CHPN FREE Certified Hospice and Palliative Nurse Questions and Answers 2 — Questions and Answers
Question 1: A hospice patient with end-stage COPD develops increasing dyspnea despite maximum bronchodilator therapy. Which intervention is most appropriate to manage refractory dyspnea?
- Low-dose oral morphine (Correct answer)
- Nebulized albuterol every 2 hours
- Intubation and mechanical ventilation
- Intravenous aminophylline
Correct answer: Low-dose oral morphine
Low-dose opioids are the gold standard for managing refractory dyspnea in hospice patients by reducing the sensation of breathlessness.
Question 2: Which statement best describes the role of the hospice nurse in facilitating a family meeting about goals of care?
- The nurse ensures all family members understand the patient's prognosis and helps clarify the patient's wishes (Correct answer)
- The nurse tells the family what medical decisions to make
- The nurse defers entirely to the physician for all communication
- The nurse only documents the meeting and does not participate
Correct answer: The nurse ensures all family members understand the patient's prognosis and helps clarify the patient's wishes
The hospice nurse facilitates understanding of prognosis and advocates for the patient's expressed wishes during family meetings.
Question 3: A terminally ill patient exhibits Cheyne-Stokes respirations, mottled extremities, and decreased urine output. What phase of dying do these signs indicate?
- Active dying phase (Correct answer)
- Stable chronic illness phase
- Acute exacerbation requiring hospitalization
- Remission phase
Correct answer: Active dying phase
Cheyne-Stokes respirations, mottling, and oliguria are hallmark signs of the active dying phase occurring in the final hours to days of life.
Question 4: Which ethical principle is most directly involved when a hospice nurse respects a competent patient's decision to discontinue artificial nutrition?
- Autonomy (Correct answer)
- Beneficence
- Justice
- Fidelity
Correct answer: Autonomy
Autonomy is the ethical principle that upholds a competent patient's right to make decisions about their own care, including refusing treatment.
Question 5: A hospice patient with bone metastases reports breakthrough pain rated 8/10 despite scheduled long-acting opioids. What is the most appropriate nursing intervention?
- Administer the prescribed immediate-release opioid for breakthrough pain (Correct answer)
- Increase the long-acting opioid dose without physician consultation
- Apply ice packs to the affected area only
- Reassess pain in 4 hours before intervening
Correct answer: Administer the prescribed immediate-release opioid for breakthrough pain
Breakthrough pain requires prompt administration of prescribed immediate-release opioids, which are specifically ordered for acute pain episodes between scheduled doses.
Question 6: In palliative care, what is the PRIMARY purpose of palliative sedation?
- To relieve intractable suffering when all other interventions have failed (Correct answer)
- To hasten the patient's death
- To reduce nursing workload during the night shift
- To eliminate the need for family presence at the bedside
Correct answer: To relieve intractable suffering when all other interventions have failed
Palliative sedation is used as a last resort to manage refractory symptoms that cannot be controlled by any other means, with the intent of relieving suffering.
CHPN FREE Certified Hospice and Palliative Nurse Questions and Answers 2
A hospice patient with end-stage COPD develops increasing dyspnea despite maximum bronchodilator therapy.
Which intervention is most appropriate to manage refractory dyspnea?