CHPN - Certified Hospice and Palliative Nurse Patient Assessment and Planning Questions and Answers

Question 1

A hospice nurse is using the Palliative Performance Scale (PPS) to assess a new patient. The patient is mainly sitting or lying down, unable to do any work, has extensive disease, and requires considerable assistance with self-care. They are able to take normal to reduced oral intake and have a full level of consciousness. Which PPS level BEST represents this patient's status?

Accepted Answer

50%

Answer

A PPS score of 50% is appropriate for a patient who is mainly sitting or lying down, unable to perform any work, has extensive disease, and requires considerable assistance with self-care, but still has relatively normal or only somewhat reduced oral intake and a full level of consciousness. A 70% level indicates reduced ambulation, while 30% and 10% levels involve being totally bed-bound with more severe limitations in intake and consciousness.

Question 2

When conducting an initial patient assessment, the hospice nurse utilizes the Edmonton Symptom Assessment System (ESAS). What is the primary purpose of this tool?

Accepted Answer

To assess the severity of nine common symptoms from the patient's perspective.

Answer

The Edmonton Symptom Assessment System (ESAS) is a validated tool used to assess the severity of nine common symptoms in palliative care, such as pain, tiredness, nausea, depression, and anxiety, rated on a scale from 0 to 10. Its primary purpose is to capture the patient's subjective experience of these symptoms to guide management, not to determine hospice eligibility, measure functional status (like the PPS), or document advance directives.

Question 3

Which of the following is the MOST critical initial step in the advance care planning process for a new hospice patient who is capable of making decisions?

Accepted Answer

Engaging the patient in a conversation about their values, goals, and preferences for care.

Answer

The most critical initial step in advance care planning is to have a meaningful conversation with the patient to understand their values, goals, and wishes for future medical care. This conversation provides the foundation for all subsequent documentation, such as living wills or the appointment of a healthcare proxy. Rushing to complete forms without this understanding can lead to care that does not align with the patient's true preferences.

Question 4

A 78-year-old male with end-stage COPD is admitted to hospice. During the initial psychosocial assessment, which area is MOST important for the nurse to explore to develop a holistic plan of care?

Accepted Answer

The patient's current coping mechanisms, support systems, and spiritual beliefs.

Answer

A holistic psychosocial assessment in palliative care prioritizes understanding the patient's current emotional state, their sources of strength and support (family, friends), their coping strategies for dealing with their illness, and any spiritual or existential concerns. While financial resources and disease history are part of the comprehensive assessment, the core of the psychosocial domain focuses on the patient's and family's emotional, social, and spiritual well-being to address potential distress.

Question 5

According to the Medicare Conditions of Participation, a comprehensive assessment for a new hospice patient must be completed by the interdisciplinary group (IDG) within how many days of the election of hospice care?

Accepted Answer

5 calendar days

Answer

The Medicare Conditions of Participation mandate that the hospice interdisciplinary group (IDG) must complete a comprehensive assessment for each patient within 5 calendar days after the election of hospice care. The initial nursing assessment must be done within 48 hours, but the full IDG comprehensive assessment has a 5-day timeframe.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Patient Assessment and Planning Questions and Answers