Activity 6: Ethics and Symptom Management | Hospice & Palliative Board Review

Ethics and Symptom Management

1

Which of the following may serve as a hospice medical director?

A. NP

B. MD

C. DO

D. PA

E. B and C

2

Acting in a patient’s best interest demonstrates which of the following principles?

A. Autonomy

B. Paternalism

C. Beneficence

D. Maternalism

3

Supporting a patient’s right to self-determination reflects which of the following principles?

A. Beneficence

B. Paternalism

C. Maternalism

D. Autonomy

4

Which of the following is not appropriate for hospice?

A. Patient with stage 4 lung cancer PPS 30

B. Patient with stage 4 breast cancer PPS 50

C. Patient with stage 4 lung cancer PPS 90

D. Patient with stage 4 breast cancer PPS 40

5

Which of the following are unable to complete a face-to-face certification for hospice services?

A. MD

B. NP

C. DO

D. RN

6

General inpatient hospice care is appropriate for?

A. Any actively dying patient

B. Any patient who recently was in the hospital

C. Hospice-appropriate patients whose symptoms cannot be managed in any other venue

D. A patient whose caregiver needs relief

7

Hospice respite care is appropriate for?

A. Any home hospice patient

B. Any general inpatient hospice patient

C. Any hospice patient residing in a facility

D. A hospice patient whose caregiver needs relief

8

Palliative care should be offered to:

A. Any newly diagnosed stage 4 cancer patient

B. Those with chronic, progressive illness who wish to focus on quality of life

C. Patients with a prognosis of 6 months or less

D. Choice A and B

9

Which of the following would be most appropriate for general inpatient hospice?

A. A patient in home hospice comfortable with a PPS of 10

B. A patient with ES CHF in the hospital with PPS 30 and well-controlled dyspnea

C. A patient with ES dementia, FAST 7d, and multiple wounds requiring skilled nursing care

D. A patient with ES dementia, FAST 7d, whose family is unable to care for him at home

10

52-year-old African American male with a history of esophageal cancer diagnosed 6 months ago has completed chemotherapy and presents to your clinic with worsening dysphagia. He is only able to swallow small amount of liquids. His PPS is 80%. Which is next best step in management of patient?

A. Placement of PEG tube

B. Repeat first line chemotherapy

C. GI referral for endoscopic stenting

D. Referral for radiation therapy

11

The United States has one of the best health systems in the world.

A. True

B. False

12

The United States has good return on investment from its health system regarding total expenditures and life expectancy.

A. True

B. False

13

The United States spends an inordinate amount of GDP on healthcare.

A. True

B. False

14

The recent decline in life expectancy in the United States can be partially accounted for by the opioid epidemic.

A. True

B. False

15

Any provider can prescribe buprenorphine for opioid dependence.

A. True

B. False

16

Methadone can be prescribed for chronic cancer pain.

A. True

B. False

17

Every patient receiving methadone should have an EKG completed prior to methadone initiation.

A. True

B. False

18

Work of breathing can be used to help determine dyspnea for a patient who is unable to verbalize.

A. True

B. False

19

Patients taking opiates and benzodiazepines concomitantly are at higher risk of sudden death.

A. True

B. False

20

Methylnaltrexone should be used for any patient with constipation.

A. True

B. False