CHPN MCQ Practice 5

Question 1

A patient with end-stage renal disease on hospice develops severe, refractory agitation. Which opioid is generally AVOIDED in this population due to toxic metabolite accumulation?

Accepted Answer

Morphine

Answer

Morphine's active metabolite morphine-6-glucuronide accumulates in renal failure and can cause neuroexcitatory effects including agitation, myoclonus, and seizures.

Question 2

The NURSE Act is relevant to palliative care nursing practice because it:

Accepted Answer

Provides a legal framework supporting nurses who advocate for adequate pain and symptom management

Answer

The NURSE Act (Nurses for the Understanding of Research, Science, and Education in pain management) supports nurses' advocacy for adequate pain treatment without fear of regulatory reprisal.

Question 3

A terminally ill patient states, 'I've been thinking about taking all my pills at once.' The nurse's FIRST priority is:

Accepted Answer

Perform a thorough assessment of suicidal ideation including intent, plan, and access to means

Answer

Any statement suggesting suicidal ideation requires immediate, thorough assessment of intent, plan, and means before determining the appropriate intervention.

Question 4

Palliative sedation for refractory suffering is ethically justified under which doctrine?

Accepted Answer

Doctrine of Double Effect

Answer

The Doctrine of Double Effect holds that an action intended to relieve suffering (sedation) is ethically permissible even if it may foreseeably hasten death as an unintended secondary effect.

Question 5

A patient on hospice is found to have a new, painful vertebral compression fracture. Which palliative intervention would MOST directly address the underlying cause of pain?

Accepted Answer

Palliative radiation therapy to the affected vertebra

Answer

Palliative radiation therapy is highly effective at reducing bone pain from metastatic disease by targeting the underlying cause, and is consistent with hospice comfort goals.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN MCQ Practice 5