Certified Hospice And Palliative Nurse (CHPN)
Certification Exam Practice Test Questions And
Correct Answers With Rationales
1. Which of the following is the primary goal of palliative care?
A. To cure the underlying disease
B. To improve quality of life for patients and families
C. To extend life expectancy at all costs
D. To provide only end-of-life care
Rationale: The main goal of palliative care is to improve quality of
life through symptom management, psychosocial support, and
spiritual care for patients and their families.
2. A patient with terminal cancer expresses a desire to stop
chemotherapy. The nurse’s best response is to:
A. Encourage the patient to reconsider
B. Notify the oncologist immediately without discussion
C. Explore the patient’s reasons and goals for care
, D. Tell the patient it’s their legal right to refuse treatment
Rationale: Exploring the patient’s reasoning demonstrates respect
for autonomy while ensuring the decision is informed and values-
based.
3. The best indicator of pain in a nonverbal hospice patient is:
A. Vital signs
B. Family report
C. Behavioral cues such as grimacing or restlessness
D. Medication use history
Rationale: Behavioral indicators are the most reliable means of
assessing pain in nonverbal or cognitively impaired patients.
4. Which medication is most appropriate for managing dyspnea in an
end-of-life patient?
A. Lorazepam
B. Albuterol
C. Morphine
D. Prednisone
Rationale: Opioids like morphine reduce the sensation of air hunger
and are the first-line treatment for dyspnea in palliative care.
,5. A patient with advanced COPD asks if they will become addicted to
opioids prescribed for breathlessness. The nurse should respond:
A. “Addiction is likely at this stage.”
B. “You should avoid opioids for safety.”
C. “At this stage, opioids are safe and effective for comfort.”
D. “You should use them only if symptoms are severe.”
Rationale: In palliative care, the focus is comfort, and addiction
concerns are minimal when opioids are used appropriately for
symptom control.
6. Which of the following is an ethical principle guiding hospice care?
A. Paternalism
B. Autonomy
C. Justice only
D. Beneficence over autonomy
Rationale: Respecting autonomy allows patients to make decisions
consistent with their values and goals.
7. The hospice nurse notices increased confusion in a terminal patient on
opioids. The likely cause is:
A. Disease progression only
B. Opioid-induced neurotoxicity
C. Psychological distress
, D. Sleep deprivation
Rationale: Neurotoxicity can occur from opioid accumulation,
particularly in renal impairment, causing confusion or agitation.
8. The best nursing intervention for a dying patient with noisy
respirations (“death rattle”) is to:
A. Increase fluids
B. Suction frequently
C. Reposition the patient and use anticholinergics
D. Increase oxygen
Rationale: Repositioning and medications like glycopyrrolate reduce
secretions without invasive discomfort.
9. Which statement about hospice care eligibility under Medicare is
true?
A. The patient must have a terminal illness with a 1-year prognosis
B. Only cancer patients qualify
C. The patient must have a prognosis of 6 months or less if the
disease follows its normal course
D. The patient must refuse all treatments
Rationale: Medicare hospice benefit requires a prognosis of six
months or less, as certified by physicians.
Certification Exam Practice Test Questions And
Correct Answers With Rationales
1. Which of the following is the primary goal of palliative care?
A. To cure the underlying disease
B. To improve quality of life for patients and families
C. To extend life expectancy at all costs
D. To provide only end-of-life care
Rationale: The main goal of palliative care is to improve quality of
life through symptom management, psychosocial support, and
spiritual care for patients and their families.
2. A patient with terminal cancer expresses a desire to stop
chemotherapy. The nurse’s best response is to:
A. Encourage the patient to reconsider
B. Notify the oncologist immediately without discussion
C. Explore the patient’s reasons and goals for care
, D. Tell the patient it’s their legal right to refuse treatment
Rationale: Exploring the patient’s reasoning demonstrates respect
for autonomy while ensuring the decision is informed and values-
based.
3. The best indicator of pain in a nonverbal hospice patient is:
A. Vital signs
B. Family report
C. Behavioral cues such as grimacing or restlessness
D. Medication use history
Rationale: Behavioral indicators are the most reliable means of
assessing pain in nonverbal or cognitively impaired patients.
4. Which medication is most appropriate for managing dyspnea in an
end-of-life patient?
A. Lorazepam
B. Albuterol
C. Morphine
D. Prednisone
Rationale: Opioids like morphine reduce the sensation of air hunger
and are the first-line treatment for dyspnea in palliative care.
,5. A patient with advanced COPD asks if they will become addicted to
opioids prescribed for breathlessness. The nurse should respond:
A. “Addiction is likely at this stage.”
B. “You should avoid opioids for safety.”
C. “At this stage, opioids are safe and effective for comfort.”
D. “You should use them only if symptoms are severe.”
Rationale: In palliative care, the focus is comfort, and addiction
concerns are minimal when opioids are used appropriately for
symptom control.
6. Which of the following is an ethical principle guiding hospice care?
A. Paternalism
B. Autonomy
C. Justice only
D. Beneficence over autonomy
Rationale: Respecting autonomy allows patients to make decisions
consistent with their values and goals.
7. The hospice nurse notices increased confusion in a terminal patient on
opioids. The likely cause is:
A. Disease progression only
B. Opioid-induced neurotoxicity
C. Psychological distress
, D. Sleep deprivation
Rationale: Neurotoxicity can occur from opioid accumulation,
particularly in renal impairment, causing confusion or agitation.
8. The best nursing intervention for a dying patient with noisy
respirations (“death rattle”) is to:
A. Increase fluids
B. Suction frequently
C. Reposition the patient and use anticholinergics
D. Increase oxygen
Rationale: Repositioning and medications like glycopyrrolate reduce
secretions without invasive discomfort.
9. Which statement about hospice care eligibility under Medicare is
true?
A. The patient must have a terminal illness with a 1-year prognosis
B. Only cancer patients qualify
C. The patient must have a prognosis of 6 months or less if the
disease follows its normal course
D. The patient must refuse all treatments
Rationale: Medicare hospice benefit requires a prognosis of six
months or less, as certified by physicians.
