CHPN CHPN - Certified Hospice and Palliative Nurse Medications and Pharmacology

Question 1

What is the recommended first-line opioid for moderate-to-severe pain management in hospice patients with normal renal function?

Accepted Answer

Morphine sulfate

Answer

Meperidine (Demerol)

Answer

Codeine

Answer

Tramadol

Question 2

A hospice patient receiving oral morphine 15 mg every 4 hours is being converted to an equianalgesic IV dose. What is the correct IV morphine equivalent?

Accepted Answer

5 mg IV

Answer

15 mg IV

Answer

10 mg IV

Answer

7.5 mg IV

Question 3

Which medication is most commonly used in hospice to reduce excessive respiratory secretions (death rattle)?

Accepted Answer

Glycopyrrolate (Robinul)

Answer

Haloperidol

Answer

Lorazepam

Answer

Dexamethasone

Question 4

A patient on a fentanyl transdermal patch requires breakthrough pain dosing. The appropriate breakthrough dose is calculated as what percentage of the 24-hour opioid total?

Accepted Answer

5–15%

Answer

1–2%

Answer

25–30%

Answer

50%

Question 5

Which adverse effect of opioids does NOT develop tolerance over time and requires ongoing management throughout therapy?

Accepted Answer

Constipation

Answer

Sedation

Answer

Nausea

Answer

Respiratory depression

Question 6

A hospice patient is prescribed lorazepam 0.5 mg sublingual every 4 hours PRN for anxiety. Which finding would prompt the nurse to hold this medication?

Accepted Answer

Respiratory rate of 8 breaths per minute and oxygen saturation of 85%

Answer

Respiratory rate of 18 breaths per minute

Answer

Blood pressure of 100/60 mmHg

Answer

Complaint of dry mouth