CHPN Domain 5: Practice Issues Welcome to your CHPN Domain 5: Practice Issues 1. CHPN: Practice Issues A hospice nurse is coordinating care for a patient with advanced dementia. The patient's family requests additional information about the use of non-pharmacological interventions. Which of the following is considered the most effective non-pharmacological intervention for reducing agitation in dementia patients? Scheduled repositioning Cognitive stimulation therapy Music therapy Increased fluid intake None 2. CHPN: Practice Issues In a case where a patient's advance directive is not available, and they are unable to make their own decisions, who is primarily responsible for making decisions regarding the patient's care? The attending physician A court-appointed guardian The closest family member The hospice nurse None 3. CHPN: Practice Issues Which of the following actions best exemplifies a hospice nurse's role in advocating for patient autonomy? Implementing family decisions without consulting the patient Discussing care preferences directly with the patient whenever possible Following hospital protocols regardless of the patient's stated preferences Advising the patient based on the nurse's personal beliefs None 4. CHPN: Practice Issues A hospice nurse is part of an interdisciplinary team that includes doctors, social workers, and spiritual care providers. Which of the following best describes the nurse's role in this team? To lead the team and make final decisions on patient care To provide direct patient care and relay observations to the team To handle all medical procedures independently To coordinate appointments and transportation for the patient None 5. CHPN: Practice Issues What is the primary ethical consideration when dealing with a terminally ill patient who refuses to eat or drink? The nurse must force nutrition to prolong life The nurse must respect the patient's wishes after ensuring they are informed The nurse should prioritize the family's wishes The nurse should make decisions based on the patient's past preferences None 6. CHPN: Practice Issues Which strategy is most effective for a hospice nurse managing a multidisciplinary team in a culturally diverse setting? Applying the same standards uniformly to all team members Customizing communication styles to fit the cultural backgrounds of team members Prioritizing efficiency over cultural considerations Delegating cultural issues to social workers None 7. CHPN: Practice Issues In assessing the quality of hospice care, which outcome measure is most important for a hospice nurse to monitor? The number of patients served annually Patient and family satisfaction with end-of-life care Efficiency of administrative processes Number of staff meetings held per month None 8. CHPN: Practice Issues How should a hospice nurse approach the care of a non-communicative patient who is in apparent distress? Assuming the cause of distress based on common symptoms Waiting for family input before acting Observing for non-verbal cues and consulting with the care team Administering pain medication routinely None 9. CHPN: Practice Issues A hospice nurse is caring for a patient who frequently changes their mind about pain management strategies. What is the best approach for the nurse to take? Decide on the most appropriate pain management strategy and insist on it Respect the patient's right to change their mind and adjust care plans accordingly Consult only the family to finalize the pain management plan Ignore the changes and continue with the original plan None 10. CHPN: Practice Issues When a patient in hospice care expresses a desire to discuss their fears about dying, how should the nurse respond? Redirect the conversation to a more positive topic Listen empathetically and encourage expression of these fears Suggest waiting for a family member to be present Offer reassurances that everything will be fine None 11. CHPN: Practice Issues How should a hospice nurse handle a situation where a patient's family is in conflict over the patient's care preferences? Support the opinion of the eldest family member Arrange a family meeting with the healthcare team to discuss the patient's wishes Decide based on what most family members want Enforce hospital policies regardless of family disagreements None 12. CHPN: Practice Issues A hospice nurse finds that a patient's cultural beliefs about death significantly differ from their own. What is the most appropriate action for the nurse to take? Try to convince the patient to view death from a medical perspective Respect and incorporate the patient's cultural beliefs into the care plan Ignore the cultural beliefs as irrelevant to medical care Document the beliefs but not integrate them into care None 13. CHPN: Practice Issues What should a hospice nurse prioritize when communicating about a terminal diagnosis to a patient who has limited health literacy? Use medical jargon to ensure accuracy Provide information in a simple, clear, and respectful manner Avoid detailed explanations to prevent confusion Let family members convey the diagnosis None 14. CHPN: Practice Issues In a case where a terminally ill patient has multiple caregivers, what is the key role of the hospice nurse? To assign tasks to each caregiver To mediate personal conflicts between caregivers To educate and support caregivers in providing consistent care To supervise caregivers at all times None 15. CHPN: Practice Issues Which approach is most suitable for a hospice nurse when managing a patient who is experiencing existential distress at the end of life? Provide strong reassurances about the normality of their feelings Arrange for psychological counseling without patient consent Engage in open discussions about the patient's feelings and fears Focus only on physical symptoms and ignore existential concerns None 16. CHPN: Practice Issues How should a hospice nurse react when a patient consistently refuses to take prescribed medications? Discontinue all medications to respect the patient's wishes Explore the reasons behind the refusal and seek alternatives or adjustments Report the patient to higher authorities for non-compliance Force the patient to comply through legal means None 17. CHPN: Practice Issues What is an essential component for a hospice nurse when establishing trust with a newly admitted patient? Demonstrating authority over medical knowledge Ensuring quick medical interventions Showing consistency and reliability in care Promising to cure or significantly improve the condition None 18. CHPN: Practice Issues When a hospice patient expresses a desire to die at home, but their home environment is deemed unsafe, what should the hospice nurse prioritize in their response? Arrange for necessary modifications to make the home safe Convince the patient to die in a hospital instead Dismiss the patient's wishes as impractical Transfer the patient to a hospice facility without discussion None 19. CHPN: Practice Issues In end-of-life care, a patient requests not to be told about the progression of their disease. How should the hospice nurse handle this request? Inform them despite their wishes to ensure they are aware Respect the patient's wishes and provide care without disclosing progression details Discuss the disease progression with the family instead Record the request but periodically reevaluate and inform the patient None 20. CHPN: Practice Issues What should a hospice nurse prioritize when a terminally ill patient has conflicting requests from different family members regarding their care? The nurse's own assessment of what's best for the patient The wishes of the family member who is legally responsible The patient's own preferences and wishes The most medically recommended option None 21. CHPN: Practice Issues When a hospice patient shows signs of withdrawal and depression, what is the most appropriate nursing action? Immediately prescribe antidepressants Encourage family members to cheer up the patient Assess for potential causes and facilitate appropriate interventions Ignore as a normal part of the dying process None 22. CHPN: Practice Issues A patient in hospice care frequently discusses their fear of dying alone. What strategy should the hospice nurse implement? Recommend psychiatric evaluation Schedule more frequent visits and check-ins Discourage such negative thoughts Increase medication dosages to reduce anxiety None 23. CHPN: Practice Issues What is the most effective way for a hospice nurse to support a patient who is grieving the impending loss of their own life? Encourage the patient to remain strong and not show sadness Provide space for the patient to express their grief and listen actively Focus on the positive aspects and minimize discussion of death Suggest avoiding discussions about death to reduce grief None 24. CHPN: Practice Issues When a hospice nurse encounters a patient with cultural values very different from their own, which of the following is the most appropriate action? Attempt to change the patient's views to align more closely with Western medicine Educate the patient about the nurse's own cultural values Respect and attempt to understand the patient's cultural values and incorporate them into care Ignore cultural differences as irrelevant to medical care None 25. CHPN: Practice Issues A hospice nurse is caring for a patient who believes in the therapeutic benefits of alternative medicine alongside conventional treatments. What is the most appropriate response by the nurse? Dismiss the patient's beliefs as unscientific Incorporate safe alternative practices that do not conflict with medical treatments Insist on relying solely on conventional medical treatments Allow the patient to use alternative medicine exclusively None 26. CHPN: Practice Issues When a hospice nurse is faced with a patient who consistently exhibits aggressive behavior due to pain and frustration, what is the most appropriate nursing action? Use restraints to prevent harm Respond with similar aggression to assert control Assess pain levels and explore all options for pain management Withdraw care to avoid confrontation None 27. CHPN: Practice Issues Which of the following actions best exemplifies a hospice nurse's role in advocating for patient autonomy? Implementing family decisions without consulting the patient Discussing care preferences directly with the patient whenever possible Following hospital protocols regardless of the patient's stated preferences Advising the patient based on the nurse's personal beliefs None 28. CHPN: Practice Issues How should a hospice nurse approach the care of a non-communicative patient who is in apparent distress? Assuming the cause of distress based on common symptoms Waiting for family input before acting Observing for non-verbal cues and consulting with the care team Administering pain medication routinely None 29. CHPN: Practice Issues What should a hospice nurse prioritize when communicating about a terminal diagnosis to a patient who has limited health literacy? Use medical jargon to ensure accuracy Provide information in a simple, clear, and respectful manner Avoid detailed explanations to prevent confusion Let family members convey the diagnosis None 30. CHPN: Practice Issues What is the most effective way for a hospice nurse to support a patient who is grieving the impending loss of their own life? Encourage the patient to remain strong and not show sadness Provide space for the patient to express their grief and listen actively Focus on the positive aspects and minimize discussion of death Suggest avoiding discussions about death to reduce grief None 1 out of 30 Time is Up! Time's up
