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Death and dying on the RCSI theory paper

Kubler-Ross stages, palliative care principles, comfort care, last offices, supporting families.

22 multiple-choice questions, each with an explanation and the document it was checked against. Three questions are free; the pass opens the other 19 and every other topic. Wrong answers come back first the next time you practise, and a question counts as mastered after two correct answers in a row.

Sample questions from this topic

Question 1
What does NICE recommend about oxygen for breathlessness in the last days of life?
1. AOxygen in place of opioids, which depress breathing further
2. BHigh-flow oxygen by mask for everyone who reports breathlessness
3. COnly for known or suspected hypoxaemia; try a fan first
4. DOxygen is contraindicated in dying patients
Show answer
Answer: C. NICE NG31 1.5.16: do not routinely start oxygen for breathlessness in the last days of life; offer it only to people known or suspected to have symptomatic hypoxaemia, and consider non-pharmacological measures first (the guideline preamble gives a fan as an example, alongside positioning and reassurance).
Source: NICE NG31 Care of dying adults in the last days of life (2015), 1.5.16
Question 2
Which of the following is a reversible cause of nausea in the last days of life that NICE says should be considered?
1. ATalking about death with the family
2. BLying in a hospital bed for long periods
3. CHypercalcaemia or bowel obstruction
4. DAdvanced age and frailty in themselves
Show answer
Answer: C. NICE NG31 1.5.18: assess for likely causes of nausea and vomiting in the last days of life, including medicines, recent chemotherapy or radiotherapy, psychological causes, biochemical causes such as hypercalcaemia, raised intracranial pressure, gastrointestinal motility disorder, and ileus or bowel obstruction, and treat them where appropriate.
Source: NICE NG31 Care of dying adults in the last days of life (2015), 1.5.18 and 1.5.22
Question 3
How often does NICE recommend reviewing a dying person for changes and updating their care plan?
1. AWeekly, or when the family asks
2. BAt least every 24 hours
3. CEvery 72 hours
4. DEvery 4 hours with full vital signs
Show answer
Answer: B. NICE NG31: review the dying person for changes and update the individualised care plan at least every 24 hours, including symptoms, hydration, medicines and the wishes of the person and those important to them.
Source: NICE NG31 Care of dying adults in the last days of life (2015), 1.1.6

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Every fact was checked against the public document named on the answer. This topic draws on:

Death and dying: RCSI aptitude test practice questions

Death and dying on the RCSI theory paper

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