CHPN Care at the Time of Death 2

Question 1

The most appropriate nursing intervention for a hospice patient experiencing the death rattle is to:

Accepted Answer

Reposition the patient to facilitate postural drainage and administer anticholinergic medication as ordered

Answer

Repositioning (e.g., lateral or semi-prone) facilitates drainage of secretions, and anticholinergic agents such as glycopyrrolate or hyoscine reduce secretion production, addressing the death rattle without distressing the patient.

Question 2

When a patient is actively dying and can no longer swallow oral medications, the preferred alternative route of administration in hospice care is:

Accepted Answer

Subcutaneous or sublingual administration

Answer

Subcutaneous continuous infusion or sublingual administration are preferred in hospice because they are comfortable, effective, and do not require venous access, which is often difficult in dying patients.

Question 3

A family member of an actively dying patient asks: 'Can my mother still hear us?' The best hospice nurse response is:

Accepted Answer

'We don't know for certain, but hearing is believed to be one of the last senses to fade—continue speaking to her.'

Answer

Research and clinical experience support that hearing may persist near death even when the patient cannot respond, so encouraging family to speak to their loved one is both supportive and evidence-informed.

Question 4

Mouth care for an actively dying patient who can no longer swallow should be performed:

Accepted Answer

Every 15 to 30 minutes with moistened swabs to maintain comfort

Answer

Frequent mouth care with moistened swabs prevents dry mucous membranes and maintains comfort, which is the primary goal when the patient can no longer take fluids orally.

Question 5

A hospice nurse is repositioning an actively dying patient. Which principle should guide repositioning decisions?

Accepted Answer

Limit repositioning to what the patient tolerates comfortably; pressure injury prevention is secondary to comfort

Answer

In the actively dying phase, comfort is the primary goal; aggressive repositioning schedules are not appropriate if they cause distress, and pressure injury prevention takes lower priority.

(CHPN) Hospice Certified Professional Practice Test

(CHPN) Hospice Certified Professional Practice Test

CHPN Care at the Time of Death 2