Quiz 1: The principles and practice of palliative care for children

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

1. The aim of palliative care is to:
   • Provide comfort, support and relief of suffering
   • Care for patients with cancer only
   • Care for the dying patient only
   • Prevent the patient from dying in hospital
2. The children who require palliative care are those:
   • Who have an acute illness and will recover
   • Who have either a life-threatening or life-limiting condition
   • Who are dying from HIV/AIDS only
   • Who live in urban areas and have access to treatment
3. A life-limiting condition is one that:
   • Can be cured immediately if treated correctly
   • Is life-threatening if not treated immediately
   • Will shorten the person’s life span as there is no hope for a cure
   • Needs care and support at the end-of-life only
4. What is the goal of palliative care?
   • Cure the condition
   • Hasten death
   • Maximise quality of life
   • Look after the doctors and nurses caring for the patient
5. In South Africa the constitution defines a child from:
   • Birth to 12 years
   • Birth to 15 years
   • Birth to 16 years
   • Birth to 18 years
6. Why are the palliative care needs of children different to those of adults?
   • Adults only need palliative care at the end-of-life
   • Adults need to make all the decisions for the child
   • Children are not ‘small adults’ as their developmental needs are different
   • Children can only receive palliative care in a hospital setting
7. What is a common incorrect belief about children’s palliative care?
   • It is for children with cancer and HIV/AIDS only
   • Children need palliative care from time of diagnosis of a life-limiting or life-threatening condition
   • It can be provided in any setting
   • It aims to relieve pain and suffering
8. The Constitution of South Africa states that:
   • Only adults have the right to basic health services which includes curative and palliative care
   • Only adults over the age of 18 years have the right to social services
   • Every child has the right to basic healthcare services which includes palliative care
   • Every child over the age of 5 years has the right to social services
9. What is a continuum of care?
   • The care and support that is provided throughout the course of an illness
   • The care that is provided once the disease cannot be treated anymore
   • Support for the patient when their child is admitted into hospital until they are discharged
   • Support that is provided to the family after the patient has died
10. When should palliative care be offered?
    • When the doctor refers the child to a hospice
    • After the doctor has informed the family that curative treatment is no longer feasible
    • Alongside curative care from the time of diagnosis of a life-threatening or life-limiting illness
    • To children whose family can afford palliative care services
11. An illness trajectory:
    • Tells you exactly when the patient will die
    • Is the general course an illness is likely to follow
    • Will indicate when active treatment needs to be started
    • Follows the same pattern in both adults and children
12. An illness trajectory can be helpful to:
    • Plan the management goals and the changing needs along the course of the illness
    • Estimate the cost of palliative care
    • Decide when to stop educating the child
    • Make arrangements to provide private nursing care
13. Categorising children’s illnesses can assist in:
    • Deciding what medication to treat the child with
    • Identifying the child’s palliative care needs
    • Deciding which hospital to treat the child in
    • Deciding when to give up hope
14. Children’s palliative care category 4 are conditions or illnesses that are:
    • Progressive conditions that cannot be cured
    • Life-threatening for which curative treatment may be possible but can fail, such as cancer
    • Likely to end in premature death but where long periods of treatment can prolong life, such as an HIV infected child on treatment
    • Irreversible but non-progressive, such as severe cerebral palsy
15. What does perinatal palliative care focus on?
    • Decision making to terminate the pregnancy if a life-limiting diagnosis is made during a routine antenatal ultrasound
    • Guiding and supporting families in decision making and planning in the event of a life-limiting diagnosis being made during pregnancy or soon after birth.
    • Good medical care for a newborn infant born with severe physical abnormalities
    • Getting the mother home after the delivery of her infant
16. Where can palliative care be provided?
    • Only in a hospice
    • Only at a hospital with special palliative care beds
    • Only at home by a hospice service when the child is dying
    • In any setting
17. The need for children’s palliative care in South Africa is estimated at:
    • 2000 children needing specialist palliative care
    • 10 000 children needing generalist palliative care
    • Over 800 000 children needing generalist palliative care
    • Less than 50 000 children needing specialist palliative care
18. What is a hospice?
    • An organisation that provides palliative care in a variety of settings
    • A small hospital found in a rural area
    • A group of people who provide bereavement counselling
    • A hospital for children with cancer
19. What level of care should a child with a complex condition receive?
    • A palliative care approach at a level 1 facility only
    • Matched to the level of healthcare service required at the time
    • General palliative care at secondary level only
    • Specialist palliative care at a tertiary hospital
20. What is a referral pathway?
    • The transfer of a patient from a nurse to a doctor for further care
    • The path the illness is likely to follow
    • The referral of patients for reassessment and a second opinion
    • The transfer of a patient between different levels of care