access to opioids, trained staff and services leaves most needs unmet. Need
extends far beyond cancer.
4. Total pain, as described by Saunders, includes:
A. Only physical pain
B. Physical, psychological, social and spiritual dimensions of suffering
C. Only pain from surgery
D. Only spiritual distress
Correct Answer: B. Physical, psychological, social and spiritual dimensions of suffering
Rationale: Recognizing all dimensions of pain guides holistic assessment and treatment.
Focusing only on physical pain misses important sources of suffering.
5. Therapeutic presence by the palliative care nurse involves:
A. Leaving quickly to avoid emotional situations
B. Focusing only on tasks
C. Offering advice without listening
D. Being fully attentive, listening and staying with the patient and family during difficult
moments
Correct Answer: D. Being fully attentive, listening and staying with the patient and family
during difficult moments
Rationale: Presence conveys compassion and helps patients feel heard and less alone.
Avoidance and task focus miss emotional needs.
,6. Prognostic uncertainty in serious illness means that clinicians should:
A. Avoid all discussion until certain
B. Give exact dates of death
C. Acknowledge uncertainty while still discussing possible outcomes and planning ahead
D. Assume patients do not want information
Correct Answer: C. Acknowledge uncertainty while still discussing possible outcomes and
planning ahead
Rationale: Planning can occur despite uncertainty, and many patients want prognostic
information. Exact dates are rarely accurate.
7. Disparities in palliative and hospice care include:
A. Equal use across all groups
B. Lower hospice use among Black and Hispanic patients, reflecting access, trust and cultural
factors
C. Higher hospice use among all minority groups
D. No differences by geography
Correct Answer: B. Lower hospice use among Black and Hispanic patients, reflecting access,
trust and cultural factors
Rationale: Addressing disparities requires culturally responsive care and building trust. Rural
areas also face access gaps.
8. Palliative care principles can be applied in the intensive care unit by:
A. Avoiding all discussions about prognosis
B. Delaying symptom management
C. Addressing symptoms, holding family meetings and aligning treatments with patient goals
D. Excluding families
Correct Answer: C. Addressing symptoms, holding family meetings and aligning treatments
with patient goals
Rationale: ICU palliative care improves communication and comfort. Avoidance and exclusion
increase distress.
, 9. Hospice bereavement services must be offered to families for up to:
A. 1 week
B. 5 years
C. Bereavement services are not required
D. 13 months after the patient's death
Correct Answer: D. 13 months after the patient's death
Rationale: Bereavement follow-up is a required part of the hospice benefit. It supports families
through the first year and anniversary.
10. Medicare's service intensity add-on payment supports hospices for:
A. Volunteer visits
B. Equipment purchases
C. Registered nurse and social worker visits provided in the last 7 days of life during routine
home care
D. Bereavement mailings
Correct Answer: C. Registered nurse and social worker visits provided in the last 7 days of life
during routine home care
Rationale: The add-on encourages professional presence when patients and families need it
most. Volunteer, equipment and mailing costs are not part of it.
11. Families of hospice patients should be taught to call:
A. 911 for all concerns
B. No one
C. The hospice on-call nurse first for symptoms or changes, rather than 911 when comfort is the
goal
D. The insurance company
Correct Answer: C. The hospice on-call nurse first for symptoms or changes, rather than 911
when comfort is the goal
Rationale: Hospice nurses can respond to symptoms and support families. Calling 911 may lead
to unwanted resuscitation and hospitalization.
Questions with Correct Answers
100 questions
1. Cultural humility in palliative care involves:
A. Assuming all members of a culture have the same beliefs
B. Ignoring cultural factors
C. Applying one's own values to all patients
D. Ongoing self-reflection and learning from each patient about their beliefs and preferences
Correct Answer: D. Ongoing self-reflection and learning from each patient about their beliefs
and preferences
Rationale: Each patient's preferences may differ from cultural generalizations. Humility and
curiosity guide individualized care.
2. A goal of palliative care is to:
A. Shorten life
B. Avoid all medications
C. Help patients live as well as possible for as long as possible
D. Replace all medical specialists
Correct Answer: C. Help patients live as well as possible for as long as possible
Rationale: Palliative care supports comfort, function and meaning. It does not intend to shorten
life or replace other care.
,3. According to WHO, among people worldwide who need palliative care:
A. Nearly all receive it
B. Only a small proportion, about 14 percent, currently receive it, with most need in low- and
middle-income countries
C. Most live in high-income countries
D. Need is limited to cancer patients
Correct Answer: B. Only a small proportion, about 14 percent, currently receive it, with most
need in low- and middle-income countries
Rationale: Limited access to opioids, trained staff and services leaves most needs unmet. Need
extends far beyond cancer.
4. Total pain, as described by Saunders, includes:
A. Only physical pain
B. Physical, psychological, social and spiritual dimensions of suffering
C. Only pain from surgery
D. Only spiritual distress
Correct Answer: B. Physical, psychological, social and spiritual dimensions of suffering
Rationale: Recognizing all dimensions of pain guides holistic assessment and treatment.
Focusing only on physical pain misses important sources of suffering.
5. Therapeutic presence by the palliative care nurse involves:
A. Leaving quickly to avoid emotional situations
B. Focusing only on tasks
C. Offering advice without listening
D. Being fully attentive, listening and staying with the patient and family during difficult
moments
Correct Answer: D. Being fully attentive, listening and staying with the patient and family
during difficult moments
Rationale: Presence conveys compassion and helps patients feel heard and less alone.
Avoidance and task focus miss emotional needs.
,6. Prognostic uncertainty in serious illness means that clinicians should:
A. Avoid all discussion until certain
B. Give exact dates of death
C. Acknowledge uncertainty while still discussing possible outcomes and planning ahead
D. Assume patients do not want information
Correct Answer: C. Acknowledge uncertainty while still discussing possible outcomes and
planning ahead
Rationale: Planning can occur despite uncertainty, and many patients want prognostic
information. Exact dates are rarely accurate.
7. Disparities in palliative and hospice care include:
A. Equal use across all groups
B. Lower hospice use among Black and Hispanic patients, reflecting access, trust and cultural
factors
C. Higher hospice use among all minority groups
D. No differences by geography
Correct Answer: B. Lower hospice use among Black and Hispanic patients, reflecting access,
trust and cultural factors
Rationale: Addressing disparities requires culturally responsive care and building trust. Rural
areas also face access gaps.
8. Palliative care principles can be applied in the intensive care unit by:
A. Avoiding all discussions about prognosis
B. Delaying symptom management
C. Addressing symptoms, holding family meetings and aligning treatments with patient goals
D. Excluding families
Correct Answer: C. Addressing symptoms, holding family meetings and aligning treatments
with patient goals
Rationale: ICU palliative care improves communication and comfort. Avoidance and exclusion
increase distress.
, 9. Hospice bereavement services must be offered to families for up to:
A. 1 week
B. 5 years
C. Bereavement services are not required
D. 13 months after the patient's death
Correct Answer: D. 13 months after the patient's death
Rationale: Bereavement follow-up is a required part of the hospice benefit. It supports families
through the first year and anniversary.
10. Medicare's service intensity add-on payment supports hospices for:
A. Volunteer visits
B. Equipment purchases
C. Registered nurse and social worker visits provided in the last 7 days of life during routine
home care
D. Bereavement mailings
Correct Answer: C. Registered nurse and social worker visits provided in the last 7 days of life
during routine home care
Rationale: The add-on encourages professional presence when patients and families need it
most. Volunteer, equipment and mailing costs are not part of it.
11. Families of hospice patients should be taught to call:
A. 911 for all concerns
B. No one
C. The hospice on-call nurse first for symptoms or changes, rather than 911 when comfort is the
goal
D. The insurance company
Correct Answer: C. The hospice on-call nurse first for symptoms or changes, rather than 911
when comfort is the goal
Rationale: Hospice nurses can respond to symptoms and support families. Calling 911 may lead
to unwanted resuscitation and hospitalization.
