Certified Hospice & Palliative Nurse (CHPN) Exam

A 51-year-old hospice patient with metastatic breast cancer is experiencing severe pain in association with daily dressing changes of an ulcerating malignant skin wound. These pain episodes are consistent with:

A 57-year-old patient with end-stage heart failure expresses sadness that she can no longer volunteer in church because of the progression of her disease. The hospice nurse should do which of the following?

The palliative care advanced practice nurse should be proficient in all of the following EXCEPT:

Typical features of late-stage dementia include all of the following EXCEPT:

A 62-year-old hospice patient with lung cancer develops shortness of breath and facial swelling. The hospice nurse notes distended neck veins. The most likely explanation for these findings is:

You are the nurse on-call and receive a call from a continuous care nurse who states that her patient has started to have "rattling" secretions and the patient's wife is very concerned. You know from report that this patient is imminent. What would be the most appropriate response?

Mary is a 73-year-old patient with a 50-year history of smoking. She is very thin with a barrel chest, dyspnea and supraclavicular retractions upon exertion. What level of oxygen may be most effective for Mary?

Which of the following most accurately describes "breakthrough" pain?

Madge is an 88 year-old with end stage colon cancer, who is imminently dying. She has been unresponsive for the past six hours, but is restless at times with furrowing of her brow. She is still swallowing her secretions, and sucks on the oral sponge when mouth care is provided. Prior to her change in status, she was receiving Oxycontin 40 mg po q12 hr ATC with Oxydose 8-12 mg po q2hrs prn for breakthrough pain. In light of Madge's change in level of consciousness, what changes should be made to her pain management regimen?

Of the following, which may indicate a poor prognosis for the hospice patient with a diagnosis of end-stage cardiac disease?