Chpn: Quiz About Nurses
The Certified Hospice and Palliative Nurse (CHPN®) examination was designed for experienced hospice and palliative registered nurses. To be eligible for the HPCC CHPN® Examination, an applicant must hold a current, unrestricted registered nurse license in the United States. Take this quiz to know your CHPN Aptitude.
- 1.Grief can BEST be described as changes in feeling and behaviors that occur in response to
- A.
Perceived loss
- B.
Unexpressed anger
- C.
A terminal diagnosis
- D.
Physical and emotional stress
- 2.Six weeks after admission to hspice, an elderly wife is no longer able to care for her husband. They have no relatives. Neighbors are helpful, but also elderly. The couple wants to remain at home. Which of the following should the nurse recommend?
- A.
A social work referral
- B.
Nursing home placement
- C.
Daily home health aid visits
- D.
Volunteer visits 3 times a day
- 3.Early assessment and diagnosis of spinal cord compression is important because
- A.
Advanced pain management techniques can be initiated before the pain worsens.
- B.
Is it ually the cause of death that could be delayed by timely treatment.
- C.
Permanent neurological dysfunction, includes paralysis, will result if untreated.
- D.
Physical therpay can be instituted to help prevent loss of strength in the lower extremities.
- 4.The spouse of a patient who is terminally ill calls to report that her husband has become very confused. He is going through his closet and packing a suitcase for a trip. The nurse should explain to the wife that
- A.
She should administer a sedative to help him relax.
- B.
She should convience him that his trip has been cancelled.
- C.
Similiar behavior have been noted in patients approaching death.
- D.
Her husband has become agitated due to his opioid therapy.
- 5.A patients physcian has ordered a placebo by injection on a routine basis. The nurse should
- A.
Decline to adminster a placebo.
- B.
Teach the family to administer the placebo.
- C.
Assess the patients response to the placebo.
- D.
Recognize that psychological pain is often relieved by placebos.
- 6.A patient with AIDS is referred to the hospice program and is taking a combination antietroviral agents. Which of the following is MOST important to consider when proceeding with evaluation for the hospice program?
- A.
Antiretrovial agents are an appropriate palliative therapy until the patient dies.
- B.
A patient is admitted to hospice only when antireviral agents have been discontinued.
- C.
Antirevirals agents are not covered under the Medicare Hospice or Medicaid benefits.
- D.
A discussion of treatment goals with the attending physicain and the patient/family is recommended prior to admission.
- 7.A patient receiving sustained-release morphine has required 6 doses of immediate release morphine in 24 hours for breakthrough pain. If the physician questions the need to increase the baseline sustained-relase morphine, the nurses BEST response would be to discuss
- A.
Cost-effectiveness.
- B.
Erasing pain memory.
- C.
Ease of therapy delivery.
- D.
Elevating the pain threshold.
- 8.A patient has decided to stop dialysis and enter a hospice program. Which of the following symptoms should the nurse be prepared to manage in this patient?
- A.
Hiccoughs, pain, and arrhythmias.
- B.
Nausea, dry mouth, and pruitus.
- C.
Constipation, fever, and seizures.
- D.
Hypotension, ascites, and confusion
- 9.When initiating around the clock opioids, the nurse should instruct the patient and family that the sedative effect usually last
- A.
A few days
- B.
A few weeks
- C.
Several hours
- D.
Throughout the course of treatment
- 10.According to the NHPCO standards for hospice program of care, every hospice team member should address work-related grief and loss issues by
- A.
Attending support groups.
- B.
Recieving counseling services.
- C.
Having access to emotional support.
- D.
Participating in debriefing sessions.
- 11.A 51 year old home care patient has end stage alcoholic cirrhosis. He has a history of physical and emotional abuse towards his wife and daughters. He is receving 360 mg of sustained release morphine every 12 hours with 100 mg of immediate-release morphine every hr prn. He consistently rates his pain as an 8/10. After adjusting the pain medications, which of the following would be the most appropriate action?
- A.
Obtain an order for an anxiety medication.
- B.
Discuss placement in a long-term care facility.
- C.
Consider a plan to address unresolved relationship issues.
- D.
Arrage for a volunteer to provide respite care for the wife.
- 12.A nurse notices a group of unilateral vesicular eruptions with a dermatomal distribution on a patient's back. Which of the following should be suspected?
- A.
Hives
- B.
Herpes zoster
- C.
Contact dermatitis
- D.
Herpes simplex
- 13.A patient with end stage congestive heart failure has been referred to hospice by his family practice physician. Which of the following is the MOST important information needed to evaluate medical appropriateness for the hospice program?
- A.
Oxygen use, medication history, mental status
- B.
Dobutamine therapy, history of cor pulmonale, chest x ray
- C.
Ejection fraction, recent hospitalizations, performance status
- D.
Nutritional status, desire for hospice program, Karnofsky score
- 14.A steriod can be prescribed for an anorexic patient who complains of weakness and lack of energy in order to
- A.
Increase strength.
- B.
Treat underlying infection.
- C.
Address electrolyte imbalance
- D.
Induce a feeling of well-being.
- 15.A hospice patient in a nursing home has refused intravenous and tube feedings in the past and has indicated her wishes in an advance directive, The patients condition has deteriorated and intake is minimal. The nursing home staff is concerned the patient will starve to death and request nasogastric tueb feedings. Which of the following is the BEST action for the nurse?
- A.
Request an ethics consult.
- B.
Share the staffs concern with the patient and family.
- C.
Consider a time-limited trial of nasogastric feedings,
- D.
Plan a team meeting with the nursing home and hospice staff.
- 16.What ethical principle is involved when the family members of a recently diagnosed patient with pancreatic cancer request the patient not be told of the diagnosis or prognosis?
- A.
Veracity
- B.
Justice
- C.
Malefience
- D.
Confidentiality
- 17.Chronic disseminated intravascular coagulopathy may be exhibited in
- A.
Renal failure.
- B.
Cardiomyopathy.
- C.
Huntington's disease.
- D.
Metastatic malignancy.
- 18.Which of the following is the primary purpose of the Word Health Organization Analgesic Ladder for Cancer Pain Management?
- A.
Define steps for legalization of drugs.
- B.
Specify acceptable standards for drug dosage.
- C.
Describe interrelationships among different drugs.
- D.
Identify categories of drugs to be use progressively.
- 19.Which of the following needs to be present for a group to be cohesive?
- A.
Shared focus
- B.
Ongoing relationships
- C.
Similar cultural background
- D.
Comparable levels of education
- 20.A patient has metastatic lung cancer, cord compression, and a venous access device. The patient experiences tachycardia, mental status changes, rigors, and warm dry skin. These are early signs of
- A.
Thrombosis.
- B.
Dehydration.
- C.
Septic shock.
- D.
Superior vena cava syndrome.
- 21.Which of the following is essential in responding to a patients spiritual needs?
- A.
Being available to pray with the patient.
- B.
Obtaining permission to contact the patient's clergy.
- C.
Sharing ones own spiritual beliefs with the patient.
- D.
Discerning when physical symptoms are indicative of spiritual concerns.
- 22.A 79 year old man with a history of CVA and multiple TIA's has been able to live indepensently with assistance from his family. He is hospitalized after being found walking a mile from his home, frightened and crying. He is oriented only to person. Key factor is differentiating delirium from dementia in the patient would be
- A.
Mood lability.
- B.
Diminished cognitive/intellectual abilities.
- C.
Rapid versus slow onset of confusion.
- D.
Short tem memory loss.
- 23.Which of the following is usually the final physical debilitation exhibited by a patient with amyotrophic lateral sclerosis?
- A.
Sepsis
- B.
Dysphagia
- C.
Respiratory failure
- D.
Cerebral hemorrhage
- 24.A 39 year old father is dying and his wife is caring for him. His two young children are not allowed in his room. How should the interdisciplinary team proceed INITIALLY?
- A.
Discuss with the parents their reasons for the childrens exclusion.
- B.
Respect the parents wishes and refer the children to a grief group.
- C.
Arrange for spiritual and social work counseling for the family.
- D.
Have a volunteer stay with the children for a few hours.
- 25.A patient with a history of ovarian cancer presents to the palliative care clinic with lower extremity swelling that started 3 days ago. The patient reports that the limb feels heavy and aches constantly. Which of the following actions should the nurse take?
- A.
Obtain an order for anti-embolitic stockings
- B.
Assess for signs and symptoms of thrombosis.
- C.
Instruct the patient to curtail her activity until the swelling improves.
- D.
Ascertain that the patient has an opiod analgesic avilable for pain management.
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