CHPN : HPCC Certified Hospice and Palliative Nurse Exam

In the management of severe pain, which of the following medications is typically considered the first-line treatment?
A. Nonsteroidal anti-inflammatory drugs (NSAIDs)
B. Opioids
C. Acetaminophen
D. Antidepressants
Answer: B
Explanation: Opioids are typically considered the first-line treatment for severe pain. They are potent analgesic medications that can effectively relieve moderate to severe pain. Opioids work by binding to opioid receptors in the central nervous system, thereby reducing the perception of pain. However, it is important for the hospice nurse to carefully assess and monitor the patient's response to opioids and adjust the dosage as needed to achieve optimal pain relief while minimizing side effects.
Question: 2
Which of the following is an example of neuropathic pain?
A. Bone pain
B. Visceral pain
C. Phantom limb pain
D. Musculoskeletal pain
Answer: C Explanation: Phantom limb pain is a type of neuropathic pain that occurs after the amputation of a limb. It is characterized by pain sensations originating from the amputated limb, even though the limb is no longer present. This type of pain is believed to result from damage to the nerves in the residual limb and the brain's perception of the missing limb. It is important for the hospice nurse to recognize neuropathic pain and provide appropriate interventions to manage and alleviate the patient's symptoms.
Question: 3
Which of the following interventions is an example of a non-pharmacologic approach to pain management?
A. Administering opioids
B. Prescribing antidepressant medication
C. Performing palliative surgery
D. Applying cold packs
Answer: D
Explanation: Applying cold packs is an example of a non-pharmacologic approach to pain management. Non-pharmacologic interventions involve techniques or therapies that do not involve medication administration. Cold packs can help reduce pain and inflammation by numbing the affected area and constricting blood vessels. They can be a useful adjunct to pharmacologic pain management strategies. Hospice nurses should be knowledgeable about various non-pharmacologic interventions toprovide holistic care and address pain using a multimodal approach.
Question: 4
A 67-year-old patient who has end-stage pancreatic cancer reports a progressively decreased ability to perform activities of daily living and A. The symptoms that the patient has reported are not related to the cancer diagnosis
B. The patient will recover from this exacerbation but will not return to the previous level of functioning
C. The patient’s symptoms are consistent with the beginning of a predictable period of decline commonly associated with cancer diagnoses
D. The interdisciplinary team should discuss appetite-enhancing medications and the use of a stimulant to combat fatigue
Answer: C
Explanation: In end-stage pancreatic cancer, a progressively decreased ability to perform activities of daily living and significant weight loss are common indicators of the beginning of a predictable period of decline. These symptoms are related to the cancer diagnosis and signify a decline in the patient's condition. It is important for the hospice nurse to recognize these symptoms and provide appropriate care and support to the patient during this period.
Question: 5
Which of the following is an example of an adjuvant medication used in pain management?
A. Gabapentin
B. Ibuprofen
C. Morphine
D. Fentanyl
Answer: A Explanation: Gabapentin is an example of an adjuvant medication used in pain management. Adjuvant medications are medications that are not primarily intended to treat pain but can enhance the analgesic effect of other pain medications. Gabapentin is commonly used to treat neuropathic pain and can be used in combination with opioids or other analgesics to provide synergistic pain relief. Hospice nurses should be familiar with different adjuvant medications and their indications to optimize pain management for their patients.
Question: 6
Which of the following is an example of a complementary therapy used in palliative care?
A. Palliative surgery
B. Radiation therapy
C. Psychological therapy
D. Acupressure
Answer: D
Explanation: Acupressure is an example of a complementary therapy used in palliative care. Complementary therapies are non-conventional treatments that are used alongside conventional medical care to enhance well-being and alleviate symptoms. Acupressure involves applying pressure to specific points on the body to promote relaxation, relieve pain, and improve overall wellbeing. It can be a valuable addition to the comprehensive care provided by hospice nurses to support patients in managing pain and improving their quality of life.
Question: 7
When titrating medication for pain management, what is the primary goal of A. To identify the maximum safe dosage of the medication
B. To determine the frequency of medication administration
C. To evaluate the patient's tolerance to the medication
D. To establish the minimum effective dosage of the medication
Answer: D
Explanation: The primary goal of determining the baseline and breakthrough doses when titrating medication for pain management is to establish the minimum effective dosage of the medication. This involves finding the lowest dose that provides adequate pain relief without causing excessive side effects. By identifying the minimum effective dosage, the hospice nurse can optimize pain management while minimizing the risk of adverse reactions.
Question: 8
Which of the following factors may influence a patient's experience of pain?
A. Fear
B. All of the above
C. Cultural beliefs
D. Fatigue
Answer: B
Explanation: All of the above factors may influence a patient's experience of pain. Fear, fatigue, and cultural beliefs are just a few examples of the many factors that can impact how a patient perceives and experiences pain. Hospice nurses should consider these factors when assessing and managing pain in order to provide holistic and patient-centered care.
Which of the following is a nonverbal indicator of pain in a non-communicative patient?
A. Reporting location of pain
B. Verbalizing pain intensity
C. Grimacing
D. Pointing to the painful area
Answer: C
Explanation: Grimacing is a nonverbal indicator of pain commonly observed in non-communicative patients who are unable to verbally express their pain. It involves facial expressions such as frowning, tightening of facial muscles, or wincing. Nonverbal indicators of pain are important cues for the hospice nurse to assess and evaluate pain in patients who are unable to communicate verbally, allowing for appropriate pain management interventions to be implemented.

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