# A client with metastatic pancreatic cancer and long-standing, stable chronic obstructive pulmonary disease is being admitted to a home hospice program under the Medicare hospice benefit. During the admission visit, the client's spouse asks the hospice nurse to clarify what will and will not be covered once the election is signed. Which statements by the nurse are accurate? Select all that apply. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=558435&lang=en > language: en > subject: Personal Hygiene > category: BCC ## Question A client with metastatic pancreatic cancer and long-standing, stable chronic obstructive pulmonary disease is being admitted to a home hospice program under the Medicare hospice benefit. During the admission visit, the client's spouse asks the hospice nurse to clarify what will and will not be covered once the election is signed. Which statements by the nurse are accurate? Select all that apply. 1 Once hospice is elected, the routine bronchodilator used for the unrelated COPD is no longer covered through Medicare and becomes the client's expense. 2 Coverage for care unrelated to the terminal illness, such as management of the client's stable COPD, continues under the client's original Medicare benefits. 3 The hospice benefit routinely covers room and board charges if the client resides in an assisted living facility during hospice care. 4 The client retains the right to revoke the hospice election at any time and return to standard Medicare-covered curative treatment. 5 Electing hospice transfers final decision-making authority for the client's treatment plan to the interdisciplinary team. 6 A palliative procedure intended to relieve pain from the tumor can be covered under the hospice benefit when the goal is comfort rather than cure. ## Explanation Hospice election changes how Medicare covers care related to the terminal illness, while unrelated care such as stable COPD management can continue under the client's other Medicare coverage (Choice 2). The client may revoke the hospice election and return to standard Medicare coverage (Choice 4). A comfort-focused procedure for tumor pain may be covered when it is part of the hospice plan of care (Choice 6). Election does not automatically shift an unrelated bronchodilator to personal expense (Choice 1), routinely cover assisted-living room and board (Choice 3), or transfer final treatment authority to the interdisciplinary team (Choice 5). ## In-depth explanation Correct Answer Choices 2, 4, 6 Clinical Reasoning Hospice election changes how Medicare covers care related to the terminal illness, while unrelated care such as stable COPD management can continue under the client's other Medicare coverage (Choice 2). The client may revoke the hospice election and return to standard Medicare coverage (Choice 4). A comfort-focused procedure for tumor pain may be covered when it is part of the hospice plan of care (Choice 6). Election does not automatically shift an unrelated bronchodilator to personal expense (Choice 1), routinely cover assisted-living room and board (Choice 3), or transfer final treatment authority to the interdisciplinary team (Choice 5). Option Review - Incorrect — Medicare coverage can continue for care that is unrelated to the terminal illness. Hospice election does not by itself make the client personally responsible for the routine COPD medication. - Correct — This is correct because hospice election changes coverage only for care related to the terminal illness, so ongoing management of the unrelated stable COPD remains covered under the client's original Medicare benefits. - Incorrect — This is incorrect because room and board in an assisted living or long-term care setting is not automatically covered by the hospice benefit unless specific short-term inpatient or respite criteria are met. - Correct — This is correct because clients retain the right to revoke hospice election at any point and resume standard Medicare-covered curative treatment for the terminal illness if they choose to do so. - Incorrect — The interdisciplinary team coordinates and recommends care, but hospice election does not transfer the client's treatment decision-making authority to the team. - Correct — This is correct because procedures intended to relieve symptoms such as tumor-related pain are consistent with the hospice philosophy of comfort care even though curative treatment is generally not covered. Sources 12026 NCLEX-RN Test Plan 2Medicare: Hospice care coverage ## Clinical scenario A client with metastatic pancreatic cancer and stable, long-standing chronic obstructive pulmonary disease (COPD) is admitted to a Medicare-certified home hospice program. During the admission visit, the client's spouse asks the hospice nurse what care will and will not be covered once the election is signed. ## Related questions - [A hospice nurse is planning pain management for a client with metastatic cancer who can ta…](https://mymerci.kr/pages/nclex_q.php?qn_id=363998&lang=en) - [A nurse is creating a pressure injury prevention plan for an immobile older adult admitted…](https://mymerci.kr/pages/nclex_q.php?qn_id=366392&lang=en) - [A dying client's family asks to perform meaningful spiritual and cultural rituals at the b…](https://mymerci.kr/pages/nclex_q.php?qn_id=368302&lang=en) - [A nurse cares for family members after a loved one is told that an illness is terminal. 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