FREE Hospice and Palliative Nurse Questions and Answers

Question 1

What traits are connected to Alzheimer's disease?

Accepted Answer

Pre-clinical and symptomatic phases

Answer

One kind of dementia called Alzheimer's disease has a known pre-clinical stage during which pathophysiologic alterations start to take place. This stage is followed by a symptomatic stage during which cognitive and functional deterioration becomes apparent. Only Lewy body dementia is linked to lewy body deposits in the brain. The rate of dementia progression is frequently influenced by underlying variables, while some data points to a faster rate of advancement in Alzheimer's patients with early start. The most typical symptoms are discomfort, constipation, and behavioral abnormalities; irreversible organ failure is not one of these symptoms.

Question 2

You are the nurse on call when a continuous care nurse calls to inform you that her patient's wife is quite worried since her patient has started to have "rattling" secretions. You are aware that the patient is actually dying because of the report. What would be the best course of action?

Accepted Answer

Reposition patient on his side

Answer

The term "terminal secretions" refers to the noisy, congested breathing that occurs frequently as a person is dying; this breathing is also referred to as the "death rattle". They typically do not bother the patient, but they can be extremely upsetting to family members. To reduce the noise caused by this condition, the patient can be repositioned by being turned on his side. Anticholinergics can also be provided, however their effectiveness is often constrained once the secretions begin.

Question 3

What traits are most frequently linked to end-stage renal disease?

Accepted Answer

10% or less of normal renal function exists; consequence of diabetes

Answer

Diagnosis of end-stage renal disease (ESRD), which frequently results from diabetes or hypertension, occurs when there is less than 10% of normal renal function. Alcohol abuse or comorbidities like starvation or peripheral vascular disease may be present, but they are not the main causes of the condition. Dialysis and kidney transplantation are both options for treatment. African Americans are more commonly impacted by ESRD than Hispanic ones. Oliguria rather than polyuria is a sign of ESRD.

Question 4

Doris is a 73-year-old patient who has been diagnosed with emphysema and has smoked for 50 years. She has a barrel chest, is quite slender, and occasionally experiences both resting and exertional dyspnea as well as supraclavicular retractions. What non-pharmacologic treatment would most likely help this patient's dyspnea?

Accepted Answer

Positioning in the tripod position

Answer

Due to the extended tension-state of the diaphragm in this position, patients with emphysema may get some relief from dyspnea by leaning forward while sitting and crossing their arms over a table (the "tripod position"). Lowering the head of the bed would probably make dyspnea worse; pursed mouth breathing would be more helpful in reducing dyspnea than deep nose breathing; and although guided imagery may elevate mood, there is no proof that it directly affects dyspnea.

Question 5

Mason is a brand-new heart failure hospice patient. Mason claims to have put on six pounds since being released from the hospital three days ago. Mason reports feeling sick to his stomach and having a bad appetite, and the nurse observes that he has dependent peripheral edema 2+. What is the pathogenesis of Mason's heart disease in light of these findings?

Accepted Answer

Diastolic dysfunction, with poor ventricle filling

Answer

Mason suffers from right-sided (diastolic) heart failure, which causes a widespread edema of the limbs and the hepatic system as a result of inadequate ventricular filling. Nausea, anorexia, peripheral edema, ascites, weakness, and weight gain are signs of right-sided failure. Left-sided heart failure is indicated by poor cardiac output, a reduced ejection fraction, and organ perfusion failure.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

FREE Hospice and Palliative Nurse Questions and Answers