CHPN Trivia 5 — Questions and Answers
Question 1: Which of the following best describes the primary goal of hospice care as distinguished from curative care?
- Prolonging life by all available means
- Achieving comfort and quality of life when cure is no longer the goal (Correct answer)
- Providing aggressive chemotherapy to slow disease progression
- Transferring patients to skilled nursing facilities for rehabilitation
Correct answer: Achieving comfort and quality of life when cure is no longer the goal
Hospice focuses on comfort, dignity, and quality of life rather than curative or life-prolonging interventions.
Question 2: St. Christopher's Hospice, the world's first modern hospice, was founded in which city?
- New York City, USA
- Toronto, Canada
- London, England (Correct answer)
- Dublin, Ireland
Correct answer: London, England
Dame Cicely Saunders opened St. Christopher's Hospice in London in 1967, establishing the modern hospice model.
Question 3: A POLST (Physician Orders for Life-Sustaining Treatment) form differs from a standard advance directive primarily because it:
- Can be completed by any adult regardless of health status
- Is a legal medical order immediately actionable by emergency responders (Correct answer)
- Requires a notary for legal validity
- Covers financial and property decisions
Correct answer: Is a legal medical order immediately actionable by emergency responders
A POLST is a portable medical order signed by a physician that EMS and healthcare staff can act on immediately, unlike a directive that must be interpreted.
Question 4: Which opioid side effect does NOT develop tolerance with continued opioid use?
- Nausea
- Sedation
- Constipation (Correct answer)
- Pruritus
Correct answer: Constipation
Constipation persists throughout opioid therapy because tolerance does not develop to opioid effects on gut motility.
Question 5: Which interdisciplinary team member is primarily responsible for assessing and addressing existential distress and spiritual needs in hospice?
- Social worker
- Chaplain or spiritual care provider (Correct answer)
- Hospice physician
- Bereavement coordinator
Correct answer: Chaplain or spiritual care provider
Chaplains and spiritual care providers are the primary team members trained to address spiritual and existential suffering.
Question 6: Mottling of the skin (livedo reticularis) in a dying patient indicates:
- Septicemia requiring immediate antibiotic therapy
- Peripheral circulatory failure as death approaches (Correct answer)
- Allergic drug reaction to opioids
- Deep vein thrombosis
Correct answer: Peripheral circulatory failure as death approaches
Mottling reflects poor peripheral perfusion and pooling of blood in superficial vessels, a common sign of imminent death.
Question 7: Which scale is most appropriate for assessing pain in a non-verbal hospice patient with advanced dementia?
- Numeric Rating Scale (NRS 0–10)
- Visual Analog Scale (VAS)
- PAINAD (Pain Assessment in Advanced Dementia) (Correct answer)
- McGill Pain Questionnaire
Correct answer: PAINAD (Pain Assessment in Advanced Dementia)
The PAINAD scale uses behavioral observations (breathing, vocalization, facial expression, body language, consolability) to estimate pain in non-verbal dementia patients.
CHPN Trivia 5
Which of the following best describes the primary goal of hospice care as distinguished from curative care?