CERTIFIED HOSPICE PALLIATIVE NURSE CHPN EXAM
LATEST VERSION WITH ALL QUESTIONS FROM
ACTUAL EXAM 100% CORRECT ANSWERS, AND
RATIONALE
Leukemia 2 types - CORRECT ANSWERS-chronic and acute
Leukemia Clinical Manifestations - CORRECT ANSWERS-Infection, fever, enlarged liver, spleen,
kidneys, bleeding/bruising not explained, & hemorrhage
pale, petechia, purpura
liver failure symptoms - CORRECT ANSWERS-fatigue, jaundice, ascites
Dark urine, gray stool, bruising
symptoms of bleeding internally - CORRECT ANSWERS-sudden fever > 101°, dyspnea,
abdominal paik, dehydration
Lymphoma types - CORRECT ANSWERS-Hodgkins and Non-Hodgkins
Hodgkin's disease - CORRECT ANSWERS-painless lymph node swelling, generally in upper
body, general fatigue, weight loss, fever, nifht sweats, back pain
Non-Hodgkin's Lymphoma - CORRECT ANSWERS-same symptoms except itching & night
sweats
Parkinson's disease - CORRECT ANSWERS-Slow progression of motor skills, resting tremors,
slowness, rigidity. typically in people >65
Parkinson Signs/Symptoms - CORRECT ANSWERS-pill rolling movements in bands, loss of
facial expression, difficulty initiating movement, gait changes
,Renal Cancer/symptoms - CORRECT ANSWERS-asymptomatic early. Gross hematuria, dull,
aching pain, palpable abdomen mass.
polycythemia- HA, dizzy, vein inflammation, itchy. hypercalcemia- tired, poor appetite, freq. urine, thirst,
n/v, confusion, constipation, poor concentration
sickle cell disease - CORRECT ANSWERS-pallor, jaundice, weakness, fatigue common
symptoms
sickle cell crisis - CORRECT ANSWERS-multiple pain events, pale lips, tongje, palms, nail beds,
lethargy, difficulty arousing, high fever 2 days
sickle cell risk - CORRECT ANSWERS-high r/o bacterial infections
palliative sedation - CORRECT ANSWERS-midazolam, propofol
terminal weaning - CORRECT ANSWERS-gradual withdrawal of mechanical ventilation
terminal Extubation - CORRECT ANSWERS-abrupt Removal of endotracheal tube
Death Rattle Meds - CORRECT ANSWERS-anticholinergic should be given @ 1st site of
moisture. they cannot dry up secretions already present
poverty barriers at EOL - CORRECT ANSWERS-additional challenges to EOL care. lack of
support.
BIPAP (non-invasive ventilation) - CORRECT ANSWERS-may be utilized at EOL for dyspnea in
some pts who do not want to be intubated for RF but want something more than supplemental o2.
ALS has been shown to improve quality of life.
unhealthy coping in caregiver @ EOL - CORRECT ANSWERS-signs: negative feelings (anger),
withholding info to other family, refusing assistance, focusing on their needs only, refusing to
acknowledge or accommodate differences in opinion among caregivers.
, intervene with assistance/resources
tricyclic antidepressants - CORRECT ANSWERS-tx neuropathic pain. High A/E
tricyclic antidepressants A/E - CORRECT ANSWERS-Anticholinergic common: dry mouth,
urinary retention, tachycardia, delirium, constipation
additional: arrhythmias, sedation, weight gain, sweating, sexual dysfunction.
*pt may refuse to continue r/t A/E
myoclonus - CORRECT ANSWERS-jerks, sudden, brief, and uncontrollable movement. mostly
upper extremity. most common cause is opiod. sign of opiod toxicity- need to change meds. Narcan for
acute tx.
benzos & antispasmodics can be tx in *some* pts
Hypercalcemia - CORRECT ANSWERS-urgent & serious late stage malignancy (unrelated to
bone mets). no tx results in death
hypercalcemia occurrence - CORRECT ANSWERS-most common breast CA & multiple
myeloma but can occur with others.
Hypercalcemia symptoms - CORRECT ANSWERS-n/v, constipation, anorexia
weakness, mental change, fatigue
bradycardia, EKG changes
Hypercalcemia treatment - CORRECT ANSWERS-palliative care pt: IV hydration, calcitonin
(inhibits bone resorption) & biophonates (inhibits bone resorption & reduces Calcium levels)- but this is
delayed to 48 hrs after administration.
federal law & organ donation - CORRECT ANSWERS-family must be asked about donation
when pts die in the hospital if there is no advanced directive outlining pts wishes
LATEST VERSION WITH ALL QUESTIONS FROM
ACTUAL EXAM 100% CORRECT ANSWERS, AND
RATIONALE
Leukemia 2 types - CORRECT ANSWERS-chronic and acute
Leukemia Clinical Manifestations - CORRECT ANSWERS-Infection, fever, enlarged liver, spleen,
kidneys, bleeding/bruising not explained, & hemorrhage
pale, petechia, purpura
liver failure symptoms - CORRECT ANSWERS-fatigue, jaundice, ascites
Dark urine, gray stool, bruising
symptoms of bleeding internally - CORRECT ANSWERS-sudden fever > 101°, dyspnea,
abdominal paik, dehydration
Lymphoma types - CORRECT ANSWERS-Hodgkins and Non-Hodgkins
Hodgkin's disease - CORRECT ANSWERS-painless lymph node swelling, generally in upper
body, general fatigue, weight loss, fever, nifht sweats, back pain
Non-Hodgkin's Lymphoma - CORRECT ANSWERS-same symptoms except itching & night
sweats
Parkinson's disease - CORRECT ANSWERS-Slow progression of motor skills, resting tremors,
slowness, rigidity. typically in people >65
Parkinson Signs/Symptoms - CORRECT ANSWERS-pill rolling movements in bands, loss of
facial expression, difficulty initiating movement, gait changes
,Renal Cancer/symptoms - CORRECT ANSWERS-asymptomatic early. Gross hematuria, dull,
aching pain, palpable abdomen mass.
polycythemia- HA, dizzy, vein inflammation, itchy. hypercalcemia- tired, poor appetite, freq. urine, thirst,
n/v, confusion, constipation, poor concentration
sickle cell disease - CORRECT ANSWERS-pallor, jaundice, weakness, fatigue common
symptoms
sickle cell crisis - CORRECT ANSWERS-multiple pain events, pale lips, tongje, palms, nail beds,
lethargy, difficulty arousing, high fever 2 days
sickle cell risk - CORRECT ANSWERS-high r/o bacterial infections
palliative sedation - CORRECT ANSWERS-midazolam, propofol
terminal weaning - CORRECT ANSWERS-gradual withdrawal of mechanical ventilation
terminal Extubation - CORRECT ANSWERS-abrupt Removal of endotracheal tube
Death Rattle Meds - CORRECT ANSWERS-anticholinergic should be given @ 1st site of
moisture. they cannot dry up secretions already present
poverty barriers at EOL - CORRECT ANSWERS-additional challenges to EOL care. lack of
support.
BIPAP (non-invasive ventilation) - CORRECT ANSWERS-may be utilized at EOL for dyspnea in
some pts who do not want to be intubated for RF but want something more than supplemental o2.
ALS has been shown to improve quality of life.
unhealthy coping in caregiver @ EOL - CORRECT ANSWERS-signs: negative feelings (anger),
withholding info to other family, refusing assistance, focusing on their needs only, refusing to
acknowledge or accommodate differences in opinion among caregivers.
, intervene with assistance/resources
tricyclic antidepressants - CORRECT ANSWERS-tx neuropathic pain. High A/E
tricyclic antidepressants A/E - CORRECT ANSWERS-Anticholinergic common: dry mouth,
urinary retention, tachycardia, delirium, constipation
additional: arrhythmias, sedation, weight gain, sweating, sexual dysfunction.
*pt may refuse to continue r/t A/E
myoclonus - CORRECT ANSWERS-jerks, sudden, brief, and uncontrollable movement. mostly
upper extremity. most common cause is opiod. sign of opiod toxicity- need to change meds. Narcan for
acute tx.
benzos & antispasmodics can be tx in *some* pts
Hypercalcemia - CORRECT ANSWERS-urgent & serious late stage malignancy (unrelated to
bone mets). no tx results in death
hypercalcemia occurrence - CORRECT ANSWERS-most common breast CA & multiple
myeloma but can occur with others.
Hypercalcemia symptoms - CORRECT ANSWERS-n/v, constipation, anorexia
weakness, mental change, fatigue
bradycardia, EKG changes
Hypercalcemia treatment - CORRECT ANSWERS-palliative care pt: IV hydration, calcitonin
(inhibits bone resorption) & biophonates (inhibits bone resorption & reduces Calcium levels)- but this is
delayed to 48 hrs after administration.
federal law & organ donation - CORRECT ANSWERS-family must be asked about donation
when pts die in the hospital if there is no advanced directive outlining pts wishes
