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Clinical Signs Predicting Imminent Death — SCE Palliative Medicine MCQ

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HardEnd of Life CareClinical Signs Predicting Imminent DeathSCE Palliative Medicine

A bed-bound patient with PPS 20%, minimal intake, Cheyne–Stokes respiration, falling consciousness and peripheral mottling is deteriorating. How should prognosis be communicated?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Hours to days, acknowledging uncertainty and possible temporary stabilisation

Explanation lettering: C = shown as A · D = shown as C · A = shown as D

A is correct. A cluster of late signs supports recognition that the patient is probably entering the last days of life, but NICE stresses clinical uncertainty and the possibility of temporary stabilisation or improvement. B and E contradict the observed trajectory, C attributes a prognostic effect to hydration that is unproven, and D withholds information until it can no longer support preparation and shared decisions.

Reference: NICE NG31: care of dying adults: https://www.nice.org.uk/guidance/ng31/chapter/Recommendations