ACC End-of-Life Care and Palliative Support 2

Question 1

How should caregivers assess pain in late-stage Alzheimer's patients who can no longer verbally communicate?

Accepted Answer

Use behavioral observation tools such as facial grimacing, restlessness, and body tension

Answer

Assume pain is absent if the patient does not ask for medication

Answer

Administer the maximum dose of pain medication as a precaution

Answer

Only assess pain during scheduled physician visits

Question 2

Which physical sign may indicate that a late-stage Alzheimer's patient is in the final hours of life?

Accepted Answer

Cheyne-Stokes respiration (irregular breathing with periods of apnea)

Answer

Regular, deep breathing with long pauses

Answer

Increased muscle tone and resistance to repositioning

Answer

Bright pink skin coloration and warm extremities

Question 3

What is 'comfort-focused care' in the context of end-stage Alzheimer's disease?

Accepted Answer

Shifting the care goal to maximizing comfort and minimizing suffering rather than curative treatment

Answer

Providing aggressive treatment to extend life as long as possible

Answer

Limiting family involvement to prevent emotional distress

Answer

Discontinuing all medications without medical guidance

Question 4

Which action best supports the family of a dying Alzheimer's patient during the end-of-life period?

Accepted Answer

Providing clear, honest updates about the patient's condition and what to expect

Answer

Encouraging family to minimize time at the bedside to avoid emotional burden

Answer

Advising family to avoid discussing death to protect the patient

Answer

Limiting family involvement in care decisions to the primary physician

Question 5

When should a caregiver contact the hospice nurse about a patient's condition?

Accepted Answer

Whenever there is a significant change in the patient's condition or comfort level

Answer

Only when a scheduled check-in time arrives

Answer

Only if the family requests a nurse visit

Answer

When the patient has not eaten for 24 hours, as a standard protocol

Question 6

Which intervention is recommended to manage dyspnea (labored breathing) in end-stage Alzheimer's patients?

Accepted Answer

Repositioning the patient, using a fan for airflow, and administering low-dose opioids as prescribed

Answer

Placing the patient flat on their back and restricting movement

Answer

Immediately initiating mechanical ventilation

Answer

Withholding all fluids to reduce lung congestion

Question 7

What role does the caregiver play in a palliative care team for an Alzheimer's patient?

Accepted Answer

The caregiver provides direct comfort care, communicates patient needs, and coordinates with the care team

Answer

The caregiver makes all medical decisions independently

Answer

The caregiver serves as an observer only and defers all decisions to the physician

Answer

The caregiver's role ends once the patient enters hospice care