CHPN CHPN - Certified Hospice and Palliative Nurse Pain Management Strategies Questions and Answers 2

Question 1

A hospice patient with advanced pancreatic cancer reports deep, poorly localized abdominal pain that is constant and aching. Which type of pain does this most likely represent?

Accepted Answer

Visceral pain

Answer

Somatic pain

Answer

Neuropathic pain

Answer

Incident pain

Question 2

Which assessment tool is most appropriate for evaluating pain in a hospice patient with advanced dementia who is nonverbal?

Accepted Answer

PAINAD scale

Answer

Numeric Rating Scale

Answer

Visual Analog Scale

Answer

Brief Pain Inventory

Question 3

A patient on long-term opioid therapy develops tolerance. Which clinical finding best indicates opioid tolerance rather than disease progression?

Accepted Answer

Decreased duration of analgesia with stable disease imaging

Answer

New onset of bone pain at a previously unaffected site

Answer

Increasing pain with documented tumor growth on imaging

Answer

Development of allodynia in the affected limb

Question 4

When rotating from oral morphine to transdermal fentanyl in a hospice patient, which principle is most important to apply?

Accepted Answer

Use equianalgesic conversion tables and reduce the calculated dose by 25-50% for incomplete cross-tolerance

Answer

Convert at a 1:1 equianalgesic ratio without dose reduction

Answer

Discontinue morphine immediately when the patch is applied

Answer

Apply two patches simultaneously to prevent breakthrough pain

Question 5

A hospice nurse is managing a patient with severe neuropathic pain from chemotherapy-induced peripheral neuropathy. Which medication class is considered first-line adjuvant therapy for this type of pain?

Accepted Answer

Anticonvulsants such as gabapentin or pregabalin

Answer

Benzodiazepines such as lorazepam

Answer

Muscle relaxants such as cyclobenzaprine

Answer

Stimulants such as methylphenidate

Question 6

Which non-pharmacological intervention has the strongest evidence for reducing pain perception in hospice patients and works by activating the gate control theory of pain?

Accepted Answer

Transcutaneous electrical nerve stimulation (TENS)

Answer

Aromatherapy with lavender essential oil

Answer

Music therapy sessions

Answer

Guided imagery meditation