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.
A search fpr meaning and purpose in life is a common experience for dying patients and their families.
Dying patients and their families are too consumed with financial problems ever to think about spiritual concerns.
Dying patients and their families have little fear because hospice takes care of everything.
The same care plan can be used for all families because their needs are the same.
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Monitoring the disease process
Prolonging life
Comfort of the patient
Improvement of abnormal blood work
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Include what is meaningful or frightening to the patient
Always be done by the hospice Chaplin
Fully descirbes the rules of the church the patient attends
Never be discussed on the first visit
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Is dangerous because it reduces respirations
Is totally inappropriate because it will lead to addiction
Reduces tachypnea and overventilation, making breathing more efficient
Is a bad choice because it will gradually need to be increased
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Obtain an order for anti-embolitic stockings
Assess for signs and symptoms of thrombosis.
Instruct the patient to curtail her activity until the swelling improves.
Ascertain that the patient has an opiod analgesic avilable for pain management.
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Wait to see if the condition changes
Discharge the patient to a nursing home.
Evaluate the patient for present care needs.
Discharge the patient to a home care agency.
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The patient is a stubborn unrealistic person.
Denial is a method of coping, which the patient needs at this time.
It is your job to insist that the patient verbalize the truth.
Everyone with terminal illness goes through denial, and reality will set in as the condition worsens.
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Shared focus
Ongoing relationships
Similar cultural background
Comparable levels of education
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Site assessment, muscle and sensory assessment
Glascow coma scale, capillary refill
Urine output
Mini mental status exam
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As well defined and with specific boundaries
To be carried out totally independent of other disciplines
As reflecting unique expertise that is integreated into a coordinated team approach
As one to be performed without personal involvement or emotional attachment.
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Adding an antidepressant will increase her energy level.
She needs to conserve her energy for those activities that she feels are most important.
Controlling her pain will provide more energy and will keep her awake during the day.
Improving her appetite and oral intake can increase her energy level.
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"I visit his grave site every Sunday."
" I'm just no good to anyone any more."
"It's hard to cook for just one person."
"Sometimes I feel so angry at my husband."
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Ataxic breathing.
Paradoxical breathing.
Cheyne-Stokes breathing.
Kussmaul-Kien respirations.
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Neurptoxicity- peripheral neuropathies, constipation
Nephrotoxicity- blood in urine, renal failure
Gastrointestinal symptoms- nausea, vomiting, diarrhea
Cardiotoxicity- loss of cardiac muscle tone, congestive heart failure
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Sepsis
Dysphagia
Respiratory failure
Cerebral hemorrhage
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Function autonomously as an interdisciplinary team member.
Foster close realationships with patients and families.
Work within defined practice guidelines.
Make decisions for patients when they are no longer capable.
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Hives
Herpes zoster
Contact dermatitis
Herpes simplex
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Request an ethics consult.
Share the staffs concern with the patient and family.
Consider a time-limited trial of nasogastric feedings,
Plan a team meeting with the nursing home and hospice staff.
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Extra cylinders should be stored in a closet.
Humidification is necessary with a cylinder system.
A lower air flow should be used with a cylinder system.
The guaged cylinders should be stabilized in an upright position.
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Fever, tachycarida
Symptoms may be masked by corticosteroids
Always present in elderly patients
Can be affected by chemo and disease process
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Perceived loss
Unexpressed anger
A terminal diagnosis
Physical and emotional stress
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A legal next of kin?
A healthcare surrogate?
An executor of the estate?
A preferred hospice provider?
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Mood lability.
Diminished cognitive/intellectual abilities.
Rapid versus slow onset of confusion.
Short tem memory loss.
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HIV
Infections
Acute injury
Diabetes
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Antiretroviral agents are an appropriate palliative therapy until the patient dies.
A patient is admitted to hospice only when antiretroviral agents have been discontinued.
Antiretroviral agents are not covered under the Medicare Hospice or Medicaid benefits.
A discussion of treatment goals with the attending physician and the patient/family is recommended prior to admission.
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Oxygen use, medication history, mental status
Dobutamine therapy, history of cor pulmonale, chest x ray
Ejection fraction, recent hospitalizations, performance status
Nutritional status, desire for hospice program, Karnofsky score
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They are stoic in the face of pain or bad news and are openly verbal about their illness and problems.
They believe in reincarnation but that they are powerful to influence what form their life will take.
Personal feelings, decisions, and interactions are kept within the family, and females having the dominant role
They believe illness is an imbalance of disharmony within self, or as the self interacts with environment and they honor centuries- old methods of restoring balance.
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Furosemide
Paracentesis
Nasogastric tube
Hydrochlorothiazide
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6 months
12 to 13 months
18 to 24 months
36 months
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Assess hydration status and consider nutritional supplements.
Obtain an order for an antiemetic and pain medication.
Perform a digital rectal examination and an abdominal assessment.
Obtain an order for serum electrolytes adn stimulant laxative.
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Pseudomonas
PCP (pneumocystis carini pneumonia)
Tuberculosis
Disseminated CMV (cytomegalovirus)
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Is provided in accordance with the religion of the hospice chaplain
Is provided only by a hospice staff member
Is provided to every single patient and family admitted to hospice care
Identifies and strives to relieve the spiritual suffering of the patient and family
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Maintain hope for remission.
Promote improved immune responses.
Decrease side effects of treatments.
Reduce tumor mass to relieve symptoms.
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An expression of anger
A demonstration of depression
An attempt to conserve time and energy
An indirect request for support and attention
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Neuropathic
Somatic
Referred
Visceral
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Sensitivity to pain decreases with age.
Altered pain perception is present.
There is a tendency to overestimate the pain.
Polypharmacy may interfere with medication adherence.
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Ondansetron
Phenytoin
Megesterol
Chlorpromazine
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Of lack of trust in health care providers
Doing so will show disrespect for the deceased
If the body is left alone, the spirit may become angered and seek revenge
None of the above
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Discuss with the parents their reasons for the childrens exclusion.
Respect the parents wishes and refer the children to a grief group.
Arrange for spiritual and social work counseling for the family.
Have a volunteer stay with the children for a few hours.
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Review previous studies.
Submit a research grant proposal.
Obtain physician approval.
Write an informed consent document.
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Advanced pain management techniques can be initiated before the pain worsens.
Is it ually the cause of death that could be delayed by timely treatment.
Permanent neurological dysfunction, includes paralysis, will result if untreated.
Physical therpay can be instituted to help prevent loss of strength in the lower extremities.
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She should administer a sedative to help him relax.
She should convience him that his trip has been cancelled.
Similiar behavior have been noted in patients approaching death.
Her husband has become agitated due to his opioid therapy.
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Adding a corticosteroid
Decreasing the dose of phenytoin
Increasing the dose of phenytoin
Changing the dosing interval of phenytoin
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A social work referral
Nursing home placement
Daily home health aide visits
Volunteer visits 3 times a day
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Deep muscle massage
Compression stockings
Relaxation techniques
Passive range of motion
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When did he last urinate?
Does he say anything you can understand?
Is there anyone to whom he needs to say goodbye?
Has a spiritual advisor been to see him lately?
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Attending support groups.
Recieving counseling services.
Having access to emotional support.
Participating in debriefing sessions.
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Sharp, stabbing, and increasing with movement.
Aching, throbbing, and worsening upon movement.
Burning, localized and not affected by movement.
Cramping, generalized, and relieved with movement.
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