Study Guide Flashcards
7 cards from real CHPN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Study Guide flashcards as text
A hospice nurse is performing a pain assessment on a patient with end-stage dementia who cannot self-report. Which validated tool is MOST appropriate?
Answer: PAINAD (Pain Assessment in Advanced Dementia)
PAINAD is specifically validated for assessing pain in patients with advanced dementia who cannot self-report.
Under the Medicare Hospice Benefit, which level of care is provided in a hospice facility or hospital for short-term pain and symptom management?
Answer: General inpatient care (GIP)
General inpatient care (GIP) is provided in a facility when symptoms cannot be managed in the home setting.
Which opioid rotation principle should the CHPN apply when switching a patient from oral morphine to transdermal fentanyl?
Answer: Use an equianalgesic conversion table and reduce the calculated dose by 25-50%
When rotating opioids, equianalgesic tables guide conversion and a 25-50% reduction accounts for incomplete cross-tolerance.
A palliative care patient asks about the difference between palliative sedation and euthanasia. The nurse's BEST response is:
Answer: Palliative sedation aims to relieve refractory suffering, not to hasten death, while euthanasia intentionally ends life
Palliative sedation targets refractory symptom relief and death is not the intended outcome, distinguishing it ethically and legally from euthanasia.
Which finding indicates that a patient with heart failure is entering the active dying phase?
Answer: Mottling of the knees and lower extremities
Mottling (livedo reticularis) of the knees and lower extremities is a classic sign of imminent death due to circulatory failure.
A family member insists that the patient be given IV fluids because 'they are starving.' The hospice nurse's MOST therapeutic response is:
Answer: Explain that dehydration in dying patients often reduces secretions and edema, and the patient may not experience thirst or hunger
Educating the family that natural dehydration near end of life is typically not distressing and may reduce discomfort addresses their concern therapeutically.
Which ethical principle is PRIMARILY invoked when a competent patient refuses a recommended blood transfusion at end of life?
Answer: Autonomy
Autonomy is the principle that competent individuals have the right to make decisions about their own medical care, including refusal of treatment.