Certified Hospice and Palliative Nurse Test

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Certified Hospice and Palliative Nurse (CHPN)

History

The National Board for Certification of Hospice and Palliative Nurses (NBCHPN) is an independent certification body affiliated with the Hospice and Palliative Nurses Association (HPNA). Originally established in 1993 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 in 1994, until today, the NBCHPN has certified more than 12,000 nursing professionals in this specialty.[1] Initially, the exam only covered hospice nurses. However, a “role delineation study” (job task analysis) conducted in 1998 showed that a significant number of RNs were providing palliative care outside of the hospice setting. In 1999, the exam was updated to include items assessing competence in both hospice and palliative care and the name of the credential was changed from Certified Registered Nurse Hospice (CRNH) to its current name, Certified Hospice and Palliative Nurse (CHPN).[2]

Function of the Test

CHPN Study Guide

Hospice and palliative care nurses provide end-of-life treatment and care to patients and their families.[3] Holding the widely recognized CHPN credential demonstrates to employers, insurers and regulators, and patients and their families that an individual is a competent, professional caregiver who is committed to quality care.[4] Candidates must hold a valid RN license (United States and Territories) or its equivalent (Canada) without restrictions in order to take the exam.[5] In addition, candidates must fulfill an experience requirement of either 500 hours hospice and/or palliative care nursing within the year prior to application, or 1,000 hours within the 24 months prior to applying for the exam.[6] According to a recent job analysis, CHPNs tend to be females with a bachelor’s degree who work in a hospice care facility. 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. Patients are often seen in their own homes while under hospice care, and the majority of the CHPNs duties involve direct patient care.[7] The CHPN continues to be a sought-after credential. In 2014, over 2,600 candidates earned the credential.[8]

Test Administration

CHPN Flashcards

The computer-based exam is administered by American Measurement Professionals (AMP), the NBCHPN-approved testing vendor, at over 200 locations across the United States. Candidates interface with AMP directly to apply for and schedule their exams.[9] The exam is given during four one-month testing windows throughout the year. 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.[10] The cost to take the exam is $415. There is a $120 discount for Hospice and Palliative Nurses Association (HPNA) members.[11] Special accommodations for candidates with disabilities as defined under the Americans with Disabilities Act (ADA) may be requested in writing directly from AMP at the time of application. The request must be accompanied by documentation, completed and signed by an appropriate health care professional, describing the candidate’s disability and listing any requested accommodations.[12] Candidates who pass the exam receive a certificate and are entitled to use the CHPN designation after their names. 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.[13]

Test Format

Sections of the CHPN Test
CHPN Test Subject Areas Percent
Life-Limiting Conditions in Adult Patients 15%
Pain Management 24%
Symptom Management 24%
Care of Patient and Family 13%
Education and Advocacy 9%
Interdisciplinary/Collaborative Practice 8%
Professional Issues 7%
Total 100%

Test Structure

The CHPN has 150 multiple choice questions that deal with seven major topics: Life-Limiting Conditions in Adult Patiens; Pain Management; Symptom Management; Care of Patient and Family; Education and Advocacy; Interdisciplinary/Collaborative Practice; and Professional Issues. Out of the 150 questions, 15 are unscored, pretest questions.[14]

Test Environment

Testing for the CHPN takes place at AMP Assessment Centers. 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.[15]

Test Content

  • Sample CHPN Practice Questions
  1. A 54-year-old patient with end-stage renal failure dies of sudden cardiac arrest 6 days after withdrawal of dialysis. This patient’s death was most likely caused by which of the following complications of renal failure?
    A. Hypercalcemia
    B. Anemia
    C. Hyperkalemia
    D. Hyperphosphatemia
  2. Management of persistent hiccups in the palliative care patient may include all of the following except:
    A. pharyngeal stimulation (e.g., palate massage)
    B. muscle relaxants (e.g., baclofen)
    C. decreasing gastric distention (e.g., smaller meals, gas agents)
    D. opioids
  3. Use of a fentanyl patch would be most appropriate in which of the following patients?
    A. 73-year-old lung cancer patient with severe, poorly controlled pain
    B. 26-year-old leukemia patient starting opioid therapy for bone pain
    C. 51-year-old hospice patient with severe pain associated with daily wound dressing changes
    D. 48-year-old melanoma patient with stable pain and dysphagia
  4. A 41-year-old patient with advanced ovarian cancer reports feeling hopelessness and despair. All of the following are appropriate nursing interventions for helping patients maintain hope at the end of life except:
    A. withholding bad news
    B. using humor when appropriate
    C. anticipating and treating distressing physical symptoms
    D. encouraging patients in positive self-talk
  5. All of the following are possible complications of constipation in the palliative care patient except:
    A. fever
    B. agitation
    C. abdominal pain
    D. urinary retention
  6. When a patient confides to the nurse that he is underreporting his pain because he “wants to be strong for my wife and kids,” the hospice nurse should explain that:
    A. other patients would live longer if they were all as strong as he is
    B. accurate reporting of pain will help ensure that all of the patient's goals for palliative care are addressed
    C. minimizing pain medication use will help prevent addiction
    D. pain is an inevitable and universal component of end-of-life care
  7. A patient with breast cancer has progressive upper extremity swelling due to lymphedema. The mainstay of treatment for extremity lymphedema is:
    A. diuretics
    B. exercise
    C. external compression
    D. diet
  8. Among the following, the most appropriate analgesic medication for initial treatment of mild pain in the palliative care patient is:
    A. morphine
    B. dexamethasone
    C. acetaminophen
    D. codeine

More free CHPN practice test questions.

Scoring

Raw scores are obtained by adding up the number of correctly answered questions on each exam. Raw scores are then converted to scaled scores to determine a candidate’s pass/fail status. 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.[16] Because the scaled score is based on the total number of correct answers given, candidates who answer as many questions as possible, even if they must make an educated guess for some answers, increase their chances of achieving a passing score. The exam is structured so that difficult questions can be bookmarked and left unanswered, and returned to later to be completed.[17] After completing the exam, each candidate is given a “score report” showing the pass/fail status, the total scaled score achieved for the exam, and raw scores achieved for each category of questions on the exam. 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.[18]

Recent/Future Developments

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. In 2015, the option to recertify by examination was discontinued and CHPNs must now fulfill practice hour requirements, earn a specified number of continuing education credits, and complete a “situational judgement exercise” in the form of case studies.[19]

Answers to Sample Questions

1;C 2;D 3;D 4;A 5;A 6;B 7;C 8;C

References

  1. ^ Candidate Handbook June 24, 2015
  2. ^ Why Certification? June 27, 2015
  3. ^ Certified Hospice and Palliative Nurse (CHPN) June 24, 2015
  4. ^ Why Certification? June 27, 2015
  5. ^ Candidate Handbook June 24, 2015
  6. ^ Hospice and Palliative Care Nurse (CHPN) June 27, 2015
  7. ^ A National Role Delineation Study of the Hospice and Palliative Registered Nurse June 27, 2015
  8. ^ Newsletters June 27, 2015
  9. ^ Certified Hospice and Palliative Nurse (CHPN) June 27, 2015
  10. ^ Deadlines & Fees June 27, 2015
  11. ^ Deadlines & Fees June 27, 2015
  12. ^ Request for Special Examination Accommodations June 27, 2015
  13. ^ CHPN Candidate Handbook June 28, 2015
  14. ^ CHPN Content 10 June 2015
  15. ^ Testing Handbook 10 June 2015
  16. ^ Scaled Scores June 27, 2015
  17. ^ CHPN Candidate Handbook June 28, 2015
  18. ^ CHPN Candidate Handbook June 28, 2015
  19. ^ Certified Hospice and Palliative Nurse (CHPN) June 27, 2015