Hospice And Palliative Registered Nurse Certification
Exam Questions And Answers
Which assessment findings would most strongly suggest an issue with morphine? Correct Answer:
myoclonus is a symptom of the toxic effects of morphine metabolites
Which cancer is least likely to metastasize to the bone? Correct Answer: Colorectal; it mainly
metastasizes to the liver, lung, and peritoneum.
What is the drug of choice to relieve a patient's feeling of "air hunger" in end stage pulmonary
disease? Correct Answer: morphine; opioids provide palliative support for symptoms of
breathlessness or suffocation.
What is not an appropriate intervention for a bowel obstruction Correct Answer: Metoclopramide
The classic signs of superior vena cava syndrome (SVCS) Correct Answer: facial edema, dyspnea,
edematous arms w/bluish color=this is oncologic emergency requiring immediate attention.
Anticipatory grief Correct Answer: the proces of psychological, social, and somatic reactions to a
perceived future loss.
Signs and symptoms of imminent death Correct Answer: dysphagia
Stage II skin breakdown Correct Answer: skin is blistered, cracked or abraded
The state of having suffered a loss Correct Answer: bereavement
Disseminated Intravascular Coagulation (DIC) Correct Answer: focal ischemia, widespread
thrombosis or bleeding, superficial gangrene, jaundice, acrocyanosis, altered sensation, ulceration of
gastrointestinal system, decreased urinary output, and dyspnea.
Prognosis of days to weeks, intervention for dysphagia Correct Answer: teach family the importance
of oral hygiene to prevent complications such as mouth soreness and infections.
Safety is a priority w/persons w/dementia Correct Answer: supervision, minimal stimulation, and
discouraging sleep during daytime hours maximize night safety.
Xerostomia Correct Answer: dry mouth, and can be a side effect of medications and a long term
effect of radiation.
Spiritual care of the hospice patient and family Correct Answer: identifies and strives to relieve the
spiritual suffering of the patient and family
Grief Correct Answer: the feelings related to the perception of the loss and is a normal reaction to
loss.
Mentoring Correct Answer: a relationship between an experienced person and a less experienced
person
, Justice Correct Answer: to consider rules and actions that result in fair and equitable use of available
resources.
Medicare hospice benefit periods Correct Answer: 90-, 90-, and unlimited 60-day periods
Crossing of professional boundaries Correct Answer: providing a personal cell phone number to the
family
Syncopal episodes and falls Correct Answer: consider discontinuing antihypertensive medications if
blood pressure is consistently low
When revoking the medicare hospice benefit Correct Answer: The patient will lose the remaining
days of the current period if they revoke the medicare hospice benefit
The dose-limiting side effect of morphine Correct Answer: Myoclonus=myoclonus is the chronic
spasm of a muscle; if moclonus is present, accepted practice is to rotate to another opioid.
First priority when pt. Unable to make own decisions and being cared for by family Correct Answer:
knowing how the family makes decisions and who the decision makers are is priority.
Therapy for stage II wounds Correct Answer: relieve pressure and apply protective/occlusive
dressings.
Starting oral dose for methadone Correct Answer: 2.5-5 mg every 8 hours (half dose for elderly or
severe renal or liver disease)
Side effect of methadone Correct Answer: prolong QT interval
Equianalgesic conversion process -step one Correct Answer: step one- add up the total amount of
the current drug given in 24 hours
Remember to add in both the scheduled and breakthrough or rescue doses
Calculate separately if more than one drug
Epuianalgesic conversion process -step two Correct Answer: step two- Divide current 24 hour total by
the equianalgesic value for the current drug and route of administration.
Most commonly used opioid analgesics
Morphine-Parental 10mg/enteral 30mg
Codeine-parental 130mg/enteral 200mg (not recommended)
Fentanyl-parental 50-100 mcg/ enteral TRIF (transmucosal immediate release fentanyl)
Hydrocodone- parental n/a enteral 30 mg.
Hydromorphone- parental 1.5mg/enteral 7.5mg.
Levorphanol-parental 2 mg acute, 1mg. Chronic/enteral 4mg. Acute 1 mg. Chronic
Methadone-parental unknown/ enteral unknown
Oxycodone-parental n/a enteral 20mg.
Equianalgesic conversion process- step three Correct Answer: Multiply the step 2 number by the
equianalgesic value for the new drug and route (this will give you the new 24-hour dose
Exam Questions And Answers
Which assessment findings would most strongly suggest an issue with morphine? Correct Answer:
myoclonus is a symptom of the toxic effects of morphine metabolites
Which cancer is least likely to metastasize to the bone? Correct Answer: Colorectal; it mainly
metastasizes to the liver, lung, and peritoneum.
What is the drug of choice to relieve a patient's feeling of "air hunger" in end stage pulmonary
disease? Correct Answer: morphine; opioids provide palliative support for symptoms of
breathlessness or suffocation.
What is not an appropriate intervention for a bowel obstruction Correct Answer: Metoclopramide
The classic signs of superior vena cava syndrome (SVCS) Correct Answer: facial edema, dyspnea,
edematous arms w/bluish color=this is oncologic emergency requiring immediate attention.
Anticipatory grief Correct Answer: the proces of psychological, social, and somatic reactions to a
perceived future loss.
Signs and symptoms of imminent death Correct Answer: dysphagia
Stage II skin breakdown Correct Answer: skin is blistered, cracked or abraded
The state of having suffered a loss Correct Answer: bereavement
Disseminated Intravascular Coagulation (DIC) Correct Answer: focal ischemia, widespread
thrombosis or bleeding, superficial gangrene, jaundice, acrocyanosis, altered sensation, ulceration of
gastrointestinal system, decreased urinary output, and dyspnea.
Prognosis of days to weeks, intervention for dysphagia Correct Answer: teach family the importance
of oral hygiene to prevent complications such as mouth soreness and infections.
Safety is a priority w/persons w/dementia Correct Answer: supervision, minimal stimulation, and
discouraging sleep during daytime hours maximize night safety.
Xerostomia Correct Answer: dry mouth, and can be a side effect of medications and a long term
effect of radiation.
Spiritual care of the hospice patient and family Correct Answer: identifies and strives to relieve the
spiritual suffering of the patient and family
Grief Correct Answer: the feelings related to the perception of the loss and is a normal reaction to
loss.
Mentoring Correct Answer: a relationship between an experienced person and a less experienced
person
, Justice Correct Answer: to consider rules and actions that result in fair and equitable use of available
resources.
Medicare hospice benefit periods Correct Answer: 90-, 90-, and unlimited 60-day periods
Crossing of professional boundaries Correct Answer: providing a personal cell phone number to the
family
Syncopal episodes and falls Correct Answer: consider discontinuing antihypertensive medications if
blood pressure is consistently low
When revoking the medicare hospice benefit Correct Answer: The patient will lose the remaining
days of the current period if they revoke the medicare hospice benefit
The dose-limiting side effect of morphine Correct Answer: Myoclonus=myoclonus is the chronic
spasm of a muscle; if moclonus is present, accepted practice is to rotate to another opioid.
First priority when pt. Unable to make own decisions and being cared for by family Correct Answer:
knowing how the family makes decisions and who the decision makers are is priority.
Therapy for stage II wounds Correct Answer: relieve pressure and apply protective/occlusive
dressings.
Starting oral dose for methadone Correct Answer: 2.5-5 mg every 8 hours (half dose for elderly or
severe renal or liver disease)
Side effect of methadone Correct Answer: prolong QT interval
Equianalgesic conversion process -step one Correct Answer: step one- add up the total amount of
the current drug given in 24 hours
Remember to add in both the scheduled and breakthrough or rescue doses
Calculate separately if more than one drug
Epuianalgesic conversion process -step two Correct Answer: step two- Divide current 24 hour total by
the equianalgesic value for the current drug and route of administration.
Most commonly used opioid analgesics
Morphine-Parental 10mg/enteral 30mg
Codeine-parental 130mg/enteral 200mg (not recommended)
Fentanyl-parental 50-100 mcg/ enteral TRIF (transmucosal immediate release fentanyl)
Hydrocodone- parental n/a enteral 30 mg.
Hydromorphone- parental 1.5mg/enteral 7.5mg.
Levorphanol-parental 2 mg acute, 1mg. Chronic/enteral 4mg. Acute 1 mg. Chronic
Methadone-parental unknown/ enteral unknown
Oxycodone-parental n/a enteral 20mg.
Equianalgesic conversion process- step three Correct Answer: Multiply the step 2 number by the
equianalgesic value for the new drug and route (this will give you the new 24-hour dose
