Adult-Gerontology CNS Test Palliative Care & End-of-Life 2

Question 1

A patient is actively dying and develops noisy breathing due to pooling of secretions. Which medication is most appropriate?

Accepted Answer

Glycopyrrolate

Answer

Glycopyrrolate, an anticholinergic agent, reduces salivary and bronchial secretions and is a first-line treatment for the terminal death rattle without crossing the blood-brain barrier.

Question 2

An actively dying patient has refractory dyspnea unrelieved by oxygen or bronchodilators. What is the most appropriate pharmacological intervention?

Accepted Answer

Low-dose oral morphine

Answer

Low-dose opioids (morphine) are the most evidence-based pharmacological intervention for refractory dyspnea at end of life, reducing the subjective sensation of breathlessness.

Question 3

Which assessment scale is commonly used to evaluate a dying patient's level of consciousness and alertness at end of life?

Accepted Answer

Richmond Agitation-Sedation Scale (RASS)

Answer

The Richmond Agitation-Sedation Scale (RASS) is frequently used in palliative care to assess level of consciousness and guide sedation for terminal agitation and palliative sedation.

Question 4

What is palliative sedation (also called terminal sedation)?

Accepted Answer

Reducing consciousness to relieve refractory suffering at end of life

Answer

Palliative sedation involves intentionally reducing a patient's consciousness to relieve intractable suffering when other symptom management strategies have failed, not to hasten death.

Question 5

A CNS observes an actively dying patient whose respirations alternate between periods of apnea and rapid, deep breathing. This pattern is most consistent with:

Accepted Answer

Cheyne-Stokes respirations

Answer

Cheyne-Stokes respirations are characterized by a cyclical pattern of gradually increasing then decreasing depth of breathing alternating with apneic episodes, commonly seen in dying patients.

Adult-Gerontology CNS Test Practice Test

Adult-Gerontology CNS Test Practice Test

Adult-Gerontology CNS Test Palliative Care & End-of-Life 2