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HOSPICE & PALLIATIVE NURSE
CERTIFICATION ACTUAL EXAM 2026/2027
COMPLETE ACCURATE EXAM REAL
QUESTIONS WITH WELL ELABORATED
ANSWERS AND RATIONALES. (100%
CORRECT VERIFIED SOLUTIONS)
1. A hospice patient in Manhattan wishes to continue seeing
their private attending physician who is not employed by the
hospice. Under NYS regulations, which statement is correct?
a) The attending physician must sign a waiver of liability.
b) The attending physician can bill Medicare separately for
services related to the terminal illness.
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c) The hospice must pay the attending physician directly.
d) The patient must switch to the hospice medical director.
Answer: b – Under the Medicare Hospice Benefit, the
attending physician (if not hospice employed) may continue to
bill Medicare separately for services related to the terminal
illness. NYS follows federal rules.
2. A palliative care nurse in a NYS nursing home is asked to
initiate hospice for a dementia patient. The patient’s health
care proxy refuses. What is the nurse’s best action?
a) Start hospice anyway if the patient is suffering.
b) Respect the proxy’s decision and document.
c) Call APS for elder abuse.
d) Ask the facility administrator to override the proxy.
Answer: b – In NY, a health care proxy’s decision is legally
binding unless it violates accepted medical standards.
Document refusal and provide palliative measures within
nursing home.
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3. Under NYS Public Health Law, how often must a hospice
interdisciplinary group (IDG) review the plan of care for a
patient receiving continuous home care?
a) Daily
b) Every 48 hours
c) Weekly
d) Every 15 days
Answer: a – For continuous home care (crisis care), NYS
requires daily IDG review to justify the level of care.
4. A patient in Rochester has no advance directives. Who is the
legal surrogate decision-maker for hospice consent in NYS?
a) Any adult child
b) Spouse, then adult child, then parent, then sibling (in order)
c) The hospice social worker
d) The primary nurse
Answer: b – NY Family Health Care Decisions Act (FHCDA)
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establishes a surrogate hierarchy: spouse → adult child →
parent → sibling.
5. A hospice nurse documents a patient’s prognosis as “6
months or less if the illness runs its normal course.” This is
required for:
a) Medicaid only
b) Medicare Hospice Benefit eligibility
c) NYS Palliative Care Information Act
d) Hospital discharge planning
Answer: b – Two physicians (hospice medical director +
attending) must certify terminal prognosis of ≤6 months for
Medicare Hospice.
6. A patient revokes their hospice benefit on a Friday
afternoon. According to NYS regulations, what must the
hospice do?
a) Continue services for 7 days.
b) Discontinue services immediately and notify the patient’s
HOSPICE & PALLIATIVE NURSE
CERTIFICATION ACTUAL EXAM 2026/2027
COMPLETE ACCURATE EXAM REAL
QUESTIONS WITH WELL ELABORATED
ANSWERS AND RATIONALES. (100%
CORRECT VERIFIED SOLUTIONS)
1. A hospice patient in Manhattan wishes to continue seeing
their private attending physician who is not employed by the
hospice. Under NYS regulations, which statement is correct?
a) The attending physician must sign a waiver of liability.
b) The attending physician can bill Medicare separately for
services related to the terminal illness.
,Page 2 of 139
c) The hospice must pay the attending physician directly.
d) The patient must switch to the hospice medical director.
Answer: b – Under the Medicare Hospice Benefit, the
attending physician (if not hospice employed) may continue to
bill Medicare separately for services related to the terminal
illness. NYS follows federal rules.
2. A palliative care nurse in a NYS nursing home is asked to
initiate hospice for a dementia patient. The patient’s health
care proxy refuses. What is the nurse’s best action?
a) Start hospice anyway if the patient is suffering.
b) Respect the proxy’s decision and document.
c) Call APS for elder abuse.
d) Ask the facility administrator to override the proxy.
Answer: b – In NY, a health care proxy’s decision is legally
binding unless it violates accepted medical standards.
Document refusal and provide palliative measures within
nursing home.
,Page 3 of 139
3. Under NYS Public Health Law, how often must a hospice
interdisciplinary group (IDG) review the plan of care for a
patient receiving continuous home care?
a) Daily
b) Every 48 hours
c) Weekly
d) Every 15 days
Answer: a – For continuous home care (crisis care), NYS
requires daily IDG review to justify the level of care.
4. A patient in Rochester has no advance directives. Who is the
legal surrogate decision-maker for hospice consent in NYS?
a) Any adult child
b) Spouse, then adult child, then parent, then sibling (in order)
c) The hospice social worker
d) The primary nurse
Answer: b – NY Family Health Care Decisions Act (FHCDA)
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establishes a surrogate hierarchy: spouse → adult child →
parent → sibling.
5. A hospice nurse documents a patient’s prognosis as “6
months or less if the illness runs its normal course.” This is
required for:
a) Medicaid only
b) Medicare Hospice Benefit eligibility
c) NYS Palliative Care Information Act
d) Hospital discharge planning
Answer: b – Two physicians (hospice medical director +
attending) must certify terminal prognosis of ≤6 months for
Medicare Hospice.
6. A patient revokes their hospice benefit on a Friday
afternoon. According to NYS regulations, what must the
hospice do?
a) Continue services for 7 days.
b) Discontinue services immediately and notify the patient’s
