CERTIFIED HOSPICE PALLIATIVE
NURSE CHPN EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
AIDSainfectiona-aans--Bacterial,aViral,aFungal,aParasitic
AIDSadementiaa-aans--causesaEncephalopathy,a15%aeffected
ALSa(amyotrophicalateralasclerosis)a1stasymptoma-aans--
swallowingadifficultyafollowedabyadistalaweakness
CerebralaMetastasesa-aans--Brainametsaaccountafora40%aofaallaCancerapatients.
CerebralaMetastasesasymptomsa-aans--HAainitialacomplaint,aN/V,aconfusion,alethargy
Leukemiaa2atypesa-aans--chronicaandaacute
LeukemiaaClinicalaManifestationsa-aans--
Infection,afever,aenlargedaliver,aspleen,akidneys,ableeding/bruisinganotaexplained,a&ahemo
rrhagea
pale,apetechia,apurpura
liverafailureasymptomsa-aans--fatigue,ajaundice,aascites
Darkaurine,agrayastool,abruising
symptomsaofableedingainternallya-aans--
suddenafevera>a101°,adyspnea,aabdominalapaik,adehydration
Lymphomaatypesa-aans--HodgkinsaandaNon-Hodgkins
Hodgkin'sadiseasea-aans--
painlessalymphanodeaswelling,agenerallyainaupperabody,ageneralafatigue,aweightaloss,afev
er,anifhtasweats,abackapain
Non-Hodgkin'saLymphomaa-aans--sameasymptomsaexceptaitchinga&anightasweats
Parkinson'sadiseasea-aans--
Slowaprogressionaofamotoraskills,arestingatremors,aslowness,arigidity.atypicallyainapeoplea>
65
,ParkinsonaSigns/Symptomsa-aans--
pillarollingamovementsainabands,alossaofafacialaexpression,adifficultyainitiatingamovement,a
gaitachanges
RenalaCancer/symptomsa-aans--
asymptomaticaearly.aGrossahematuria,adull,aachingapain,apalpableaabdomenamass.
polycythemia-aHA,adizzy,aveinainflammation,aitchy.ahypercalcemia-
atired,apooraappetite,afreq.aurine,athirst,an/v,aconfusion,aconstipation,apooraconcentration
sickleacelladiseasea-aans--pallor,ajaundice,aweakness,afatigueacommonasymptoms
sickleacellacrisisa-aans--
multipleapainaevents,apalealips,atongje,apalms,anailabeds,alethargy,adifficultyaarousing,ahigh
afevera2adays
sickleacellariska-aans--highar/oabacterialainfections
palliativeasedationa-aans--midazolam,apropofol
terminalaweaninga-aans--gradualawithdrawalaofamechanicalaventilation
terminalaExtubationa-aans--abruptaRemovalaofaendotrachealatube
DeathaRattleaMedsa-aans--
eadyapresent
povertyabarriersaataEOLa-aans--additionalachallengesatoaEOLacare.alackaofasupport.
BIPAPa(non-invasiveaventilation)a-aans--
mayabeautilizedaataEOLaforadyspneaainasomeaptsawhoadoanotawantatoabeaintubatedaforaRFa
butawantasomethingamoreathanasupplementalao2.
ALSahasabeenashownatoaimproveaqualityaofalife.
unhealthyacopingainacaregivera@aEOLa-aans--
signs:anegativeafeelingsa(anger),awithholdingainfoatoaotherafamily,arefusingaassistance,afoc
usingaonatheiraneedsaonly,arefusingatoaacknowledgeaoraaccommodateadifferencesainaopini
onaamongacaregivers.a
interveneawithaassistance/resources
tricyclicaantidepressantsa-aans--txaneuropathicapain.aHighaA/E
tricyclicaantidepressantsaA/Ea-aans--
Anticholinergicacommon:adryamouth,aurinaryaretention,atachycardia,adelirium,aconstipatio
na
additional:aarrhythmias,asedation,aweightagain,asweating,asexualadysfunction.a
, *ptamayarefuseatoacontinuear/taA/E
myoclonusa-aans--
jerks,asudden,abrief,aandauncontrollableamovement.amostlyaupperaextremity.amostacomm
onacauseaisaopiod.asignaofaopiodatoxicity-aneedatoachangeameds.aNarcanaforaacuteatx.a
benzosa&aantispasmodicsacanabeatxaina*some*apts
Hypercalcemiaa-aans--
urgenta&aseriousalateastageamalignancya(unrelatedatoaboneamets).anoatxaresultsainadeath
hypercalcemiaaoccurrencea-aans--
mostacommonabreastaCAa&amultipleamyelomaabutacanaoccurawithaothers.
Hypercalcemiaasymptomsa-aans--n/v,aconstipation,aanorexiaa
weakness,amentalachange,afatigue
bradycardia,aEKGachanges
Hypercalcemiaatreatmenta-aans--
palliativeacareapt:aIVahydration,acalcitonina(inhibitsabonearesorption)a&abiophonatesa(inhibi
tsabonearesorptiona&areducesaCalciumalevels)-
abutathisaisadelayedatoa48ahrsaafteraadministration.
federalalawa&aorganadonationa-aans--
familyamustabeaaskedaaboutadonationawhenaptsadieainatheahospitalaifathereaisanoaadvanced
adirectiveaoutliningaptsawishes
Xerostomia-awhataisais/testa-aans--pasty,athickasaliva
crackeratest:agiveaptacrackeratoaeat.aifaptaisaunableatoachewa&aswallowaw/outaliquid,athenate
staisa+
tongueablade:aplaceaonaptatonguea&aifaitasticks-a+
measurementaofasaliva-asawbaoraptaspitsaintoacontaineraforaperiodaofatime
lackaofaradialapulsea-aans--deathalikelyatoaoccurainaaafewahrs
Byrocka&aMerrimansaEOLaconstructa-aans--6adimensions-aapplyatoapta&acaregiver
byrocka&amerrimansaEOLadimensionsa-aans--well-
being:asubjectiveafeelingsaaboutacondition,aemotionsa(anxiety,afear,areadiness,aacceptanc
e)
physical:acomfortalevela&aphysicaladistress
function:aabilityatoacarryaoutaADLs
interpersonal:adegree/qualityarelationshipsa&achangesafromacaregiving
transcedent:aperceptionaofameaningaofalifeaasawellaasaspiritual/religiousavalues
*aachangeaina1adimensionaaffectsaotheradimensions.aex:a^apain=adec.afunction
NURSE CHPN EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
AIDSainfectiona-aans--Bacterial,aViral,aFungal,aParasitic
AIDSadementiaa-aans--causesaEncephalopathy,a15%aeffected
ALSa(amyotrophicalateralasclerosis)a1stasymptoma-aans--
swallowingadifficultyafollowedabyadistalaweakness
CerebralaMetastasesa-aans--Brainametsaaccountafora40%aofaallaCancerapatients.
CerebralaMetastasesasymptomsa-aans--HAainitialacomplaint,aN/V,aconfusion,alethargy
Leukemiaa2atypesa-aans--chronicaandaacute
LeukemiaaClinicalaManifestationsa-aans--
Infection,afever,aenlargedaliver,aspleen,akidneys,ableeding/bruisinganotaexplained,a&ahemo
rrhagea
pale,apetechia,apurpura
liverafailureasymptomsa-aans--fatigue,ajaundice,aascites
Darkaurine,agrayastool,abruising
symptomsaofableedingainternallya-aans--
suddenafevera>a101°,adyspnea,aabdominalapaik,adehydration
Lymphomaatypesa-aans--HodgkinsaandaNon-Hodgkins
Hodgkin'sadiseasea-aans--
painlessalymphanodeaswelling,agenerallyainaupperabody,ageneralafatigue,aweightaloss,afev
er,anifhtasweats,abackapain
Non-Hodgkin'saLymphomaa-aans--sameasymptomsaexceptaitchinga&anightasweats
Parkinson'sadiseasea-aans--
Slowaprogressionaofamotoraskills,arestingatremors,aslowness,arigidity.atypicallyainapeoplea>
65
,ParkinsonaSigns/Symptomsa-aans--
pillarollingamovementsainabands,alossaofafacialaexpression,adifficultyainitiatingamovement,a
gaitachanges
RenalaCancer/symptomsa-aans--
asymptomaticaearly.aGrossahematuria,adull,aachingapain,apalpableaabdomenamass.
polycythemia-aHA,adizzy,aveinainflammation,aitchy.ahypercalcemia-
atired,apooraappetite,afreq.aurine,athirst,an/v,aconfusion,aconstipation,apooraconcentration
sickleacelladiseasea-aans--pallor,ajaundice,aweakness,afatigueacommonasymptoms
sickleacellacrisisa-aans--
multipleapainaevents,apalealips,atongje,apalms,anailabeds,alethargy,adifficultyaarousing,ahigh
afevera2adays
sickleacellariska-aans--highar/oabacterialainfections
palliativeasedationa-aans--midazolam,apropofol
terminalaweaninga-aans--gradualawithdrawalaofamechanicalaventilation
terminalaExtubationa-aans--abruptaRemovalaofaendotrachealatube
DeathaRattleaMedsa-aans--
eadyapresent
povertyabarriersaataEOLa-aans--additionalachallengesatoaEOLacare.alackaofasupport.
BIPAPa(non-invasiveaventilation)a-aans--
mayabeautilizedaataEOLaforadyspneaainasomeaptsawhoadoanotawantatoabeaintubatedaforaRFa
butawantasomethingamoreathanasupplementalao2.
ALSahasabeenashownatoaimproveaqualityaofalife.
unhealthyacopingainacaregivera@aEOLa-aans--
signs:anegativeafeelingsa(anger),awithholdingainfoatoaotherafamily,arefusingaassistance,afoc
usingaonatheiraneedsaonly,arefusingatoaacknowledgeaoraaccommodateadifferencesainaopini
onaamongacaregivers.a
interveneawithaassistance/resources
tricyclicaantidepressantsa-aans--txaneuropathicapain.aHighaA/E
tricyclicaantidepressantsaA/Ea-aans--
Anticholinergicacommon:adryamouth,aurinaryaretention,atachycardia,adelirium,aconstipatio
na
additional:aarrhythmias,asedation,aweightagain,asweating,asexualadysfunction.a
, *ptamayarefuseatoacontinuear/taA/E
myoclonusa-aans--
jerks,asudden,abrief,aandauncontrollableamovement.amostlyaupperaextremity.amostacomm
onacauseaisaopiod.asignaofaopiodatoxicity-aneedatoachangeameds.aNarcanaforaacuteatx.a
benzosa&aantispasmodicsacanabeatxaina*some*apts
Hypercalcemiaa-aans--
urgenta&aseriousalateastageamalignancya(unrelatedatoaboneamets).anoatxaresultsainadeath
hypercalcemiaaoccurrencea-aans--
mostacommonabreastaCAa&amultipleamyelomaabutacanaoccurawithaothers.
Hypercalcemiaasymptomsa-aans--n/v,aconstipation,aanorexiaa
weakness,amentalachange,afatigue
bradycardia,aEKGachanges
Hypercalcemiaatreatmenta-aans--
palliativeacareapt:aIVahydration,acalcitonina(inhibitsabonearesorption)a&abiophonatesa(inhibi
tsabonearesorptiona&areducesaCalciumalevels)-
abutathisaisadelayedatoa48ahrsaafteraadministration.
federalalawa&aorganadonationa-aans--
familyamustabeaaskedaaboutadonationawhenaptsadieainatheahospitalaifathereaisanoaadvanced
adirectiveaoutliningaptsawishes
Xerostomia-awhataisais/testa-aans--pasty,athickasaliva
crackeratest:agiveaptacrackeratoaeat.aifaptaisaunableatoachewa&aswallowaw/outaliquid,athenate
staisa+
tongueablade:aplaceaonaptatonguea&aifaitasticks-a+
measurementaofasaliva-asawbaoraptaspitsaintoacontaineraforaperiodaofatime
lackaofaradialapulsea-aans--deathalikelyatoaoccurainaaafewahrs
Byrocka&aMerrimansaEOLaconstructa-aans--6adimensions-aapplyatoapta&acaregiver
byrocka&amerrimansaEOLadimensionsa-aans--well-
being:asubjectiveafeelingsaaboutacondition,aemotionsa(anxiety,afear,areadiness,aacceptanc
e)
physical:acomfortalevela&aphysicaladistress
function:aabilityatoacarryaoutaADLs
interpersonal:adegree/qualityarelationshipsa&achangesafromacaregiving
transcedent:aperceptionaofameaningaofalifeaasawellaasaspiritual/religiousavalues
*aachangeaina1adimensionaaffectsaotheradimensions.aex:a^apain=adec.afunction
