CHPN Professional Practice Issues 4 — Questions and Answers
Question 1: Which standard most directly obligates the hospice nurse to maintain competence in palliative symptom management?
- The Medicare Hospice Conditions of Participation
- The ANA Standards of Professional Nursing Practice (Correct answer)
- The Joint Commission patient safety goals
- The state nurse practice act only
Correct answer: The ANA Standards of Professional Nursing Practice
The ANA Standards of Professional Nursing Practice include a standard requiring nurses to attain knowledge and competence that reflects current nursing practice.
Question 2: A hospice nurse overhears a colleague making a derogatory remark about a dying patient's lifestyle. The nurse should first:
- Document the incident in the patient's chart
- Address the colleague directly and remind them of professional conduct expectations (Correct answer)
- Immediately report the colleague to the state board
- Inform the patient of what was said
Correct answer: Address the colleague directly and remind them of professional conduct expectations
Direct peer feedback is the first step in addressing unprofessional conduct before escalating to formal reporting.
Question 3: When a patient lacks decision-making capacity and has no advance directive or surrogate, the team should base care decisions on:
- The nurse's clinical judgment about best outcomes
- The 'best interest' standard guided by what a reasonable person would likely want (Correct answer)
- The most aggressive curative intervention available
- The family member who arrives first
Correct answer: The 'best interest' standard guided by what a reasonable person would likely want
In the absence of a surrogate or directive, the best interest standard asks what a reasonable person in the patient's situation would likely choose.
Question 4: A hospice nurse is completing a performance improvement project on pain reassessment compliance. This activity reflects which professional nursing role?
- Caregiver
- Educator
- Quality improvement/researcher (Correct answer)
- Case manager
Correct answer: Quality improvement/researcher
Participating in quality improvement projects is a core component of the nurse's professional and research role.
Question 5: Which of the following best describes the concept of cultural humility in hospice nursing practice?
- Memorizing the customs of each patient's culture
- Maintaining an ongoing process of self-reflection and openness to patients' cultural perspectives (Correct answer)
- Asking patients to adapt to the healthcare system's norms
- Treating all patients identically regardless of background
Correct answer: Maintaining an ongoing process of self-reflection and openness to patients' cultural perspectives
Cultural humility emphasizes lifelong learning, self-reflection, and power-sharing rather than achieving a fixed level of cultural knowledge.
Question 6: A nurse practicing in a state where medical aid in dying (MAID) is legal is asked by a patient about their options. The nurse should:
- Refuse to discuss any information about MAID
- Provide factual information and refer the patient to appropriate resources per agency policy (Correct answer)
- Personally facilitate the process immediately
- Discourage the patient from pursuing legal options
Correct answer: Provide factual information and refer the patient to appropriate resources per agency policy
Nurses have a duty to provide accurate information about legal options and refer appropriately, while following agency policy regarding participation.
Question 7: An IDT member from social work raises a concern that a patient's home environment is unsafe for hospice care. The nurse's role is to:
- Defer entirely to social work and take no further action
- Collaborate with the IDT to assess risks and develop a safe care plan (Correct answer)
- Discharge the patient from hospice immediately
- Contact APS without an IDT discussion first
Correct answer: Collaborate with the IDT to assess risks and develop a safe care plan
Unsafe environments require collaborative IDT problem-solving to maintain patient safety while honoring the patient's preference to remain at home.
CHPN Professional Practice Issues 4
Which standard most directly obligates the hospice nurse to maintain competence in palliative symptom management?