CHPN — Certified Hospice and Palliative Nurse,
WITH CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS LATEST
ALREADY GRADED A+ (2025/2026)
Question 1
A 68-year-old patient with end-stage COPD is admitted
to hospice. Which assessment finding should the nurse
prioritize as the most significant indicator of imminent
death?
A) Decreased appetite and weight loss of 5 pounds over
2 weeks
B) Cheyne-Stokes respirations with periods of apnea
lasting 20–30 seconds
C) Patient's statement that "I feel like I'm ready to go"
D) Increased somnolence and difficulty rousing the patient
Answer: B
1
,Rationale: Cheyne-Stokes respirations with prolonged
apneic periods (>15 seconds) is a classic physiological
sign of impending death, indicating progressive brainstem
dysfunction and respiratory center failure. While
decreased appetite, weight loss, verbal expressions of
readiness, and increased somnolence are all important
signs of decline, Cheyne-Stokes respirations with
significant apnea is the most acute and definitive
indicator of imminent death (hours to days). The nurse
should also assess for other signs including mottling,
decreased urine output, and changes in vital signs.
Question 2
A hospice nurse is conducting an initial assessment of a
patient with advanced heart failure. Which tool is most
appropriate for evaluating the patient's functional status
and prognosis?
2
,A) Palliative Performance Scale (PPS)
B) Mini-Mental State Examination (MMSE)
C) Braden Scale
D) Morse Fall Scale
Answer: A
Rationale: The Palliative Performance Scale (PPS) is a
validated tool specifically designed to assess functional
status and predict prognosis in palliative care populations.
It measures five domains: ambulation, activity/evidence
of disease, self-care, intake, and consciousness level. The
MMSE assesses cognitive function, the Braden Scale
evaluates pressure injury risk, and the Morse Fall Scale
assesses fall risk—none of which are specific to palliative
prognosis assessment.
Question 3
During a family meeting, the patient's adult children
disagree about whether to continue aggressive treatment.
3
, Which action by the nurse demonstrates best practice in
facilitating this discussion?
A) Recommend that the family take a vote and proceed
with the majority opinion
B) Suggest that the primary decision-maker be identified
and make the final choice
C) Explore each family member's understanding of the
patient's previously expressed wishes
D) Advise the family to consult with an ethics committee
before making any decisions
Answer: C
Rationale: Best practice in palliative care family meetings
involves exploring what the patient would have wanted
based on previously expressed wishes, values, and goals.
This patient-centered approach honors autonomy and
reduces family conflict by refocusing on the patient's
preferences rather than family members' personal
opinions. The nurse should facilitate open communication,
4
WITH CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS LATEST
ALREADY GRADED A+ (2025/2026)
Question 1
A 68-year-old patient with end-stage COPD is admitted
to hospice. Which assessment finding should the nurse
prioritize as the most significant indicator of imminent
death?
A) Decreased appetite and weight loss of 5 pounds over
2 weeks
B) Cheyne-Stokes respirations with periods of apnea
lasting 20–30 seconds
C) Patient's statement that "I feel like I'm ready to go"
D) Increased somnolence and difficulty rousing the patient
Answer: B
1
,Rationale: Cheyne-Stokes respirations with prolonged
apneic periods (>15 seconds) is a classic physiological
sign of impending death, indicating progressive brainstem
dysfunction and respiratory center failure. While
decreased appetite, weight loss, verbal expressions of
readiness, and increased somnolence are all important
signs of decline, Cheyne-Stokes respirations with
significant apnea is the most acute and definitive
indicator of imminent death (hours to days). The nurse
should also assess for other signs including mottling,
decreased urine output, and changes in vital signs.
Question 2
A hospice nurse is conducting an initial assessment of a
patient with advanced heart failure. Which tool is most
appropriate for evaluating the patient's functional status
and prognosis?
2
,A) Palliative Performance Scale (PPS)
B) Mini-Mental State Examination (MMSE)
C) Braden Scale
D) Morse Fall Scale
Answer: A
Rationale: The Palliative Performance Scale (PPS) is a
validated tool specifically designed to assess functional
status and predict prognosis in palliative care populations.
It measures five domains: ambulation, activity/evidence
of disease, self-care, intake, and consciousness level. The
MMSE assesses cognitive function, the Braden Scale
evaluates pressure injury risk, and the Morse Fall Scale
assesses fall risk—none of which are specific to palliative
prognosis assessment.
Question 3
During a family meeting, the patient's adult children
disagree about whether to continue aggressive treatment.
3
, Which action by the nurse demonstrates best practice in
facilitating this discussion?
A) Recommend that the family take a vote and proceed
with the majority opinion
B) Suggest that the primary decision-maker be identified
and make the final choice
C) Explore each family member's understanding of the
patient's previously expressed wishes
D) Advise the family to consult with an ethics committee
before making any decisions
Answer: C
Rationale: Best practice in palliative care family meetings
involves exploring what the patient would have wanted
based on previously expressed wishes, values, and goals.
This patient-centered approach honors autonomy and
reduces family conflict by refocusing on the patient's
preferences rather than family members' personal
opinions. The nurse should facilitate open communication,
4
