CHPN CORE CURRICULUM STUDY GUIDE.
Perfect Prep for Every Paper | Precision in Every Answer!
A Mandarin-speaking patient with severe back pain was admitted to the hospital. The
patient has radiographic imaging results indicating possible cancerous lesions. The
physician plans to speak with the patient about the potential next steps of care. To
ensure that the patient can make informed decisions, it is best that:
A. The patient is provided information in his or her primary language by a medical
translator.
B. Family members are present at the bedside and assist with translation.
C. The physician asks a Mandarin-speaking colleague to translate.
D. The physician meets with the family to discuss treatment goals. - Answer: Correct
answer is a: Sharing medical information with patients must be done in their primary
language by a medical translator to ensure accuracy and culturally competent care.
The key concepts embedded in patient- and family-centered care are:
A. Interdisciplinary team, participation, collaboration, and chart review.
B. Dignity and respect, information sharing, participation, and collaboration.
C. Leadership, advocacy, participation, and patient safety.
D. Respect, medication reconciliation, advance care planning, and advocacy. - Answer:
Correct answer is b: The four key concepts embedded in patient- and family-centered
care are dignity and respect, information sharing, participation, and collaboration.
A hospice patient experiences a sudden increase in pain and dyspnea. The nurse case
manager makes a visit to the patient's home to assess the patient. The nurse
collaborates with the patient's attending physician to escalate the patient's medication
regimen. However, this has not been effective. The patient will require an increased
level of care. Which levels of hospice care would be appropriate for this patient?
A. Respite care or general inpatient level of care.
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
,B. Routine care or respite care.
C. Respite care or continuous home care.
D. General inpatient or continuous home care. - Answer: The correct answer is d: There
are conditions of participation (cops) that hospices must meet in order to participate in
the Medicare and Medicaid programs. Provision of general inpatient (GIP) care is one of
these cops. GIP care focuses on pain control and other symptoms in a hospital, skilled
nursing facility (SNF), or hospice inpatient facility. GIP care is for the management of
symptoms that cannot be managed outside of one of these facilities. GIP care requires
24-hour nursing services to be available to provide direct patient care. GIP care is
intended to be short-term. Continuous home care (CHC) is another cop. CHC is a
service that can only be provided during periods of crisis to allow patients to remain in
their homes. It cannot be provided at snfs, hospitals, or inpatient hospice facilities. Care
is provided eight to 24 hours a day to manage pain and other symptoms in the patient's
residence. The care does not need to be "continuous," but must total eight hours or
more of care within the 24-hour period. Care must be predominantly provided by
nurses.
Which of the following is the most diagnoses type of cancer?
A. Sarcoma.
B. Carcinoma.
C. Lymphoma.
D. Leukemia - Answer: Correct answer is b: Carcinoma is the most diagnosed type of
cancer, accounting for 80% to 90% of all cancer cases. Carcinoma begins in epithelial
cells. Epithelial cells are found on the outside surfaces of the skin and internal organs.
They are also found inside hollow organs such as the digestive tract and blood vessels.
Examples of carcinomas include prostate cancer, breast cancer, lung cancer, and
colorectal cancer.
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
,A patient with ovarian cancer becomes confused and excessively weak. The patient
complains of nausea and lack of appetite with extreme thirst and lack of urine output.
Which oncologic emergency would the nurse suspect the patient may be experiencing?
A. Superior vena cava syndrome.
B. Stevens-Johnson syndrome.
C. Malignant hypercalcemia.
D. Hyperviscosity syndrome. - Answer: Correct answer is c: Malignant hypercalcemia is
an oncologic emergency occurring in 20% to 30% of patients with cancer. It most often
occurs in patients with breast, lung, renal, or ovarian cancers; squamous cell
carcinomas of the head and neck; multiple myeloma; and certain lymphomas. Early
symptoms may include polyuria, changes in mental status, nausea, vomiting, and
constipation.
A patient with a pacemaker and an active implanted cardiac defibrillator (ICD) with stage
IV heart failure has elected hospice. The nurse determines that the patient teaching
about deactivating the ICD is successful when the patient states:
A. "Deactivating the ICD means my pacemaker will no longer work."
B. "Deactivating the ICD ensures I will not receive a shock if my heart has a dangerous
rhythm."
C. "As soon as the ICD is deactivated, I will qualify for hospice."
D. "If I choose to not deactivate the ICD now, I cannot change my mind in the future." -
Answer: Correct answer is b: Turning off the ICD means the patient will not receive a
shock in the event of a ventricular arrhythmia. Turning off the ICD will not hasten death
or cause pain; however, leaving the ICD activated could mean the device may deliver a
painful shock to the patient at the end of life.
A patient with a score of 7C on the Functional Assessment Staging Tool (FAST) is most
likely to have a Palliative Performance Scale (PPS) of:
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
, A. 80%.
B. 60%.
C. 40%.
D. 10%. - Answer: Correct answer is c: A PPS score of 40% indicates that a patient is
mainly in bed, requires assistance with care, and has reduced intake. A patient who
scores a 7C on the FAST scale has severe stage dementia, is eligible for hospice, and
can no longer walk. 10% is the stage immediately before death.
In patients with significant dementia, the risk of aspiration is high and feeding tubes are
often offered as alternatives for nutritional support. It is important to educate decision-
makers that:
A. Aspiration of oral secretions remains highly probable, creating a continued risk for
aspiration pneumonia.
B. Use of feeding tubes in patients with advanced dementia extends life expectancy by
several years.
C. Dementia patients tolerate feeding tube placements and feedings for the rest of their
lives without any complications.
D. Once tube feedings are started, they can never be stopped, even if the patient's
goals of care change. - Answer: Patients and their families should be made aware that
even with the use of feeding tubes, patients with moderately severe or severe dementia
remain at risk for aspiration pneumonia due to either aspiration of oral secretions or
aspiration of tube feedings. Data does not support the use of this intervention; most
patients with advanced dementia still die within a year of feeding tube placement.
According to the Hospice Conditions of Participation (cops), as established by the
Centers for Medicare and Medicaid Services (CMS), the hospice plan of care includes
an updated comprehensive assessment noting individual patient progress towards
goals that must be reviewed, revised, and documented by the hospice interdisciplinary
team in collaboration with the patient's attending physician every:
4
APPHIA - Crafted with Care and Precision for Academic Excellence.
Perfect Prep for Every Paper | Precision in Every Answer!
A Mandarin-speaking patient with severe back pain was admitted to the hospital. The
patient has radiographic imaging results indicating possible cancerous lesions. The
physician plans to speak with the patient about the potential next steps of care. To
ensure that the patient can make informed decisions, it is best that:
A. The patient is provided information in his or her primary language by a medical
translator.
B. Family members are present at the bedside and assist with translation.
C. The physician asks a Mandarin-speaking colleague to translate.
D. The physician meets with the family to discuss treatment goals. - Answer: Correct
answer is a: Sharing medical information with patients must be done in their primary
language by a medical translator to ensure accuracy and culturally competent care.
The key concepts embedded in patient- and family-centered care are:
A. Interdisciplinary team, participation, collaboration, and chart review.
B. Dignity and respect, information sharing, participation, and collaboration.
C. Leadership, advocacy, participation, and patient safety.
D. Respect, medication reconciliation, advance care planning, and advocacy. - Answer:
Correct answer is b: The four key concepts embedded in patient- and family-centered
care are dignity and respect, information sharing, participation, and collaboration.
A hospice patient experiences a sudden increase in pain and dyspnea. The nurse case
manager makes a visit to the patient's home to assess the patient. The nurse
collaborates with the patient's attending physician to escalate the patient's medication
regimen. However, this has not been effective. The patient will require an increased
level of care. Which levels of hospice care would be appropriate for this patient?
A. Respite care or general inpatient level of care.
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
,B. Routine care or respite care.
C. Respite care or continuous home care.
D. General inpatient or continuous home care. - Answer: The correct answer is d: There
are conditions of participation (cops) that hospices must meet in order to participate in
the Medicare and Medicaid programs. Provision of general inpatient (GIP) care is one of
these cops. GIP care focuses on pain control and other symptoms in a hospital, skilled
nursing facility (SNF), or hospice inpatient facility. GIP care is for the management of
symptoms that cannot be managed outside of one of these facilities. GIP care requires
24-hour nursing services to be available to provide direct patient care. GIP care is
intended to be short-term. Continuous home care (CHC) is another cop. CHC is a
service that can only be provided during periods of crisis to allow patients to remain in
their homes. It cannot be provided at snfs, hospitals, or inpatient hospice facilities. Care
is provided eight to 24 hours a day to manage pain and other symptoms in the patient's
residence. The care does not need to be "continuous," but must total eight hours or
more of care within the 24-hour period. Care must be predominantly provided by
nurses.
Which of the following is the most diagnoses type of cancer?
A. Sarcoma.
B. Carcinoma.
C. Lymphoma.
D. Leukemia - Answer: Correct answer is b: Carcinoma is the most diagnosed type of
cancer, accounting for 80% to 90% of all cancer cases. Carcinoma begins in epithelial
cells. Epithelial cells are found on the outside surfaces of the skin and internal organs.
They are also found inside hollow organs such as the digestive tract and blood vessels.
Examples of carcinomas include prostate cancer, breast cancer, lung cancer, and
colorectal cancer.
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
,A patient with ovarian cancer becomes confused and excessively weak. The patient
complains of nausea and lack of appetite with extreme thirst and lack of urine output.
Which oncologic emergency would the nurse suspect the patient may be experiencing?
A. Superior vena cava syndrome.
B. Stevens-Johnson syndrome.
C. Malignant hypercalcemia.
D. Hyperviscosity syndrome. - Answer: Correct answer is c: Malignant hypercalcemia is
an oncologic emergency occurring in 20% to 30% of patients with cancer. It most often
occurs in patients with breast, lung, renal, or ovarian cancers; squamous cell
carcinomas of the head and neck; multiple myeloma; and certain lymphomas. Early
symptoms may include polyuria, changes in mental status, nausea, vomiting, and
constipation.
A patient with a pacemaker and an active implanted cardiac defibrillator (ICD) with stage
IV heart failure has elected hospice. The nurse determines that the patient teaching
about deactivating the ICD is successful when the patient states:
A. "Deactivating the ICD means my pacemaker will no longer work."
B. "Deactivating the ICD ensures I will not receive a shock if my heart has a dangerous
rhythm."
C. "As soon as the ICD is deactivated, I will qualify for hospice."
D. "If I choose to not deactivate the ICD now, I cannot change my mind in the future." -
Answer: Correct answer is b: Turning off the ICD means the patient will not receive a
shock in the event of a ventricular arrhythmia. Turning off the ICD will not hasten death
or cause pain; however, leaving the ICD activated could mean the device may deliver a
painful shock to the patient at the end of life.
A patient with a score of 7C on the Functional Assessment Staging Tool (FAST) is most
likely to have a Palliative Performance Scale (PPS) of:
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
, A. 80%.
B. 60%.
C. 40%.
D. 10%. - Answer: Correct answer is c: A PPS score of 40% indicates that a patient is
mainly in bed, requires assistance with care, and has reduced intake. A patient who
scores a 7C on the FAST scale has severe stage dementia, is eligible for hospice, and
can no longer walk. 10% is the stage immediately before death.
In patients with significant dementia, the risk of aspiration is high and feeding tubes are
often offered as alternatives for nutritional support. It is important to educate decision-
makers that:
A. Aspiration of oral secretions remains highly probable, creating a continued risk for
aspiration pneumonia.
B. Use of feeding tubes in patients with advanced dementia extends life expectancy by
several years.
C. Dementia patients tolerate feeding tube placements and feedings for the rest of their
lives without any complications.
D. Once tube feedings are started, they can never be stopped, even if the patient's
goals of care change. - Answer: Patients and their families should be made aware that
even with the use of feeding tubes, patients with moderately severe or severe dementia
remain at risk for aspiration pneumonia due to either aspiration of oral secretions or
aspiration of tube feedings. Data does not support the use of this intervention; most
patients with advanced dementia still die within a year of feeding tube placement.
According to the Hospice Conditions of Participation (cops), as established by the
Centers for Medicare and Medicaid Services (CMS), the hospice plan of care includes
an updated comprehensive assessment noting individual patient progress towards
goals that must be reviewed, revised, and documented by the hospice interdisciplinary
team in collaboration with the patient's attending physician every:
4
APPHIA - Crafted with Care and Precision for Academic Excellence.
