CHPN Professional Practice Issues 5 — Questions and Answers
Question 1: A hospice nurse is asked to precept a new graduate nurse. Which teaching approach best aligns with adult learning principles?
- Providing detailed lectures covering all policies at once
- Using case-based, problem-centered scenarios relevant to actual patient care (Correct answer)
- Requiring memorization of drug dosing tables first
- Assigning self-study modules without clinical discussion
Correct answer: Using case-based, problem-centered scenarios relevant to actual patient care
Adult learners are problem-centered and motivated by real-world relevance; case-based scenarios are the most effective teaching method.
Question 2: When a hospice patient's goals of care conflict with the IDT's clinical recommendations, the most appropriate response is to:
- Follow IDT recommendations as the clinical experts
- Engage in open, empathic dialogue to understand the patient's values and revise the care plan accordingly (Correct answer)
- Document the conflict and proceed with clinical recommendations
- Discharge the patient for noncompliance
Correct answer: Engage in open, empathic dialogue to understand the patient's values and revise the care plan accordingly
Goals-of-care conversations that explore patient values allow the team to align the care plan with what matters most to the patient.
Question 3: A family member who is the patient's healthcare proxy demands that the nurse withhold the patient's diagnosis from them. The nurse should:
- Comply with the family's request to protect the proxy relationship
- Inform the patient if they have decision-making capacity and wish to know their diagnosis (Correct answer)
- Ask the proxy to submit the request in writing before complying
- Consult only the physician before deciding
Correct answer: Inform the patient if they have decision-making capacity and wish to know their diagnosis
A patient with intact decision-making capacity has the right to full disclosure; a proxy cannot override that right.
Question 4: Which practice best supports a hospice nurse's own resilience and professional longevity?
- Working overtime to ensure all patients are seen
- Engaging in regular self-care practices and seeking peer support (Correct answer)
- Avoiding discussion of difficult patient situations
- Separating entirely from work during personal time with no reflection
Correct answer: Engaging in regular self-care practices and seeking peer support
Self-care practices combined with peer support are evidence-based strategies for building resilience and preventing compassion fatigue.
Question 5: Which statement about the nurse's scope of practice regarding pronouncing death in the home hospice setting is most accurate?
- Nurses may never pronounce death; only physicians can
- Registered nurses may pronounce death in many states when authorized by state law and agency policy (Correct answer)
- Only hospice medical directors can pronounce death
- Death can only be pronounced in the presence of a coroner
Correct answer: Registered nurses may pronounce death in many states when authorized by state law and agency policy
Many states authorize RNs to pronounce expected deaths in hospice and home settings, subject to state law and organizational policy.
Question 6: A nurse notices a pattern of incomplete pain assessments in chart audits. The best quality improvement action is to:
- Retrain only the nurses whose charts were incomplete
- Conduct a root cause analysis and implement system-level improvements (Correct answer)
- Increase supervisory oversight indefinitely
- Add more documentation fields to the electronic record
Correct answer: Conduct a root cause analysis and implement system-level improvements
Root cause analysis identifies the underlying system factors driving the gap, enabling durable improvement rather than individual blame.
Question 7: A hospice nurse participates in a research study reviewing de-identified patient outcomes. Which ethical principle primarily governs this activity?
- Fidelity
- Justice
- Respect for persons and beneficence under research ethics guidelines (Correct answer)
- Veracity
Correct answer: Respect for persons and beneficence under research ethics guidelines
Human subjects research is governed by the principles of respect for persons, beneficence, and justice as outlined in the Belmont Report.
CHPN Professional Practice Issues 5
A hospice nurse is asked to precept a new graduate nurse.
Which teaching approach best aligns with adult learning principles?