MCQs review 373-384
Understanding Dyspnea and Patient Care
This quiz is designed to enhance your understanding of caring for patients experiencing dyspnea, particularly in palliative and hospice settings. It covers essential medical knowledge and provides insights into effective communication with patients facing severe illnesses.
Key Topics:
- Management of dyspnea
- Communication with terminally ill patients
- Nutrition and anorexia in palliative care
- Patient comfort measures
Which of the following professionals is least likely to be helpful in caring for patients with severe dyspnea?
A. Physician
B. Chaplain
C. Social worker
D. Financial counselor
When treating mild dyspnea in patients who are not taking any pain medications, which of the following may be the most appropriate medication to order?
A. Oxycodone, 10 mg every 4 hours and as needed
B. Acetaminophen with hydrocodone, one tablet every 4 hours, with an additional dose for breakthrough dyspnea of one tablet every 2 hours as needed
C. Hydromorphone tablets, 2 mg to 4 mg every 4 hours, with an additional dose for breakthrough dyspnea of 1 mg to 2 mg every 2 hours as needed
D. Slow-release morphine, 30 mg twice a day
When treating nonspecific cancer-related dyspnea, which of the following is least likely to be an appropriate action?
A. Supportive listening to help relieve anxiety
B. Thoracentesis to relieve pleural effusion
C. Oxycodone, 5 mg to 10 mg every 4 hours and as needed
D. Naloxone, if the patient is breathing 12 times per minute
When treating dyspnea in hospice patients, which of the following is not appropriate?
A. Repositioning the patient to a more upright position
B. Improving air flow with a fan
C. Addressing patient and family anxieties about suffocation
D. Avoiding the use of opioids
. When treating anorexia, which of the following measures is likely to be appropriate in most situations?
A. Patient and family education about the natural progression of cancer and its effects on appetite
B. Appetite stimulants
C. IV hydration
D. Insertion of a nasogastric tube
When dry mouth is a problem, which of the following is the least likely to be helpful?
A. Order pilocarpine, 5 mg twice a day
B. Switch from chlorpromazine to metoclopramide or haloperidol
C. Order a saliva substitute every 1 to 2 hours
D. Switch from doxepin to amitriptyline
When a terminally ill patient is losing weight because of difficulties swallowing, which of the following is the most appropriate first step?
A. Surgical resection of the obstructing lesion
B. An order of crushed, liquid, or rectal suppository forms of medication
C. Placement of an esophageal stent
D. Palliative radiation therapy
Which of the following is an appropriate first step when treating anorexia in an ambulatory terminally ill patient?
A. Ordering megestrol, 160 mg to 200 mg daily
B. Ordering dexamethasone, 2 mg to 4 mg one to three times a day
C. Assessing for presence of oral candidiasis
D. Ordering dronabinol, 2.5 mg to 5.0 mg two to three times a day
. Which of the following statements is true?
A. Most patients believe that information about their diagnosis and prognosis benefits them even when the news is bad.
B. The manner in which bad news about a diagnosis is communicated is less important than the inclusion of complete descriptions of all test results.
C. Experienced, skilled physicians can easily determine how much information patients want about diagnosis and prognosis.
D. When a physician’s nonverbal cues contradict a verbal message, patients are much more likely to believe the physician’s verbal statements
A patient’s reluctance to discuss diagnosis and prognosis is rarely due to which of the following?
A. A need to periodically deny the existence of a life-threatening condition
B. The widespread belief among patients that information about diagnosis and prognosis will do them harm
C. The desire to protect themselves, their family members, and their physicians from the distressing emotions that often accompany discussions of poor prognosis
D. Subtle, nonverbal cues from the physician indicating that such discussions are unwelcome
Which of the following statements is true regarding patient communication?
A. Honest communication increases a patient’s and family’s sense of control and self-worth.
B. A feeling of being listened to is not considered an effective healing agent for terminally ill patients
C. Physicians should first focus on communicating with the patient before alleviating distressing symptoms
D. Poor communication skills may interfere with a physician’s ability to perform an adequate history but has little impact on the patient’s overall sense of suffering
Which of the following statements is true?
A. There is little correlation between the potential for a medical malpractice suit and a physician’s ability to communicate effectively
B. A physician’s ability to communicate effectively with patients is not affected by the physician’s own intrapersonal communication style
C. Effective communication with patients during the history-taking process provides more information about diagnosis than laboratory tests
D. Therapeutic communication is important, except when interacting with comatose patients.
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