A hospice patient with advanced acute leukemia presents with petechiae and frequent nosebleeds. Which laboratory abnormality most likely explains these findings?

Elevated white blood cell count

A hospice patient receiving long-term opioids develops tolerance. What does tolerance mean?

Need for higher doses to achieve the same effect

Physiological withdrawal symptoms

Reply “Continue” to proceed with Section 5: Education and Advocacy (Questions 61–75). Advance care planning primarily aims to:

Ensure patient wishes are understood and respected

Prevent all life-sustaining treatment

A social worker and nurse disagree about discharge planning. What is the best approach?

Seek interdisciplinary discussion

Practice Test 1 Complete (Questions 1–100). Reply “Continue” to begin Practice Test 2 (Questions 101–200). Questions are newly written and do not repeat Practice Test 1. A patient with chronic leukemia in hospice develops severe bone pain unrelieved by acetaminophen. What is the most appropriate next intervention?

Increase acetaminophen indefinitely

Which behavior most strongly indicates opioid addiction rather than physical dependence?

Withdrawal symptoms after abrupt discontinuation

Increased dose requirement over time

Expected physiological adaptation

A dementia patient becomes agitated during bathing. What is the most appropriate first action?

Increase sedative dosage immediately

Reply “Continue” to proceed with Section 5: Education and Advocacy (Questions 161–175). Which statement best reflects effective advance care planning?

It is an ongoing process of discussion about values and goals

It is completed only during medical crisis

It focuses solely on resuscitation status

It eliminates the need for surrogate decision-makers

Certified Hospice and Palliative Nurse (CHPN®) Exam

Free Certified Hospice and Practice Questions

10 sample questions for the Certified Hospice and Palliative Nurse (CHPN®) Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Life-Limiting Conditions in Adult Patients, Pain Management, Symptom Management, Care of Patient and Family, Education and Advocacy, Interdisciplinary/Collaborative Practice, Professional Issues.

Question 1 · Life-Limiting Conditions in Adult Patients
A hospice patient with advanced acute leukemia presents with petechiae and frequent nosebleeds. Which laboratory abnormality most likely explains these findings?
- A.Elevated white blood cell count
- B.Hypercalcemia
- C.Thrombocytopenia
- D.Elevated hemoglobin
Show answer and explanation
Answer: C. Thrombocytopenia
Petechiae and epistaxis are classic signs of low platelet count. In advanced leukemia, bone marrow suppression reduces platelet production, leading to thrombocytopenia and increased bleeding risk.
Question 2 · Pain Management
A hospice patient receiving long-term opioids develops tolerance. What does tolerance mean?
- A.Psychological craving
- B.Physiological withdrawal symptoms
- C.Drug-seeking behavior
- D.Need for higher doses to achieve the same effect
Show answer and explanation
Answer: D. Need for higher doses to achieve the same effect
Tolerance is a pharmacologic adaptation requiring dose increases to maintain pain control. It differs from addiction.
Question 3 · Symptom Management
A nonverbal dementia patient grimaces during repositioning. What should the nurse suspect?
- A.Behavioral resistance
- B.Delirium
- C.Depression
- D.Pain
Show answer and explanation
Answer: D. Pain
Nonverbal pain indicators include facial grimacing and resistance during movement.
Question 4 · Education and Advocacy
Reply “Continue” to proceed with Section 5: Education and Advocacy (Questions 61–75).
Advance care planning primarily aims to:
- A.Increase hospital admissions
- B.Ensure patient wishes are understood and respected
- C.Prevent all life-sustaining treatment
- D.Replace physician authority
Show answer and explanation
Answer: B. Ensure patient wishes are understood and respected
Advance care planning ensures that treatment decisions align with the patient’s values and preferences.
Question 5 · Interdisciplinary/Collaborative Practice
A social worker and nurse disagree about discharge planning. What is the best approach?
- A.Seek interdisciplinary discussion
- B.Exclude one party
- C.Document and ignore
- D.Escalate to legal authorities
Show answer and explanation
Answer: A. Seek interdisciplinary discussion
Interdisciplinary discussion encourages shared understanding and coordinated care.
Question 6 · Life-Limiting Conditions in Adult Patients
Practice Test 1 Complete (Questions 1–100).
Reply “Continue” to begin Practice Test 2 (Questions 101–200).
Questions are newly written and do not repeat Practice Test 1.
A patient with chronic leukemia in hospice develops severe bone pain unrelieved by acetaminophen. What is the most appropriate next intervention?
- A.Discontinue all medications
- B.Increase acetaminophen indefinitely
- C.Initiate opioid therapy
- D.Begin aggressive chemotherapy
Show answer and explanation
Answer: C. Initiate opioid therapy
Moderate to severe cancer-related bone pain requires opioid therapy. Hospice care prioritizes adequate analgesia.
Question 7 · Pain Management
Which behavior most strongly indicates opioid addiction rather than physical dependence?
- A.Withdrawal symptoms after abrupt discontinuation
- B.Compulsive use despite harm
- C.Increased dose requirement over time
- D.Expected physiological adaptation
Show answer and explanation
Answer: B. Compulsive use despite harm
Addiction involves compulsive use and harmful behaviors beyond physical dependence.
Question 8 · Symptom Management
A dementia patient becomes agitated during bathing. What is the most appropriate first action?
- A.Restrain the patient
- B.Stop and reassess triggers
- C.Increase sedative dosage immediately
- D.Force completion of hygiene
Show answer and explanation
Answer: B. Stop and reassess triggers
Agitation may result from discomfort or fear. Reassessment identifies triggers.
Question 9 · Education and Advocacy
Reply “Continue” to proceed with Section 5: Education and Advocacy (Questions 161–175).
Which statement best reflects effective advance care planning?
- A.It is completed only during medical crisis
- B.It is an ongoing process of discussion about values and goals
- C.It focuses solely on resuscitation status
- D.It eliminates the need for surrogate decision-makers
Show answer and explanation
Answer: B. It is an ongoing process of discussion about values and goals
Advance care planning is an ongoing dialogue about patient values, preferences, and goals, not a one-time event.
Question 10 · Interdisciplinary/Collaborative Practice
Role ambiguity within the hospice team may result in:
- A.Fragmented care delivery
- B.Reduced communication errors
- C.Improved coordination
- D.Increased efficiency
Show answer and explanation
Answer: A. Fragmented care delivery
Unclear roles often lead to confusion and fragmented patient care.

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