CHPN Exam Review Questions And Answers
Rigor Mortis Answer 2-6 hours after death adenosine phosphate (ATP) ceases to be
synthesized due to depletion of glycogen stores begins in the involuntary muscles-heart,
GI, bladder, arteries Ceases after 96 hours persons with larger body mass-more
pronounced to rigor persons of smaller mass are less subject to rigor
Rigor Mortis nursing implications Answer natural and immediate positioning does not
change the appearance of the body position person in relaxed peaceful position use
petroleum jelly to help them close the eyelids position head on pillow so jaw does not
hang open fold their hands if rigor mortis does happen funeral home director is able to
massage it out reassure family muscles can contract so it can appear they move
Algor mortis - Answer The cooling of the body following death
- temp drops to 1-1.8 degrees celsius
- as body cools it loses its natural elasticity
- if high fever was present before death, body temp is more pronounced and the person
may appear to sweat after death
- body cooling can take more hours to cool if fever present
Nursing implications of algor mortis Answer can prepare family for the coolness of the
skin to touch or increased moisture explaining changes suggest kissing hair instead of
skin skin becomes fragile, can tear easily apply dressings for skin tear with circular
bandage or paper tape do not place traction on skin
postmortem decomposition or "Liver Mortis" - Answer - discoloration and softening of
the body are caused by breakdown of red blood cells and resultant relase of hemoglobin
that stains vessel walls and tissues
- Appears as mottling or bruising
- appears in dependent parts of body where sking has been punctured (IV or chest tube
sites)
, - becomes extensive in short time
- has gray hue
- in cardiac deaths-face is purple regardless of positioning
Nursing implications for Liver mortis - Answer - inform family member this is normal
changes
- prop body on pillows and shoulders/head and elevate HOB to 30 degrees
- remove heavy blankets and cover with thin sheet
Beneficence - Answer duty to "do good" to act for another benefit
- benefits, burdens, and cost of treatment are considered with regards to beneficence
Nonmaleficence - Response to not inflict harm or "do not harm"
- invoked when considering life prolonging therapies that can harm a patient by causing
increased suffering without increasing quality of life
- can provide support for withholding/withdrawing treatments
Futility - Response irreversibly- dying patients have arrived at a stage where additional
treatment offers no physiogogical benefit or is hopeless and optional
- utilized to support witholding/withdrawing therapy
- makes judgment based on both values and evidence
Justice - Answer fair, equitable, and appropriate treatment in light of what is due or
owed to persons
Distributive justice - Answer allocation of scarce healthcare resources
- distribution of societal rights and responsibilities
Vulnerability- Response focus on person susceptibility- to internal factors such as age
Rigor Mortis Answer 2-6 hours after death adenosine phosphate (ATP) ceases to be
synthesized due to depletion of glycogen stores begins in the involuntary muscles-heart,
GI, bladder, arteries Ceases after 96 hours persons with larger body mass-more
pronounced to rigor persons of smaller mass are less subject to rigor
Rigor Mortis nursing implications Answer natural and immediate positioning does not
change the appearance of the body position person in relaxed peaceful position use
petroleum jelly to help them close the eyelids position head on pillow so jaw does not
hang open fold their hands if rigor mortis does happen funeral home director is able to
massage it out reassure family muscles can contract so it can appear they move
Algor mortis - Answer The cooling of the body following death
- temp drops to 1-1.8 degrees celsius
- as body cools it loses its natural elasticity
- if high fever was present before death, body temp is more pronounced and the person
may appear to sweat after death
- body cooling can take more hours to cool if fever present
Nursing implications of algor mortis Answer can prepare family for the coolness of the
skin to touch or increased moisture explaining changes suggest kissing hair instead of
skin skin becomes fragile, can tear easily apply dressings for skin tear with circular
bandage or paper tape do not place traction on skin
postmortem decomposition or "Liver Mortis" - Answer - discoloration and softening of
the body are caused by breakdown of red blood cells and resultant relase of hemoglobin
that stains vessel walls and tissues
- Appears as mottling or bruising
- appears in dependent parts of body where sking has been punctured (IV or chest tube
sites)
, - becomes extensive in short time
- has gray hue
- in cardiac deaths-face is purple regardless of positioning
Nursing implications for Liver mortis - Answer - inform family member this is normal
changes
- prop body on pillows and shoulders/head and elevate HOB to 30 degrees
- remove heavy blankets and cover with thin sheet
Beneficence - Answer duty to "do good" to act for another benefit
- benefits, burdens, and cost of treatment are considered with regards to beneficence
Nonmaleficence - Response to not inflict harm or "do not harm"
- invoked when considering life prolonging therapies that can harm a patient by causing
increased suffering without increasing quality of life
- can provide support for withholding/withdrawing treatments
Futility - Response irreversibly- dying patients have arrived at a stage where additional
treatment offers no physiogogical benefit or is hopeless and optional
- utilized to support witholding/withdrawing therapy
- makes judgment based on both values and evidence
Justice - Answer fair, equitable, and appropriate treatment in light of what is due or
owed to persons
Distributive justice - Answer allocation of scarce healthcare resources
- distribution of societal rights and responsibilities
Vulnerability- Response focus on person susceptibility- to internal factors such as age
