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Advanced Certified Hospice and Palliative Nurse (HPNA)
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Question: 1
When providing palliative care to a pediatric patient, which of the following populations may have unique needs that require specialized interventions?
1. Older adults
2. Adolescents
eonates wer: D
anation: Neonates, or newborn infants, may have unique needs that re alized interventions in pediatric palliative care. Neonates have distinc iological, developmental, and psychosocial characteristics that need to idered when providing care. Older adults, adolescents, and young adul lso have specific needs, but neonates often require specialized attenti
o their vulnerability and unique healthcare requirements.
stion: 2
tient with advanced cancer is being evaluated using a standardized sment and prognostic tool. The tool incorporates clinical parameters, atory values, and performance status to estimate the patient's prognos ch of the following tools is commonly used for this purpose?
Young adults
3. N
Ans
Expl quire
speci t
phys be
cons ts
may a on
due t
Que
A pa asses
labor is.
Whi
1. Glasgow Coma Scale (GCS)
2. Karnofsky Performance Status (KPS)
3. Modified Rankin Scale (MRS)
4. Barthel Index (BI)
stion: 3
lliative care nurse is conducting a psychosocial and spiritual assessme ient. Which of the following questions would be most appropriate to a atient's spiritual beliefs and practices?
How would you describe your mood on a daily basis?" Do you have any concerns about your physical health?" What gives your life meaning and purpose?"
Are you experiencing any financial difficulties?"
wer: C
anation: The question "What gives your life meaning and purpose?" w ost appropriate to assess the patient's spiritual beliefs and practices. It ores the patient's values, beliefs, and sources of inspiration, providing
Explanation: The Karnofsky Performance Status (KPS) is commonly used as a standardized assessment and prognostic tool in palliative care. It measures the patient's functional status and performance ability, providing an estimate of their prognosis. The Glasgow Coma Scale (GCS), Modified Rankin Scale (MRS), and Barthel Index (BI) are used for different purposes, such as assessing neurological status, disability, and activities of daily living, respectively.
Que
A pa nt on
a pat ssess
the p
1. "
2. "
3. "
4. "
Ans
Expl ould
be m expl
insights into their spiritual well-being. Questions about mood, physical health concerns, and financial difficulties are important but focus on different aspects of the patient's psychosocial well-being.
Question: 4
serious illness in palliative care?
1. Mild fatigue
2. New-onset confusion
3. Occasional nausea
4. Transient muscle aches
wer: B
anation: New-onset confusion is considered a red flag indicating serio ss in palliative care. It can be a manifestation of various underlying ca as infection, metabolic disturbances, medication side effects, or centr ous system pathology. Mild fatigue, occasional nausea, and transient cle aches are common symptoms that may not necessarily indicate seri ss.
stion: 5
ng a functional assessment of an elderly patient, the nurse notes diffic ctivities of daily living (ADLs) such as bathing, dressing, and meal aration. Which of the following interventions would be most appropri
eferral to a physical therapist for gait training rescribing assistive devices for mobility
rranging home health aide assistance with ADLs
Ans
Expl us
illne uses,
such al
nerv
mus ous
illne
Que
Duri ulties
with a
prep ate?
1. R
2. P
3. A
4. Scheduling regular follow-up appointments for monitoring
Answer: C
Explanation: Arranging home health aide assistance with ADLs would be the most appropriate intervention for an elderly patient experiencing difficulties
with ADLs. Home health aides can provide hands-on assistance and support with bathing, dressing, meal preparation, and other ADLs, helping the patient maintain independence and quality of life. Referral to a physical therapist, prescribing assistive devices, and scheduling follow-up appointments may be appropriate in other situations but do not directly address the patient's current ADL challenges.
spice nurse is caring for a patient with end-stage heart failure. The pa riences increased dyspnea, orthopnea, and edema, despite optimal me agement. These signs and symptoms are indicative of:
isease progression isease remission isease stabilization isease resolution
wer: A
anation: Increased dyspnea, orthopnea, and edema in a patient with en heart failure despite optimal medical management indicate disease ression. These symptoms suggest worsening heart function and fluid tion, which are characteristic of advanced heart failure. Disease lization, remission, and resolution are not expected outcomes in end-s
Question: 6
A ho tient
expe dical
man
1. D
2. D
3. D
4. D
Ans
Expl d-
stage prog reten
stabi tage
heart failure.
Question: 7
A patient with a history of chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea, cough, and increased sputum production. On physical examination, decreased breath sounds and wheezing are noted. Which
of the following findings would be most consistent with acute exacerbation of COPD?
1. Increased forced expiratory volume in 1 second (FEV1)
2. Elevated arterial oxygen saturation (SaO2)
3. Decreased peak expiratory flow rate (PEFR)
wer: C
anation: Decreased peak expiratory flow rate (PEFR) is a characteristi ng in acute exacerbation of COPD. It reflects the limitation of airflow rway inflammation and bronchoconstriction. Increased FEV1 and elev would not be expected in an acute exacerbation, as they indicate bett unction. Normal chest X-ray would also be unlikely, as it may show
yperinflation or consolidation in acute exacerbation of COPD.
stion: 8
tient in the final stages of a terminal illness exhibits signs of imminen
h. Which of the following signs is commonly observed during this pha
ncreased appetite creased urine output creased muscle strength
Normal chest X-ray
Ans
Expl c
findi due
to ai ated
SaO2 er
lung f signs
of h
Que
A pa t
deat se?
1. I
2. In
3. In
4. Decreased respiratory rate Answer: D
Explanation: Decreased respiratory rate is commonly observed as a sign of imminent death in a patient in the final stages of a terminal illness. As the body shuts down and organ systems begin to fail, the respiratory rate often slows
down, leading to shallow breathing and periodic pauses between breaths. Increased appetite, increased urine output, and increased muscle strength are not typical signs in this phase.
Question: 9
ning discussions?
election of a funeral home rescription of specific medications
etermination of financial arrangements dentification of a surrogate decision-maker
wer: D
anation: Identification of a surrogate decision-maker is an essential ponent of advance care planning discussions. It involves identifying a ed individual who can make healthcare decisions on behalf of the pati
ecome unable to do so. Prescription of specific medications, mination of financial arrangements, and selection of a funeral home a onsidered essential components of advance care planning discussions.
e important in other contexts, but the primary focus of advance care ning is ensuring that the patient's healthcare preferences and goals are rstood and can be honored.
A patient with a terminal illness expresses interest in advance care planning. Which of the following components is essential to include in advance care plan
1. S
2. P
3. D
4. I
Ans Expl
com
trust ent if
they b
deter re
notc They
may b plan unde

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