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Introduction
The Certified Hospice and Palliative Nurse (CHPN) exam assesses a nurse’s expertise in caring for patients with serious, life-limiting illnesses. It focuses on symptom management, psychosocial support, ethical decision-making, and family-centered care. Practicing exam-style questions improves critical thinking, reinforces key concepts, and builds confidence before the CHPN certification exam.
Practice Questions
Q1. A terminally ill patient reports severe dyspnea. Which intervention is most appropriate?
A. Administer supplemental oxygen and low-dose opioids
B. Encourage deep breathing exercises only
C. Increase fluid intake
D. Restrict movement completely
Answer: A
Detailed Explanation: Opioids reduce the sensation of breathlessness, and supplemental oxygen supports oxygenation.
Q2. Which is a key principle of palliative care?
A. Focus solely on curative treatment
B. Provide relief of pain and symptoms while supporting quality of life
C. Limit family involvement
D. Avoid discussing prognosis
Answer: B
Detailed Explanation: Palliative care emphasizes symptom relief, comfort, and patient/family support.
Q3. A patient nearing end of life has decreased oral intake and dry mucous membranes. The nurse should:
A. Force oral fluids
B. Provide small sips of water, ice chips, or oral swabs
C. Start IV fluids immediately
D. Ignore hydration
Answer: B
Detailed Explanation: Gentle hydration and comfort measures are preferred at end of life; aggressive hydration can cause discomfort.
Q4. A patient is experiencing terminal agitation. The nurse anticipates:
A. Low-dose sedatives such as lorazepam
B. Physical restraints
C. High-dose opioids only
D. Ignoring the behavior
Answer: A
Detailed Explanation: Benzodiazepines help relieve anxiety and agitation in end-of-life care.
Q5. Which symptom is most common in patients receiving end-of-life care?
A. Pain
B. Fever only
C. Rash
D. Increased appetite
Answer: A
Detailed Explanation: Pain management is a primary concern in hospice and palliative care.
Q6. A patient with metastatic cancer reports nausea. The nurse should:
A. Administer antiemetic as prescribed and provide small, frequent meals
B. Encourage large meals
C. Avoid medications
D. Force fluids
Answer: A
Detailed Explanation: Antiemetics and dietary adjustments help manage nausea and maintain comfort.
Q7. Which is a sign of impending death?
A. Decreased level of consciousness, irregular breathing, mottled skin
B. Increased appetite and energy
C. High blood pressure
D. Fever only
Answer: A
Detailed Explanation: These are common physiologic changes seen in the final days or hours of life.
Q8. A family expresses guilt about not being able to visit daily. The nurse should:
A. Encourage verbalization of feelings and provide support
B. Dismiss their feelings
C. Avoid conversation
D. Give medical facts only
Answer: A
Detailed Explanation: Supporting emotional needs and validating feelings is central in palliative care.
Q9. Which medication is commonly used for managing pain in hospice patients?
A. Morphine
B. Acetaminophen only
C. Aspirin only
D. Antibiotics
Answer: A
Detailed Explanation: Opioids like morphine are standard for managing moderate to severe pain in palliative care.
Q10. Which intervention supports respiratory comfort in a patient with terminal dyspnea?
A. Position upright, fan for air circulation, opioids if needed
B. Lie flat in bed
C. Force deep breathing exercises
D. Restrict oxygen
Answer: A
Detailed Explanation: Upright positioning and airflow improve comfort, while opioids reduce breathlessness.
Q11. A patient expresses fear about dying. The nurse should:
A. Listen empathetically and provide emotional support
B. Change the subject
C. Offer medical statistics only
D. Avoid discussing feelings
Answer: A
Detailed Explanation: Emotional support and active listening are essential in hospice care.
Q12. Which is a priority in managing terminal delirium?
A. Assess for reversible causes and provide low-dose antipsychotics if needed
B. Restrain the patient
C. Ignore symptoms
D. Provide high-dose opioids only
Answer: A
Detailed Explanation: Delirium may have reversible causes; antipsychotics help manage distressing symptoms.
Q13. A patient refuses food and fluids near the end of life. The nurse should:
A. Respect the patient’s wishes while providing comfort measures
B. Force feeding
C. Insert NG tube immediately
D. Limit patient contact
Answer: A
Detailed Explanation: Comfort and dignity take priority over artificial nutrition in end-of-life care.
Q14. Which intervention is appropriate for a patient experiencing constipation from opioid use?
A. Administer prescribed stool softeners and encourage mobility if possible
B. Increase opioid dose
C. Restrict fluids
D. Avoid bowel assessment
Answer: A
Detailed Explanation: Proactive bowel management prevents discomfort from opioid-induced constipation.
Q15. A patient experiences severe anxiety during terminal illness. The nurse anticipates:
A. Benzodiazepines or other appropriate anxiolytics
B. Only deep breathing exercises
C. Ignore symptoms
D. High-dose opioids
Answer: A
Detailed Explanation: Pharmacologic and non-pharmacologic interventions help alleviate anxiety and distress.
Q16. Which assessment indicates dehydration in a hospice patient?
A. Dry mucous membranes, decreased urine output, sunken eyes
B. Increased appetite
C. Moist skin
D. Normal urine output
Answer: A
Detailed Explanation: These are classic signs of dehydration at end of life; interventions focus on comfort.
Q17. A patient receiving palliative care has terminal secretions (“death rattle”). The nurse should:
A. Administer prescribed anticholinergics and reposition patient
B. Suction aggressively
C. Force fluids
D. Ignore family concerns
Answer: A
Detailed Explanation: Medications like scopolamine reduce secretions; repositioning improves comfort.
Q18. Which ethical principle is most important in hospice care?
A. Respecting patient autonomy
B. Maximizing hospital profits
C. Ignoring family concerns
D. Providing unnecessary aggressive treatment
Answer: A
Detailed Explanation: Patient-centered care and honoring wishes are central ethical principles.
Q19. Which symptom is common in advanced cancer patients receiving palliative care?
A. Fatigue
B. Hyperactivity
C. Increased appetite
D. Fever only
Answer: A
Detailed Explanation: Fatigue is prevalent in advanced illness and impacts quality of life; management includes energy conservation.
Q20. A patient is experiencing pain but reports fear of taking opioids due to addiction. The nurse should:
A. Provide education about safe use and address concerns empathetically
B. Refuse to give medication
C. Encourage alternative therapies only
D. Avoid discussion
Answer: A
Detailed Explanation: Patient education and reassurance improve adherence and comfort.
Q21. Which action helps families cope with anticipatory grief?
A. Encourage open discussion, provide resources, and offer emotional support
B. Avoid conversations about death
C. Discourage visitation
D. Focus only on medical care
Answer: A
Detailed Explanation: Supporting families emotionally is essential in hospice care.
Q22. A patient with terminal illness has severe nausea. Which is an appropriate intervention?
A. Administer antiemetics, provide small frequent meals
B. Restrict all food and fluids
C. Ignore symptoms
D. Force oral intake
Answer: A
Detailed Explanation: Symptom management prioritizes comfort while maintaining hydration and nutrition as tolerated.
Q23. Which is a priority for a hospice nurse managing end-of-life care?
A. Pain and symptom relief
B. Aggressive curative treatment
C. Hospitalization only
D. Routine lab monitoring only
Answer: A
Detailed Explanation: Hospice nursing focuses on comfort, dignity, and symptom management.
Q24. A patient is experiencing terminal restlessness. Which intervention is most appropriate?
A. Administer low-dose sedatives and provide calming environment
B. Restrain the patient
C. Ignore symptoms
D. Increase intravenous fluids
Answer: A
Detailed Explanation: Comfort measures and appropriate sedation improve quality of life.
Q25. Which intervention supports a peaceful death?
A. Maintain comfort, dignity, and provide family support
B. Aggressively pursue life-prolonging treatments regardless of wishes
C. Limit communication
D. Restrict visitation
Answer: A
Detailed Explanation: Hospice care prioritizes a dignified, symptom-free death and emotional support for patients and families.
Conclusion
The CHPN exam evaluates knowledge in end-of-life care, symptom management, ethical decision-making, and family-centered support. These 25 practice questions reflect real-world hospice and palliative care scenarios. Review frequently, practice critical thinking, and good luck on your CHPN certification exam