CHPN Non-Pain Symptom Management 2

Question 1

A hospice patient with advanced COPD reports severe air hunger despite being on low-flow oxygen. Which intervention is MOST effective for relieving dyspnea in this patient?

Accepted Answer

Administer low-dose oral morphine

Answer

Low-dose opioids such as morphine are the most evidence-based pharmacologic treatment for refractory dyspnea in palliative patients.

Question 2

Which of the following best describes the mechanism by which a bedside fan helps relieve dyspnea in palliative care patients?

Accepted Answer

It stimulates trigeminal nerve receptors, reducing breathlessness perception

Answer

Cool airflow directed at the face stimulates trigeminal receptors and reduces the central perception of breathlessness.

Question 3

A dying patient develops noisy, gurgling respirations ('death rattle'). The family is distressed. What is the PRIORITY nursing intervention?

Accepted Answer

Educate the family that the patient is not suffering and reposition the patient

Answer

Death rattle is caused by pooled secretions the patient can no longer clear; family education and repositioning are first-line because the patient is typically unconscious and not distressed.

Question 4

Which anticholinergic medication is commonly used to reduce excessive respiratory secretions ('death rattle') near end of life?

Accepted Answer

Glycopyrrolate

Answer

Glycopyrrolate is an anticholinergic that reduces secretion production without crossing the blood-brain barrier, minimizing CNS side effects.

Question 5

A hospice patient with advanced cancer develops massive hemoptysis. What is the MOST appropriate immediate nursing action?

Accepted Answer

Position the patient with the bleeding lung dependent and administer sedation

Answer

Positioning the affected lung down prevents blood from flooding the contralateral lung, and sedation (e.g., midazolam) provides comfort during this terminal event.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN Non-Pain Symptom Management 2