CHPN CHPN Pharmacology & Medication Management

Question 1

Which opioid is considered first-line for moderate-to-severe pain in hospice patients with normal renal function?

Accepted Answer

Morphine

Answer

Morphine is the gold-standard first-line opioid for moderate-to-severe pain in hospice patients with intact renal function.

Question 2

A hospice patient is experiencing opioid-induced constipation. Which medication is specifically FDA-approved for this indication?

Accepted Answer

Methylnaltrexone

Answer

Methylnaltrexone (Relistor) is a peripherally acting mu-opioid receptor antagonist FDA-approved specifically for opioid-induced constipation.

Question 3

When converting from oral morphine to subcutaneous morphine, what is the standard conversion ratio?

Accepted Answer

3:1 (oral to subcutaneous)

Answer

The standard oral to subcutaneous morphine conversion is 3:1, meaning 30 mg oral morphine equals 10 mg subcutaneous morphine.

Question 4

Which benzodiazepine is most commonly used in hospice care to manage refractory dyspnea and anxiety at end of life?

Accepted Answer

Lorazepam

Answer

Lorazepam is preferred in hospice for its short-to-intermediate half-life, multiple routes of administration, and efficacy for dyspnea and anxiety.

Question 5

A hospice nurse notes a patient on fentanyl patches is febrile. What is the most important medication concern?

Accepted Answer

Fever increases fentanyl absorption through the patch, risking overdose

Answer

Elevated body temperature increases transdermal fentanyl absorption significantly, which can lead to opioid toxicity.

(CHPN) Hospice Certified Professional Practice Test