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Hospice And Palliative Registered Nurse Certification Exam – Questions & Accurate Answers
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Hospice And Palliative Registered Nurse Certification Exam – Questions & Accurate Answers
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Hospice And Palliative Registered Nurse CertificationExam – Questions & Accurate Answers
Which assessment findings would most strongly suggest an issue with
morphine? Right Ans - myoclonus is a symptom of the toxic effects of
morphine metabolites
Which cancer is least likely to metastasize to the bone? Right Ans -
Colorectal; it mainly metastasizes to the liver, lung, and peritoneum.
What is the drug of choice to relieve a patient's feeling of "air hunger" in end
stage pulmonary disease? Right Ans - morphine; opioids provide palliative
support for symptoms of breathlessness or suffocation.
What is not an appropriate intervention for a bowel obstruction Right Ans -
Metoclopramide
The classic signs of superior vena cava syndrome (SVCS) Right Ans - facial
edema, dyspnea, edematous arms w/bluish color=this is oncologic emergency
requiring immediate attention.
anticipatory grief Right Ans - the proces of psychological, social, and
somatic reactions to a perceived future loss.
signs and symptoms of imminent death Right Ans - dysphagia
stage II skin breakdown Right Ans - skin is blistered, cracked or abraded
The state of having suffered a loss Right Ans - bereavement
Disseminated Intravascular Coagulation (DIC) Right Ans - focal ischemia,
widespread thrombosis or bleeding, superficial gangrene, jaundice,
acrocyanosis, altered sensation, ulceration of gastrointestinal system,
decreased urinary output, and dyspnea.
prognosis of days to weeks, intervention for dysphagia Right Ans - teach
family the importance of oral hygiene to prevent complications such as mouth
soreness and infections.
,safety is a priority w/persons w/dementia Right Ans - supervision,
minimal stimulation, and discouraging sleep during daytime hours maximize
night safety.
xerostomia Right Ans - dry mouth, and can be a side effect of medications
and a long term effect of radiation.
spiritual care of the hospice patient and family Right Ans - identifies and
strives to relieve the spiritual suffering of the patient and family
Grief Right Ans - the feelings related to the perception of the loss and is a
normal reaction to loss.
mentoring Right Ans - a relationship between an experienced person and a
less experienced person
Justice Right Ans - to consider rules and actions that result in fair and
equitable use of available resources.
medicare hospice benefit periods Right Ans - 90-, 90-, and unlimited 60-
day periods
crossing of professional boundaries Right Ans - providing a personal cell
phone number to the family
syncopal episodes and falls Right Ans - consider discontinuing
antihypertensive medications if blood pressure is consistently low
When revoking the medicare hospice benefit Right Ans - The patient will
lose the remaining days of the current period if they revoke the medicare
hospice benefit
The dose-limiting side effect of morphine Right Ans -
Myoclonus=myoclonus is the chronic spasm of a muscle; if moclonus is
present, accepted practice is to rotate to another opioid.
, first priority when pt. unable to make own decisions and being cared for by
family Right Ans - knowing how the family makes decisions and who the
decision makers are is priority.
therapy for stage II wounds Right Ans - relieve pressure and apply
protective/occlusive dressings.
starting oral dose for methadone Right Ans - 2.5-5 mg every 8 hours (half
dose for elderly or severe renal or liver disease)
side effect of methadone Right Ans - prolong QT interval
equianalgesic conversion process -step one Right Ans - step one- add up
the total amount of the current drug given in 24 hours
remember to add in both the scheduled and breakthrough or rescue doses
Calculate separately if more than one drug
epuianalgesic conversion process -step two Right Ans - step two- Divide
current 24 hour total by the equianalgesic value for the current drug and
route of administration.
Most commonly used opioid analgesics
Morphine-Parental 10mg/enteral 30mg
codeine-parental 130mg/enteral 200mg (not recommended)
fentanyl-parental 50-100 mcg/ enteral TRIF (transmucosal immediate release
fentanyl)
hydrocodone- parental n/a enteral 30 mg.
hydromorphone- parental 1.5mg/enteral 7.5mg.
levorphanol-parental 2 mg acute, 1mg. chronic/enteral 4mg. acute 1 mg.
chronic
methadone-parental unknown/ enteral unknown
oxycodone-parental n/a enteral 20mg.
equianalgesic conversion process- step three Right Ans - Multiply the step
2 number by the equianalgesic value for the new drug and route (this will give
you the new 24-hour dose
equianalgesic conversion process-step four Right Ans - Determine how
many doses the patient will take each day and divide this number into the
total 24-hour dose (this gives the amount of medication needed per dose)
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