CHPN Care at the Time of Death

Question 1

Which physiological change is most indicative that death is imminent within hours?

Accepted Answer

Mottling extending to the knees and thighs

Answer

Mottling (livedo reticularis) extending from the extremities toward the trunk indicates severe circulatory failure and is a reliable sign that death is imminent within hours.

Question 2

The 'death rattle' heard in actively dying patients is primarily caused by:

Accepted Answer

Accumulation of secretions in the oropharynx that the patient can no longer clear

Answer

The death rattle results from pooled oropharyngeal secretions and relaxation of throat muscles that prevent the patient from clearing secretions through coughing or swallowing.

Question 3

Cheyne-Stokes respirations, commonly seen in the final days of life, are characterized by:

Accepted Answer

Alternating periods of apnea and hyperpnea in a crescendo-decrescendo pattern

Answer

Cheyne-Stokes respirations follow a cyclical pattern of gradually increasing depth and rate followed by decreasing depth, then apnea, reflecting brainstem dysfunction and altered carbon dioxide sensitivity.

Question 4

A hospice patient's extremities are cool and cyanotic, with mottling, and respirations are irregular. The family asks how long the patient has to live. The most accurate response is:

Accepted Answer

These signs suggest death may occur within hours to a few days

Answer

Cool, cyanotic extremities with mottling and irregular respirations are classic signs of the active dying phase, which typically precedes death by hours to a few days.

Question 5

Which of the following is considered a late sign of approaching death?

Accepted Answer

Mandibular breathing (jaw breathing)

Answer

Mandibular breathing, where only the jaw moves with each breath as chest wall muscles cease functioning, is a very late sign indicating death is typically minutes to hours away.

(CHPN) Hospice Certified Professional Practice Test

(CHPN) Hospice Certified Professional Practice Test

CHPN Care at the Time of Death