CHPN FREE Hospice and Palliative Nurse Guide Questions and Answers 2 — Questions and Answers
Question 1: A hospice patient with end-stage heart failure develops Cheyne-Stokes respirations. What should the nurse communicate to the family?
- This is a normal breathing pattern near end of life (Correct answer)
- The patient needs immediate intubation
- Oxygen therapy must be increased to 100%
- The patient should be transferred to the ICU
Correct answer: This is a normal breathing pattern near end of life
Cheyne-Stokes respirations are a common and expected breathing pattern as death approaches, and families should be educated that this is normal.
Question 2: Which medication is most appropriate for managing terminal secretions (death rattle) in a hospice patient?
- Glycopyrrolate (Correct answer)
- Metformin
- Lisinopril
- Methotrexate
Correct answer: Glycopyrrolate
Glycopyrrolate is an anticholinergic medication commonly used to reduce terminal secretions by decreasing saliva and mucus production.
Question 3: A palliative care nurse is caring for a patient whose family insists on continuing aggressive treatment despite the patient's advance directive refusing it. What is the nurse's primary obligation?
- Advocate for the patient's documented wishes (Correct answer)
- Follow the family's verbal instructions
- Defer all decisions to the attending physician
- Withhold information from the family to reduce conflict
Correct answer: Advocate for the patient's documented wishes
The nurse is ethically and legally obligated to advocate for the patient's autonomy as documented in their advance directive.
Question 4: Which scale is specifically designed to assess functional status and prognosis in hospice patients?
- Palliative Performance Scale (PPS) (Correct answer)
- Glasgow Coma Scale
- Braden Scale
- Morse Fall Scale
Correct answer: Palliative Performance Scale (PPS)
The Palliative Performance Scale (PPS) measures ambulation, activity, self-care, intake, and consciousness level to assess functional decline in palliative patients.
Question 5: What is the primary goal of palliative sedation in hospice care?
- To relieve refractory symptoms that cannot be controlled by other means (Correct answer)
- To hasten the patient's death
- To eliminate the need for family involvement in care
- To reduce staffing requirements for complex patients
Correct answer: To relieve refractory symptoms that cannot be controlled by other means
Palliative sedation is used as a last resort to manage refractory symptoms such as intractable pain or agitation when all other interventions have failed.
Question 6: A hospice nurse notices that a bereaved spouse has not resumed normal activities eight months after the patient's death and expresses persistent yearning. Which condition should the nurse screen for?
- Prolonged grief disorder (Correct answer)
- Normal grief response
- Major depressive disorder with psychotic features
- Acute stress disorder
Correct answer: Prolonged grief disorder
Prolonged grief disorder is characterized by persistent, intense grief lasting beyond expected timeframes with functional impairment and yearning for the deceased.
CHPN FREE Hospice and Palliative Nurse Guide Questions and Answers 2
A hospice patient with end-stage heart failure develops Cheyne-Stokes respirations.
What should the nurse communicate to the family?