CHPN FREE Certified Hospice and Palliative Nurse Questions and Answers 3

Question 1

A hospice nurse is caring for a patient whose family insists on continuing aggressive IV fluid resuscitation despite the patient's advance directive declining such measures.
What should the nurse do FIRST?

Accepted Answer

Review the advance directive with the family and explain the patient's documented wishes

Answer

Comply with the family's request immediately

Answer

Contact law enforcement to enforce the directive

Answer

Discontinue all care until the conflict is resolved

Question 2

Which medication is most commonly used to manage terminal secretions (death rattle) in a hospice patient?

Accepted Answer

Glycopyrrolate

Answer

Furosemide

Answer

Dexamethasone

Answer

Metoclopramide

Question 3

A hospice patient with a history of opioid use is experiencing nausea and sedation on their current morphine regimen but has inadequate pain relief. Which strategy is most appropriate?

Accepted Answer

Opioid rotation to a different opioid at an equianalgesic dose

Answer

Doubling the current morphine dose

Answer

Discontinuing all opioids immediately

Answer

Adding a benzodiazepine for sedation

Question 4

According to the Medicare Hospice Benefit, which criterion must be met for a patient to be eligible for hospice services?

Accepted Answer

Two physicians certify a life expectancy of six months or less if the disease runs its normal course

Answer

The patient must be over 65 years of age

Answer

The patient must have a do-not-resuscitate order on file

Answer

The patient must reside in a skilled nursing facility

Question 5

Which assessment tool is specifically designed to evaluate pain in non-verbal or cognitively impaired hospice patients?

Accepted Answer

FLACC scale

Answer

Visual Analog Scale

Answer

Numeric Rating Scale

Answer

McGill Pain Questionnaire

Question 6

A hospice nurse notices that a bereaved spouse shows signs of complicated grief six months after the patient's death, including persistent disbelief and inability to function. What is the most appropriate action?

Accepted Answer

Refer the spouse to a mental health professional specializing in grief therapy

Answer

Tell the spouse that their grief is a normal reaction and will pass with time

Answer

Discontinue bereavement follow-up since the patient has died

Answer

Prescribe antidepressant medication