Quiz 8: Palliative care

Please choose the one, most correct answer to each question or statement.

1. What is palliative care?
   • Primary care provided at a local clinic
   • Poor care which is offered when the facilities and staff are not available to provide good care
   • Care that aims at curing the patient
   • Care that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness
2. What is the main aim of palliative care?
   • To improve the quality of life and relieve symptoms
   • To save money by keeping the patient out of hospital
   • To remove the responsibility from the family by hospitalising the patient
   • To transfer care from doctors to nurses
3. When should palliative care start?
   • As soon as the diagnosis is made that the illness is life-threatening and probably cannot be cured
   • When the family accepts that the patient may die of the cancer
   • On the day before a patient is discharged home from hospital
   • Only when the patient is dying
4. How do you gain a patient’s trust?
   • By giving clear, strict instructions
   • By promising that they will get better
   • By good communication
   • By bringing them sweets or small presents
5. It is best to start a conversation by:
   • Discussing the role of religion in palliative care
   • Telling the patient about your experience with palliative care
   • Talking about current news items on TV
   • Asking the patient about their family or interests
6. Pain is best assessed by:
   • Asking the patient to describe their pain
   • Counting the number of pain tablets remaining in the bottle
   • Taking the patient’s pulse and temperature
   • Speaking to the family
7. If possible, pain medication should be given by:
   • Applying an anti-inflammatory skin patch
   • Slow intravenous injection
   • Mouth
   • Rectal suppositories
8. The best medication for mild to moderate pain is:
   • Morphine
   • Aspirin
   • Paracetamol (Panado)
   • Steroids
9. Ibuprofen (Brufen) for pain:
   • Should be given once a day
   • Has an added effect if given with paracetamol
   • Is of little value as it is an anti-inflammatory
   • Is usually used for severe pain
10. How frequently should oral morphine be given?
    • Four hourly
    • Six hourly
    • Eight hourly
    • Whenever the patient has pain
11. How should the dose of morphine be increased if the pain is not controlled?
    • Double the dose
    • Give the doses more frequently
    • Take the medication in small sips over half an hour
    • Calculate the new daily dose by adding the previous day’s regular doses to the extra doses needed
12. How should the medication be given if the patient has difficulty swallowing tablets?
    • Pass a nasogastric tube to give crushed tablets
    • Use a liquid medication
    • Give the medication by intramuscular injection
    • Use a syringe driver to give the medication by continuous intravenous infusion
13. How should a fungating wound be cleaned?
    • With soap and water
    • With surgical spirits
    • With a saline or metronidazole (Flagyl) solution
    • Mercurochrome or gentian violet
14. Bedsores are caused by?
    • Pressure on the skin and underlying tissues
    • Malignant secondary deposits
    • Infection with Staphylococcus
    • Fungal infections
15. Bedsores can be prevented by:
    • Prophylactic antibiotics
    • Keeping the patients nursed on their back
    • Local antifungal cream
    • Turning patients at least every 2 hours
16. Constipation is best prevented with?
    • Regular enemas
    • Laxatives twice a day
    • Adding fruit and fibre to the diet
    • Not eating between meals
17. Patients with breathlessness should be nursed:
    • Lying flat on their backs
    • In the semi-Fowler’s position
    • Sitting upright
    • Lying on their left side
18. What may help nausea?
    • Drink water with meals
    • Eat more fatty foods
    • Stay in bed
    • Have frequent small snacks
19. Psychosocial problems:
    • Should only be managed by a social worker
    • Can often be improved by a primary care nurse
    • Are best ignored as they usually cannot be solved
    • Are uncommon in patients if they are cared for in hospital
20. Which topics are best not discussed when counselling a patient?
    • The financial implications to the family
    • Sexuality
    • Spiritual needs
    • The patient should feel free to discuss any concern