CHPN MCQ Practice 4

Question 1

A patient with advanced cancer reports neuropathic pain described as burning and shooting. In addition to opioids, which adjuvant analgesic is MOST appropriate?

Accepted Answer

Gabapentin

Answer

Gabapentin (and pregabalin) are first-line adjuvant analgesics for neuropathic pain, acting on calcium channels to reduce neuronal excitability.

Question 2

Under the Medicare Hospice Benefit, which service is NOT typically covered?

Accepted Answer

Curative chemotherapy for the terminal diagnosis

Answer

The Medicare Hospice Benefit requires patients to forgo curative treatment for their terminal illness; disease-modifying or curative therapies are not covered under the hospice benefit.

Question 3

A hospice nurse observes a patient with Cheyne-Stokes respirations. This breathing pattern is characterized by:

Accepted Answer

Periods of apnea alternating with cycles of increasing and decreasing respiratory depth

Answer

Cheyne-Stokes respiration is a cyclical pattern of waxing and waning tidal volumes with periodic apnea, common in the final hours to days of life.

Question 4

When a patient lacks decision-making capacity and has no advance directive, the legal hierarchy for surrogate decision-making in most US states typically begins with:

Accepted Answer

The legal next of kin (spouse or adult children)

Answer

In the absence of an advance directive or durable power of attorney for health care, most US states recognize the legal next of kin—spouse, then adult children—as the default surrogate decision-maker.

Question 5

A hospice nurse is preparing a patient for discharge to home. Which teaching is MOST critical for the family managing opioid medications?

Accepted Answer

Store opioids in a locked location away from children and visitors

Answer

Opioid medications must be stored securely in a locked location to prevent accidental ingestion by children or diversion by visitors.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN MCQ Practice 4