HAC End-of-Life & Palliative Care 2 — Questions and Answers
Question 1: A palliative care patient tells the aide she is angry at God and questions why this is happening to her. The BEST response is to:
- Tell her that everything happens for a reason
- Listen quietly and acknowledge her feelings without judgment (Correct answer)
- Suggest she speak with a priest immediately
- Redirect her attention to a TV program
Correct answer: Listen quietly and acknowledge her feelings without judgment
Active, non-judgmental listening validates the patient's spiritual distress and supports emotional well-being.
Question 2: Which physical sign indicates that death may occur within hours?
- Increased urine output
- Mottling of the skin on the legs and feet (Correct answer)
- Elevated blood pressure
- Complaints of hunger
Correct answer: Mottling of the skin on the legs and feet
Mottling — a bluish-purple blotchy discoloration of the skin — is a sign of failing circulation and imminent death.
Question 3: A hospice aide notices a dying patient's breathing has become irregular with long pauses. This pattern is called:
- Kussmaul breathing
- Cheyne-Stokes respiration (Correct answer)
- Orthopneic breathing
- Biot's respiration
Correct answer: Cheyne-Stokes respiration
Cheyne-Stokes respiration — cycles of deep breaths followed by apneic pauses — is common in the final hours of life.
Question 4: The primary goal of hospice care is to:
- Cure the underlying disease
- Provide comfort and quality of life (Correct answer)
- Hasten the dying process
- Restore the patient to full function
Correct answer: Provide comfort and quality of life
Hospice focuses on palliative comfort — relieving pain and symptoms — rather than curative treatment.
Question 5: A family member asks the aide to keep the patient's terminal diagnosis secret from the patient. The aide should:
- Honor the family's request and never discuss the diagnosis
- Report the situation to the supervising nurse for guidance (Correct answer)
- Tell the patient the full diagnosis immediately
- Document the request and take no further action
Correct answer: Report the situation to the supervising nurse for guidance
Withholding information involves ethical and legal considerations that must be handled by the supervising nurse or care team.
Question 6: When providing mouth care to an unconscious dying patient, the aide should:
- Use a full glass of water to rinse the mouth
- Use a moistened swab to keep lips and mucous membranes moist (Correct answer)
- Skip mouth care since the patient is unconscious
- Apply thick petroleum jelly inside the mouth
Correct answer: Use a moistened swab to keep lips and mucous membranes moist
Moistened swabs keep the mouth comfortable and prevent cracking without risking aspiration in an unconscious patient.
Question 7: A dying patient has not eaten in three days. The family is upset and wants the aide to force-feed her. The aide should:
- Attempt to feed the patient to reassure the family
- Explain that decreased appetite is normal at end of life and notify the nurse (Correct answer)
- Call 911 for nutritional support
- Insert a feeding tube
Correct answer: Explain that decreased appetite is normal at end of life and notify the nurse
Loss of appetite is a natural part of the dying process; the aide should educate the family and involve the nurse for further guidance.
HAC End-of-Life & Palliative Care 2
A palliative care patient tells the aide she is angry at God and questions why this is happening to her.
The BEST response is to: