NCLEX End-of-Life and Palliative Care
Updated October 27, 2026
End-of-life care questions on the NCLEX-RN test comfort, communication and respect for the client’s wishes. They often ask about palliative versus hospice care, advance directives, symptom management and supporting the family. Here are the high-yield points, followed by free practice questions.
Follow your facility’s policies and the client’s plan of care.
Palliative vs. hospice care
| Palliative care | Hospice care | |
|---|---|---|
| Focus | Relief of symptoms and stress at any stage of serious illness | Comfort care when life expectancy is limited and curative treatment has stopped |
| Can the client receive curative treatment? | Yes | Generally no |
Advance directives
- A living will states the treatments a person does or doesn’t want.
- A durable power of attorney for health care (health care proxy) names someone to make decisions if the person can’t.
- A DNR (do not resuscitate) order means no CPR; other care, including comfort measures, continues.
Signs that death may be near
- Changes in breathing, such as long pauses (Cheyne-Stokes breathing) or noisy breathing from secretions
- Cool, mottled skin, especially on the hands, feet and knees
- Decreased urine output
- Less eating and drinking, and more sleeping
- Decreasing responsiveness. Hearing is thought to be one of the last senses to go, so keep talking to the client.
Comfort measures
- Treat pain and shortness of breath as ordered.
- Provide mouth care and keep the lips moist.
- Reposition gently for comfort.
- Support the family and respect cultural and spiritual practices.
Free end-of-life care practice questions
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A client with a DNR order develops shortness of breath. What should the nurse do?Answer: BA DNR order means no CPR. It doesn't mean withholding comfort care or symptom treatment.
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What is the main difference between palliative and hospice care?Answer: APalliative care focuses on relieving symptoms at any stage and can be given with curative treatment. Hospice care is for the end of life, when curative treatment has stopped.
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The family of a dying client asks whether the client can hear them. What is the best response?Answer: BHearing is thought to remain until very late, so families are encouraged to keep speaking to their loved one.
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Which document names a person to make health care decisions if the client can't?Answer: CA durable power of attorney for health care (health care proxy) names a decision-maker. A living will states treatment wishes.
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Which finding suggests that death may be approaching?Answer: DAs circulation slows near death, the skin on the hands, feet and knees often becomes cool and mottled, and urine output decreases.
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Which comfort measure is most appropriate for a dying client with a dry mouth?Answer: ARegular mouth care and moistening the lips relieve the discomfort of a dry mouth without burdening the client.
Pass the NCLEX-RN on your first try
- All 178 questions across the eight Client Needs categories of the 2026 NCLEX-RN test plan
- An explanation for every answer, with the guideline, drug label or priority rule behind it
- Unlimited full 85-question practice exams, with each area in its test plan share