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A patient with metastatic breast cancer remains ambulatory but can no longer perform any housework or hobbies. She is fully independent with all ADLs, has a normal appetite, and is fully alert. What is her Palliative Performance Scale (PPS) score?
A patient with end-stage COPD spends the majority of the day sitting in a recliner. He can walk short distances to the bathroom with a walker but requires help with bathing and dressing. Intake is reduced. What is the PPS score?
A patient with advanced dementia is now bedbound and requires total assistance for all ADLs and feeding. She takes only small sips of liquids and is frequently drowsy or confused. What is the most accurate PPS score?
When using the PPS to assess a patient, you find that Ambulation is Mainly in Bed, Self-Care is Total Care, and Intake is Normal. Following the Left-to-Right rule of PPS interpretation, what is the score?
A patient is able to walk around the house but requires assistance with most ADLs due to significant fatigue and weakness. They are unable to perform any household chores. Intake is normal and they are alert. What is the PPS score?
A patient with glioblastoma is bedbound, requires total care for all needs, and is in a deep coma. They are no longer taking any oral fluids. What is the PPS score?
A patient with Stage IV renal cell carcinoma is Mainly in Bed but is able to assist slightly with their own sponge bath and can use a urinal independently. They can no longer do any work. What is the PPS score?
A patient with ALS is bedbound and requires total care. He remains fully alert and is able to swallow a pureed diet with significantly reduced intake. What is the PPS score?
Which PPS level is the highest at which a patient is first described as having Extensive Disease and being Unable to do any work?
In a 2026 palliative care setting, a patient's PPS score drops from 60% to 40% over a 4-week period. What is the most important clinical implication for the CHPN to communicate to the interdisciplinary team?
A patient requires assistance with bathing and dressing but remains continent of bowel and bladder. According to the FAST scale, which stage is this patient currently in?
To meet Medicare Local Coverage Determination (LCD) for hospice with a primary diagnosis of Alzheimer's, what is the minimum FAST stage required, and what additional clinical finding must be present?
A hospice patient with dementia has lost the ability to sit up independently and can no longer smile. Which specific sub-stage of the FAST scale does this represent?
A patient can no longer manage complex tasks like finances or planning a dinner party but can still perform basic ADLs and live at home with minimal support. Identify the FAST stage.
In the progression of Stage 6 dementia, which functional deficit typically occurs immediately BEFORE the onset of urinary incontinence?
An Alzheimer's patient is FAST 7a. They have lost 12% of body weight in 6 months and have a Stage 3 pressure injury. Do they meet the structural requirements for hospice eligibility for dementia?
A caregiver reports the patient needs help selecting clothes appropriate for the season but can still bathe and dress themselves once the clothes are laid out. What FAST stage is this?
A patient's speech is limited to Yes, No, and Thank you, used repeatedly throughout the day. Which FAST stage does this represent?
Which tool is often preferred over the MMSE in hospice for tracking end-stage dementia decline, and why?
A patient with Frontotemporal Dementia (FTD) maintains the ability to walk but has total aphasia. Why might the FAST scale be an unreliable prognostic tool here?
A patient with metastatic lung cancer is ambulatory and capable of all self-care but is unable to carry out any work activities. They are up and about more than 50% of waking hours. What is their ECOG Performance Status?
A hospice patient requires frequent medical care and significant assistance with activities of daily living (ADLs). They are unable to care for themselves. Which Karnofsky Performance Status (KPS) score best represents this patient?
A nurse assesses a patient who spends 7 hours of a 12-hour daytime period in bed or a chair. The patient is capable of only limited self-care. Applying the ECOG scale, which grade is most appropriate?
A palliative care patient can care for themselves but is unable to carry on normal activity or do active work. Which KPS score is assigned?
A patient with end-stage heart failure is disabled, requires special care and assistance, and is mostly bedbound but not yet requiring institutionalization or acute hospitalization. Differentiate between KPS 40 and KPS 30.
A terminal patient is completely disabled, cannot carry on any self-care, and is totally confined to bed or chair. What is the ECOG score?
A hospice nurse is documenting the status of a patient who is very sick, requires active supportive treatment, and is moribund with fatal processes progressing rapidly. Contrast KPS 20 and KPS 10.
A patient is assessed at ECOG Grade 3. What is the approximate corresponding Karnofsky Performance Status (KPS) percentage range used by the interdisciplinary team (IDT) for prognosticating?
Beyond simple assessment, what is the primary clinical significance of utilizing the KPS and ECOG scales in the palliative setting according to HPCC standards?
A patient with COPD is restricted in physically strenuous activity but is ambulatory and able to perform light housework or office work. How is this patient classified on the ECOG scale?
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