CHPN Basic Questions 4

Question 1

A patient with terminal cancer requests that cardiopulmonary resuscitation not be performed. Which document legally records this wish in most US states?

Accepted Answer

POLST (Physician Orders for Life-Sustaining Treatment)

Answer

A POLST form is a portable, signed medical order that is immediately actionable by EMS and medical personnel across care settings.

Question 2

When converting a patient from oral morphine to an equianalgesic dose of IV morphine, the correct conversion ratio is:

Accepted Answer

3:1 (oral to IV)

Answer

The equianalgesic ratio for oral to IV morphine is 3:1, meaning 30 mg oral morphine equals approximately 10 mg IV morphine.

Question 3

Which symptom cluster is MOST characteristic of the active dying phase in the final 24-48 hours of life?

Accepted Answer

Mottling, Cheyne-Stokes respirations, and decreased consciousness

Answer

Mottling of the extremities, irregular breathing patterns, and decreased consciousness are hallmark signs of imminent death.

Question 4

A hospice patient develops terminal restlessness (terminal agitation). The MOST appropriate pharmacologic intervention is:

Accepted Answer

Haloperidol or midazolam

Answer

Haloperidol addresses delirium-related agitation and midazolam provides sedation for refractory terminal restlessness.

Question 5

Which statement BEST describes the goal of palliative sedation in refractory symptom management?

Accepted Answer

To reduce consciousness to the level needed to relieve intractable suffering

Answer

Palliative sedation is titrated to the minimum level of sedation necessary to achieve patient comfort, not to cause death.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN Basic Questions 4