CHPN Exam Prep: Certified Hospice and Palliative Nurse (HPCC) Study Guide + 590+ Practice Questions

A hospice nurse is facilitating support for a family immediately after the death of their loved one. Which intervention is most aligned with best practices in providing immediate bereavement support at the time of death?

Scenario: Mrs. Thompson, a 68-year-old female with metastatic breast cancer, presents with severe back pain, progressive leg weakness, and urinary retention over the past 48 hours. On examination, she has decreased sensation below the T10 dermatome and hyperreflexia in the lower extremities. The hospice team suspects malignant spinal cord compression (MSCC). What is the most urgent intervention required to prevent permanent neurological deficits?

Scenario: Mrs. Thompson, a 68-year-old patient with terminal lung cancer, has become increasingly withdrawn and refuses to discuss her prognosis with her family. Her daughter confides in you, the hospice nurse, that Mrs. Thompson has always had a strained relationship with her son, who lives abroad and has not visited in years. The daughter tearfully states, “I think Mom is holding onto guilt about something, but she won’t talk about it.” Which of the following is the most appropriate nursing intervention to address Mrs. Thompson’s unresolved interpersonal matters?

Mrs. Johnson, a 72-year-old patient with advanced Parkinson’s disease, is admitted to hospice care. She reports frequent urinary leakage when she coughs or laughs. She also experiences sudden urges to urinate but often cannot reach the bathroom in time. Based on her symptoms, which type of urinary incontinence is she most likely experiencing?

Scenario: Mr. Thompson, a 68-year-old patient with advanced metastatic brain cancer, is admitted to hospice care. He has a history of generalized tonic-clonic seizures. His family reports that he experienced a 3-minute seizure earlier today, followed by prolonged confusion. The hospice nurse is reviewing his medications, which include phenytoin, dexamethasone, and morphine. What is the priority nursing intervention to prevent further seizure complications?

A hospice patient with advanced brain metastases experiences a generalized tonic-clonic seizure. Which of the following is the most appropriate immediate nursing intervention?

Which non-pharmacologic intervention is most effective in reducing dyspnea in hospice patients with advanced chronic obstructive pulmonary disease (COPD)?

Scenario: Mrs. Thompson, a 68-year-old patient with advanced metastatic breast cancer, reports severe pain in her lower back. She describes it as a constant, dull ache that worsens with movement. She rates her pain as 8/10 on the numeric rating scale. She also mentions occasional sharp, shooting pains down her left leg. Which of the following is the most appropriate next step in conducting a comprehensive pain assessment?

Which of the following statements is true regarding the Centers for Medicare & Medicaid Services (CMS) regulations for hospice care eligibility?

Scenario: Mrs. Thompson, a 68-year-old female with metastatic breast cancer to the bone, is admitted to hospice care. She reports severe, unrelenting back pain that worsens with movement. On assessment, she has new-onset lower extremity weakness and urinary retention. Which of the following is the most likely complication requiring urgent intervention?

A hospice patient with advanced cancer is experiencing significant anxiety and existential distress. The nurse considers recommending a psychological therapy to address these concerns. Which of the following therapies is most strongly supported by evidence for improving emotional well-being and reducing existential suffering in palliative care patients?

*Scenario:* Mrs. Thompson, a 72-year-old patient with advanced COPD, is admitted to hospice care. She appears withdrawn and avoids eye contact during conversations with the nurse. Her daughter mentions that Mrs. Thompson has always been private about her emotions. The nurse notices that when discussing her prognosis, Mrs. Thompson frequently changes the subject. Which of the following is the *most likely* barrier to effective communication in this situation?

A 68-year-old patient with metastatic breast cancer presents with fatigue, confusion, nausea, and polyuria. Laboratory results reveal a serum calcium level of 13.2 mg/dL. Which of the following is the most appropriate initial intervention for managing hypercalcemia in this palliative care patient?

A hospice nurse is conducting a family meeting to discuss goals of care for a patient with advanced-stage cancer. The patient’s spouse expresses a strong desire to continue aggressive treatment, while the patient has previously stated a preference for comfort-focused care. Which action by the nurse best aligns with the principles of patient-centered advocacy in this situation?

A hospice patient with advanced gastric cancer experiences persistent hiccoughs (hiccups) that are unresponsive to non-pharmacological interventions. Which of the following medications is considered the first-line pharmacological treatment for refractory hiccoughs in palliative care?

According to the American Pain Society (APS) guidelines, which of the following is a key recommendation for managing chronic pain in hospice and palliative care patients?

*Mrs. Thompson, a hospice patient with end-stage COPD, has been under your care for several months. Her family expresses a desire to honor her memory after her passing. They ask about meaningful ways to commemorate her life, including the option of sending sympathy cards to close friends and relatives. Which of the following is the MOST appropriate nursing intervention regarding the use of “Send Cards” in this situation?*

Mr. Thompson, a 68-year-old patient with advanced bone metastases, is experiencing severe breakthrough pain. He is currently on a scheduled regimen of extended-release morphine (ER morphine) 60 mg every 12 hours. The hospice nurse is reviewing his pain management plan. Which of the following is the most appropriate scheduling strategy for breakthrough pain medication in this patient?

Scenario: Mrs. Thompson, a 68-year-old patient with terminal lung cancer, has an advance directive stating she does not want mechanical ventilation. However, her daughter, who holds her healthcare power of attorney (POA), insists on intubation when Mrs. Thompson becomes acutely hypoxic. The hospice nurse knows Mrs. Thompson’s wishes but is uncertain about the legal implications. What is the most appropriate action for the nurse to take?

*Scenario:* Mrs. Thompson, a 72-year-old patient with advanced heart failure, is under hospice care. Her daughter, who lives out of state, is concerned about her mother’s worsening symptoms and requests frequent updates. The hospice nurse notices discrepancies in communication between the physician, social worker, and chaplain regarding Mrs. Thompson’s care plan. What is the most effective strategy to improve care coordination for Mrs. Thompson?

When pronouncing death in a hospice setting, which of the following actions is most critical for the nurse to perform before notifying the family?

Scenario: Mrs. Thompson, an 82-year-old patient with end-stage heart failure, is actively dying. Her family is present at the bedside and expresses distress over her irregular, labored breathing. They ask the nurse if anything can be done to ease her discomfort. What is the most appropriate nursing intervention to provide comfort and dignity at this time?

A hospice nurse is assisting a terminally ill patient in achieving self-determined life closure. The patient expresses a desire to reconcile with estranged family members but is unsure how to proceed. Which intervention by the nurse would best support the patient’s goal?

Scenario: Mr. Johnson, a 68-year-old patient with advanced liver cancer, presents with prolonged bleeding from a minor skin abrasion. His laboratory results show an elevated INR of 4.2 and a platelet count of 85,000/µL. He is not currently on anticoagulant therapy. Which intervention is the most appropriate for managing his coagulation problem?

Scenario: Mrs. Thompson, a 72-year-old patient with advanced heart failure, has been admitted to hospice care. Her daughter, who is her primary caregiver, expresses frustration that her mother “doesn’t follow the dietary restrictions” despite repeated education. Upon assessment, you notice that the daughter often provides high-sodium foods due to cultural preferences. Which approach best assesses the daughter’s ability to learn and respond to barriers in implementing dietary changes?

Mrs. Thompson, a 72-year-old patient with end-stage COPD, is actively dying. Her family is present at the bedside and appears anxious, frequently asking the nurse if she is in pain. The nurse observes irregular breathing patterns and occasional moaning. Which intervention is most appropriate for the nurse to provide death vigil support in this situation?

*Mrs. Thompson, a 68-year-old patient with advanced breast cancer, develops unilateral arm swelling and heaviness. Her medical history includes axillary lymph node dissection. On assessment, her skin appears thickened with a positive Stemmer’s sign. Which of the following interventions is the MOST appropriate initial management for her lymphedema?*

A hospice nurse is discussing advance directives with a patient who has a terminal illness. The patient expresses concern about losing decision-making capacity in the future. Which of the following statements made by the nurse is most appropriate regarding advance directives?

A hospice nurse is facilitating a discussion with the family of a terminally ill patient who is refusing further life-prolonging treatments. The family insists on continuing aggressive interventions, citing cultural beliefs. Which ethical principle should the nurse prioritize while mediating this conflict?

A hospice patient with advanced cancer is receiving continuous subcutaneous hydromorphone via an infusion pump for severe pain. The nurse notes increased drowsiness, respiratory rate of 8 breaths per minute, and pinpoint pupils. What is the priority nursing intervention?