CHPN Practice Questions (2026) — Free Sample Questions with Answers

Answer: B

Decreased appetite with a preference for liquids: Reduced intake is common weeks before death and is not by itself a sign of imminent death.

Mottled knees and feet with periods of apnea: Correct. Mottling and irregular breathing with apneic pauses (e.g., Cheyne-Stokes) reflect circulatory and respiratory decline in the final hours to days.

Increased sleep with easy arousal to voice: Increased sleep with preserved arousability occurs earlier in decline; unresponsiveness is more typical near death.

Mild ankle edema at the end of the day: Dependent edema is common in advanced illness and does not specifically predict imminent death.

Signs of active dying: mottling, cool extremities, apnea and irregular breathing, decreased urine output, terminal secretions and unresponsiveness - prepare and support the family.

Answer: C

96 mg: This inverts the ratio (120 x 20/25); converting from oxycodone to morphine increases the milligram dose.

120 mg: This assumes a 1:1 ratio between oxycodone and oral morphine, ignoring the table.

150 mg: Correct. Total oxycodone = 80 + 40 = 120 mg/day; 120 x 25/20 = 150 mg oral morphine per 24 hours.

100 mg: This uses only the scheduled 80 mg of oxycodone (80 x 25/20) and omits the breakthrough doses.

Conversion steps: total all opioid used in 24 hours (scheduled + breakthrough), apply the table ratio, then reduce 25-50% for incomplete cross-tolerance when changing drugs and divide into scheduled doses.

Answer: A

Low-dose oral morphine with a fan directed at the face: Correct. Low-dose opioids are first-line pharmacologic therapy for refractory dyspnea, and airflow from a fan to the face also reduces breathlessness.

High-flow oxygen at 6 L/min by nasal cannula: Oxygen benefits hypoxemic patients; at 93% saturation it offers little benefit over airflow and may raise CO2 in COPD.

Withholding all opioids to avoid respiratory depression: Carefully titrated low-dose opioids relieve dyspnea without clinically significant respiratory depression.

Scheduled furosemide to remove excess lung fluid: Diuretics help dyspnea from fluid overload (e.g., heart failure), which is not described here.

Refractory dyspnea: treat reversible causes, then use low-dose opioids, fan to face, positioning and calm reassurance; reserve oxygen for hypoxemia.

Answer: D

She cries on their anniversary and visits his grave: Anniversary reactions and memorial activities are normal parts of grief.

She keeps a few of his belongings in the bedroom: Keeping meaningful belongings is common and not pathological.

She says she sometimes still senses his presence: Sensing the deceased's presence is a common, normal grief experience.

She has daily intense yearning and cannot work: Correct. Persistent, intense yearning or preoccupation more than 12 months after the death, with significant impairment, fits prolonged grief disorder.

Normal grief waxes and wanes; prolonged grief disorder (DSM-5-TR) involves intense yearning or preoccupation persisting at least 12 months in adults, with distress and functional impairment.

Answer: C

Accept the money privately so as not to offend him: Accepting a secret cash gift is a boundary violation and usually breaches agency policy.

Accept it and donate it to charity in the family's name: Accepting the cash still crosses the boundary, regardless of what the nurse does with it.

Thank him, decline the cash, and explain agency policy: Correct. Graciously declining, acknowledging his gratitude and following policy (e.g., suggesting a donation to the hospice) maintains therapeutic boundaries.

Ask for a smaller amount so it is not considered a gift: Soliciting any money from a family is an unacceptable boundary violation.

Secret gifts, money and personal favors move a relationship out of the therapeutic zone; the nurse is responsible for maintaining boundaries.

Answer: A

A face-to-face encounter by a hospice physician or NP in the prior 30 days: Correct. Before the third benefit period and each later period, a hospice physician or nurse practitioner must have a face-to-face encounter no more than 30 calendar days prior.

A new written election statement signed by the patient for the new period: The election remains in effect across benefit periods unless revoked; a new election is not required.

Proof that the patient's condition has measurably declined since the last period: Recertification requires a prognosis of 6 months or less, supported by documentation; measurable decline is not a strict requirement.

Approval of continued care by a Medicare administrative contractor in advance: There is no advance contractor approval process; the hospice physician certifies terminal illness.

Medicare hospice benefit periods: two 90-day periods, then unlimited 60-day periods. A face-to-face encounter is required before the third and each subsequent period.