FREE Certified Hospice and Palliative Nurse Questions and Answers

Question 1

Which patient is most likely to not receive adequate care for their pain symptoms?

Accepted Answer

86-year old female with COPD, living in an assisted living facility

Answer

Contrary to popular belief, under-treatment of pain is more likely to occur in older people, people of color, and women than in younger individuals with fewer co-morbidities. The 86-year-old possesses two of the three risk variables for each of the four case studies.

Question 2

What other medications must to be taken along with any opioid regimen?

Accepted Answer

Senna

Answer

Any patient using an opioid should also be prescribed a prophylactic bowel regimen to avoid or treat constipation, as it is one of the major side effects of opioid therapy. Senna is a laxative stimulant that increases bowel movement by chemically stimulating the gut. Diphenhydramine is an antihistamine used to treat opioid-induced pruritus, ondansetron HCl is a 5-HT3 receptor antagonist used to prevent nausea and vomiting, and pamidronate is a bisphosphonate used as an adjuvant to opioids for bone pain.

Question 3

Draco uses a short-acting prn opioid for breakthrough pain in addition to taking continuous-release morphine every 12 hours for pain management. At 9–10 hours, he is having end-of-dose failure. What would be the best course of action to treat Draco's discomfort?

Accepted Answer

The dosing interval of the continuous-release morphine should be decreased to every 8 hours, at the same dose, with no change in the prn dosing

Answer

End-of-dose failure in Draco means that the blood levels of the medication are dropping in the final hours of the dosage cycle before the body absorbs the next dose as planned. Breakthrough pain, which is defined by an episode of agony despite control of ongoing baseline pain, is not the same as this. Jordan will have more consistent drug blood levels thanks to a shorter round-the-close drug interval. A short-acting bolus immediately before the next dosing cycle would only be produced by increasing the prn dose, and this could result in drowsiness and other adverse effects. It is not required to transition to another opioid because this is often done because of a negative side effect. In the last hours of the dosing cycle, a corticosteroid would not produce the desired pain control outcome.

Question 4

Which of the following could point to a bad prognosis for a hospice patient with an end-stage cardiac condition?

Accepted Answer

Unexplained syncope

Answer

Indicators of a poor prognosis in this patient population include unexplained syncope, prior cardiac arrest with resuscitation, and an embolic stroke originating from the cardiac system.

Question 5

Which of the following is a crucial component of supporting the patient's care needs when a hospice patient is dealing with growing weakness, exhaustion, and decreasing mobility?

Accepted Answer

Prioritizing energy use

Answer

Supporting the hospice patient who is progressively weaker and more exhausted requires prioritizing energy consumption. Giving the patient the tools to prioritize their physical, emotional, and spiritual needs will enable them to focus their limited resources on the areas that are most important to them.

CHPN Exam Practice Test

CHPN Exam Practice Test

FREE Certified Hospice and Palliative Nurse Questions and Answers