CHPN Pain Management Strategies 5

Question 1

A terminally ill patient develops opioid-induced respiratory depression. Which medication reverses this effect and what is the priority nursing concern?

Accepted Answer

Naloxone; administer in small titrated doses to avoid precipitating severe pain and withdrawal

Answer

Naloxone reverses opioid-induced respiratory depression, but in opioid-tolerant palliative patients it must be titrated in small doses to restore breathing without precipitating acute pain crisis or withdrawal.

Question 2

A patient rates their pain 3/10 and states they are comfortable. The nurse observes mild grimacing. What is the most appropriate action?

Accepted Answer

Document the self-report of 3/10 as the pain score and reassess per protocol

Answer

Self-report remains the gold standard; a patient who states they are comfortable at 3/10 should be believed and documented accordingly, with ongoing reassessment.

Question 3

Which description best defines 'total pain' as conceptualized in palliative care?

Accepted Answer

The multidimensional experience encompassing physical, psychological, social, and spiritual suffering

Answer

Dame Cicely Saunders' concept of 'total pain' recognizes that suffering in dying patients is multidimensional, requiring holistic assessment and intervention across all domains.

Question 4

A palliative nurse notes a patient's pain worsens significantly at night. Which factor should be assessed first?

Accepted Answer

Reduced distraction, increased anxiety, and circadian variation in pain thresholds

Answer

Nocturnal pain worsening is often multifactorial: fewer distractions amplify pain perception, anxiety peaks at night, and some pain types have circadian patterns.

Question 5

A patient on long-term opioid therapy reports that the same dose no longer provides adequate relief. This phenomenon is best described as:

Accepted Answer

Opioid tolerance

Answer

Opioid tolerance is the pharmacologic phenomenon in which a given dose produces less effect over time, requiring dose escalation — it is distinct from addiction.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN Pain Management Strategies 5