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

Question 1

A palliative care nurse is assessing a patient with advanced cancer who rates pain as 8/10 despite scheduled oral oxycodone. The patient is alert and able to swallow. Which action best addresses inadequate analgesia?

Accepted Answer

Calculate a 10–15% rescue dose of the total daily opioid and administer now

Answer

A breakthrough (rescue) dose of 10–15% of the total 24-hour opioid dose is the standard approach for uncontrolled pain in a patient already on a scheduled opioid. This addresses the immediate pain without requiring a route change or medication switch before reassessment.

Question 2

A hospice nurse notes that a patient's breathing has changed to irregular periods of apnea alternating with rapid breaths. The family is frightened. How should the nurse explain this finding?

Accepted Answer

This is Cheyne-Stokes respiration, a normal physiological change in the final hours to days of life

Answer

Cheyne-Stokes respiration results from reduced cerebral perfusion and altered carbon dioxide sensitivity as death approaches. It is an expected, non-distressing finding for the patient and does not indicate pain or a reversible condition; family education helps reduce fear.

Question 3

Which ethical principle is MOST directly supported when a hospice team honors a patient's advance directive refusing cardiopulmonary resuscitation?

Accepted Answer

Autonomy

Answer

Respecting a competently executed advance directive upholds autonomy—the patient's right to make informed decisions about their own care, including the right to refuse life-sustaining treatment. While other principles also apply, autonomy is the primary principle directly supported.

Question 4

A nurse is preparing to administer subcutaneous haloperidol to a hospice patient with terminal delirium. The patient is non-verbal and restless. What is the PRIMARY goal of this intervention?

Accepted Answer

Reduce agitation and perceptual disturbances to improve patient comfort

Answer

Haloperidol is a first-line antipsychotic used in terminal delirium to reduce agitation, confusion, and perceptual disturbances, improving patient comfort. It is not intended to render the patient unconscious or to replace analgesia; its goal is symptom control.

Question 5

A hospice patient's family asks why the nurse is no longer encouraging the patient to eat or drink. The patient is in the final days of life and has lost interest in food and fluids. What is the most accurate response?

Accepted Answer

Decreased intake causes the release of ketones and endorphins that may reduce discomfort

Answer

Natural reduction in food and fluid intake at end of life is associated with ketosis and endogenous endorphin release, which can actually reduce hunger and contribute to a sense of comfort. Artificial hydration in the final days rarely extends meaningful life and may increase secretions and edema.

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 MCQ 1