NURS 349 TRANSITIONS OF CARE EXAM Q & A WITH RATIONALES 2024, Exams of Nursing

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NURS 3 49

Transitions of Care

Q & A w/ Rationales

A:

1. What is the main goal of palliative care? a) To cure the patient's disease b) To provide comfort and quality of life c) To hasten the patient's death d) To prolong the patient's life Answer: B. Palliative care aims to relieve suffering and improve quality of life for patients with serious illnesses, regardless of their prognosis or stage of disease. Rationale: Palliative care is not the same as hospice care, which is only for patients who are terminally ill and have a life expectancy of six months or less. Palliative care can be provided at any time during the illness trajectory, along with curative or life-prolonging treatments.
2. Which of the following is an example of a transition of care in palliative care and end-of-life care? a) A patient is discharged from the hospital to a skilled nursing facility b) A patient is transferred from the intensive care unit to the palliative care unit c) A patient is enrolled in a hospice program at home d) All of the above Answer: D. All of the above are examples of transitions of care, which are defined as changes in health care settings, providers, or level of care for a patient. Rationale: Transitions of care are common and complex in palliative care and end-of-life care, as patients may have

a) Lack of standardized protocols and tools for communication and documentation b) Inadequate training and education for health care providers on palliative care and end-of-life care c) Mismatch between the patient's needs and preferences and the available resources and services d) All of the above Answer: D. All of the above are barriers to effective transitions of care in palliative care and end-of-life care. Rationale: Transitions of care in palliative care and end-of- life care can be challenging due to various factors that may hinder communication, coordination, continuity, and quality of care. Some examples are: lack of interoperable electronic health records, lack of standardized handoff tools or checklists, lack of palliative care specialists or teams, lack of access to hospice or home health services, lack of awareness or acceptance of palliative care or hospice among patients, families, or providers, lack of advance directives or goals of care discussions.

5. What are some strategies to improve transitions of care in palliative care and end-of-life care? a) Implementing evidence-based models or interventions for transitions of care, such as transitional care programs, case management, or telehealth b) Developing policies and guidelines for transitions of care, such as referral criteria, eligibility criteria, or discharge planning c) Engaging patients and families in shared decision making and advance care planning

d) All of the above Answer: D. All of the above are strategies to improve transitions B: Question 1: Which of the following best defines transitions of care in the context of palliative care and end-of-life care across the life span? a) The process of transferring a patient from one healthcare setting to another, such as from hospital to home care, while ensuring the continuity of care. b) The provision of acute medical interventions to prolong life in the final stages of a terminal illness. c) The administration of pain management techniques to alleviate suffering in terminally ill patients. d) The implementation of advanced directives to guide medical decision-making for patients with life-limiting illnesses. Answer: a) The process of transferring a patient from one healthcare setting to another, such as from hospital to home care, while ensuring the continuity of care. Rationale: Transitions of care encompass the movement of patients between different healthcare settings and the coordination of services to ensure a seamless continuum of care, which is crucial in palliative and end-of-life care across the life span. Question 2: What is a key challenge in the transitions of

a) Curing the underlying illness b) Providing comfort and improving quality of life c) Administering aggressive medical treatments d) Focusing on disease-specific interventions Answer: b) Providing comfort and improving quality of life Rationale: The primary goal of palliative care is to enhance the quality of life for patients facing serious illnesses by addressing their physical, emotional, and spiritual needs, rather than focusing solely on disease-specific treatments. Question 5: Which interdisciplinary team members are typically involved in providing comprehensive palliative care for patients? a) Physicians, pharmacists, and social workers b) Nurses, physical therapists, and dietitians c) Chaplains, art therapists, and music therapists d) All of the above Answer: d) All of the above Rationale: Comprehensive palliative care often involves a multidisciplinary team comprising various healthcare professionals to address the diverse needs of patients and their families. Question 6: What distinguishes hospice care from general palliative care? a) Hospice care is exclusively provided in inpatient settings. b) General palliative care focuses on relieving symptoms,

while hospice care is for patients with a prognosis of six months or less to live. c) Hospice care is primarily funded by private insurance, while general palliative care is covered by Medicare. d) General palliative care is provided by specialized teams, while hospice care is delivered by primary care physicians. Answer: b) General palliative care focuses on relieving symptoms, while hospice care is for patients with a prognosis of six months or less to live. Rationale: Hospice care is a form of specialized palliative care designed for patients with a prognosis of six months or less to live, focusing on comfort and quality of life rather than curative treatments. Question 7: Which factor contributes to the underutilization of palliative care services among culturally diverse populations? a) Preference for traditional healing practices b) Limited availability of palliative care providers from diverse backgrounds c) Lack of insurance coverage for palliative care services d) Cultural taboos surrounding end-of-life discussions Answer: d) Cultural taboos surrounding end-of-life discussions Rationale: Cultural taboos and beliefs about death and dying can create barriers to accessing palliative care services among culturally diverse populations, leading to underutilization of these services.

their overall well-being. Question 10: How does the provision of palliative care contribute to healthcare cost management? a) By increasing the utilization of expensive medical technologies b) By reducing unnecessary hospital readmissions and emergency department visits c) By prolonging the duration of hospital stays for terminally ill patients d) By promoting aggressive disease-specific treatments Answer: b) By reducing unnecessary hospital readmissions and emergency department visits Rationale: The provision of palliative care has been associated with reducing healthcare costs by lowering unnecessary hospital readmissions and emergency department visits, while concurrently improving the quality of care for patients with serious illnesses. Question 11: In the context of end-of-life care, what does the term "double effect" refer to? a) Administering high doses of pain medication to hasten the patient's death b) Providing palliative sedation to manage intractable symptoms while potentially shortening the patient's life c) Initiating aggressive life-sustaining treatments against the patient's wishes d) Withholding information about the prognosis from the patient and family

Answer: b) Providing palliative sedation to manage intractable symptoms while potentially shortening the patient's life Rationale: The principle of "double effect" refers to providing palliative sedation to alleviate severe, refractory symptoms, even if it may potentially hasten the patient's death, while the primary intention remains the relief of suffering. Question 12: What legal document outlines a person's preferences for medical treatment and end-of-life care? a) Living will b) Power of attorney c) Advance directive d) Medical proxy form Answer: c) Advance directive Rationale: An advance directive is a legal document that allows individuals to specify their preferences for medical treatment and end-of-life care, ensuring their wishes are honored, particularly when they are unable to communicate their decisions. Question 13: Which organization offers specialized certification for healthcare professionals in the field of palliative care? a) National Association for Home Care & Hospice (NAHC) b) American Nurses Credentialing Center (ANCC)

align with the principles of holistic nursing practice? a) By focusing exclusively on physical symptom management b) By disregarding the emotional and spiritual needs of patients c) By prioritizing patient-centered care and addressing the whole person d) By emphasizing aggressive, disease-specific treatments Answer: c) By prioritizing patient-centered care and addressing the whole person Rationale: The philosophy of palliative care aligns with the principles of holistic nursing practice by emphasizing patient-centered care and addressing the physical, emotional, social, and spiritual dimensions of the individual, promoting holistic well-being. C:

1. Which of the following is a commonly cited reason for the need to improve transitions of care in palliative and end-of-life care across the life span? a) Lack of funding for healthcare facilities b) Limited availability of healthcare professionals specialized in palliative care c) Ineffective communication among healthcare teams d) Patients' preference to receive care in hospital settings

Answer: c) Ineffective communication among healthcare teams Rationale: Ineffective communication among healthcare teams has been identified as a major barrier to providing quality care during transitions of care in palliative and end- of-life care. This can lead to gaps in care, misunderstandings, and unnecessary hospital admissions.

2. When does the palliative care approach begin? a) Only in the last few days of life b) As soon as a life-threatening illness is diagnosed c) After all curative treatment options have been exhausted d) Only in the final weeks of life Answer: b) As soon as a life-threatening illness is diagnosed Rationale: The palliative care approach focuses on providing relief from symptoms and suffering associated with a life-threatening illness, starting from the time of diagnosis and continuing throughout the illness trajectory, irrespective of the prognosis or stage of the disease.
3. Which of the following is a key characteristic of quality end-of-life care? a) Aggressive and intensive medical interventions b) High-cost treatments and therapies c) Consistent and respectful communication d) Prolonging life at any cost Answer: c) Consistent and respectful communication

d) Increases the length of hospital stays for patients Answer: c) Helps align patients' wishes with their healthcare decisions Rationale: Advance care planning involves discussing and documenting patients' preferences for care and treatment options in the event that they are unable to make decisions for themselves. This helps align patients' wishes with their healthcare decisions, ensuring that their choices are respected and followed.

6. Which of the following strategies can help improve transitions of care in palliative and end-of-life care? a) Fragmented and inconsistent communication b) Minimal patient and family involvement c) Enhanced care coordination and collaboration d) Limited engagement with community resources Answer: c) Enhanced care coordination and collaboration Rationale: Enhancing care coordination and collaboration among healthcare providers, patients, and families is a crucial strategy in improving transitions of care in palliative and end-of-life care. This includes effective communication, information sharing, and involvement of all stakeholders to ensure seamless transitions and continuity of care.
7. Which healthcare professional plays a central role in coordinating and providing palliative care in various settings?

a) Occupational therapist b) Nurse practitioner c) Physical therapist d) Dietitian Answer: b) Nurse practitioner Rationale: Nurse practitioners are advanced practice registered nurses who have the skills and knowledge to coordinate and provide palliative care across settings. They work closely with other healthcare professionals, patients, and families to ensure comprehensive and person-centered care.

8. In which setting is hospice care most commonly provided? a) Intensive care unit (ICU) b) Acute care hospital c) Rehabilitation center d) Home Answer: d) Home Rationale: Hospice care is most commonly provided in a home setting. It focuses on providing end-of-life care and support to patients who prefer to receive care in the comfort of their own homes, surrounded by their loved ones. However, hospice care can also be provided in other settings such as hospitals or long-term care facilities.
9. What is the primary goal of palliative care? a) Curing the underlying illness or condition

11. Which of the following is considered an essential component of culturally competent end-of-life care? a) Providing standardized care protocols for all patients b) Ignoring patients' cultural beliefs and preferences c) Recognizing and respecting diverse cultural practices and beliefs d) Focusing solely on physical care needs Answer: c) Recognizing and respecting diverse cultural practices and beliefs Rationale: Culturally competent end-of-life care involves recognizing and respecting diverse cultural practices, customs, beliefs, and values. It ensures that patients' cultural contexts are considered when making care decisions and provides care that is sensitive to their individual cultural needs and preferences.
12. What is the primary objective of a palliative care consult? a) To initiate aggressive medical interventions b) To recommend relocation to a long-term care facility c) To provide support and symptom management d) To prolong life at any cost Answer: c) To provide support and symptom management Rationale: The primary objective of a palliative care consult is to provide support and symptom management for patients with life-threatening illnesses. Palliative care consultations aim to improve the patient's quality of life by addressing physical, emotional, and spiritual symptoms, as

well as providing psychosocial support to the patient and their family.

13. Which ethical principle guides decision-making in palliative and end-of-life care? a) Beneficence b) Autonomy c) Justice d) Non-maleficence Answer: b) Autonomy Rationale: Autonomy is the ethical principle that guides decision-making in palliative and end-of-life care. It emphasizes respecting the rights of patients to make their own choices regarding treatment options, and it requires healthcare professionals to ensure patients have access to comprehensive information necessary to make informed decisions.
14. What is one potential benefit of implementing standardized care protocols during transitions of care in palliative and end-of-life care? a) Decreased need for interdisciplinary collaboration b) Increased healthcare costs c) Improved consistency and coordination of care d) Reduced patient satisfaction Answer: c) Improved consistency and coordination of care Rationale: Implementing standardized care protocols during transitions of care in palliative and end-of-life care