COPD Palliative Care and End-of-Life Management in COPD 2

Question 1

Benzodiazepines such as lorazepam are used in end-stage COPD primarily to treat:

Accepted Answer

Anxiety and panic attacks associated with dyspnea

Answer

Hypercapnic respiratory failure

Answer

Acute bronchospasm

Answer

Cor pulmonale

Question 2

Which of the following best defines 'hospice eligibility' criteria for a COPD patient in the United States?

Accepted Answer

Prognosis of 6 months or less if disease follows its natural course, as certified by a physician

Answer

FEV1 <50% and any exacerbation in the past year

Answer

Requirement for home oxygen for at least 12 months

Answer

Inability to perform any activities of daily living

Question 3

A COPD patient declines cardiopulmonary resuscitation but wishes to continue bronchodilator therapy and corticosteroids during exacerbations. This is best described as:

Accepted Answer

Selective life-sustaining treatment consistent with goals-of-care discussions

Answer

Full comfort care only

Answer

Non-compliance with medical recommendations

Answer

A contradiction that requires ethics consultation

Question 4

Which statement about opioid use for dyspnea in COPD is MOST accurate?

Accepted Answer

Low-dose opioids can safely relieve dyspnea without clinically significant respiratory depression in most COPD patients

Answer

Opioids should never be used because they invariably cause fatal respiratory depression

Answer

Opioids only help pain, not breathlessness

Answer

Opioids are indicated only after the patient is unconscious

Question 5

When discussing prognosis with a COPD patient, a CCE educator should:

Accepted Answer

Use honest, compassionate communication aligned with the patient's readiness and preferences

Answer

Provide an exact date of expected death to allow planning

Answer

Avoid all prognosis discussions to prevent causing distress

Answer

Delegate all prognosis conversations to the pulmonologist only

Question 6

Which of the following is a recognized barrier to palliative care integration in COPD compared to cancer?

Accepted Answer

COPD has an unpredictable disease trajectory making prognostication difficult

Answer

COPD patients experience less symptom burden than cancer patients

Answer

COPD patients rarely express interest in comfort-focused care

Answer

Pulmonologists are not trained to discuss palliative care

Question 7

A family member insists on full resuscitation for a COPD patient who has a valid POLST requesting comfort measures only. The CCE educator's BEST response is to:

Accepted Answer

Support the patient's documented wishes and involve the care team and social worker to mediate the conflict

Answer

Honor the family's wishes since they are the legal decision-makers

Answer

Ignore the POLST and defer to the family

Answer

Contact law enforcement to enforce the POLST