CHPN Trivia 3 — Questions and Answers
Question 1: Which hospice level of care is specifically designed for a patient experiencing a short-term acute symptom crisis that cannot be managed at home?
- Routine home care
- Continuous home care
- General inpatient care (Correct answer)
- Respite care
Correct answer: General inpatient care
General inpatient care (GIP) provides short-term acute symptom management in a hospital or inpatient hospice facility.
Question 2: The CHPN credential is awarded by which certifying body?
- NHPCO
- HPNA (Hospice and Palliative Nurses Association)
- NBCHPN (National Board for Certification of Hospice and Palliative Nurses) (Correct answer)
- ANCC
Correct answer: NBCHPN (National Board for Certification of Hospice and Palliative Nurses)
The National Board for Certification of Hospice and Palliative Nurses (NBCHPN) administers the CHPN exam.
Question 3: Equianalgesic dosing charts are used in hospice primarily to:
- Calculate insurance reimbursement for opioids
- Convert between different opioids or routes while maintaining equivalent pain control (Correct answer)
- Determine maximum daily opioid doses allowed by law
- Schedule DEA compliance audits
Correct answer: Convert between different opioids or routes while maintaining equivalent pain control
Equianalgesic charts allow safe opioid rotation or route changes by providing dose equivalencies between agents.
Question 4: Which document specifically designates a surrogate decision-maker for healthcare decisions when a patient lacks capacity?
- Living will
- DNR order
- Durable power of attorney for healthcare (Correct answer)
- POLST form
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare (healthcare proxy) legally designates another person to make medical decisions.
Question 5: In the Kübler-Ross model, which stage involves the patient bargaining with God or fate to delay death?
- Anger
- Depression
- Bargaining (Correct answer)
- Acceptance
Correct answer: Bargaining
The bargaining stage involves attempts to negotiate — often with a higher power — for more time or a different outcome.
Question 6: Which opioid is CONTRAINDICATED in patients with renal failure due to toxic metabolite accumulation?
- Oxycodone
- Hydromorphone
- Meperidine (Correct answer)
- Fentanyl
Correct answer: Meperidine
Meperidine accumulates normeperidine in renal failure, causing CNS toxicity including seizures.
Question 7: The phrase 'total pain,' coined by Dame Cicely Saunders, refers to:
- Pain rated 10/10 on a numeric scale
- The physical, psychological, social, and spiritual dimensions of suffering (Correct answer)
- Refractory pain unresponsive to opioids
- Pain requiring continuous IV infusion
Correct answer: The physical, psychological, social, and spiritual dimensions of suffering
Saunders' concept of total pain recognizes that suffering encompasses physical, emotional, social, and spiritual components.