CHPN - Certified Hospice and Palliative Nurse Hospice and Palliative Nurse Basic 1

Question 1

Which document allows a competent adult to designate another person to make healthcare decisions on their behalf if they become unable to do so?

Accepted Answer

Durable power of attorney for healthcare

Answer

A durable power of attorney for healthcare (also called a healthcare proxy or healthcare agent) legally designates a surrogate decision-maker for medical decisions when the patient loses decision-making capacity. A living will expresses the patient's own wishes but does not appoint a surrogate.

Question 2

In palliative care, the term 'total pain' (as coined by Dame Cicely Saunders) encompasses which dimensions?

Accepted Answer

Physical, psychological, social, and spiritual dimensions

Answer

Dame Cicely Saunders, founder of the modern hospice movement, defined 'total pain' as a multidimensional concept encompassing physical, psychological, social, and spiritual suffering. Effective hospice nursing addresses all four dimensions rather than treating pain as purely a physical phenomenon.

Question 3

A hospice nurse is educating a family about the expected signs of imminent death. Which of the following is a hallmark physiological sign that death is likely within hours to days?

Accepted Answer

Mottling of the knees and feet with Cheyne-Stokes respirations

Answer

Mottling (livedo reticularis) of the extremities combined with Cheyne-Stokes (irregular, periodic) respirations are classic signs of imminent death, reflecting circulatory shutdown and brainstem changes. Decreased urine output, anorexia, and hypotension are also expected findings.

Question 4

Under the Medicare Hospice Benefit, which level of care is designed to provide short-term inpatient symptom management that cannot be managed in the home setting?

Accepted Answer

General inpatient care

Answer

General inpatient care (GIP) is a Medicare Hospice Benefit level intended for short-term management of pain or other acute symptoms that cannot be controlled in the home. It is provided in a Medicare-approved inpatient facility and is not intended for custodial or long-term placement.

Question 5

Which ethical principle is MOST directly applied when a hospice nurse honors a patient's refusal of artificial nutrition and hydration?

Accepted Answer

Autonomy

Answer

Autonomy is the ethical principle that upholds an individual's right to make informed decisions about their own care, including the right to refuse any treatment. When a nurse respects a patient's refusal of artificial nutrition and hydration, she is enacting that patient's self-determination.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Hospice and Palliative Nurse Basic 1