Patient & Family-Centered Care Flashcards

A patient with a POLST form specifying DNR/DNI is found unresponsive by the family. The family calls 911. The hospice nurse's priority is:

Answer: Support the family in honoring the POLST by clearly communicating the patient's wishes to emergency responders

The nurse's priority is ensuring the patient's documented wishes on the POLST are communicated clearly to EMS to prevent unwanted interventions.

Which statement BEST explains the difference between an advance directive and a POLST form?

Answer: POLST forms are actionable medical orders; advance directives express preferences that guide surrogates

POLST forms are physician-signed medical orders immediately actionable by providers, while advance directives are legal documents expressing wishes for surrogates.

A hospice nurse is conducting a goals-of-care conversation with a patient who has weeks to live. The BEST opening question is:

Answer: 'What matters most to you in the time you have left?'

Opening with 'What matters most to you?' invites the patient to define their own values and goals, forming the foundation of patient-centered care planning.

A patient wants to be kept comfortable but her son insists on hospitalization for IV nutrition. The nurse should:

Answer: Clarify and advocate for the patient's expressed comfort-focused goals

The nurse's ethical duty is to advocate for the patient's own expressed wishes, which take precedence over family preferences.

Which factor is MOST important to assess when a patient requests hospice care at home?

Answer: Availability of a capable and willing primary caregiver

A capable, willing primary caregiver is the most critical factor for safe and effective home hospice care delivery.

A patient asks the hospice nurse, 'Am I dying soon?' The most therapeutically appropriate response is:

Answer: 'Tell me more about what's prompting your question right now.'

Exploring the patient's question opens a therapeutic dialogue about their fears and information needs rather than deflecting or making specific predictions.

When is it appropriate for a hospice nurse to contact the patient's primary care provider outside of the hospice team?

Answer: When the patient has a condition unrelated to the terminal diagnosis that requires management

Hospice assumes care for conditions related to the terminal diagnosis, but the PCP may still manage unrelated conditions under certain hospice benefit structures.