AMSN Pain Management and Palliative Care 2

Question 1

A dying patient's family asks why the nurse is administering morphine for dyspnea when the patient is not in pain. The best response is:

Accepted Answer

'Low-dose morphine reduces the sensation of air hunger in dying patients without hastening death when used appropriately.'

Answer

'Morphine is only for pain; I'll check the order again.'

Answer

'We are using morphine to help the patient die more comfortably and quickly.'

Answer

'This medication will keep the patient sedated so the family can have peace.'

Question 2

A patient receiving high-dose opioids for cancer pain is concerned about addiction. The nurse's best response is:

Accepted Answer

'Physical dependence is expected with long-term opioids, but addiction (compulsive misuse despite harm) is rare in cancer pain patients taking opioids as prescribed.'

Answer

'Your concern is valid — opioids always lead to addiction.'

Answer

'You should be worried — we will start weaning your dose immediately.'

Answer

'Addiction doesn't apply to cancer patients so don't worry about it.'

Question 3

A patient in hospice care becomes increasingly confused, restless, and distressed in the final days of life. The nurse recognizes this as:

Accepted Answer

Terminal restlessness (terminal delirium), a common end-of-life phenomenon

Answer

Severe medication overdose

Answer

A sign of undertreated pain requiring dose escalation

Answer

Normal sleep pattern changes

Question 4

A palliative care patient declines a recommended blood transfusion, stating it conflicts with their religious beliefs. The nurse's appropriate response is:

Accepted Answer

Respect the patient's decision and document their refusal, ensuring informed consent principles are upheld

Answer

Administer the transfusion anyway because the patient needs it to survive

Answer

Contact ethics to override the patient's decision

Answer

Pressure the family to convince the patient to accept the transfusion

Question 5

A family member asks the nurse to 'not tell my mother she has terminal cancer' to protect her feelings. The nurse should:

Accepted Answer

Explain that the patient has the right to know her diagnosis and discuss goals of care; involve the palliative care team

Answer

Agree and withhold the diagnosis from the patient

Answer

Avoid the topic and hope the patient doesn't ask

Answer

Tell the patient immediately without family present

Question 6

A patient with advanced heart failure is transitioned to comfort-focused care. Which order would the nurse anticipate discontinuing?

Accepted Answer

Daily lipid-lowering statin therapy

Answer

Morphine sulfate PRN for dyspnea

Answer

Oral opioids for pain management

Answer

Mouth care and skin care