CHPN Certified Hospice and Palliative Nurse Certification
Exam Latest Version with All Questions from Actual Exam
100% Correct Answers, and Rationale
Section 1: Pain Management (Questions 1–19)
1. A 65-year-old patient with advanced lung cancer rates pain as 8/10. What is the priority
assessment?
A) Comprehensive pain history using OPQRST.
B) Immediate opioid administration.
C) Ignore if patient is comfortable.
D) Physical exam only. Correct Answer: A) Comprehensive pain history using OPQRST.
Rationale: OPQRST (Onset, Provocation, Quality, Region, Severity, Time) guides pain
assessment per HPNA standards. HPCC Domain 1: Pain assessment.
2. A patient on morphine 10 mg IV q4h reports inadequate pain relief. What intervention?
A) Titrate dose to 15 mg IV q4h.
B) No change.
C) Switch to NSAIDs.
D) Ignore complaint.
Correct Answer: A) Titrate dose to 15 mg IV q4h.
Rationale: Opioid titration is standard for breakthrough pain. HPCC Domain 1:
Pharmacologic interventions.
3. A non-verbal patient grimaces during movement. What pain assessment tool?
A) PAINAD scale.
B) Numeric scale.
C) No tool.
D) Verbal descriptor.
Correct Answer: A) PAINAD scale.
Rationale: PAINAD is validated for non-verbal patients. HPCC Domain 1: Assessment in
special populations.
4. A patient with neuropathic pain from chemotherapy. What non-pharmacologic
intervention?
A) Acupuncture.
B) No intervention.
C) Opioids only.
D) Ignore pain.
Correct Answer: A) Acupuncture.
Rationale: Complementary therapy for neuropathic pain per NCCN guidelines. HPCC
Domain 1: Non-pharmacologic management.
5. A patient with bone metastasis pain. What pharmacologic plan?
A) Opioids and bisphosphonates.
B) No opioids.
C) NSAIDs only.
D) Ignore pain.
Correct Answer: A) Opioids and bisphosphonates.
, Rationale: Bisphosphonates reduce bone pain; opioids for severe pain. HPCC Domain 1:
Pharmacologic interventions.
6. A patient reports pain 6/10 after dose. What evaluation?
A) Reassess in 30 minutes and adjust if needed.
B) No reassessment.
C) Stop medication.
D) Ignore pain.
Correct Answer: A) Reassess in 30 minutes and adjust if needed.
Rationale: Pain reassessment is required per standards. HPCC Domain 1: Evaluation.
7. A patient with opioid-induced constipation. What intervention?
A) Senna 8.6 mg daily.
B) No laxative.
C) Opioids.
D) Ignore constipation.
Correct Answer: A) Senna 8.6 mg daily.
Rationale: Prophylactic for opioid side effects. HPCC Domain 1: Symptom management
in pain.
8. A patient with breakthrough pain. What plan?
A) Rescue dose of immediate-release opioid.
B) No rescue.
C) Long-acting only.
D) Ignore breakthrough.
Correct Answer: A) Rescue dose of immediate-release opioid.
Rationale: 10-20% of total daily dose for breakthrough. HPCC Domain 1: Pain planning.
9. A patient with cultural pain beliefs. What assessment?
A) Incorporate cultural expressions into scale.
B) No incorporation.
C) Standard scale only.
D) Ignore culture.
Correct Answer: A) Incorporate cultural expressions into scale.
Rationale: Cultural competence in assessment. HPCC Domain 1: Cultural factors.
10. A patient with cancer pain on fentanyl patch. What change?
A) Titrate by 25% every 3 days if needed.
B) No titration.
C) Switch to oral.
D) Ignore pain.
Correct Answer: A) Titrate by 25% every 3 days if needed.
Rationale: Safe titration for transdermal fentanyl. HPCC Domain 1: Pharmacologic
management.
11. A patient with neuropathic pain. What intervention?
A) Gabapentin 300 mg TID.
B) No medication.
C) Opioids only.
D) NSAIDs.
Correct Answer: A) Gabapentin 300 mg TID.
Rationale: First-line for neuropathic pain. HPCC Domain 1: Pharmacologic interventions.
, 12. A patient reports pain 4/10 after non-opioid. What evaluation?
A) Consider opioid if persistent.
B) No evaluation.
C) Stop non-opioid.
D) Ignore pain.
Correct Answer: A) Consider opioid if persistent.
Rationale: WHO ladder step-up. HPCC Domain 1: Evaluation.
13. A patient with sickle cell pain. What management?
A) IV opioids and hydration.
B) No opioids.
C) Oral NSAIDs only.
D) Ignore pain.
Correct Answer: A) IV opioids and hydration.
Rationale: Standard for vaso-occlusive crisis. HPCC Domain 1: Pain management.
14. A patient with opioid tolerance. What plan?
A) Rotate opioids to prevent tolerance.
B) No rotation.
C) Increase dose indefinitely.
D) Ignore tolerance.
Correct Answer: A) Rotate opioids to prevent tolerance.
Rationale: Opioid rotation manages tolerance. HPCC Domain 1: Planning.
15. A patient with pain and nausea. What intervention?
A) Metoclopramide for nausea.
B) No medication.
C) Opioids only.
D) Ignore nausea.
Correct Answer: A) Metoclopramide for nausea.
Rationale: Prokinetic for opioid-induced nausea. HPCC Domain 1: Symptom
management.
16. A patient with cancer pain uses TENS. What evaluation?
A) Pain score reduction post-use.
B) No evaluation.
C) Ignore TENS.
D) Stop TENS.
Correct Answer: A) Pain score reduction post-use.
Rationale: Assesses non-pharmacologic efficacy. HPCC Domain 1: Evaluation.
17. A patient with terminal pain. What goal?
A) Comfort over cure.
B) Cure pain.
C) No goal.
D) Ignore pain.
Correct Answer: A) Comfort over cure.
Rationale: Palliative focus. HPCC Domain 1: Planning.
18. A patient with opioid-induced sedation. What intervention?
A) Naloxone if respiratory depression.
B) No naloxone.
Exam Latest Version with All Questions from Actual Exam
100% Correct Answers, and Rationale
Section 1: Pain Management (Questions 1–19)
1. A 65-year-old patient with advanced lung cancer rates pain as 8/10. What is the priority
assessment?
A) Comprehensive pain history using OPQRST.
B) Immediate opioid administration.
C) Ignore if patient is comfortable.
D) Physical exam only. Correct Answer: A) Comprehensive pain history using OPQRST.
Rationale: OPQRST (Onset, Provocation, Quality, Region, Severity, Time) guides pain
assessment per HPNA standards. HPCC Domain 1: Pain assessment.
2. A patient on morphine 10 mg IV q4h reports inadequate pain relief. What intervention?
A) Titrate dose to 15 mg IV q4h.
B) No change.
C) Switch to NSAIDs.
D) Ignore complaint.
Correct Answer: A) Titrate dose to 15 mg IV q4h.
Rationale: Opioid titration is standard for breakthrough pain. HPCC Domain 1:
Pharmacologic interventions.
3. A non-verbal patient grimaces during movement. What pain assessment tool?
A) PAINAD scale.
B) Numeric scale.
C) No tool.
D) Verbal descriptor.
Correct Answer: A) PAINAD scale.
Rationale: PAINAD is validated for non-verbal patients. HPCC Domain 1: Assessment in
special populations.
4. A patient with neuropathic pain from chemotherapy. What non-pharmacologic
intervention?
A) Acupuncture.
B) No intervention.
C) Opioids only.
D) Ignore pain.
Correct Answer: A) Acupuncture.
Rationale: Complementary therapy for neuropathic pain per NCCN guidelines. HPCC
Domain 1: Non-pharmacologic management.
5. A patient with bone metastasis pain. What pharmacologic plan?
A) Opioids and bisphosphonates.
B) No opioids.
C) NSAIDs only.
D) Ignore pain.
Correct Answer: A) Opioids and bisphosphonates.
, Rationale: Bisphosphonates reduce bone pain; opioids for severe pain. HPCC Domain 1:
Pharmacologic interventions.
6. A patient reports pain 6/10 after dose. What evaluation?
A) Reassess in 30 minutes and adjust if needed.
B) No reassessment.
C) Stop medication.
D) Ignore pain.
Correct Answer: A) Reassess in 30 minutes and adjust if needed.
Rationale: Pain reassessment is required per standards. HPCC Domain 1: Evaluation.
7. A patient with opioid-induced constipation. What intervention?
A) Senna 8.6 mg daily.
B) No laxative.
C) Opioids.
D) Ignore constipation.
Correct Answer: A) Senna 8.6 mg daily.
Rationale: Prophylactic for opioid side effects. HPCC Domain 1: Symptom management
in pain.
8. A patient with breakthrough pain. What plan?
A) Rescue dose of immediate-release opioid.
B) No rescue.
C) Long-acting only.
D) Ignore breakthrough.
Correct Answer: A) Rescue dose of immediate-release opioid.
Rationale: 10-20% of total daily dose for breakthrough. HPCC Domain 1: Pain planning.
9. A patient with cultural pain beliefs. What assessment?
A) Incorporate cultural expressions into scale.
B) No incorporation.
C) Standard scale only.
D) Ignore culture.
Correct Answer: A) Incorporate cultural expressions into scale.
Rationale: Cultural competence in assessment. HPCC Domain 1: Cultural factors.
10. A patient with cancer pain on fentanyl patch. What change?
A) Titrate by 25% every 3 days if needed.
B) No titration.
C) Switch to oral.
D) Ignore pain.
Correct Answer: A) Titrate by 25% every 3 days if needed.
Rationale: Safe titration for transdermal fentanyl. HPCC Domain 1: Pharmacologic
management.
11. A patient with neuropathic pain. What intervention?
A) Gabapentin 300 mg TID.
B) No medication.
C) Opioids only.
D) NSAIDs.
Correct Answer: A) Gabapentin 300 mg TID.
Rationale: First-line for neuropathic pain. HPCC Domain 1: Pharmacologic interventions.
, 12. A patient reports pain 4/10 after non-opioid. What evaluation?
A) Consider opioid if persistent.
B) No evaluation.
C) Stop non-opioid.
D) Ignore pain.
Correct Answer: A) Consider opioid if persistent.
Rationale: WHO ladder step-up. HPCC Domain 1: Evaluation.
13. A patient with sickle cell pain. What management?
A) IV opioids and hydration.
B) No opioids.
C) Oral NSAIDs only.
D) Ignore pain.
Correct Answer: A) IV opioids and hydration.
Rationale: Standard for vaso-occlusive crisis. HPCC Domain 1: Pain management.
14. A patient with opioid tolerance. What plan?
A) Rotate opioids to prevent tolerance.
B) No rotation.
C) Increase dose indefinitely.
D) Ignore tolerance.
Correct Answer: A) Rotate opioids to prevent tolerance.
Rationale: Opioid rotation manages tolerance. HPCC Domain 1: Planning.
15. A patient with pain and nausea. What intervention?
A) Metoclopramide for nausea.
B) No medication.
C) Opioids only.
D) Ignore nausea.
Correct Answer: A) Metoclopramide for nausea.
Rationale: Prokinetic for opioid-induced nausea. HPCC Domain 1: Symptom
management.
16. A patient with cancer pain uses TENS. What evaluation?
A) Pain score reduction post-use.
B) No evaluation.
C) Ignore TENS.
D) Stop TENS.
Correct Answer: A) Pain score reduction post-use.
Rationale: Assesses non-pharmacologic efficacy. HPCC Domain 1: Evaluation.
17. A patient with terminal pain. What goal?
A) Comfort over cure.
B) Cure pain.
C) No goal.
D) Ignore pain.
Correct Answer: A) Comfort over cure.
Rationale: Palliative focus. HPCC Domain 1: Planning.
18. A patient with opioid-induced sedation. What intervention?
A) Naloxone if respiratory depression.
B) No naloxone.
