2019 Edition

CHPN Practice Exam

Take this free CHPN practice test to get a sample of the types of questions on the actual Hospice and Palliative Nurse certification exam. 

The CHPN exam is a 3 hour exam covering 150 multiple choice questions. The CHPN exam focuses on five domain practice areas: Life-limiting Conditions in Adult Patients, Pain Management, Symptom Management, Patient and Family Care and Practical Issues.  

You can also try the Complete 750 Question CHPN Practice Exam Kit with fully explained answers, testing tips and more.

 
 

Patient Care: Life-Limiting Conditions in Adult Patients

1. Alzheimer disease is associated with what characteristics?
2. You are the nurse on-call and receive a call from a continuous care nurse who states that her patient has started to have "rattling" secretions and the patient's wife is very concerned. You know from report that this patient is actively dying. What would be the most appropriate response?
3. Which characteristics are most closely associated with end-stage renal disease?
4. Mary is a 73-year-old patient with a 50-year history of smoking and a diagnosis of emphysema. She is very thin with a barrel chest, has intermittent dyspnea both at rest and with exertion, and supraclavicular retractions on exertion. What non-pharmacologic intervention would likely improve dyspnea in this patient?
5. John is a new hospice patient with heart failure. John reports a six-pound weight gain since his discharge from the hospital 3 days ago. The nurse notes that John has dependent peripheral edema 2 +, and he reports feeling nauseated and with poor appetite. Based on these findings, what is the pathophysiology of John's heart disease?
6. A nurse is meeting a patient for the first time. When introducing himself, the nurse notes a series of symptoms that are concerning for acute stroke. Which symptoms are associated with acute stroke?

Patient Care: Pain Management

7. Which of the following most accurately describes "breakthrough" pain?
8. Madge is an 88 year-old with end stage colon cancer, who is transitioning. She has been minimally responsive for the past six hours, but opens her eyes in response to her name.  She is restless at times with furrowing of her brow. She is still swallowing her secretions, and sucks on the oral sponge when mouth care is provided. Prior to her change in status, she was receiving Oxycontin 40 mg po tablets q12 hr ATC with liquid oxycodone 8-12 mg po q2hrs prn for breakthrough pain. In light of Madge's change in level of consciousness, what changes should be made to her pain management regimen?
9. Which patient is at most risk for under-treatment of pain symptoms?
10. Margaret is an 87-year old with breast cancer that has metastasized to bone and brain. She lives alone, and is checked in on by a neighbor every other day. During a home visit, Margaret complains of dull, constant pain in her back and breastbone. The nurse notes that the oxycodone tablets that he had counted out for her for the last two days are still in the pill box; Margaret cannot explain why she did not take them as prescribed. This is the second occasion when the nurse has found tablets not taken. What is an appropriate pain management strategy for Margaret?
11. What should be prescribed concurrently with any opioid regimen?
CDA Practice Test
12. Jordan is taking continuous-release morphine every 12 hours for pain control, and has a short-acting prn opioid for break through pain. He is experiencing end-of-dose failure at 9-10 hours. What would be the most appropriate intervention to manage Jordan's pain?

Patient Care: Symptom Management

13. Of the following, which may indicate a poor prognosis for the hospice patient with a diagnosis of end-stage cardiac disease?
14. When a hospice patient is facing increasing weakness, with increased fatigue and decreased mobility, which of the following is an important aspect of supporting the patient's care needs?
15. Terri has an indwelling pleural catheter in place for intermittent drainage of her pleural effusion. The nurse is present to provide teaching on the use of the catheter at home. Which point is important for the nurse to stress to Terri to avoid vasovagal symptoms?
16. Daryl has an incomplete bowel obstruction secondary to metastatic ovarian cancer. She is experiencing significant abdominal pain and is vomiting fecal matter. She and her family want non-pharmacologic interventions only. Which intervention is likely to be the most effective?
17. Michelle has metastatic head/neck cancer and is in the last stages of life. She is cared for at home by her niece. In the last 24 hours she has become increasingly restless, and is repetitively attempting to get out of bed, while calling out in distress. Which group of interventions would be the most appropriate for Michelle at this time?

Care of Patient and Family

18. Which service for the hospice patient would be paid for by the Hospice Medicare/Medicaid benefit?
19. After a patient's death, how long are bereavement services available to families and other individuals associated with the patient?
20. Heidi is in her last days of life, being cared for by her husband and adult children. Over the last week she has increased her sleep from 16 to 20 hours per day and is taking only sips of water and juice. Her daughter calls the nurse, concerned that Heidi suddenly became alert and clearly demanded that she needs to get up and get into line with people outside who are waiting for her. These statements by Heidi have upset the family, but Heidi is comforted by them. What is an appropriate intervention for this family?
21. Ayaan has metastatic pancreatic cancer and is cared for at home by his wife and adult children. During a recent visit, the nurse notes that his symptoms have dramatically worsened and he is nearing the last days of life. The nurse knows that the family's spiritual beliefs hold that speaking about dying is considered "giving up", and is not acceptable. However, after the nurse's assessment, Ayaan's wife asks the nurse how he is doing, and happily reports that she thinks he is "improving". What would be the most appropriate response from the nurse?

Education and Advocacy

22. Eric is a 69-year-old with end-stage esophageal cancer who has just returned home from the hospital after having a PEG tube placed. His wife, Margaret, will be caring for him, and states that she learned how to give him his tube feedings in the hospital. What is the most effective manner of assessing Margaret's ability to perform this task?
23. If a patient and family are struggling financially, which member of the IDT may be most helpful in identifying available community resources for support?
CDA Practice Test
24. Lorna has metastatic ovarian cancer, and is in her final days of life. Throughout her hospice benefit period she has rated her pain as 8 or 9 out of 10 consistently, and has required increasing doses of pain medication to be comfortable. In the last 24 hours she has become non-verbal. Her son is concerned that she will not be able to communicate her suffering to him. What would be the most appropriate educational point to make to her son?

Interdisciplinary / Collaborative Practice

25. Which statement is most accurate regarding palliative/hospice interdisciplinary teams (IDT)?
26. According to Medicare guidelines, how often does a registered nurse need to make a visit to the patient's home for the purpose of supervising a hospice aide?
27. What would be the best option for involving the patient and family in the IDT discussion in the hospice residential setting, if they would like to participate?

Professional Issues

28. What is the best practice regarding use of the electronic health record in patient care?
29. You have recently started caring for a new patient who is a member of your church, and the patient permitted news of her hospice admission to be added to the weekly church announcements. At Bible study, a mutual friend asks how she is doing. What is the most appropriate response?
30. Although some variations in state laws exist, generally, a therapy, including palliative and end of life care, can be withheld or withdrawn under which condition?

CHPN Practice Test

The CHPN exam gives registered nurses a credential which demonstrates that they are specially qualified to work with patients with life limiting illness and their families.  The exam consists of 150 questions and a candidate is given 3 hours to complete the exam.  To learn more about the exam, read our CHPN Test Guide.


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