Easing Physical Symptoms: It’s Not Just Hospice Anymore Coursera Quiz Answers 2022 [💯% Correct Answer]

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About Easing Physical Symptoms: It’s Not Just Hospice Anymore Course

In subsequent weeks you will learn about some of the most common and distressing symptoms such as anorexia (loss of appetite), dyspnea (shortness of breath), fatigue (weakness), delirium(confusion), and constipation, and nausea/vomiting.

Course Apply Link – Easing Physical Symptoms: It’s Not Just Hospice Anymore

Easing Physical Symptoms: It’s Not Just Hospice Anymore Quiz Answers

Week 01: Easing Physical Symptoms: It’s Not Just Hospice Anymore Quiz Answers

Introduction to Common Symptoms and Anorexia Assessment

Janice has severe COPD and heart failure. She needs oxygen supplements because her oxygen level is low, especially with exercise and at night. She is often tired and short of breath.

Which of the following statements are true about physical symptoms that Janice may be experiencing? Choose all that apply.

• When Janice and her healthcare providers treat the COPD and heart failure, her symptoms of weakness and shortness of breath will resolve.
• Helping Janice with her symptoms in addition to treating the COPD and heart failure can improve quality of life.
• Janice should be screened for other symptoms that may not be well controlled such as loss of appetite, insomnia, confusion and nausea.
• Helping Janice with her symptoms in addition to treating the COPD and heart failure may improve her survival

When Janice and Pat (Janice’s daughter) visit the hospital, Janice is seen by Melvin, a nurse with the new palliative care team. As part of their first visit he uses an Edmonton Symptom Assessment Scale (ESAS) to do a more comprehensive assessment.

Which of the following statements are true about symptom assessment? Choose all that apply.

• Melvin can depend that Janice will always report her symptoms accurately when he uses the ESAS.
• Melvin should use the ESAS to help Janice report her symptoms on his follow-up visit later this month.

• With the ESAS Melvin will ask Janice to report how severe different physical symptoms are NOW using a 0 -10 scale, with 0 being ‘no problem’ and 10 being ‘the worst’.
• Janice’s daughter Pat is present. Since Janie is short of breath it would be just as accurate to ask Pat to complete the ESAS.
• Janice reports on the ESAS that fatigue is a very distressing symptom that she rates as 8 out of 10 in severity. Pat, however is more concerned about loss of appetite.

Janice has noticed that she doesn’t have much of an appetite and has lost 5 KG in the last 6 months.

• The word (_____________) comes from the Greek and means not feeling hungry or not having an appetite.

Unintentional weight loss, cachexia, is common in patients with cancer or other serious illness such as heart, lung or kidney failure. However, since Janice was obese to begin with, she will benefit from the weight loss.

• True
• False

Janice has become very thin and there is visibly less muscle mass in her arms and legs.

Which of the following statements are true about cachexia and hypermetabolic state? Choose all that apply.

• Eating more calories in the form of fat and protein will always prevent muscle loss in someone like Janice.
• Muscle weakness and fatigue increase the risk that Janice will fall and injury herself.
• In hypermetabolic state the body is breaking down its own muscle to use for energy.
• Janice was exposed to TB when she was child. A chest x-ray and other tests confirm that the TB is now active. Treating her TB could help with Janice’s anorexia and cachexia.

Beto (Roberto) Hernandez is a 78 year-old Hispanic gentleman who has moderate dementia for which he takes a pill. Recently Beto needed to move into an Assisted Living Facility (ALF) since he was not safe to live in his apartment alone. In the last 6 months he has not been very hungry and has lost 5 KG (10lbs). Melvin, the nurse with the palliative care team visits Beto to evaluate his anorexia and weight.

Considering a whole patient assessment, what are some factors that Melvin should be considering that may contribute to Beto’s anorexia and weight loss? Choose all that apply.

• Melvin should encourage friends and family to visit around meal time and to eat with Beto.
• The ALF has changed his diet to “low salt” because he has a history of high blood pressure, but Beto thinks the food is bland.

• Melvin should avoid suggesting snacks since Beto will not be hungry for his meals.
• Melvin does not need to worry about Beto’s medications because they are not likely to contribute to anorexia.

Maria, Beto’s daughter, is upset because her father doesn’t eat the special tamales she has made. They were his favorite and Maria learned how to make them from her Mom. There is a lot of stress whenever Maria and other family come to visit Beto because of his decreased appetite.

What are ways that Melvin could help Beto and his family cope with anorexia? Choose all that apply.

• Melvin should review with Beto and his family ways that might help him enjoy meal time and have a better quality of life.
• Melvin should avoid bringing up the issue of anorexia because there isn’t anything he can do to help.
• Naming “I can see that the loss of appetite and weight loss is scary” is the first step in the NURSE protocol that Melvin could use to help process strong emotions around loss of appetite
• Melvin should consider recommending a feeding tube to Beto and his family before he loses too much more weight.
• Melvin recommends that Maria bring a photo album that she can look at with her Dad.

Melvin helps Beto, Maria and the ALF review Beto’s diet to help enjoy his food and improve nutrition.

Which of the following are potential ways to improve Beto’s food intake by modifying his diet? Choose all that apply.

• Homemade fruit smoothies and dairy-free shakes made with almond milk might help enrich Beto’s diet since he has lactose intolerance.
• Remind Beto to graze, have snacks and small meals throughout the day.
• Nutritional supplements in cans or boxes are better for you than regular food because they have vitamins.
• Since Beto has had high cholesterol it is important to be on a low-fat diet.

Which of the following problems could be making it harder for Beto to eat as much? Choose all that apply.

• Acid reflux that is worse from lying down after eating.
• Constipation
• Dentures that don’t fit well or teeth that are broken or decayed.
• Chewable multivitamin.

Maria asked Melvin about medications that might improve her father’s appetite.

Megesterol (Megase) is proven to improve overall quality of life, survival and lean body mass and survival in people with severe anorexia by increasing appetite .

• True
• False

Week 02: Easing Physical Symptoms: It’s Not Just Hospice Anymore Quiz Answers

Dyspnea Assessment

Based on the information you have learned from this module on dyspnea, answer the following questions about Martha and her dyspnea.

What is the greatest challenge in working with persons, like Martha, who have dyspnea?

• Dyspnea is present with many different conditions
• Dyspnea is a subjective experience
• Abnormal physical examintation findings may not be present
• The severity of a person’s symptoms are not often appreciated by the healthcare provider.

What kind of dyspnea is Martha experiencing?

• Acute dyspnea
• Chronic dyspnea

What is the cause of Martha’s dyspnea?

• Cancer
• Asthma
• Heart failure
• Idiopathic pulmonary fibrosis
• COPD

Which of the following is an integrative therapy that can help decrease Martha’s dyspnea and enhance her well-being?

• Mindfulness
• Aerobic exercise
• Reiki
• Hot pack

Martha is in the hospital with pneumonia and is recovering. She is getting ready to be discharged and develops dyspnea after showering. The nurse wishes to determine the severity of her shortness of breath and oxygenation level. How should she be evaluated?

• CT Scan
• Chest x-ray
• Pulse oximetry
• Listen to her lung with stethoscope

Martha’s healthcare provider used a pulse oximeter to determine the amount of oxygen in her bloodstream. Her oxygenation level is 90. Which of the following is true?

• Her oxygenation level is abnormal
• Her oxygenation level is normal

Which of the following body positions may help Martha with shortness of breath?

• Sit upright with legs crossed and hands in the air
• Lie on the right side
• Sit upright, lean forward, and keep good posture
• Lie flat

What are some ways Martha can minimize her shortness of breath? (Choose all that apply)

• Pacing
• Nebulizer treatments with Lasix
• Pursed lip breathing
• Conserve energy
• Use a fan near her face

Martha is trying make changes in her lifestyle because of her dyspnea. What are some suggestions you can give her? (Select all that apply)

• Ask her what activities are important to her
• Tell her to take frequent breaks
• Help her figure out the time of day when she feels her best and schedule activities then
• Tell her not to ask for help; others will offer help when they can
• Help her make flexible goals

Martha’s condition is worsening and her healthcare provider would like her to try some low dose oral morphine to help her shortness of breath. Martha is worried about using morphine as she is concerned about side effects. What is the worst thing you can say to Martha to ease her concerns?

• Don’t worry about addiction, you are not going to live that long.
• The use of immediate release, low dose, and short acting morphine by mouth has been shown to help breathing in persons with various lung diseases.
• When used safely, morphine typically does not cause respiratory depression or stop breathing.
• Don’t worry about addiction, you are not going to live that long.
• The use of immediate release, low dose, and short acting morphine by mouth has been shown to help breathing in persons with various lung diseases.
• When used safely, morphine typically does not cause respiratory depression or stop breathing.

Week 03: Easing Physical Symptoms: It’s Not Just Hospice Anymore Quiz Answers

Weakness and Fatigue Assessment

Ollie Green has stage IV lung cancer and has been receiving treatment with radiation and chemotherapy. His pain is well controlled. He talked with a nurse and doctor at the cancer center and they told him everyone with cancer gets weak and he would just have to “tough it out”. He is concerned about his ability to do his own self-care and live at home.

Ollie is living with an incurable illness, stage IV lung cancer and is struggling with fatigue. Choose all that are correct.

• Ollie is not likely to be thinking about Medical Aid in Dying because his pain is under good control.
• Ollie should be evaluated for depression and his emotional response to the weakness.
• Ollie says he is weak. It would be important to understand if this is throughout his body or if he has more weakness in one arm, leg or one side of the body compared to the other.
• Ollie just needs a blood transfusion because chemotherapy causes anemia.

Fatigue is multidimensional. Ollie likely has 3 or more reasons or issues that are contributing to his sense of fatigue. This can make fatigue more difficult to evaluate and treat.

• True
• False

You have been talking with Ollie about his experience with fatigue. Which of the follow describe an aspect of the fatigue experience? Choose all that are correct.

• Asthenia is the feeling that a person has that they are tired, and that this tiredness is persistent and feels like it will never go away.
• Fatigue is a subjective experience, like pain, characterized by feelings of tiredness and a perception of decreased capacity for physical or mental work.
• Ollie is having trouble balancing his checkbook, but his mental fatigue and exhaustion will be much better after resting overnight.
• Fatigue is not likely to contribute to other problems like a fall.

Ollie has been experiencing fatigue while receiving radiation to his chest for lung cancer. He will finish the treatment in two days. You tell Ollie that he can expect to start feeling stronger just a few days after radiation is completed.

• True
• False

You are meeting with Ollie near the end of the radiation treatment. As part of your evaluation of Ollie you have done a comprehensive symptom assessment and he has a number of other troubling symptoms. Which statements accurately reflect the relationship of other symptoms and fatigue? Choose all that are correct.

• Ollie is having some difficulty with swallowing and may be dehydrated.
• Controlling other symptoms like pain, shortness of breath and insomnia allows people to cope with their fatigue better and allows more time for effective interventions to manage fatigue.
• Ollie had insomnia and his doctors started him on a sleeping pill, so this is not a concern for fatigue.
• Ollie’s chest pain is better with medication and radiation. He may need to adjust the amount of opioid medication down now.

Ollie has been taking an arthritis medication, Ibuprofen, with his other opioid medications for pain. For the last few weeks he has been feeling more fatigued. Today he is feeling very weak, almost fainted, had a large black bowel movement and came to the Emergency Room. He is having bleeding in his stomach. The ibuprofen is stopped and he is started on medicines to help heal ulcers and stomach irritation.

Now Ollie has anemia and it is contributing to his fatigue. What statement accurately describes the relationship of anemia and fatigue? Choose all that are correct.

• Fatigue is correlated with lower hemoglobin levels; the lower the hemoglobin the more likely you are to experience fatigue and the more severe it can be.
• Ollie, like, everyone with anemia, needs to be on an iron supplement.

• Erythropoietin (EPO) stimulates the bone marrow to make more blood. It is particularly helpful in people who also have kidney disease.
• People with anemia always have their fatigue improved when they get a blood transfusion
• Ollie’s hemoglobin level is 6.5 grams/dl (normal >14 grams/dl) and a blood transfusion is likely to help him feel less fatigue and stabilize the situation.

The palliative care team is consulted to see Ollie in the hospital after he is admitted due to the anemia and bleeding from his stomach. The palliative care team reviews all of Ollie’s medications because of concerns for polypharmacy. Which statement accurately describes the relationship of polypharmacy and fatigue? Choose all that are correct.

• Lowering the dose of medications, changing the schedule to night for medications that are sedating or even stopping medications often improve fatigue.
• Ollie is on pravastatin (a medication to lower cholesterol). He should continue to take this since he was told he would need it for the rest of his life
• All pain medications, including acetaminophen (Tylenol) and medications for arthritis, such as ibuprofen, are sedating and can make fatigue worse.
• Ollie is on an oral medication for diabetes mellitus. You wonder if he still needs it because he feels weak sometimes after he takes it.

Upon visiting Ollie at home, he reports that he had a fall after he stood up at the side of his bed and felt dizzy. This could be a sign of Autonomic Dysfunction.

• True
• False

Ollie has been avoiding exercising because he feels fatigued. What statement accurately describes the relationship of exercise and fatigue? Choose all that are correct.

• NURSE is a technique to help providers respond to and help Ollie process his emotions about fatigue and weakness.
• Ollie would not benefit from a home visit and he should go to Physical Therapy.
• Physical Therapy and Occupational Therapy are not indicated for people living with incurable disease.
• Energy Conservation is the concept of Ollie saving limited energy resources for activities that increase quality of life and are important to him.
• Exercise, such as short walks, or sitting up instead of lying in bed most of the day may help fatigue and delay weakness and bed confinement.

Ollie has been hesitant to accept a home health aide and home maker services despite his fatigue. Which statement accurately describe the relationship of home health aides and home maker services with fatigue? Choose all that are correct.

• Home Maker Services can support oral intake and nutrition.
• A home visit may result in recommending moving Ollie to a different room in the home that is more central may promote safety by avoiding stairs, (energy conservation) and reduce isolation from other family.
• Trained aides can alert the patient, family and the palliative care team if fatigue is worsening and safety issues is developing between check-ups.
• Home health aides will contribute to fatigue because they disrupt Ollie’s routine.

Ollie has been able to live at home. In the last month Ollie, the home health aide and the Palliative Care team met because Ollie was getting weaker and it was no longer safe for him to stay in the home alone. His sister came from out of town and moved in with Ollie so that he would not have to go to a nursing home. Ollie’s cancer is getting worse and he is expected to live only a few more weeks to short months. Fatigue is still a major problem and he is hoping to be stronger when his son visits. Ollie and his sister ask about medications that might help with fatigue.

Medications to directly help with fatigue are usually used later in the course of illness when fatigue is severe and not responding to other interventions.

Correctly identify the medication, mechanism and indication.

Ollie is having trouble with being too sleepy in the morning after he takes his pain medications. He tried to reduce the dose but the pain in his chest was too severe. All three of these medications might be helpful, but which is the best choice?

• Mirtazapine (Remeron) is an antidepressant that may help with sleep and appetite.
• Dexamethasone (Decadron) is a corticosteroid and reduces inflammation (which may cause fatigue) and may help with shortness of breath from COPD, and bone pain.
• Methylphenidate (Ritalin) is a stimulant that may help Ollie feel more alert and energetic when his family is visiting in the day.

Ollie has been able to live at home. In the last month Ollie, the home health aide and the Palliative Care team met because Ollie was getting weaker and it was no longer safe for him to stay in the home alone. His sister came from out of town and moved in with Ollie so that he would not have to go to a nursing home. Ollie’s cancer is getting worse and he is expected to live only a few more weeks to short months. Fatigue is still a major problem and he is hoping to be stronger when his son visits. Ollie and his sister ask about medications that might help with fatigue.

Medications to directly help with fatigue are usually used later in the course of illness when fatigue is severe and not responding to other interventions.

Correctly identify the medication, mechanism and indication.

Ollie has been feeling very sad despite the company of his sister and the support of the palliative care team. He recently is having more insomnia and worries at night. He is particularly fatigued when he can’t sleep well.

These medications might be helpful, but which is the best choice for this situation?

• Methylphenidate (Ritalin) is a stimulant and could help Ollie feel more alert and energetic when his family is visiting in the day.
• Dexamethasone (Decadron) is a corticosteroid and reduces inflammation (which may cause fatigue) also may help with shortness of breath from COPD, and bone pain.
• Mirtazapine (Remeron) is an antidepressant that may help with sleep and appetite.

Ollie has been able to live at home. In the last month Ollie, the home health aide and the Palliative Care team met because Ollie was getting weaker and it was no longer safe for him to stay in the home alone. His sister came from out of town and moved in with Ollie so that he would not have to go to a nursing home. Ollie’s cancer is getting worse and he is expected to live only a few more weeks to short months. Fatigue is still a major problem and he is hoping to be stronger when his son visits. Ollie and his sister ask about medications that might help with fatigue.

Medications to directly help with fatigue are usually used later in the course of illness when fatigue is severe and not responding to other interventions.

Correctly identify the medication, mechanism and indication.

Ollie is feeling very weak and having more wheezing from his lung disease and pain when he coughs. All three of these medications might be helpful, but which is the best choice?

• Methylphenidate(Ritalin) is a stimulant and could help Ollie feel more alert and energetic when his family is visiting in the day.
• Mirtazapine (Remeron) is an antidepressant that may help with sleep and appetite.
• Dexamethasone (Decadron) is a corticosteroid and reduces inflammation (which may cause fatigue) and may help with shortness of breath from COPD, and bone pain.

Week 04: Easing Physical Symptoms: It’s Not Just Hospice Anymore Quiz Answers

Confusion Assessment

Your neighbor was diagnosed with Alzheimer’s last year. He is typically a calm man who is experiencing increasing disorientation to where he is and requiring help getting dressed. One day his wife knocks on your door and tells you she is worried about him and doesn’t know what to do. She tells you that yesterday he was his usual calm self but today he is restless, anxious and attempting to hit her. How would you respond to this wife?

• Advise her to arrange a medical evaluation for her husband as soon as possible.
• Tell her she needs to get counseling.
• Reassure her that this is only a progression in the dementia.
• Actively listen to her to allow her to express her concerns.

Caring for a loved one with dementia can be stressful and impact all of the following areas, EXCEPT . . .?

• Financial
• Risk for the caregiver of developing dementia.
• Job performance
• Emotional health
• Physical health

What percentage of caregivers are also employed outside the home?

• 38%
• 60%
• 52%
• 78%

From the Dementia Matters podcast, the lecturer Teepa Snow presents many strategies for caregivers to use when communicating with a person suffering with dementia. Ms. Snow reminds us that people with dementia . . .

• Might have lost the ability to identify words but are good at picking up on rhythm of speech including the frequency, the intensity and the volume.
• Have a lot of trouble hearing so the caregiver must speak loudly.
• Do better when the caregiver uses hand gestures along with speech.
• Are good at listening.

The Confusion Assessment Method is a tool that was developed to identify and screen for?

• Lewy body dementia
• Delirium
• Confusion
• Alzheimer’s disease
• Parkinson’s disease

Delirium:

• A) Can be deadly
• B) Is common
• C) Is not treatable nor reversible.
• D) Symptoms can be managed with medications and with environmental changes.
• E) Choices A, B, and D are correct
• F) Choices A, B, and C are correct

You are a palliative care professional that works in the hospital. An 87-year-old gentleman is admitted in the last hours of life. His family arrives and it becomes apparent that they disagree on the type of medical care for their loved one. One daughter insists that everything be attempted, including CPR when his heart stops. Another daughter is adamant that nothing be done including giving pain medication because she is recovering from drug addiction herself and she doesn’t want that for her father. The patient’s wife is overwhelmed and unable to make any decisions at all. The medical team is lost as to what kind of care to provide this gentleman. What could have prevented this scenario?

• Early parenting education and support programs.
• Clear, early advance care planning discussions with the patient and his family.
• An in-depth several page legal Living Will document.
• Better drug recovery programs.

The difference between delirium and Near Death Awareness (NDA) is?

• NDA occurs hours before death. Delirium can occur anywhere along the disease path.
• Delirium is not caused by drugs. NDA is impacted by drugs.

• Delirium symptoms include a range of change in consciousness from agitated, hyperactive states to hypoactive and sedated states. NDA visions and dreams are reported in a clear, conscious manner.
• Delirium symptoms do not include a range of change in consciousness from agitated, hyperactive states to hypoactive and sedated states, but NDA visions and dreams are reported in a confused, unclear manner.

The type of dementia that is caused by the destruction of brain cells due to deposit of amyloid beta protein plaques and the formation of dead and dying nerve cell tangles in the brain is called . . .?

• Lewy body dementia
• Parkinson’s disease
• Vascular dementia
• Alzheimer’s disease

The most common cause of delirium in the hospital setting is . . .?

• ICU overstimulation
• Medications
• Bad tasting food
• Multiple and invasive testing

Week 05: Easing Physical Symptoms: It’s Not Just Hospice Anymore Quiz Answers

Nausea, Vomiting, and Constipation Assessment

What is the definition of retching/dry heaving?

• Nausea that occurs because a person has been nauseous in a similar setting in the past.
• The body’s attempt to vomit without anything actually coming out of the mouth or nose.
• A feeling of sickness that results in an urge to vomit.
• Retching/dry heaving results in the forceful expulsion of gastric contents out of the mouth and nose.

Which of the following is the “most correct” answer to the statement: The reflex that results in vomiting is quite complex and involves coordination from . . .?

• The GI Tract
• The diaphragm
• Abdominal muscle
• The Gi Tract and Abdominal muscle
• All of the above

What pathways would be affected by using a medicine that blocks acetylcholine?

• Chemoreceptor trigger zone
• Cerebral cortex
• GI tract
• Chemoreceptor trigger zone and GI tract
• None of the above

Anticipatory nausea is a result of anxiety in the cerebral cortex. Because of this, what type of medicine might be most helpful in relieving this symptom?

• Metoclopramide
• Haloperidol
• Hyoscine
• Lorazepam
• None of the above

Ondansetron is a medicine commonly used to manage nausea and vomiting. What neurotransmitter(s) does it predominately interact with to relieve symptoms?

• Dopamine
• 5-HT3
• Acetylcholine
• All of the above
• None of the above

Based on the Standard Rome III Criteria for Constipation, what defines constipation?

• Straining
• Lumpy or hard stools
• Sensation of incomplete evacuation
• Sensation of anorectal obstruction
• Manual maneuvers (digital or enema) to facilitate defecation
• Less than three stools per week
• Two or more of the above

Senna and bisacodyl are examples of . . .?

• Osmotic laxatives
• Lubricants
• Stimulant laxatives
• Detergent/ Surfactant laxatives

Nausea is an unpleasant subjective feeling of the need to vomit that is experienced in the back of someone’s throat or upper stomach.

• True
• False

Dopamine and ­­­___________ are transmitters common in both the chemoreceptor trigger zone and GI tract neural pathways. Too much of either of these can activate the vomiting center and make a person experience nausea and vomiting .

Most medication management of nausea and vomiting is aimed at negating the implicated receptor (this is also known as mechanism based).

• True
• False

We will Update These Answers Soon.

More About This Course

Palliative care provides important support for people living with serious or life-limiting illnesses and their family caregivers. In this course, you will learn to use symptom assessment tools to better understand which symptoms are present and which are most distressing.

In subsequent weeks you will learn about some of the most common and distressing symptoms such as anorexia (loss of appetite), dyspnea (shortness of breath), fatigue (weakness), delirium(confusion) and constipation and nausea/vomiting.

For each of these symptoms, you will learn about the underlying cause and potential ways to support people and their families to manage the symptoms with simple practical and non-medical approaches as well as a review of medications as appropriate.

In addition, you will learn to help people with their emotional response to symptoms and loss of function.

You will be able to immediately use these insights, skills, and tools in your work with people living with serious illness. In other courses, you will learn communication skills, whole person assessment, how to ease physical pain and explore ways to ease psycho-social-spiritual distress.

Conclusion

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