CHPN Patient & Family-Centered Care 2 — Questions and Answers
Question 1: A hospice patient's adult children disagree about whether to continue aggressive wound care. What is the nurse's priority intervention?
- Defer to the eldest child as next of kin
- Facilitate a family meeting focused on the patient's stated wishes (Correct answer)
- Continue current wound care until a physician decides
- Contact the ethics committee immediately
Correct answer: Facilitate a family meeting focused on the patient's stated wishes
Facilitating a family meeting centered on the patient's previously expressed wishes aligns care decisions with patient-centered principles.
Question 2: Which behavior best demonstrates a hospice nurse applying a family systems approach to care?
- Providing care instructions only to the primary caregiver
- Assessing how the patient's illness affects all family members' roles (Correct answer)
- Limiting family involvement to avoid conflicting opinions
- Educating only those family members present at admission
Correct answer: Assessing how the patient's illness affects all family members' roles
A family systems approach recognizes that illness affects all members and their interrelationships, not just the patient.
Question 3: A caregiver reports feeling exhausted and unable to continue home care. What is the most appropriate initial nursing response?
- Arrange immediate inpatient admission for the patient
- Assess the caregiver's specific needs and available support resources (Correct answer)
- Remind the caregiver of their commitment to the patient
- Notify the physician for caregiver burnout documentation
Correct answer: Assess the caregiver's specific needs and available support resources
Assessing the caregiver's specific burden and available resources allows the nurse to tailor interventions such as respite care appropriately.
Question 4: When a patient lacks decision-making capacity, the hospice nurse should direct care discussions toward:
- The physician's clinical judgment
- The patient's legally designated surrogate or healthcare proxy (Correct answer)
- The family member who visits most frequently
- The facility social worker
Correct answer: The patient's legally designated surrogate or healthcare proxy
The legally designated surrogate or healthcare proxy is authorized to make decisions consistent with the patient's known wishes.
Question 5: A dying patient tells the nurse, 'I just want my family to stop arguing and be at peace.' This statement reflects which dimension of hospice care?
- Physical comfort needs
- Psychosocial and relational well-being (Correct answer)
- Spiritual distress resolution
- Financial and practical concerns
Correct answer: Psychosocial and relational well-being
The patient's concern for family harmony reflects a psychosocial and relational dimension of well-being central to patient-centered hospice care.
Question 6: A family member asks the hospice nurse why the patient is sleeping more and eating less. The best response is:
- 'These changes indicate the patient is depressed.'
- 'This is a normal part of the dying process; the body is conserving energy.' (Correct answer)
- 'We should increase nutritional supplements to reverse this trend.'
- 'I'll ask the doctor to adjust the medication regimen.'
Correct answer: 'This is a normal part of the dying process; the body is conserving energy.'
Explaining that decreased intake and increased sleep are normal signs of the natural dying process helps families understand and reduces anxiety.
Question 7: Which action BEST supports shared decision-making in hospice care?
- Presenting one recommended care option to simplify choices
- Providing information about options and eliciting patient and family preferences (Correct answer)
- Allowing the interdisciplinary team to make all clinical decisions
- Following standard protocols without individualization
Correct answer: Providing information about options and eliciting patient and family preferences
Shared decision-making requires providing balanced information and actively eliciting the values and preferences of both the patient and family.
CHPN Patient & Family-Centered Care 2
A hospice patient's adult children disagree about whether to continue aggressive wound care.
What is the nurse's priority intervention?