CHPN Free Hospice and Palliative Nurse Knowledge Questions and Answers 2

Question 1

A hospice patient with end-stage COPD is experiencing increasing dyspnea despite maximum bronchodilator therapy. Which intervention is most appropriate to address refractory dyspnea?

Accepted Answer

Low-dose oral morphine

Answer

Increase supplemental oxygen to 6 L/min

Answer

Administer IV aminophylline

Answer

Begin continuous nebulized albuterol

Question 2

Which of the following best describes the concept of 'total pain' as defined by Dame Cicely Saunders?

Accepted Answer

Pain that encompasses physical, psychological, social, and spiritual dimensions

Answer

Pain rated 10 out of 10 on the numeric rating scale

Answer

Pain that requires multimodal pharmacologic intervention

Answer

Pain that persists despite adequate opioid titration

Question 3

A palliative care nurse notices mottling on a patient's lower extremities, decreased urine output, and Cheyne-Stokes respirations. What phase of dying do these signs most likely indicate?

Accepted Answer

Active dying phase

Answer

Transitional phase

Answer

Stable decline phase

Answer

Crisis phase

Question 4

Which medication is most appropriate for managing terminal secretions (death rattle) in an actively dying hospice patient?

Accepted Answer

Glycopyrrolate

Answer

Furosemide

Answer

Ipratropium bromide inhaler

Answer

Normal saline nebulizer

Question 5

A family member asks the hospice nurse why their loved one has stopped eating and drinking. Which response best reflects palliative care principles?

Accepted Answer

Decreased appetite is a natural part of the dying process and forcing intake can cause discomfort

Answer

The patient needs a feeding tube to prevent malnutrition

Answer

IV fluids should be started to prevent dehydration

Answer

Appetite stimulants should be prescribed immediately

Question 6

According to the Medicare Hospice Benefit, what is the primary eligibility criterion for a patient to receive hospice services?

Accepted Answer

A physician certifies the patient has a life expectancy of six months or less if the disease runs its normal course

Answer

The patient must have a do-not-resuscitate order in place

Answer

The patient must be bedridden and unable to perform any activities of daily living

Answer

The patient must have failed all curative treatment options