CHPN Education, Support, and Advocacy 3 — Questions and Answers
Question 1: Which bereavement intervention is MOST appropriate immediately after the death of a hospice patient?
- Scheduling a grief support group in six months
- Sending a condolence card and contacting the family within 24-72 hours (Correct answer)
- Providing a list of community resources and ending contact
- Waiting until the family initiates contact with the hospice team
Correct answer: Sending a condolence card and contacting the family within 24-72 hours
Timely bereavement outreach within 24-72 hours after death demonstrates support and helps assess the family's immediate grief needs.
Question 2: A patient states they want to die at home but their adult children disagree. The nurse's PRIMARY role is to:
- Support the family's decision to ensure caregiver safety
- Advocate for the patient's expressed preference while facilitating family communication (Correct answer)
- Remain neutral and document both perspectives
- Defer the decision to the attending physician
Correct answer: Advocate for the patient's expressed preference while facilitating family communication
Nurses are patient advocates; the patient's autonomous wish to die at home should be supported while helping the family understand and process their concerns.
Question 3: When educating families about anticipatory grief, the nurse should EMPHASIZE that:
- Anticipatory grief means the family will grieve less after the death
- Grieving before the death is normal and does not diminish love for the patient (Correct answer)
- Anticipatory grief only occurs in family members with depression
- Families should suppress grief until after the patient dies
Correct answer: Grieving before the death is normal and does not diminish love for the patient
Anticipatory grief is a normal response to impending loss and does not lessen post-death grief; families need validation that it is a healthy process.
Question 4: A nurse is teaching a family caregiver about repositioning a bedbound patient. Which statement by the caregiver indicates a need for further teaching?
- 'I will reposition them every two hours.'
- 'I should inspect the skin each time I turn them.'
- 'I only need to reposition when they complain of pain.' (Correct answer)
- 'I can use pillows to support their position.'
Correct answer: 'I only need to reposition when they complain of pain.'
Repositioning should occur on a scheduled basis (every 2 hours) regardless of complaints, as patients with altered sensation may not report discomfort.
Question 5: Which community resource should a hospice nurse PRIMARILY refer an overwhelmed family caregiver to for temporary relief?
- Inpatient psychiatric unit
- Respite care services (Correct answer)
- Emergency department
- Long-term care facility admission
Correct answer: Respite care services
Respite care provides temporary relief for family caregivers and is a covered benefit under the Medicare Hospice Benefit.
Question 6: When providing cultural competent care, a hospice nurse should FIRST:
- Apply standard Western end-of-life care protocols
- Assess the patient and family's specific cultural beliefs and preferences regarding death and dying (Correct answer)
- Ask the chaplain to address all cultural needs
- Avoid discussing cultural differences to prevent offense
Correct answer: Assess the patient and family's specific cultural beliefs and preferences regarding death and dying
A cultural assessment identifies specific beliefs, rituals, and preferences that should guide individualized hospice care planning.
Question 7: A patient asks the nurse, 'How long do I have to live?' Which response BEST reflects skilled end-of-life communication?
- 'Your doctor will have to answer that question, not me.'
- 'Most patients in your situation live about two weeks.'
- 'What makes you ask that question right now? What are you hoping to understand?' (Correct answer)
- 'Try not to think about that and focus on today.'
Correct answer: 'What makes you ask that question right now? What are you hoping to understand?'
Exploring the patient's underlying concern opens a therapeutic dialogue and addresses emotional needs before providing prognostic information.
CHPN Education, Support, and Advocacy 3
Which bereavement intervention is MOST appropriate immediately after the death of a hospice patient?