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1. The hospice nurse is assessing a patient while on a routine visit. The patient reports pain while swallowing. The nurse assesses the patient's mouth and throat, noting moist mucous membranes and white curd-like plaques near the back of the tongue. The nurse will call the provider with which suggestion? a. Swab tongue for culture b. Increased hydration c. Nothing by mouth for 24 hours d. Antifungal swish and swallow This patient is exhibiting signs of an active fungal infection, candidiasis. Cultures are not recommended as this can be treated based on clinical findings. Increased hydration would only be appropriate if the odynophagia was caused by dehydration. Avoiding certain foods may bring comfort, but NPO status is not needed. 2. The nurse is reviewing the plan of care for a patient receiving general inpatient care. Though the patient's level of consciousness has decreased, symptoms of discomfort have been managed. The patient's family expresses satisfaction with the care at this level and would like to continue with general inpatient care. What is the appropriate level of care for this patient? a. Routine home care b. Continuous home care c. Inpatient respite care d. General inpatient care Routine home care is the appropriate setting for this patient. This patient no longer qualifies for general inpatient hospice care based on the lack of symptoms. A reduced level of consciousness is expected and can be managed in the home. Respite is not appropriate, as the patient is presently inpatient. Continuous home care would require a higher symptom burden. 3. The nurse is talking about goals of care with a patient who has terminal cancer of unknown origin. Which of the following patient priorities most indicates a hospice referral will be appropriate? a. "I want to figure out what caused this cancer." b. "I want to be at home with my family." c. "I want to live one more year." d. "I have nothing to look forward to."
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