CHPN Patient Assessment and Planning 5

Question 1

During an interdisciplinary team (IDT) meeting, which document MOST directly guides the hospice plan of care revision?

Accepted Answer

The comprehensive assessment with updated symptom data and patient goals

Answer

The comprehensive assessment, including updated symptom burden and current patient goals, is the primary evidence base for revising the interdisciplinary plan of care.

Question 2

A hospice nurse assesses a patient who is non-verbal using the PAINAD scale. A score of 8 out of 10 indicates:

Accepted Answer

Severe pain requiring immediate intervention

Answer

On the PAINAD scale (0–10), scores of 7–10 indicate severe pain requiring immediate pharmacologic and non-pharmacologic intervention.

Question 3

Which change in a hospice patient's urinary output is MOST consistent with the active dying process?

Accepted Answer

Oliguria with dark, concentrated urine or anuria

Answer

As renal perfusion decreases during active dying, urine output drops to oliguria or anuria and urine becomes dark and concentrated.

Question 4

A palliative nurse assesses a patient's opioid regimen. The patient uses 240 mg of oral morphine daily with four breakthrough doses of 40 mg each used consistently. What does this pattern indicate?

Accepted Answer

The current basal dose is insufficient and requires titration upward

Answer

Consistent use of more than two to three breakthrough doses per day indicates the around-the-clock (basal) dose is inadequate and should be increased accordingly.

Question 5

A hospice nurse documents a patient's prognosis using the Palliative Prognostic Score (PaP). Which variable is included in PaP calculation?

Accepted Answer

Karnofsky Performance Status and clinical prediction of survival

Answer

The PaP Score incorporates clinical prediction of survival, Karnofsky Performance Status, and laboratory values (WBC, lymphocyte percentage) to estimate 30-day survival probability.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN Patient Assessment and Planning 5