CHPNA Pain and Symptom Management 2 — Questions and Answers
Question 1: Dyspnea in a dying patient is best described as:
- A normal side effect of all medications
- The subjective sensation of difficulty or discomfort in breathing (Correct answer)
- Only occurring in patients with lung disease
- Always accompanied by low oxygen saturation
Correct answer: The subjective sensation of difficulty or discomfort in breathing
Dyspnea is the subjective experience of breathlessness or difficulty breathing and can occur even when oxygen levels appear normal.
Question 2: Which of the following comfort measures can help a patient experiencing dyspnea?
- Placing the patient flat in bed
- Positioning the patient upright and using a fan directed at the face (Correct answer)
- Administering a diuretic medication
- Increasing oral fluid intake
Correct answer: Positioning the patient upright and using a fan directed at the face
Elevating the head of the bed and directing a gentle fan toward the patient's face can reduce the sensation of breathlessness by stimulating receptors in the nasal passage.
Question 3: What is 'death rattle' and how should the nursing assistant respond?
- A type of cardiac arrhythmia; call 911
- Noisy breathing from secretions in the throat; reposition gently and reassure the family (Correct answer)
- A sign of pain; administer pain medication immediately
- Normal snoring; no action needed
Correct answer: Noisy breathing from secretions in the throat; reposition gently and reassure the family
Death rattle refers to the gurgling or rattling sound caused by secretions pooling in the throat of a dying patient; repositioning and family education are appropriate responses.
Question 4: Constipation in hospice patients is most commonly caused by:
- Excessive fluid intake
- Opioid medications, reduced mobility, and decreased intake (Correct answer)
- Antibiotic use
- High-fiber diet
Correct answer: Opioid medications, reduced mobility, and decreased intake
Constipation in hospice patients is commonly caused by opioid-induced slowing of the bowel, reduced physical activity, and decreased food and fluid intake.
Question 5: Which symptom is characterized by a persistent feeling of nausea and inability to eat?
- Anorexia-cachexia syndrome (Correct answer)
- Hyperglycemia
- Hyperthyroidism
- Dehydration alone
Correct answer: Anorexia-cachexia syndrome
Anorexia-cachexia syndrome is common in terminal illness and involves loss of appetite, weight loss, and metabolic changes that reduce the desire and ability to eat.
Question 6: What is the most important action a nursing assistant can take when a patient reports new or worsening symptoms?
- Adjust the patient's medication dosage
- Document the symptom and immediately notify the supervising nurse (Correct answer)
- Wait until the next scheduled visit
- Reassure the patient without reporting
Correct 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.
CHPNA Pain and Symptom Management 2
Dyspnea in a dying patient is best described as: