NR572 EXAMINATION 2026 VERIFIED
ANSWER COMPENDIUM
◉interdisciplinary team approach that typically encompasses pain
and symptom management, spiritual and psychological care for the
patient, and support for family caregivers during the patient's illness
and the bereavement period
palliative and end-of-life care is a focus on four broad domains: (1)
physical symptoms; (2) psychological symptoms; (3) social needs
that include interpersonal relationships, caregiving, and economic
concerns; and (4) existential or spiritual needs.. Answer: HOSPICE
AND THE PALLIATIVE CARE FRAMEWORK
◉Effective advance care planning should follow six key steps:
(1) introducing the topic
(2) structuring a discussion
(3) reviewing plans that have been discussed by the patient and
family
(4) documenting the plans,
(5) updating them periodically
(6) implementing the advance care directives
,barriers to advance care planning are problems in raising the topic
and difficulty in structuring a succinct discussion. Answer: Advance
Care Planning
◉Introduce advance care planning
-Explain the goals of the process as empowering the patient and
ensuring that you and the proxy understand the patient's
preferences
-Provide the patient relevant literature, including the advance care
directive that you prefer to use
-Recommend the patient identify a proxy decision-maker who
should attend the next meeting.
Have a structured discussion of scenarios with the patient
-Elicit the patient's overall goals related to health care.
Elicit the patient's preferences for specific interventions in a few
salient and common scenarios.
Help the patient define the threshold for withdrawing and
withholding interventions.
Define the patient's preference for the role of the proxy
-Affirm that the goal of the process is to follow the patient's wishes if
the patient loses decision-making capacity. Answer: Advance Care
Planning
,◉Review the patient's preferences
-After the patient has made choices of interventions, review them to
ensure they are consistent and the proxy is aware of them
Document the patient's preferences
-Formally complete the advance care directive and have a witness
sign it.
Provide a copy for the patient and the proxy.
Insert a copy into the patient's medical record and summarize it in a
progress note
Update the directive
-Periodically, and with major changes in health status, review the
directive with the patient and make any modifications.
Apply the directive
-The directive goes into effect only when the patient becomes unable
to make medical decisions for themself.
Reread the directive to be sure about its content.
Discuss your proposed actions based on the directive with the
proxy.. Answer: Advance Care Planning
, ◉common physical and psychological symptoms among all
terminally ill patients include pain, fatigue, insomnia, anorexia,
dyspnea, depression, anxiety, nausea, and vomiting
Nociceptive pain (2 types)
-Somatic pain is the result of direct mechanical or chemical
stimulation of nociceptors and normal neural signaling to the brain
-localized, aching, throbbing
-bone mestatisis pain
Visceral pain
-caused by nociceptors in gastrointestinal (GI), respiratory, and
other organ systems. It is a deep or colicky type of pain classically
associated with pancreatitis, myocardial infarction, or tumor
invasion of viscera
Neuropathic pain
-disordered nerve signals
-burning, electrical, or shock-like pain
Classic examples are poststroke pain, tumor invasion of the brachial
plexus, and herpetic neuralgia.. Answer: Pain management hospice
◉Tylenol
ANSWER COMPENDIUM
◉interdisciplinary team approach that typically encompasses pain
and symptom management, spiritual and psychological care for the
patient, and support for family caregivers during the patient's illness
and the bereavement period
palliative and end-of-life care is a focus on four broad domains: (1)
physical symptoms; (2) psychological symptoms; (3) social needs
that include interpersonal relationships, caregiving, and economic
concerns; and (4) existential or spiritual needs.. Answer: HOSPICE
AND THE PALLIATIVE CARE FRAMEWORK
◉Effective advance care planning should follow six key steps:
(1) introducing the topic
(2) structuring a discussion
(3) reviewing plans that have been discussed by the patient and
family
(4) documenting the plans,
(5) updating them periodically
(6) implementing the advance care directives
,barriers to advance care planning are problems in raising the topic
and difficulty in structuring a succinct discussion. Answer: Advance
Care Planning
◉Introduce advance care planning
-Explain the goals of the process as empowering the patient and
ensuring that you and the proxy understand the patient's
preferences
-Provide the patient relevant literature, including the advance care
directive that you prefer to use
-Recommend the patient identify a proxy decision-maker who
should attend the next meeting.
Have a structured discussion of scenarios with the patient
-Elicit the patient's overall goals related to health care.
Elicit the patient's preferences for specific interventions in a few
salient and common scenarios.
Help the patient define the threshold for withdrawing and
withholding interventions.
Define the patient's preference for the role of the proxy
-Affirm that the goal of the process is to follow the patient's wishes if
the patient loses decision-making capacity. Answer: Advance Care
Planning
,◉Review the patient's preferences
-After the patient has made choices of interventions, review them to
ensure they are consistent and the proxy is aware of them
Document the patient's preferences
-Formally complete the advance care directive and have a witness
sign it.
Provide a copy for the patient and the proxy.
Insert a copy into the patient's medical record and summarize it in a
progress note
Update the directive
-Periodically, and with major changes in health status, review the
directive with the patient and make any modifications.
Apply the directive
-The directive goes into effect only when the patient becomes unable
to make medical decisions for themself.
Reread the directive to be sure about its content.
Discuss your proposed actions based on the directive with the
proxy.. Answer: Advance Care Planning
, ◉common physical and psychological symptoms among all
terminally ill patients include pain, fatigue, insomnia, anorexia,
dyspnea, depression, anxiety, nausea, and vomiting
Nociceptive pain (2 types)
-Somatic pain is the result of direct mechanical or chemical
stimulation of nociceptors and normal neural signaling to the brain
-localized, aching, throbbing
-bone mestatisis pain
Visceral pain
-caused by nociceptors in gastrointestinal (GI), respiratory, and
other organ systems. It is a deep or colicky type of pain classically
associated with pancreatitis, myocardial infarction, or tumor
invasion of viscera
Neuropathic pain
-disordered nerve signals
-burning, electrical, or shock-like pain
Classic examples are poststroke pain, tumor invasion of the brachial
plexus, and herpetic neuralgia.. Answer: Pain management hospice
◉Tylenol
