Hospice competency test

Only questions are scored. Fifteen of the questions are trial items being considered for future exams. Three hours are given to complete the exam. Grade Answers as You Go. Alzheimer disease is one type of dementia, with a known pre-clinical phase during which pathophysiologic changes begin to occur, followed by a symptomatic phase where cognitive and functional decline becomes noticeable. Lewy body deposits in the brain are associated with Lewy body dementia only. The degree of dementia progression often depends on underlying factors, although there is some evidence suggesting that early-onset Alzheimer patients progress more rapidly.

Irreversible organ failure is not a hallmark characteristic; instead, pain, constipation, and behavioral changes are the most common symptoms.

Incorrect answer. Please choose another answer. Typically, they do not cause discomfort for the patient, but can be very distressing to family members.

Repositioning the patient by turning him on his side can be helpful to decrease the noise associated with this situation. Anticholinergics can also be administered, but typically, once the secretions start, anticholinergic effectiveness is limited. Lowering the head of the bed would likely worsen dyspnea; pursed mouth-breathing, rather than deep nose-breathing, would be of greater benefit to lessening dyspnea; although guided imagery may improve mood, evidence does not demonstrate that it affects dyspnea directly.

John's symptoms are due to right sided diastolic heart failure, when the ventricle does not fill adequately, leading to a generalized edema of the extremities and the hepatic system. Symptoms of right sided failure include nausea, anorexia, peripheral edema, ascites, weakness, and weight gain. Poor cardiac output, decreased ejection fraction, organ perfusion failure are indicative of left-sided heart failure.

Acute stroke is associated with aphasia which may include difficulty with both understanding and with verbalizing speechataxia, numbness or paralysis of limbs or face, vision disturbances, and headaches, which may illicit vomiting. The other symptoms are not indicative of acute stroke symptoms. Breakthrough pain is intermittent episodes of pain that occur in patients with chronic pain. Opioid regimens for pain management in the hospice and palliative care setting should include a long-acting agent, once dosing need is established, and a short-acting agent to cover episodes of breakthrough pain.

Since most liquid forms are quite concentrated, even patients who are minimally responsive can tolerate such small volumes in the buccal space and typically maintain excellent pain control. A frequent misconception is that younger patients with few co-morbidities are at greatest risk for under-treatment for pain, but in fact the elderly, minorities, and women are most at risk for under-treatment.

Of the four case scenarios, the year old has two of the three risk factors. Transdermal fentanyl, also known as a fentanyl patch, is a good choice for individuals with pain who cannot swallow or do not remember to take their medication, and would need to be titrated to effect for this patient.

It is a particularly good choice for Margaret because she may be forgetful due to her brain metastasis, which would not improve by providing liquid morphine instead of tablets. As she does not live with a caregiver, depending on the neighbor to assure adequate pain management is not an effective plan. As Margaret is not in pain crisis, symptom control efforts should be initiated and the effect evaluated before referral to an inpatient hospice setting.

As constipation is a significant side effects of opioid therapy, any patient on an opioid should also be prescribed a prophylactic bowel regimen to prevent or manage constipation.

Senna is a simulant laxative that chemically stimulates the bowel to increase motility. Ondansetron HCl is a 5-HT3 receptor antagonist, used to prevent nausea and vomiting; diphenhydramine is an antihistamine used to treat opioid- induced pruritus; pamidronate is a bisphosphonate used as an adjuvant to opioids for bone pain.

Jordan is experiencing end-of-dose failure, which indicates that in the last hours of the dosing cycle, the blood levels of the drug are decreasing before uptake of the next scheduled dose. This is different than breakthrough pain, characterized by episode of pain despite control of continuous baseline pain.

By shortening the round-the-close drug interval, Jordan will experience more stable drug blood levels. Increasing the prn dosing would only result in a short-acting bolus just prior to the next dosing cycle and could cause sedation and other side effects.

A switch to another opioid is not necessary as this is typically done due to an undesirable side effect. A corticosteroid would not provide the desired pain management result in the last hours of the dosing cycle. Unexplained syncope, as well as previous cardiac arrest with resuscitation, and an embolic stroke originating from the cardiac system are all indicators of poor prognosis in this patient population. Prioritizing energy use is an important aspect of supporting the hospice patient who is experiencing progressive weakness and fatigue.

Helping the patient to identify which activities are most important to physical, emotional and spiritual needs empowers the patient to spend limited energy on those aspects that matter most to them.Originally established in to develop and administer a credentialing program for registered nurses RNs specializing in hospice care, the NBCHPN now certifies specialty nurses and nursing assistants at all levels of professional development. From the time of the first certification exam, given inuntil today, the NBCHPN has certified more than 12, nursing professionals in this specialty.

Hospice and palliative care nurses provide end-of-life treatment and care to patients and their families. Most have been in the field for over a decade, and have had significant prior experience as an RN before becoming certified in a specialty.

hospice competency test

Patients are often seen in their own homes while under hospice care, and the majority of the CHPNs duties involve direct patient care. Inover 2, candidates earned the credential. Candidates interface with AMP directly to apply for and schedule their exams. During each testing window, exams are given twice daily, Monday through Friday some weekends may be available at individual testing centers. The application period opens three months prior to the beginning of each testing window, and the deadline for applying is two weeks prior to the beginning of the testing period for online applications, and 6 weeks prior to the beginning of the period for paper applications.

Those who do not pass may retake the exam at any time by reapplying and paying the application fee. There is no waiting period for retaking the exam. Out of the questions, 15 are unscored, pretest questions. There, candidates are expected to arrive in a timely manner, and present two forms of identification.

One form must be government issued, and contain a photograph. Once in the testing room, personal items are not allowed. A locker will be provided by the testing center to store watches, wallets, keys, etc Penciles and scratch paper will be provided by the testing center for use during the exam.

The test is computer based. More free CHPN practice test questions. Raw scores are obtained by adding up the number of correctly answered questions on each exam. Scores are scaled by setting the passing raw score grade to a scaled score of 75, and converting raw scores above and below this point to scaled scores in a linear manner.

Unlike the raw score measurement, scaled scores take the difficulty of exam questions into consideration and therefore individual performance is unaffected by variations in difficulty among different versions of the exam.

The exam is structured so that difficult questions can be bookmarked and left unanswered, and returned to later to be completed. Raw scores are given this way in order to assist candidates in understanding their relative strengths in each area and support them in further study, whether to remediate in order to pass a failed exam, or to continue their education and build on their base of knowledge as a CHPN. Current options for maintaining certification are either retaking the exam after practicing the required number of hours as a CHPN, or fulfilling the practice hour requirement and completing a specified amount of continuing education.

hospice competency test

Jump to: navigationsearch. Category : Iframe. Navigation menu Personal tools Log in. Namespaces Page Discussion. Views Read View source View history. Navigation Main page Recent changes Random page Help. This page was last modified on 25 Septemberat Privacy policy About Exampedia Disclaimers Mobile view.John and Martha, Canada express iceland, June 2015 The services provided by Sjofn exceeded our expectations in all respects.

Nancy, United States South Iceland at Leisure, June 2015 We thought that Larus did an excellent job in planning the tour and our hotel stops based on our interests, which were largely to take advantage of seeing the beautiful scenery and to hike. James, United States Iceland Full Circle, June 2015 Everything about this tour was perfect. You will hear from me someday in the future for more travel.

Brie and Pat, United States Iceland Full Circle, June 2015 We booked a last minute honeymoon trip with Nordic Visitor and found the service outstanding. Margarete Ritchie, Sweden Custom Booking, June 2015 You provide a good service to people like us who come from so far away and don't know how to get accommodation etc. Alexandra had booked and organised a self drive holiday around Iceland for us in 2011 Jane, United Kingdom Golden Triangle - Starting in Copenhagen, June 2015 Hotels were all in really good, central positions, close to transport links and city centres.

Catherine, United Kingdom South Iceland at Leisure, June 2015 We had a great holiday in Iceland with the whole itinerary organised by Nordic Visitor including all the hotels and the hire car. Donna, United Kingdom Iceland Full Circle, June 2015 Booked a 10 day self drive tour of Iceland via Nordic Visitor. All in all the holiday of a lifetime, without any worries Tracy, United States The Natural Wonders of Iceland, June 2015 This was the first time I booked a vacation with a tour company I found by internet research and not from a friend or trusted source.

Meggin, United States Iceland Full Circle, June 2015 I am a research addict, which is why I love this site. Andy, United Kingdom Norway Explorer, May 2015 Excellent service from the word 'Go'.

hospice competency test

Russell, Australia Iceland Grand Tour, May 2015 Overall a great holiday experience, we were very pleased that after e-mail discussion with our consultant we changed our preferred vehicle to larger AWD type, in particular when travelling through the ice and snow.

Ian and Alison Mason, New Zealand iceland complete, May 2015 We thought the tour was very professionally organised and we had no problems whatsoever and would certainly recommend Nordic Visitor.

Liliane, Canada Iceland Full Circle, May 2015 The overall organization was very well executed. Creed, United States Iceland Complete, May 2015 We had a great time. Linda, United States City Sights and Nature's Delights, May 2015 Everything was excellent. Maria, United States Nordic Odyssey, April 2015 I want to thank Cecilia, she was wonderful. TinaKris220, United States Icelandic Winter Highlights, March 2015 I wanted to go to Iceland and was going by myself.

I can not praise this tour company enough. Highly highly recommend having them plan your tour.

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Olga, Israel Husky Tour in the Wilderness of Lapland, March 2015 Thank you so much for being there and helping people to discover those incredible places around the Scandinavia.

Jackie, United States Custom Booking, March 2015 We had a wonderful time in Iceland. Valerie, United Kingdom Icelandic Winter Highlights, February 2015 The guides where very help and tried their best for us to see a much as possible considering the weather which was out of there control, we did not mind that they re-arranged the scheduled stops.

Had a great experience, the people the places and the weather, would not be a visit to Iceland without the weather, the sunny mornings, the snow blizzards in the afternoon, the rugged beauty that brings you in to be part of the landscape, the whispering song that comes in on the wind that is Iceland, the calming melody (stay awhile and recharge), Michelle, United States South Iceland at Leisure - Winter, February 2015 We truly appreciated the quick change of plans Nordic Visitor provided due to the weather on one of the days in the countryside.

Hansa c4 vs c7, we had a wonderful time and Nordic Visitor proved to be incredibly helpful. Melanie Thomas Winter Romance, February 2015 The tour was very well organised.

Douglas, United Kingdom Iceland Full Circle - Winter, February 2015 Hotels and guest houses an interesting mixture of styles.The Bengals' attack has been hit or miss all season, although they showed signs of life on the ground thanks to rookie Joe Mixon's best day as a professional.

Green is still a problem for any team he faces, and tight end Tyler Kroft has done well in Tyler Eifert's stead. Although the Bengals are at home and the more desperate team as they sit one game out of the playoffs, it's hard to bet against Pittsburgh, who has won six straight and has been lights out on both sides of the ball.

Even if wideout Antonio Brown doesn't go (he didn't practice on Saturday and is questionable, per Jeremy Fowler of ESPN. Their exploits should lead to a close Steeler win. But now it gets even trickier and Joe Root and co as they look to complete the hardest task of all: winning the Ashes in Australia.

According to Oddschecker on November 15. Lads, these games last five days. Away from home they will have to be a strong, tight-knit group and will need big leaders.

Certified Hospice and Palliative Nurse Test

Enter Ben Stokes and Alastair Cook. Simon Heffer Premium 07 Dec 2017, 2:39pm Comment: England should fear a 5-0 - Australia have not even played their best yet Mitchell Johnson Premium 07 Dec 2017, 10:17am Who will win the 2017 Ashes. Our Ashes-ometer on whether Australia or England are on track for success 07 Dec 2017, 10:17am Can England avoid another Ashes whitewash Down Under.

England triumphed in the last series in 2015, defeating their opponents 3-2 on home soil. What are the odds of an England win. Or a series draw.

CHPN Practice Exam

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I just wish all the street and towns had twenty less letters. Aevar did an excellent job helping us when we had a problem with our rental car.

Very helpful and efficient. Thank you, again Aevar. We were absolutely delighted with our visit to Iceland and were so glad we were able to circle the entire country.

I'll admit to having tears in my eyes as we left Reyjavik. We have recommended Nordic Visitor to our friends and fellow travelers we met along the way. Keep up the good work. Overall we were very pleased with the quality of the accommodations.

The itinerary that was built for our trip was very well planned leaving enough time to explore the areas we were travelling as well as having sufficient time to find our nightly accommodations. For the most part we ate in restaurants located in the local areas as opposed to the hotels as some of the menus were very restrictive in selection.

Breakfasts provided at the accommodations were fresh and lots of variety. Visited local museums but did not book any extra activities (whale watching, guided tours) as we prefer to explore on our own.

hospice competency test

We had an amazing trip. It was so well curated. All of the destinations were thoughtful both in terms of location and distance traveled during the day. The sightseeing suggestions in the tour guide were excellent. The hotels and guest houses were all wonderful - comfortable and full of character. To put together a trip like this on our own would have required weeks of online research and we never would have been able to achieve something this perfect.

Thank you so much for a great trip. My only question is: Why is there not an "Excellent" option. Our holiday was most excellent in every way.

From my first email enquiry regarding the tour to the last minute of our holiday every aspect was excellent. Cecilia made the whole planning experience smooth and seamless, and the tour itself was most excellent.


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