AOCNP Palliative Care and Symptom Management 3

Question 1

Which intervention is most effective for managing malignant bowel obstruction in a patient with poor prognosis who is not a surgical candidate?

Accepted Answer

Octreotide plus corticosteroids plus antiemetics

Answer

Nasogastric tube feeding indefinitely

Answer

High-dose laxatives

Answer

Total parenteral nutrition as primary therapy

Question 2

Methylnaltrexone (Relistor) treats opioid-induced constipation by:

Accepted Answer

Blocking peripheral mu-opioid receptors in the GI tract without reversing central analgesia

Answer

Stimulating intestinal smooth muscle directly

Answer

Increasing intestinal secretions

Answer

Inhibiting serotonin in the gut

Question 3

Which prognostic tool is validated to estimate survival in weeks to months for palliative care patients?

Accepted Answer

Palliative Performance Scale (PPS)

Answer

ECOG Performance Status alone

Answer

Karnofsky score alone

Answer

MASCC score

Question 4

Anticipatory grief is best described as:

Accepted Answer

Grief experienced before an expected loss occurs

Answer

Grief that is absent initially and surfaces months later

Answer

Complicated grief requiring psychiatric diagnosis

Answer

Grief experienced only by the patient, not caregivers

Question 5

Which measurement best indicates that a patient is at high risk of imminent death (hours to days) in the inpatient palliative setting?

Accepted Answer

Decreased urine output, mottling, irregular respirations, and unresponsiveness

Answer

Pain score of 8/10 with stable vitals

Answer

Refusal of one meal

Answer

Mild confusion in the morning

Question 6

Which action is central to the NURSE communication framework used in delivering serious news to cancer patients?

Accepted Answer

Naming, understanding, respecting, supporting, and exploring emotions

Answer

Narrating the medical history clearly

Answer

Notifying the family before the patient

Answer

Assessing nurse competency in oncology