CHPN Patient & Family-Centered Care 5 — Questions and Answers
Question 1: A family member calls the hospice nurse six weeks after the patient's death, describing persistent sadness, difficulty functioning, and inability to accept the loss. This presentation is consistent with:
- Normal grief resolution
- Complicated or prolonged grief disorder requiring further assessment (Correct answer)
- Clinical depression requiring antidepressant therapy
- Post-traumatic stress disorder
Correct answer: Complicated or prolonged grief disorder requiring further assessment
Persistent, impairing grief that interferes with functioning beyond expected parameters warrants assessment for complicated or prolonged grief disorder.
Question 2: Hospice bereavement services must be provided to the family for a minimum of how long after the patient's death under the Medicare Hospice Benefit?
- 3 months
- 13 months (Correct answer)
- 6 months
- 24 months
Correct answer: 13 months
The Medicare Hospice Benefit requires bereavement services to be offered to surviving family members for at least 13 months following the patient's death.
Question 3: A child in the family asks the hospice nurse, 'Is grandpa going to die?' The most appropriate response is:
- 'You should ask your parents that question.'
- 'Yes, grandpa's body is stopping working, and he will die soon. It's okay to feel sad.' (Correct answer)
- 'Grandpa is just very tired and sleeping a lot.'
- 'Don't worry, the doctors are taking good care of him.'
Correct answer: 'Yes, grandpa's body is stopping working, and he will die soon. It's okay to feel sad.'
Honest, age-appropriate explanations help children process death without confusion or long-term psychological harm from being misled.
Question 4: Which intervention BEST supports anticipatory grief in family caregivers?
- Discouraging expressions of grief until after the patient's death
- Normalizing grief feelings and providing space to express fears about the impending loss (Correct answer)
- Reassuring the family that their loved one will recover
- Focusing caregivers exclusively on practical caregiving tasks
Correct answer: Normalizing grief feelings and providing space to express fears about the impending loss
Normalizing anticipatory grief and creating a safe space for expression reduces isolation and supports the caregiver's psychological well-being.
Question 5: A hospice nurse notices that an adult son has been the sole caregiver for months and appears withdrawn and tearful during visits. The priority intervention is:
- Increase the frequency of aide visits without addressing the son's distress
- Conduct a caregiver burden assessment and discuss respite options (Correct answer)
- Refer the son to a mental health professional without further assessment
- Notify the physician that the son is unable to continue caregiving
Correct answer: Conduct a caregiver burden assessment and discuss respite options
A caregiver burden assessment identifies specific stressors and guides targeted interventions such as respite care, volunteer support, or counseling referral.
Question 6: Which statement about the hospice interdisciplinary team's role in bereavement is MOST accurate?
- Bereavement care is the sole responsibility of the hospice social worker
- All IDT members contribute to bereavement support, though the social worker often coordinates it (Correct answer)
- Bereavement care begins only after the patient dies
- Nurses are not expected to provide bereavement support
Correct answer: All IDT members contribute to bereavement support, though the social worker often coordinates it
Bereavement is a shared IDT responsibility with the social worker often coordinating, but nurses and chaplains also play critical supportive roles.
Question 7: A widow calls the hospice bereavement coordinator three months after her husband's death and says, 'I keep expecting to hear him come through the door.' This most likely represents:
- A psychotic break requiring psychiatric referral
- A normal grief experience of searching and yearning (Correct answer)
- Denial indicating pathological grief
- A need for increased antidepressant dosing
Correct answer: A normal grief experience of searching and yearning
Searching and yearning for the deceased—such as expecting to see or hear them—is a common and normal component of grief in the early months.
CHPN Patient & Family-Centered Care 5
A family member calls the hospice nurse six weeks after the patient's death, describing persistent sadness, difficulty functioning, and inability to accept the loss.
This presentation is consistent with: