Mixed Deck — All CHPNA Topics Flashcards

In hospice care, bereavement support is provided for how long after a patient's death?

Answer: At least 13 months

Medicare-certified hospice programs are required to provide bereavement services to surviving family members for at least 13 months following the patient's death.

Which of the following is appropriate post-mortem care by the nursing assistant?

Answer: Bathing the body, positioning it with dignity, and allowing family time

Post-mortem care includes bathing and positioning the body with dignity and respect, and allowing family members time to say goodbye before the body is removed.

How often should a bedridden hospice patient typically be repositioned to prevent pressure injuries?

Answer: Every 2 hours

Repositioning every 2 hours relieves prolonged pressure on bony prominences and reduces the risk of pressure injuries in immobile patients.

A hospice patient reports that they have made peace with dying. The nursing assistant should:

Answer: Acknowledge this as a positive sign and document or report it to the nurse

Acceptance of dying can be a healthy sign of resolution; the nursing assistant should acknowledge it respectfully and communicate it to the care team.

What should the nursing assistant do if a patient expresses fear about dying?

Answer: Listen compassionately and notify the nurse or social worker for follow-up support

Active, compassionate listening and reporting the patient's emotional concerns to the nurse or social worker ensures the patient receives appropriate psychological and spiritual support.

Hospice care is typically provided to patients who have a prognosis of how long to live?

Answer: 6 months or less

Hospice care in the US is generally available to patients with a terminal diagnosis and a prognosis of 6 months or less if the disease follows its normal course.

Which factor can make communication more challenging in hospice care?

Answer: Cultural differences, language barriers, and altered consciousness

Cultural differences, language barriers, cognitive changes, and altered states of consciousness can all make effective communication more challenging in hospice.

What does 'unconditional positive regard' mean in hospice care?

Answer: Accepting and respecting the patient without judgment regardless of their beliefs or behaviors

Unconditional positive regard means accepting and respecting the patient as a whole person without judgment, which is fundamental to a therapeutic caregiving relationship.

If the nursing assistant suspects patient abuse or neglect, they are legally required to:

Answer: Report it to the supervising nurse and follow mandatory reporting laws

Nursing assistants are mandated reporters and must report suspected abuse or neglect to the supervising nurse and, if required, to state authorities.

What does 'breakthrough pain' mean in palliative care?

Answer: A sudden flare of pain occurring despite baseline pain control

Breakthrough pain is a transient, sudden flare of intense pain that occurs despite a patient being on a scheduled pain medication regimen.

Which of the following is an advance directive?

Answer: A living will or healthcare proxy

Advance directives are legal documents such as living wills or healthcare proxy designations that express a patient's wishes for future medical care.

A family member asks the nursing assistant to share the patient's prognosis. The nursing assistant should:

Answer: Refer the family member to the nurse or physician for clinical questions

Clinical information about prognosis is outside the nursing assistant's scope of practice and should be directed to the nurse or physician.

What is the most important action a nursing assistant can take when a patient reports new or worsening symptoms?

Answer: Document the symptom and immediately notify the supervising nurse

The nursing assistant must document observed or reported symptoms and notify the supervising nurse promptly so that medical interventions can be initiated.

Which action by the nursing assistant best supports patient dignity at end of life?

Answer: Maintaining privacy, speaking respectfully, and honoring personal and cultural preferences

Maintaining privacy, communicating with respect, and honoring personal, cultural, and spiritual preferences are fundamental ways the nursing assistant supports patient dignity.

Which of the following is a physical sign that death may be approaching within hours to days?

Answer: Mottling of the skin, cooling of extremities, and changes in breathing

Mottling (purplish blotchy skin discoloration), cooling of extremities, changes in breathing patterns, and decreased urine output are signs that death is approaching.

Which pain scale uses faces to rate pain level and is commonly used with cognitively impaired patients?

Answer: Wong-Baker FACES Pain Scale

The Wong-Baker FACES Pain Scale uses facial expressions to help patients who cannot verbally rate their pain, making it useful for cognitively impaired or pediatric patients.

Which of the following best describes 'terminal restlessness'?

Answer: Agitation, confusion, and purposeless movements occurring near the end of life

Terminal restlessness (also called terminal agitation) is a state of agitation, confusion, and involuntary movements that can occur in the final hours or days of life.

If a patient says, 'I feel like a burden to my family,' the most therapeutic response is:

Answer: 'Tell me more about how you're feeling.'

Encouraging the patient to share more promotes therapeutic communication, validates their feelings, and allows deeper support of emotional needs.

Which assessment tool is used to evaluate pain in non-verbal or cognitively impaired patients?

Answer: PAINAD (Pain Assessment in Advanced Dementia) Scale

The PAINAD scale assesses pain in patients with advanced dementia by observing breathing, vocalization, facial expression, body language, and consolability.

Which of the following is an appropriate way to support the family during the active dying phase?

Answer: Educate the family about what to expect and encourage them to stay if they wish

Educating family about the dying process and encouraging their presence helps reduce fear and allows them to support their loved one during this critical time.