COCN Palliative and End-of-Life Care Flashcards

Palliative care differs from hospice care in that palliative care:

Answer: Can be provided at any stage of cancer alongside curative treatment

Palliative care focuses on quality of life and symptom management and can be integrated with curative cancer treatment at any disease stage.

A patient with terminal cancer refuses further treatment and asks about hospice. Medicare hospice benefit requires a physician-certified prognosis of life expectancy of:

Answer: 6 months or less if the disease runs its normal course

Medicare hospice eligibility requires physician certification that life expectancy is 6 months or less if the illness follows its expected course.

Which ethical principle underlies a patient's right to refuse cancer treatment, including life-sustaining measures?

Answer: Autonomy

Autonomy is the ethical principle affirming patients' right to make informed decisions about their own care, including refusal of treatment.

The nursing concept of 'total pain' in palliative care encompasses which dimensions?

Answer: Physical, psychological, social, and spiritual suffering

Dame Cicely Saunders defined 'total pain' as encompassing physical, psychological, social, and spiritual components of suffering.

Which scale is most widely used by oncology nurses to assess pain intensity in cognitively intact adult patients?

Answer: Numeric Rating Scale (NRS) 0–10

The 0–10 Numeric Rating Scale is the most widely validated and recommended pain intensity tool for cognitively intact adults.

A dying patient develops the 'death rattle' (noisy breathing). The most appropriate nursing intervention is:

Answer: Repositioning and anticholinergic medications to reduce secretions

Repositioning reduces pooling of secretions, and anticholinergics (e.g., glycopyrrolate) decrease secretion production with minimal distress to the patient.