CHPN - Certified Hospice and Palliative Nurse Non-Pain Symptom Management Questions and Answers

Question 1

A hospice patient with advanced lung cancer is experiencing severe dyspnea and anxiety.
The patient is already on a stable dose of long-acting morphine for pain.
Which of the following interventions is the MOST appropriate initial approach to manage this acute episode of dyspnea?

Accepted Answer

Administering a breakthrough dose of a low-dose, short-acting opioid like morphine.

Answer

Administering a dose of nebulized saline.

Answer

Increasing the patient's supplemental oxygen to 10 L/min via non-rebreather mask.

Answer

Administering a stat dose of a benzodiazepine such as lorazepam.

Question 2

A nurse is caring for an imminently dying patient who has developed a loud, gurgling sound with breathing, commonly known as a 'death rattle.' The family is very distressed by the sound. Which non-pharmacological intervention should the nurse implement FIRST?

Accepted Answer

Reposition the patient on their side or elevate their head.

Answer

Perform deep tracheal suctioning to clear the secretions.

Answer

Administer a stat dose of atropine drops sublingually.

Answer

Withhold all oral fluids immediately.

Question 3

A patient with end-stage pancreatic cancer is experiencing anorexia and significant weight loss (cachexia). The physician is considering pharmacological interventions to stimulate appetite. Which of the following medications has been shown to be effective for this purpose but also carries a significant risk of venous thromboembolism?

Accepted Answer

Megestrol acetate

Answer

Olanzapine

Answer

Dexamethasone

Answer

Dronabinol

Question 4

Which of the following is the MOST appropriate first-line pharmacological agent for managing delirium and agitation in a terminal patient who is unable to swallow oral medications?

Accepted Answer

Haloperidol

Answer

Lorazepam

Answer

Phenobarbital

Answer

Propofol

Question 5

A hospice nurse is developing a plan of care for a patient experiencing significant anxiety related to their prognosis. Which non-pharmacological intervention is a key component of managing anxiety in hospice patients?

Accepted Answer

Utilizing active listening and providing a supportive presence.

Answer

Encouraging the patient to avoid discussing their fears.

Answer

Providing structured and rigid daily schedules.

Answer

Recommending strenuous physical exercise.

Question 6

A patient with advanced heart failure reports persistent, bothersome nausea without vomiting. The patient describes a constant feeling of fullness and bloating. Which prokinetic agent would be a logical choice to manage these specific symptoms?

Accepted Answer

Metoclopramide

Answer

Ondansetron

Answer

Scopolamine

Answer

Lorazepam