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Evidence Base for Hospice Care — SCE Palliative Medicine MCQ

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HardEnd of Life CareEvidence Base for Hospice CareSCE Palliative Medicine

A dying patient has distressing thirst and fluctuating delirium despite frequent mouth care and supported sips. There is no pulmonary oedema. The family request fluids. Which plan best follows NICE?

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

Reveal the answer and explanation

Correct answer: C — Trial assisted hydration with 12-hourly review for benefit and harm

Explanation lettering: E = shown as B · B = shown as D · D = shown as E

C is correct. NICE recommends considering a therapeutic trial when thirst or delirium may be dehydration-related and oral intake is inadequate. Benefits and harms are uncertain, so the plan defines a modest route and volume, continues mouth care and reviews at least every 12 hours, continuing only if benefit occurs and reducing or stopping for overload or burden. Universal refusal and indefinite treatment both misrepresent uncertainty; a rapid load and parenteral nutrition are disproportionate.

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