CHPN FREE Hospice and Palliative Nurse MCQ Questions and Answers 2 — Questions and Answers
Question 1: A hospice patient with end-stage COPD is experiencing refractory dyspnea despite maximum bronchodilator therapy. Which intervention is most appropriate to manage this symptom?
- Low-dose oral morphine (Correct answer)
- Increasing the bronchodilator frequency
- Initiating IV antibiotics
- Performing a thoracentesis
Correct answer: Low-dose oral morphine
Low-dose opioids are the gold standard for managing refractory dyspnea in end-stage COPD by reducing the central perception of breathlessness.
Question 2: Which of the following best describes the concept of 'total pain' as defined by Dame Cicely Saunders?
- Pain that encompasses physical, emotional, social, and spiritual dimensions (Correct answer)
- Pain that is rated 10 out of 10 on a numeric scale
- Pain that requires multiple opioid medications simultaneously
- Pain that cannot be managed with any available interventions
Correct answer: Pain that encompasses physical, emotional, social, and spiritual dimensions
Total pain is a holistic concept recognizing that suffering includes physical, psychological, social, and spiritual components that must all be addressed.
Question 3: A patient receiving around-the-clock morphine develops pinpoint pupils, excessive sedation, and a respiratory rate of 6 breaths per minute. What is the priority nursing intervention?
- Administer naloxone as prescribed (Correct answer)
- Increase supplemental oxygen flow rate
- Withhold the next scheduled dose and monitor
- Reposition the patient to a side-lying position
Correct answer: Administer naloxone as prescribed
Pinpoint pupils, sedation, and respiratory depression indicate opioid toxicity requiring naloxone administration to reverse the life-threatening respiratory depression.
Question 4: During a family meeting, the spouse of a terminally ill patient states, 'I don't want you to tell my husband he is dying.' What is the most appropriate nursing response?
- Explore the spouse's concerns while reinforcing the patient's right to information (Correct answer)
- Agree to withhold the information to respect the family's wishes
- Immediately inform the patient of the prognosis without the spouse present
- Refer the situation to the ethics committee before taking any action
Correct answer: Explore the spouse's concerns while reinforcing the patient's right to information
The nurse should explore the spouse's fears while advocating for the patient's autonomy and right to be informed about their own condition.
Question 5: Which scale is specifically designed to assess functional status and prognosis in palliative care patients?
- Palliative Performance Scale (PPS) (Correct answer)
- Glasgow Coma Scale (GCS)
- Braden Scale
- Morse Fall Scale
Correct answer: Palliative Performance Scale (PPS)
The Palliative Performance Scale measures ambulation, activity, self-care, intake, and consciousness level to assess functional decline and estimate prognosis.
Question 6: A hospice nurse is caring for a patient in the active dying phase who develops loud, gurgling respirations. The family is distressed. Which intervention should the nurse prioritize?
- Reposition the patient and administer a prescribed anticholinergic medication (Correct answer)
- Perform deep oropharyngeal suctioning to clear secretions
- Start IV fluids to thin the secretions
- Instruct the family to leave the room until the sound stops
Correct answer: Reposition the patient and administer a prescribed anticholinergic medication
Repositioning and anticholinergic agents such as glycopyrrolate reduce new secretion production and are first-line interventions for terminal secretions.
CHPN FREE Hospice and Palliative Nurse MCQ Questions and Answers 2
A hospice patient with end-stage COPD is experiencing refractory dyspnea despite maximum bronchodilator therapy.
Which intervention is most appropriate to manage this symptom?