CHPN - Certified Hospice and Palliative Nurse Education, Support, and Advocacy Questions and Answers

Question 1

A hospice patient with a valid Physician Orders for Life-Sustaining Treatment (POLST) form indicating "Do Not Hospitalize" develops a fever and urinary symptoms.
The patient's distressed adult child demands the patient be sent to the emergency room.
What is the CHPN's primary advocacy role in this situation?

Accepted Answer

Gently reorient the family to the patient's stated wishes on the POLST form and explore their underlying fears.

Answer

Call 911 immediately to transport the patient as the family requested.

Answer

Tell the family that their request goes against the patient's legal document and cannot be honored.

Answer

Contact the on-call physician to request an order to override the POLST due to family distress.

Question 2

When educating a family about the signs and symptoms of the active dying phase, which of the following is MOST important for the CHPN to emphasize to help reduce family distress?

Accepted Answer

That changes like mottling, altered breathing patterns, and decreased socialization are a normal part of the process.

Answer

An exact timeline of when each specific symptom will appear.

Answer

The importance of encouraging the patient to eat and drink to prevent weakness.

Answer

The likelihood that the patient will experience severe, uncontrolled pain at the very end.

Question 3

The spouse of a hospice patient tearfully states, "I feel like I'm already mourning him, even though he's still here. Is something wrong with me?" Which response by the CHPN best provides therapeutic support?

Accepted Answer

"What you are describing is very common and is known as anticipatory grief. It's okay to talk about these feelings."

Answer

"You should try to focus on the positive memories you still have time to make."

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"It's important that you remain strong for him during this difficult time."

Answer

"These feelings are concerning; perhaps you should speak with a psychiatrist."

Question 4

A CHPN is providing education to a family caregiver on the safe management of liquid opioids in the home. Which instruction is a critical component of this education to prevent diversion and ensure safety?

Accepted Answer

"Keep a detailed, written log of every dose given, including the date, time, and amount."

Answer

"Dispose of any small amounts of unused medication by flushing it down the toilet."

Answer

"Store the medication on the kitchen counter so you don't forget a dose."

Answer

"It is acceptable to share the medication with another family member who has severe pain."

Question 5

Which of the following actions by a CHPN best demonstrates patient advocacy for a non-verbal patient with advanced dementia who has become restless and is fidgeting with their clothes?

Accepted Answer

Performing a full assessment, including checking for pain, repositioning the patient, and ensuring they are clean and dry.

Answer

Asking the family what they believe the patient needs.

Answer

Documenting the restlessness and planning to reassess in one hour.

Answer

Administering the prescribed PRN dose of an anxiolytic medication immediately.

Question 6

A patient's family informs the CHPN that their cultural beliefs require a specific washing ritual to be performed by the family at the bedside immediately after death. What is the nurse's most appropriate action to support this need?

Accepted Answer

Document the request and ensure the care team facilitates a private, respectful environment for the ritual.

Answer

Politely inform the family about the hospice's standard post-mortem care procedures.

Answer

Explain that such rituals can only be performed by the designated hospice spiritual coordinator.

Answer

Suggest they perform the ritual at the funeral home to avoid disrupting other patients or staff.