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 CHPN notes that a patient on 60 mg oral morphine every 4 hours is requesting breakthrough doses every 2 hours. What is the MOST appropriate next step?
Answer: Notify the physician to reassess and consider increasing the scheduled opioid dose
Frequent breakthrough dose use (more than 3 times in 24 hours) indicates inadequate baseline analgesia and the scheduled dose should be titrated up.
Which of the following is a key component of a Goals of Care conversation in palliative nursing?
Answer: Eliciting the patient's values, fears, and understanding of their illness
Goals of Care conversations are patient-centered and require eliciting values, prognosis understanding, and personal fears to guide care planning.
A hospice patient with COPD develops increased dyspnea. After ruling out reversible causes, the MOST evidence-based pharmacologic intervention is:
Answer: Low-dose opioids (e.g., oral morphine 5 mg q4h)
Low-dose opioids are the gold standard for managing refractory dyspnea in palliative care patients.
The Kübler-Ross model of grief includes five stages. Which stage is characterized by the patient attempting to negotiate with a higher power or medical team?
Answer: Bargaining
Bargaining is the stage where patients attempt to negotiate (e.g., 'If I can just live to see my grandchild born...') as a way of coping with loss.
Which medication is the FIRST-LINE treatment for death rattle (noisy secretions) in the actively dying patient?
Answer: Glycopyrrolate or hyoscine (scopolamine)
Anticholinergic agents like glycopyrrolate or scopolamine reduce secretion production and are first-line for death rattle.
When assessing a patient for depression versus normal grief in the context of terminal illness, which feature is MOST indicative of clinical depression requiring treatment?
Answer: Pervasive hopelessness, worthlessness, and suicidal ideation beyond a wish to die sooner
Pervasive hopelessness, worthlessness, and suicidal ideation (distinct from passive wishes for death to come) distinguish clinical depression from expected grief.
A palliative patient's family demands that 'everything be done' but the patient previously completed an advance directive requesting comfort-focused care. The nurse's PRIORITY action is:
Answer: Honor the patient's advance directive as it reflects the patient's autonomous wishes when competent
A valid advance directive reflects the patient's wishes made while competent and takes precedence over family demands when the patient lacks decision-making capacity.