While receiving palliative care, a patient's colostomy was revised secondary to obstruction. Now on hospice, the current colostomy is no longer viable, and an actively draining fistula has developed. The patient is comfortable. The family requests diagnostic tests to determine the tumor's size and location. Which of the following should be the nurse's FIRST response?

A patient with advancing Alzheimer's dementia who has lost 40 lb in the last 6 months has been living alone and wants to remain independent. The palliative care nurse notices the patient is no longer able to cook and forgets to take medications. The patient was started on donepezil 2 months ago, but the family does not feel it is helping. Which of the following is the BEST option for the patient that the nurse should discuss with the family?

Advanced hepatic disease is characterized by

An Alzheimer's patient is apathetic, refusing food, and resistant to care. The nurse should understand that these symptoms

A palliative care patient presents to the emergency department with petechiae, ecchymosis, oozing gums, decreased urinary output, and shortness of breath. These symptoms MOST likely indicate

An alert and oriented patient verbalizes complete understanding and agrees to hospice admission. The patient is exhausted and weak, asking that their spouse signs the admission documents. Which of the following is the MOST appropriate response by the nurse?

A patient's partner confides to the nurse that they have been giving half the ordered dose of sustained-release morphine at night to avoid oversedation, but the patient wakes up each morning in pain. Which of the following is the FIRST step the nurse should take?

A patient's MOST likely initial reaction to a new terminal diagnosis is

A hospice patient with advanced dementia is spending more time sleeping and less time eating and drinking. He has had recurrent infections over the past 7 months. His caregiver reports that he has been more restless, has had a temperature, and his breathing is moist. The caregiver is concerned about pneumonia. The nurse's MOST appropriate action is to

A patient with recurrent breast cancer is experiencing dyspnea and a cough related to pleural effusion. Which of the following will MOST likely relieve the symptoms?

A patient remains unresponsive after a car accident 3 weeks ago. Following multiple family conferences, the medical team is recommending admission to hospice and discontinuation of life support. There is still disagreement among family members in the absence of an advance medical directive. Which of the following referrals is MOST appropriate?

Which of the following concepts regarding distraction should a nurse recognize?

Within the last week, a terminally ill patient has become restless, forgetful, and incoherent. The caregiver reports that the patient often moans loudly at night, despite the use of morphine. Which of the following should the nurse do FIRST?

For admission into a hospice program, it is necessary that the patient

Which of the following is an example of smooth muscle pain frequently reported by hospice patients?

Acetaminophen may be inadvisable in patients with a history of

Due to concern of opioid diversion within the family, the patient has requested a non-pharmacological intervention for pain. Which of the following is the BEST option?

Dyspnea, hypotension, jugular vein distention, and narrowing pulse pressure should be recognized as requiring emergent palliation for symptoms of

Which of the following is the New York Heart Association classification for a patient with symptoms of heart failure at rest?

Which of the following is an example of smooth muscle pain frequently reported by hospice patients?

A dying veteran begins to insist that the enemy is hiding under his bed. Which of the following should be the nurse's INITIAL action?

A new home hospice patient has an infected leg wound requiring daily dressing changes. The family is committed to taking care of the patient at home, but admit to being sleep deprived. The nurse's INITIAL conversation with the family should include a discussion about

Which of the following is the MOST appropriate nursing action for managing dyspnea in an actively dying patient?

A hospice patient with delirium was administered haloperidol 5 mg every 8 hours for hallucinations. The haloperidol was discontinued due to dyskinesia. The hallucinations returned and were much worse than before. The physician prescribes haloperidol 2 mg every 8 hours. Which of the following BEST explains this action?

A patient with lung cancer and brain metastases develops hiccups that are resistant to treatment with phenothiazines. Which of the following should be attempted for symptom relief?

Edema is normally caused by

The partner of a hospice patient calls the on-call nurse explaining that they have not been able to keep the patient awake long enough to take medications for two days. When the nurse offers to make a visit, the partner states, No, I just can't do this anymore. The nurse should consider

A primary purpose of hospice and palliative care is to assist the patient with

What teaching about managing lymphedema should be provided?

A patient with pancreatic cancer who is being treated with morphine and haloperidol complains of feeling full and occasionally vomits undigested food. Which of the following should be recommended?

A patient has breast cancer with lung metastasis. Their legs are discolored and cool to the touch. They are obtunded and oliguric. Which of the following is MOST likely occurring?

A hospice and palliative nurse can demonstrate a commitment to professional development by:

A patient with end stage renal disease has decided to stop dialysis as the burden of treatment outweighs the benefit. The patient expresses a desire to stop monitoring blood sugar, taking insulin, and would like to eat whatever they want. The nurse's NEXT step should be to

How frequently is the hospice medical director required by Medicare to make face-to-face visits?

Which of the following is MOST important when caring for a patient with severe refractory peripheral edema?

A patient with end-stage liver disease had a paracentesis 2 days ago. The patient has increased agitation, abdominal pain, and fever. Which of the following is the MOST likely explanation?

Which of the following would support eligibility for hospice care in a patient with coronary artery disease?

Which of the following medications can help increase energy and reduce sedation?

A patient says they do not talk about their illness to family because it would depress them. After exploring the patient's feelings more thoroughly, which of the following is the nurse's MOST appropriate action?

A patient with general debility has been on hospice for 11 months. Over the past 2 months, the patient has begun to eat 90% of their meals, experienced weight gain, and ambulates with a walker. The patient's sacral wound has healed. Which of the following should be the nurse's FIRST action?

How can a nurse BEST facilitate learning for colleagues?

An actively dying patient has periods of restlessness and appears frightened. Which of the following should the nurse do?

As a home hospice patient declines, the patient's family moves in to help. A family member is a nurse and begins to perform all of the patient care tasks that the patient's partner was previously providing. They are arguing with the patient's partner and refusing to meet with the hospice team. It is MOST important for the hospice nurse to

Atropine reduces pain from a bowel obstruction by

Nonsteroidal anti-inflammatories MOST effectively relieve which of the following types of pain?

A patient who has a brain tumor has been taking dexamethasone for 2 months. They are complaining of pain with swallowing. If inspection of their mouth reveals nothing unusual, which of the following should be suspected?

Which of the following is a correct statement regarding the Medicare Hospice Benefit?

Which of the following is the MOST significant indicator of end-stage cardiac disease?