Welcome to your 6. 🤝 Breaking Bad News, Palliative & Geriatric Care Arena — 40 Integrated MCQs
1.
A patient with advanced illness has nausea and new confusion. The team is reviewing a comfort-focused plan. Which approach best reflects sound palliative assessment?
2.
An older patient with a serious illness wants treatment of a reversible infection, relief of pain and enough mobility to return home. Which approach best brings the relevant care principles together?
3.
A patient's pain has improved, but she remains distressed because she fears leaving her dependent child without support. What is the most appropriate next step?
4.
A patient is about to receive the results of a biopsy. The doctor first asks, “What have you understood about the tests so far?” Which SPIKES step does this represent?
5.
A man with serious heart disease has distressing breathlessness. His family thinks accepting palliative care means stopping his cardiac treatment. What is the best explanation?
6.
During a consultation, a doctor gives a patient several detailed explanations immediately after disclosing a serious diagnosis. The patient becomes quiet and later cannot recall the plan. Which change would most improve the discussion?
7.
A doctor says, “I’m afraid the result is more serious than we had hoped,” then explains the finding in short, clear sentences. Which SPIKES step is the doctor using?
8.
Before explaining scan results, a doctor asks a patient what the previous team told him and what he thinks the scan may show. How will this information primarily help the doctor?
9.
An older patient’s infection has improved, but she now needs help dressing and walking. What important aspect of geriatric care does this illustrate?
10.
Two older patients have the same diagnosis. One lives independently; the other has poor mobility, recurrent falls and difficulty managing daily tasks. Why might their care plans differ?
11.
A patient thought to be in the last days of life is distressed by a dry mouth. Which action best reflects comfort-focused care?
12.
An older patient develops marked weakness after a relatively minor illness. Which concept describes reduced ability to withstand such a stress?
13.
An older patient has fallen twice and takes several prescribed medicines. Which review is particularly relevant to the falls assessment?
14.
An older man recovers from pneumonia, but he can no longer shop or manage his medicines as he did before admission. What is the most important implication for discharge planning?
15.
A woman has been told that her biopsy shows cancer. She says, "I knew something was wrong, but I cannot think clearly now." The doctor has more information about treatment. What is the best immediate approach?
16.
A patient’s pain improves after a care plan is started. What is the next general step in palliative care?
17.
An adult patient understands her diagnosis but asks that it not be discussed with her relatives yet. What should guide the doctor’s discussion with the family?
18.
A patient with progressive illness asks, "Do you mean there is no hope?" The team can still offer symptom relief and support, although disease control is uncertain. Which response is most appropriate?
19.
An older patient has several chronic conditions but remains active and independent. Which statement best guides their care?
20.
After discussing a difficult diagnosis, a patient and her spouse give different accounts of what happens next. Which action best completes the consultation?
21.
After hearing a serious diagnosis, a patient becomes silent and tearful. What is the best immediate response?
22.
Before discussing a serious diagnosis, a doctor checks the results and arranges a quiet room with adequate time. Which SPIKES step is being addressed?
23.
Which group of concerns is included in a broad palliative-care assessment?
24.
A patient in the last days of life appears uncomfortable and breathless. A relative says, "There is no point assessing her now." What is the best response from the care team?
25.
An older patient was independent before a brief illness but now needs help standing and walking. The team identifies weakness, poor intake and limited home support. Which plan best addresses the combined problem?
26.
A patient says she would like her daughter present and wants the doctor to explain the results in full. Which SPIKES step helps establish these preferences?
27.
A patient asks the doctor to explain a serious diagnosis to her first and involve her family only after she has had time to consider it. Her relatives arrive and request the results. What should the doctor do?
28.
A patient thought to be approaching death becomes more alert and starts drinking again after treatment of an intercurrent problem. What should the team do?
29.
An older woman is described as "confused" during admission. She responds accurately when she can hear the questions and becomes more engaged after her hearing aid is fitted. What does this show?
30.
During counselling, a patient asks whether treatment will certainly cure a serious illness. The outcome is uncertain. What is the best approach?
31.
A patient with serious illness is receiving treatment intended to control the disease. When can palliative care be considered?
32.
A patient receiving end-of-life care becomes unable to participate in a discussion she previously could follow. Which issue should the team address when reviewing decisions?
33.
At the end of a difficult consultation, the doctor checks what the patient understood and agrees on the next appointment. Which SPIKES step is illustrated?
34.
A dying patient who cannot drink adequately has distressing thirst. The team is considering clinically assisted hydration. Which plan is most appropriate?
35.
An older patient becomes suddenly inattentive and confused during an illness. Which problem should be considered first?
36.
A patient with a serious illness says that remaining able to talk with family matters more to him than relief that leaves him very drowsy. How should this affect care planning?
37.
A dying patient cannot drink enough, and the family asks about assisted hydration. Which principle should guide the decision?
38.
An older patient has had two falls since starting several new medicines. Which assessment is most useful when making a care plan?
39.
A patient receiving treatment for a serious illness has persistent pain and anxiety. What is the main aim of adding palliative care?
40.
A patient with advanced illness becomes weaker and eats less. Before concluding that death is near, what should the team do?
