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CHPN – Questions & Accurate Answers (Verified)
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CHPN – Questions & Accurate Answers (Verified)
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CHPN – Questions & Accurate Answers (Verified)1.A 54 - year - old patient with end - stage renal failure dies of sudden cardiac
arrest 6 days after withdrawal of dialysis . This patient's death was most likely
caused by which of the following complications of renal failure ? a .
Hypercalcemia b . Anemia . c Hyperkalemia d . Hyperphosphatemia Right
Ans - 1.C : Hyperkalemia ( elevated serum potassium level ) is a common
complication of end - stage renal failure as a result of diminished ability of the
failing kidney to excrete potassium Life - threatening hyperkalemia is often
asymptomatic until sudden cardiac arrest occurs . Chronic renal failure is
associated with several metabolic abnormalities . These include anemia ,
hypocalcemia hyperphosphatemia , metabolic acidosis , and hypoalbuminemia
. Sudden cardiac death in the patient with renal failure is most likely due to
elevated serum potassium levels .
2. Which of the following is most accurate regarding poorly controlled pain in
the palliative care patient ? a Uncontrolled pain leads to multiple harmful
physiological effects . b . Inadequate treatment of pain usually enhances a
patient's ability to interact with loved ones . Uncontrolled pain only causes
psychological harm to the patient . d . Adequate pain control makes it more
difficult to promptly identify complications of the patient's disease Right
Ans - 2. A : In addition to the serious psychological harm caused by
uncontrolled pain in the palliative care patient , there are several harmful
physiological effects of inadequate treatment of pain . Increased heart rate
and blood pressure lead to increased metabolic demand and increased
myocardial stress . Decreased mobility due to inadequate pain relief increases
the patient's risk of pressure ulcers , muscle wasting , and deep venous
thrombosis . Gastric motility generally slows , leading to ileus . Risk of
atelectasis and pneumonia are increased in patients who are breathing
shallowly because of uncontrolled pain in the chest or chest wall Excessive
sedative effects of pain medications may impair the patient's ability to interact
with loved ones , but this should be managed with medication adjustments or
use of psychoactive stimulants Uncontrolled pain does not enhance a patient's
ability to have meaningful interactions with anyone . Finally , adequate pain
control should not interfere with management of the patient's primary
disease
3. Which of the following statements is most appropriate regarding advanced
care planning in the terminally ill patient ? a . Advanced care planning should
, address issues beyond code status . b . The best time for advanced care
planning discussions is late in the course of a terminal illness . C Advanced
care planning decisions should be made after a single conversation . d .
Advanced care planning discussions are outside the scope of practice for the
palliative care Right Ans - 3. A : Supporting the patient in decision - making
with regard to advanced care planning is an extremely important component
of palliative care nursing , Advanced care planning should ideally , begin
before the late stages of a terminal illness ; it is difficult for patients and loved
ones to consider advanced care planning in the setting of an acute
decompensation . Advanced care planning should occur over the course of
several conversations to allow patients time to reflect and process what are ,
for most patients , emotionally challenging issues . Planning should address
the patient's goals regarding life - sustaining therapy ( eg , code status ) ,
preparation for the possibility of the patient becoming incapable of decision -
making , and a designated proxy for decision - making if the patient is unable
to do so . It usually provides a great deal of relief to both patients and loved
ones when end - of - life decisions are made ahead of time in keeping with the
patient's values and goals .
4. Which of the following is most accurate about heat therapy for the
treatment of pain ? a Heat therapy is most effective for the treatment of
neuropathic pain . b . Application of heat results in decreased blood flow to the
treatment area . c . Heat therapy is highly effective for treatment of pain
associated with mescle spasm d . Heat therapy is most effective over areas
with decreased sensation Right Ans - 4. C : The application of heat to an
area of pain results in multiple physiological effects . Blood flow , tissue
compliance , and muscle fiber relaxation increase in response to the
application of a heat source . Heat also results in decreased nerve
transmission of pain signals to the brain and spinal cord ( via effects on both
temperature and pressure receptors ) , which in turn enhances muscle
relaxation and blood flow . Heat may be applied in a variety of ways , most of
which are easy to use for both care providers and patients . Options include
submersion ( of either part of the body or the whole patient ) in warm water ,
radiant heaters , hot packs , heating pads , hot water bottles , and heat wraps .
Heat should not usually be applied over areas of decreased sensation because
of the risk of burns .
5. A 50 - year - old patient with metastatic ovarian cancer has been receiving
home hospice care provided primarily by her partner and a home health aide .
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