CHPN Professional Practice Issues 3 — Questions and Answers
Question 1: Under HIPAA, a hospice nurse may share a patient's health information with a family member who is NOT the designated healthcare proxy when:
- The family member requests it verbally
- The patient has given explicit permission or the disclosure is necessary for care (Correct answer)
- The nurse determines it is in the patient's best interest
- The family member is a first-degree relative
Correct answer: The patient has given explicit permission or the disclosure is necessary for care
HIPAA allows disclosure only with patient permission or when necessary for treatment, not simply because someone is family.
Question 2: Which action best demonstrates the hospice nurse's role in supporting staff wellness and preventing burnout?
- Discouraging staff from discussing difficult cases
- Facilitating regular debriefing sessions after difficult patient deaths (Correct answer)
- Assigning additional responsibilities to keep staff engaged
- Limiting staff exposure to terminal patients
Correct answer: Facilitating regular debriefing sessions after difficult patient deaths
Structured debriefing after losses provides psychological support and is a recognized strategy for reducing compassion fatigue.
Question 3: A nurse suspects a colleague is diverting controlled substances. The most appropriate action is to:
- Confront the colleague privately and warn them
- Document observations and report to the nurse manager or compliance officer (Correct answer)
- Ignore the situation to avoid conflict
- Discuss suspicions with other staff first
Correct answer: Document observations and report to the nurse manager or compliance officer
Diversion is a patient safety and legal issue requiring immediate documentation and reporting to supervisory or compliance staff.
Question 4: What best describes the concept of 'double effect' in hospice and palliative nursing?
- Using two medications for better symptom control
- An action intended to relieve suffering may hasten death as a foreseen but unintended consequence (Correct answer)
- Providing double the recommended opioid dose
- Administering two doses when the first is ineffective
Correct answer: An action intended to relieve suffering may hasten death as a foreseen but unintended consequence
The doctrine of double effect holds that an action to relieve suffering is ethically permissible even if it may foreseeably hasten death, provided death is not the intended outcome.
Question 5: A hospice nurse is offered a gift of significant monetary value from a grateful patient's family. The most appropriate response is to:
- Accept it as a sign of cultural respect
- Politely decline and follow agency policy on gifts (Correct answer)
- Accept it if it is given after the patient's death
- Report the offer to the state licensing board
Correct answer: Politely decline and follow agency policy on gifts
Accepting substantial gifts creates ethical and professional conflicts of interest; most agencies prohibit it and nurses should follow their agency's policy.
Question 6: A palliative nurse is asked to witness a patient signing their will. What is the most appropriate action?
- Witness the document, as it helps the patient
- Decline, as nurses should not act as witnesses to legal documents for their own patients (Correct answer)
- Witness only if the patient has no other options
- Ask the patient's physician to co-witness
Correct answer: Decline, as nurses should not act as witnesses to legal documents for their own patients
Nurses caring for a patient have a conflict of interest and should not witness legal documents such as wills for that patient.
Question 7: The CHPN certification credential must be renewed every:
- 2 years
- 3 years
- 4 years (Correct answer)
- 5 years
Correct answer: 4 years
CHPN certification is valid for four years, after which renewal through continued education or re-examination is required.
CHPN Professional Practice Issues 3
Under HIPAA, a hospice nurse may share a patient's health information with a family member who is NOT the designated healthcare proxy when: