CHPN CHPN - Certified Hospice and Palliative Nurse Patient Assessment and Planning Questions and Answers 3

Question 1

A hospice nurse is conducting an initial assessment of a patient with end-stage COPD. The patient states they want to continue using BiPAP at night. How should this be addressed in the care plan?

Accepted Answer

Continue BiPAP as it provides comfort and aligns with palliative goals

Answer

Discontinue BiPAP since the patient is on hospice

Answer

Refer the patient back to pulmonology for a BiPAP reassessment

Answer

Replace BiPAP with continuous supplemental oxygen only

Question 2

During a hospice reassessment visit, the nurse notes that a patient with terminal cancer has developed new-onset confusion and agitation. What should the nurse assess first?

Accepted Answer

Reversible causes of delirium such as medication effects, constipation, or urinary retention

Answer

The patient's spiritual distress level

Answer

Whether the patient has an updated advance directive

Answer

The family's ability to manage behavioral symptoms at home

Question 3

A hospice patient's spouse asks the nurse why the patient is eating and drinking less as the disease progresses. Which response best reflects evidence-based palliative care principles?

Accepted Answer

Decreased appetite is a normal part of the dying process and forcing intake can cause discomfort

Answer

We should consider placing a feeding tube to prevent malnutrition

Answer

We need to supplement with high-calorie shakes to maintain the patient's strength

Answer

I will request a dietary consultation to develop a meal plan

Question 4

Which standardized tool is most appropriate for a hospice nurse to use when assessing a patient's overall symptom burden across multiple domains?

Accepted Answer

Edmonton Symptom Assessment System (ESAS)

Answer

Karnofsky Performance Status Scale

Answer

Glasgow Coma Scale

Answer

Morse Fall Scale

Question 5

A hospice nurse is developing an interdisciplinary care plan for a patient who expresses fear about dying alone. Which team member should be consulted first to address this concern?

Accepted Answer

The hospice social worker

Answer

The hospice medical director

Answer

The hospice pharmacist

Answer

The hospice dietitian

Question 6

When assessing a hospice patient's risk for complicated grief among surviving family members, which factor is most significant?

Accepted Answer

A family member has a history of unresolved prior losses and mental health conditions

Answer

The family has adequate financial resources for funeral expenses

Answer

The patient has been on hospice services for more than six months

Answer

The family lives in a rural area with limited access to hospitals