A home health nurse is assessing the health history of a new client. The nurse should identify that which of the following conditions increases the client's risk for falls?

Choice A: The client’s insurance provides coverage for palliative care

This option is incorrect. While insurance coverage for palliative care is important, it is not a qualifying criterion for hospice care. Hospice care eligibility is primarily based on the patient’s medical condition and prognosis, not on insurance coverage.

Choice B: The client has declined additional life prolonging treatments

This option is correct. One of the key criteria for hospice care is that the patient must choose palliative care (comfort care) over curative treatments. This means the patient has decided to stop treatments aimed at prolonging life and instead focus on quality of life and symptom management.

Choice C: The client requires inpatient care due to lack of a caregiver

This option is incorrect. While the need for inpatient care can be a factor in the type of hospice services provided, it is not a criterion for qualifying for hospice care. Hospice care can be provided in various settings, including the patient’s home, regardless of caregiver availability.

Choice D: The client has documentation stating he has less than 12 months to live

This option is incorrect. The standard criterion for hospice care is a prognosis of six months or less to live if the disease follows its usual course. Documentation stating a life expectancy of less than 12 months does not meet the hospice eligibility requirement.

Choice A reason: This is incorrect. Clostridium difficile is a bacterium that causes an infection of the colon, which can result in diarrhea, abdominal pain, and fever¹. Clostridium difficile is transmitted by contact with fecal matter or contaminated surfaces². Therefore, it requires contact precautions, not airborne precautions³.

Choice B reason: This is incorrect. Influenza is a viral infection that affects the respiratory tract, causing symptoms such as fever, cough, sore throat, and muscle aches⁴. Influenza is transmitted by respiratory droplets that are generated by coughing, sneezing, or talking⁵. Therefore, it requires droplet precautions, not airborne precautions³.

Choice C reason: This is correct. Disseminated herpes zoster is a widespread form of shingles that affects multiple areas of the skin and can involve the internal organs⁶. Shingles is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox⁷. Disseminated herpes zoster is transmitted by airborne particles that contain the virus, or by direct contact with the lesions⁶. Therefore, it requires airborne precautions, as well as contact precautions³.

Choice D reason: This is incorrect. Respiratory syncytial virus (RSV) is a common respiratory virus that causes mild to severe infections of the lungs and airways, especially in infants and young children⁸. RSV is transmitted by respiratory droplets, or by contact with contaminated surfaces or secretions⁹. Therefore, it requires contact precautions, and sometimes droplet precautions, but not airborne precautions³.