CHPN — Certified Hospice and Palliative
Nurse, WITH CORRECT ACTUAL QUESTIONS
AND CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+ (2025/2026)
Pain & Symptom Management
1. A hospice patient with end-stage COPD is anxious and reports severe
breathlessness at rest. After positioning the patient upright, what is the
priority pharmacological intervention?
A) Albuterol nebulizer.
B) Oral lorazepam.
C) Oxygen therapy at 2 L/min.
D) Sublingual morphine.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: D**
**Rationale:** Low-dose opioids, especially morphine, are the gold
standard for managing dyspnea in palliative care as they reduce the
perception of breathlessness and decrease respiratory drive[reference:3].
</details>
2. A patient with metastatic breast cancer has new-onset confusion,
nausea, constipation, and polyuria. Which electrolyte imbalance is most
likely?
A) Hypokalemia.
,B) Hypernatremia.
C) Hypercalcemia.
D) Hypophosphatemia.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: C**
**Rationale:** Hypercalcemia is common in breast, lung, lymphoma,
and multiple myeloma[reference:4] and presents with neurological and
gastrointestinal symptoms (nausea, vomiting, confusion, constipation,
fatigue, weakness, and polydipsia)[reference:5]. </details>
3. A patient describes a "sharp, burning, electric shock-like" pain in their
feet from chemotherapy-induced peripheral neuropathy. This description
is characteristic of which type of pain?
A) Somatic.
B) Visceral.
C) Neuropathic.
D) Nociceptive.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: C**
**Rationale:** Neuropathic pain is caused by nerve injury, often
described as burning, shooting, tingling, or shock-like[reference:6].
Somatic pain is well-localized and described as achy or throbbing.
Visceral pain is cramping or pressure-like[reference:7]. </details>
4. A hospice patient has a stage IV sacral pressure injury with a foul odor.
The wound culture is positive for anaerobic bacteria. Which topical agent
is most effective for odor control?
A) Silver sulfadiazine.
B) Topical metronidazole.
,C) Povidone-iodine.
D) Dakin's solution.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: B**
**Rationale:** Topical metronidazole is effective in treating foul odor
caused by anaerobic bacterial colonization, a common cause of wound
malodor[reference:8]. </details>
5. A patient with spinal cord compression reports back pain that is worse
when lying flat and improves when sitting up. This classic finding is due to:
A) Increased intrathecal pressure when supine.
B) Stretching of the dura mater.
C) Venous engorgement of the epidural space.
D) Movement of the tumor when recumbent.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: A**
**Rationale:** In malignant spinal cord compression, lying flat increases
pressure within the spinal canal, worsening pain[reference:9]. This is an
oncologic emergency requiring immediate evaluation. </details>
6. A patient on a morphine PCA for cancer pain becomes difficult to
arouse and has a respiratory rate of 8 breaths/min. After calling for help,
which medication should the nurse prepare to administer?
A) Naloxone.
B) Flumazenil.
C) Naltrexone.
D) Epinephrine.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: A**
**Rationale:** Naloxone is the antidote for opioid-induced respiratory
, depression. It should be titrated carefully to reverse respiratory
depression without fully reversing analgesia, which can cause severe pain
and withdrawal. </details>
7. An end-stage renal disease patient on hospice has refractory nausea
from uremia. Which antiemetic is most effective for uremic nausea?
A) Ondansetron.
B) Metoclopramide.
C) Haloperidol.
D) Prochlorperazine.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: C**
**Rationale:** Haloperidol is an effective antiemetic for metabolic
causes of nausea, such as uremia and hypercalcemia. It also provides
mild sedation. </details>
8. A hospice patient with advanced dementia is agitated and pulling at
their clothing each evening. Non-pharmacologic interventions have failed.
Which medication is most appropriate first-line for managing terminal
agitation in dementia?
A) Haloperidol.
B) Lorazepam.
C) Morphine.
D) Trazodone.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: A**
**Rationale:** Low-dose haloperidol is often first-line for managing
agitation and psychosis in dementia when behavioral interventions fail,
due to a lower risk of paradoxical reactions compared to
benzodiazepines. </details>
Nurse, WITH CORRECT ACTUAL QUESTIONS
AND CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+ (2025/2026)
Pain & Symptom Management
1. A hospice patient with end-stage COPD is anxious and reports severe
breathlessness at rest. After positioning the patient upright, what is the
priority pharmacological intervention?
A) Albuterol nebulizer.
B) Oral lorazepam.
C) Oxygen therapy at 2 L/min.
D) Sublingual morphine.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: D**
**Rationale:** Low-dose opioids, especially morphine, are the gold
standard for managing dyspnea in palliative care as they reduce the
perception of breathlessness and decrease respiratory drive[reference:3].
</details>
2. A patient with metastatic breast cancer has new-onset confusion,
nausea, constipation, and polyuria. Which electrolyte imbalance is most
likely?
A) Hypokalemia.
,B) Hypernatremia.
C) Hypercalcemia.
D) Hypophosphatemia.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: C**
**Rationale:** Hypercalcemia is common in breast, lung, lymphoma,
and multiple myeloma[reference:4] and presents with neurological and
gastrointestinal symptoms (nausea, vomiting, confusion, constipation,
fatigue, weakness, and polydipsia)[reference:5]. </details>
3. A patient describes a "sharp, burning, electric shock-like" pain in their
feet from chemotherapy-induced peripheral neuropathy. This description
is characteristic of which type of pain?
A) Somatic.
B) Visceral.
C) Neuropathic.
D) Nociceptive.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: C**
**Rationale:** Neuropathic pain is caused by nerve injury, often
described as burning, shooting, tingling, or shock-like[reference:6].
Somatic pain is well-localized and described as achy or throbbing.
Visceral pain is cramping or pressure-like[reference:7]. </details>
4. A hospice patient has a stage IV sacral pressure injury with a foul odor.
The wound culture is positive for anaerobic bacteria. Which topical agent
is most effective for odor control?
A) Silver sulfadiazine.
B) Topical metronidazole.
,C) Povidone-iodine.
D) Dakin's solution.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: B**
**Rationale:** Topical metronidazole is effective in treating foul odor
caused by anaerobic bacterial colonization, a common cause of wound
malodor[reference:8]. </details>
5. A patient with spinal cord compression reports back pain that is worse
when lying flat and improves when sitting up. This classic finding is due to:
A) Increased intrathecal pressure when supine.
B) Stretching of the dura mater.
C) Venous engorgement of the epidural space.
D) Movement of the tumor when recumbent.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: A**
**Rationale:** In malignant spinal cord compression, lying flat increases
pressure within the spinal canal, worsening pain[reference:9]. This is an
oncologic emergency requiring immediate evaluation. </details>
6. A patient on a morphine PCA for cancer pain becomes difficult to
arouse and has a respiratory rate of 8 breaths/min. After calling for help,
which medication should the nurse prepare to administer?
A) Naloxone.
B) Flumazenil.
C) Naltrexone.
D) Epinephrine.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: A**
**Rationale:** Naloxone is the antidote for opioid-induced respiratory
, depression. It should be titrated carefully to reverse respiratory
depression without fully reversing analgesia, which can cause severe pain
and withdrawal. </details>
7. An end-stage renal disease patient on hospice has refractory nausea
from uremia. Which antiemetic is most effective for uremic nausea?
A) Ondansetron.
B) Metoclopramide.
C) Haloperidol.
D) Prochlorperazine.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: C**
**Rationale:** Haloperidol is an effective antiemetic for metabolic
causes of nausea, such as uremia and hypercalcemia. It also provides
mild sedation. </details>
8. A hospice patient with advanced dementia is agitated and pulling at
their clothing each evening. Non-pharmacologic interventions have failed.
Which medication is most appropriate first-line for managing terminal
agitation in dementia?
A) Haloperidol.
B) Lorazepam.
C) Morphine.
D) Trazodone.
<details> <summary><strong>,,,,answer,,, &
Rationale</strong></summary> **Correct ,,,,answer,,,: A**
**Rationale:** Low-dose haloperidol is often first-line for managing
agitation and psychosis in dementia when behavioral interventions fail,
due to a lower risk of paradoxical reactions compared to
benzodiazepines. </details>
