[HOSPICE AND PALLIATIVE NURSE CHPN EXAM] – PRACTICE QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
CORE DOMAINS
Patient Care: Pain Management
Patient Care: Symptom Management
Grief, Loss, and Bereavement
Communication and Counseling
Professional Issues and Ethics
Regulatory and Compliance Standards
Spiritual and Psychosocial Care
End-of-Life Care Coordination
INTRODUCTION
The purpose of this assessment is to evaluate the clinical proficiency and professional
readiness of candidates seeking the Certified Hospice and Palliative Nurse (CHPN)
designation. This comprehensive practice exam focuses on the specialized skills required
to provide holistic care to patients facing life-limiting illnesses and their families. The
assessment evaluates knowledge in pain and symptom management, ethical decision-
making, and psychosocial support through a combination of foundational theory and
scenario-based questions. By emphasizing real-world application and critical thinking,
this exam ensures that practitioners can navigate complex clinical situations and deliver
high-quality, compassionate care in accordance with national palliative standards.
SECTION ONE: QUESTIONS 1–100
, 1. A patient with end-stage heart failure reports a sudden increase in dyspnea. The
nurse notes the patient is tachypneic but has an oxygen saturation of 94% on
room air. Which intervention is the most appropriate first step?
A. Increase supplemental oxygen to 4L via nasal cannula
B. Administer a prescribed low-dose oral morphine solution
C. Perform a vigorous chest physiotherapy session
D. Request a STAT chest X-ray to rule out pneumonia
🟢 B. Administer a prescribed low-dose oral morphine solution
🔴 RATIONALE: Morphine is the gold standard for managing dyspnea in palliative care
as it reduces the perception of breathlessness, even when oxygen saturation levels are
within normal limits.
2. During a family meeting, the daughter of a terminal patient expresses guilt about
moving her father to hospice. Which response by the nurse best demonstrates
therapeutic communication?
A. You shouldn't feel guilty; you are doing what is best for him.
B. Most families feel this way at first, but it passes quickly.
C. Tell me more about what is making you feel this way.
D. Hospice is the only way to ensure he doesn't suffer at the end.
🟢 C. Tell me more about what is making you feel this way.
🔴 RATIONALE: This open-ended response encourages the family member to express
her feelings and allows the nurse to assess the specific source of the distress without
passing judgment.
, 3. Which of the following is a primary requirement for a patient to be eligible for
the Medicare Hospice Benefit?
A. A life expectancy of 12 months or less if the disease runs its normal course
B. Agreement to forgo all curative treatments for the terminal illness
C. A primary diagnosis of cancer or end-stage renal disease
D. The presence of a full-time 24-hour caregiver in the home
🟢 B. Agreement to forgo all curative treatments for the terminal illness
🔴 RATIONALE: To elect the Medicare Hospice Benefit, the patient must waive the
right to Medicare payment for curative treatment related to the terminal diagnosis,
opting instead for palliative care.
4. A hospice nurse is caring for a patient with bone metastasis who describes pain
as "aching and deep." This type of pain is classified as:
A. Neuropathic pain
B. Visceral pain
C. Somatic pain
D. Incident pain
🟢 C. Somatic pain
🔴 RATIONALE: Somatic pain originates from the bones, skin, or soft tissues and is
typically described as aching, throbbing, or well-localized.
5. A patient in the active dying phase exhibits "death rattle" (congested breathing).
What is the priority nursing intervention?
, A. Deep oropharyngeal suctioning
B. Repositioning the patient on their side
C. Increasing intravenous fluid administration
D. Administering an aggressive bolus of a loop diuretic
🟢 B. Repositioning the patient on their side
🔴 RATIONALE: Repositioning allows gravity to help drain secretions. Suctioning is
generally avoided as it is invasive and often ineffective for terminal secretions, causing
more distress to the patient.
6. Which medication is most commonly used to treat the "death rattle" caused by
accumulated secretions?
A. Furosemide
B. Lorazepam
C. Atropine ophthalmic drops (administered sublingually)
D. Albuterol nebulizer
🟢 C. Atropine ophthalmic drops (administered sublingually)
🔴 RATIONALE: Anticholinergics like atropine or hyoscyamine help dry up respiratory
secretions. Sublingual atropine drops are a common and effective off-label palliative
intervention.
7. A patient with advanced COPD is experiencing severe anxiety related to their
breathlessness. Which medication class is the secondary choice to opioids for
managing this symptom?
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
CORE DOMAINS
Patient Care: Pain Management
Patient Care: Symptom Management
Grief, Loss, and Bereavement
Communication and Counseling
Professional Issues and Ethics
Regulatory and Compliance Standards
Spiritual and Psychosocial Care
End-of-Life Care Coordination
INTRODUCTION
The purpose of this assessment is to evaluate the clinical proficiency and professional
readiness of candidates seeking the Certified Hospice and Palliative Nurse (CHPN)
designation. This comprehensive practice exam focuses on the specialized skills required
to provide holistic care to patients facing life-limiting illnesses and their families. The
assessment evaluates knowledge in pain and symptom management, ethical decision-
making, and psychosocial support through a combination of foundational theory and
scenario-based questions. By emphasizing real-world application and critical thinking,
this exam ensures that practitioners can navigate complex clinical situations and deliver
high-quality, compassionate care in accordance with national palliative standards.
SECTION ONE: QUESTIONS 1–100
, 1. A patient with end-stage heart failure reports a sudden increase in dyspnea. The
nurse notes the patient is tachypneic but has an oxygen saturation of 94% on
room air. Which intervention is the most appropriate first step?
A. Increase supplemental oxygen to 4L via nasal cannula
B. Administer a prescribed low-dose oral morphine solution
C. Perform a vigorous chest physiotherapy session
D. Request a STAT chest X-ray to rule out pneumonia
🟢 B. Administer a prescribed low-dose oral morphine solution
🔴 RATIONALE: Morphine is the gold standard for managing dyspnea in palliative care
as it reduces the perception of breathlessness, even when oxygen saturation levels are
within normal limits.
2. During a family meeting, the daughter of a terminal patient expresses guilt about
moving her father to hospice. Which response by the nurse best demonstrates
therapeutic communication?
A. You shouldn't feel guilty; you are doing what is best for him.
B. Most families feel this way at first, but it passes quickly.
C. Tell me more about what is making you feel this way.
D. Hospice is the only way to ensure he doesn't suffer at the end.
🟢 C. Tell me more about what is making you feel this way.
🔴 RATIONALE: This open-ended response encourages the family member to express
her feelings and allows the nurse to assess the specific source of the distress without
passing judgment.
, 3. Which of the following is a primary requirement for a patient to be eligible for
the Medicare Hospice Benefit?
A. A life expectancy of 12 months or less if the disease runs its normal course
B. Agreement to forgo all curative treatments for the terminal illness
C. A primary diagnosis of cancer or end-stage renal disease
D. The presence of a full-time 24-hour caregiver in the home
🟢 B. Agreement to forgo all curative treatments for the terminal illness
🔴 RATIONALE: To elect the Medicare Hospice Benefit, the patient must waive the
right to Medicare payment for curative treatment related to the terminal diagnosis,
opting instead for palliative care.
4. A hospice nurse is caring for a patient with bone metastasis who describes pain
as "aching and deep." This type of pain is classified as:
A. Neuropathic pain
B. Visceral pain
C. Somatic pain
D. Incident pain
🟢 C. Somatic pain
🔴 RATIONALE: Somatic pain originates from the bones, skin, or soft tissues and is
typically described as aching, throbbing, or well-localized.
5. A patient in the active dying phase exhibits "death rattle" (congested breathing).
What is the priority nursing intervention?
, A. Deep oropharyngeal suctioning
B. Repositioning the patient on their side
C. Increasing intravenous fluid administration
D. Administering an aggressive bolus of a loop diuretic
🟢 B. Repositioning the patient on their side
🔴 RATIONALE: Repositioning allows gravity to help drain secretions. Suctioning is
generally avoided as it is invasive and often ineffective for terminal secretions, causing
more distress to the patient.
6. Which medication is most commonly used to treat the "death rattle" caused by
accumulated secretions?
A. Furosemide
B. Lorazepam
C. Atropine ophthalmic drops (administered sublingually)
D. Albuterol nebulizer
🟢 C. Atropine ophthalmic drops (administered sublingually)
🔴 RATIONALE: Anticholinergics like atropine or hyoscyamine help dry up respiratory
secretions. Sublingual atropine drops are a common and effective off-label palliative
intervention.
7. A patient with advanced COPD is experiencing severe anxiety related to their
breathlessness. Which medication class is the secondary choice to opioids for
managing this symptom?
