CHPN General Knowledge 3

Question 1

A hospice patient with renal failure is prescribed morphine. The nurse is most concerned about accumulation of which metabolite?

Accepted Answer

Morphine-6-glucuronide (M6G)

Answer

Morphine-6-glucuronide (M6G) is an active analgesic metabolite that accumulates in renal failure and can cause prolonged sedation and respiratory depression.

Question 2

Which of the following is the most appropriate initial pharmacological treatment for opioid-induced constipation in a hospice patient?

Accepted Answer

Stimulant laxative such as senna with or without a stool softener

Answer

A stimulant laxative (e.g., senna) combined with a stool softener is the first-line treatment for opioid-induced constipation; docusate alone is insufficient.

Question 3

A family member asks the hospice nurse why their dying loved one is no longer eating. The best response is:

Accepted Answer

Decreased appetite and food intake are a natural part of the dying process and do not cause suffering.

Answer

Anorexia and decreased oral intake are expected and natural aspects of the dying process; explaining this helps families understand that withholding artificial nutrition is appropriate.

Question 4

Which level of hospice care is designed for short-term pain or symptom management that cannot be managed in the home setting?

Accepted Answer

General inpatient care

Answer

General inpatient care is a Medicare hospice benefit level for acute symptom management requiring skilled nursing or medical intervention that cannot be provided at home.

Question 5

When using an equianalgesic conversion chart to switch a patient from oral oxycodone to IV morphine, the nurse knows that:

Accepted Answer

A dose reduction of 25–50% is typically applied when converting to account for incomplete cross-tolerance

Answer

When rotating opioids, a 25–50% dose reduction is applied to account for incomplete cross-tolerance and individual variation, preventing inadvertent overdose.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN General Knowledge 3