Palliative Care: ABFM practice questions

6 board-style questions on palliative care in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 67-year-old man with stage IV non-small cell lung cancer is undergoing second-line chemotherapy. He reports moderate dyspnea, fatigue, and anxiety about his prognosis. His oncologist believes treatment may extend his life by several months. The patient's wife asks about hospice care. Which of the following is the most accurate statement about palliative care and hospice for this patient?

  1. Palliative care should be deferred until all curative treatment options are exhausted
  2. Palliative care is appropriate now and can be provided concurrently with ongoing chemotherapy
  3. Hospice enrollment is appropriate now since he has a terminal diagnosis
  4. Palliative care and hospice are the same service and should be initiated only in the last 2 weeks of life

Sample question 2

An 84-year-old woman with advanced heart failure (NYHA Class IV), moderate dementia (MMSE 16/30), and chronic kidney disease stage 4 is admitted for the third time in 2 months with decompensated heart failure. Her family asks you to "do everything" to keep her alive. She has no advance directive. Her estimated 1-year mortality is greater than 50% based on validated prognostic tools. Which of the following is the most appropriate approach to this goals-of-care conversation?

  1. Explain that further aggressive treatment is futile and recommend transitioning to comfort care only
  2. Explore the family's understanding of her condition, clarify her values and prior expressed wishes, and align treatment recommendations with her goals while providing honest prognostic information
  3. Defer the goals-of-care conversation until she has another acute decompensation
  4. Honor the family's request without further discussion, as they are the surrogate decision-makers

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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