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CHPLN exam Format | CHPLN Course Contents | CHPLN Course Outline | CHPLN exam Syllabus | CHPLN exam Objectives

Exam Code: CHPLN

Exam Name: Certified Hospice and Palliative Licensed Nurse

Certifying Body: Hospice and Palliative Credentialing Center (HPCC)

Number of Questions: 100 multiple-choice questions

Time Allotted: 2 hours (120 minutes)

Passing Score: 75% (exact scaled passing score may vary slightly)

Exam Format: Computer-based testing (CBT)



- Patient Care: End-Stage Disease Process

- Identify specific patterns of disease progression, complications, and treatment for:

- Neoplastic conditions

- Neurological conditions

- Cardiac conditions

- Pulmonary conditions

- Renal conditions

- Gastrointestinal conditions

- Debility/decline in health status (e.g., Frailty, Malnutrition, Cachexia)

- Dementia

- Hepatic conditions

- Hematologic conditions

- Altered immune disease (e.g., HIV)

- Endocrine conditions

- Identify and respond to indicators of imminent death



- Patient Care: Pain and Comfort Management

- Data Gathering

- Identify pain and other distressing symptoms

- Identify causes of pain

- Identify types of pain

- Identify factors that may influence the patient's experience of pain (e.g., fear of pain, depression, despair, cultural or spiritual issues)



- Pharmacologic Interventions

- Identify medications appropriate for severity and specific type of pain

- Administer analgesic and adjuvant medications (e.g., NSAIDS, corticosteroids, anticonvulsants, opioids)

- Nonpharmacologic Interventions

- Identify the need for nonpharmacologic interventions

- Implement nonpharmacologic interventions (e.g., massage, music, aromatherapy, and pet therapy)

- Respond to psychosocial and spiritual issues related to pain and other distressing symptoms

- Evaluation

- Identify and respond to medication side effects, interactions, and complications

- Evaluate efficacy of relief interventions (pharmacologic and nonpharmacologic)

- Identify side effects of interventional therapy (e.g., antineoplastic, radiological, surgical)



- Patient Care: Symptom Management

- Manage symptoms related to Neurological conditions

- Aphasia

- Dysphagia

- Lethargy or sedation

- Myoclonus

- Paresthesia or neuropathies

- Seizures

- Extrapyramidal symptoms

- Spinal cord compression



- Manage symptoms related to Cardiovascular conditions

- Edema (including pulmonary)

- Syncope

- Manage symptoms related to Respiratory conditions

- Congestion

- Cough

- Dyspnea

- Pleural effusions



- Manage symptoms related to Hepatic conditions

- Encephalopathy

- Esophageal varices

- Ascites

- Manage symptoms related to Gastrointestinal conditions

- Constipation

- Diarrhea or bowel incontinence

- Nausea or vomiting

- Bleeding

- Bowel obstruction



- Manage symptoms related to Genitourinary conditions

- Bladder spasms

- Urinary incontinence

- Urinary retention

- Infections

- Manage symptoms related to Musculoskeletal conditions

- Impaired mobility

- Complications of immobility

- Fractures

- Weakness or activity intolerance



- Manage alterations in Skin and Mucous Membrane

- Dry mouth

- Oral lesions

- Pruritus

- Skin integrity, including wound care

- Excessive secretions

- Manage symptoms related to Psychosocial and Emotional conditions

- Anxiety

- Stages of grief (e.g., anger, denial)

- Depression

- Impaired communication

- Sleep disturbances



- Manage symptoms related to Nutritional and Metabolic conditions

- Cachexia or wasting

- Dehydration

- Fatigue

- Manage symptoms related to the Immune System

- Fever

- Neutropenia

- Manage symptoms related to Mental Status Changes

- Agitation (including terminal restlessness)

- Confusion

- Delirium

- Dementia

- Hallucinations

- Manage symptoms related to Lymphedema



- Patient Care: Treatments and Procedures

- Care for patients with the following treatments or procedures:

- Surgical alterations (including tubes, drains, and stomas)

- Rectal route for pain and symptom management

- Respiratory therapy (e.g., oxygen, suction, inhalation treatments, tracheostomy care)

- Subcutaneous pain and symptom management

- Urinary drainage systems

- Maintain infection control procedures related to:

- Pathogens (e.g., bloodborne, airborne)

- Precautions

- Chain of infection



- Care of Patient, Family, and Other Caregivers

- Resource Management

- Identify and respond to socioeconomic factors

- Identify and respond to environmental and safety risks

- Monitor controlled substances (including use, abuse, diversion)

- Monitor health status of family caregiver

- Recommend appropriate DME for patient well-being

- Inform patient/family how to access 24-hours a day: services, medications, equipment, supplies



- Psychosocial, Spiritual, and Cultural

- Respond to spiritual needs

- Identify and respond to cultural values and behaviors

- Respond to stages of grief

- Respond to loss of hope or meaning

- Facilitate nearing death awareness

- Respond to spiritual distress or unresolved spiritual issues

- Identify suicidal or homicidal ideation

- Identify unresolved interpersonal matters

- Respond to family dynamics



- Grief and Loss

- Encourage life review

- Provide emotional support regarding grief and loss for:

- adults

- children

- Provide care and support at time of death



- Patient and Family Education and Advocacy

- Caregiver Support

- Teach family and other caregivers techniques for patient care (e.g., positioning, ostomy care)

- Monitor family and other care givers ability to provide care

- Monitor and respond to caregiver burnout

- Identify and respond to neglect and abuse



- Education

- Identify and respond to barriers to learning (e.g., communication)

- Teach about the end-stage disease process

- Teach about pain and symptom relief

- Teach alternative methods of pain and symptom relief (e.g., relaxation, distraction, humor, massage, aroma therapy)

- Teach about home safety (e.g., oxygen, firearms, fall hazards, evacuation plan)

- Teach about medication administration, compliance, safety, and disposal

- Teach about the signs and symptoms of imminent death

- Teach about self care methods



- Advocacy

- Monitor needs for levels of care or increased services

- Facilitate communication between patient, family, and health care providers

- Encourage patient and family to participate in decision-making regarding treatment options

- Access appropriate interdisciplinary team (IDT) members and other resources to meet the needs of patient and family



- Interdisciplinary and Collaborative Practice Issues

- Coordinate and Collaborate

- Coordinate patient care with other health care providers

- Arrange for equipment, supplies, or medications

- Communicate with patients attending/primary care provider



- Practice Issues

- Identify and incorporate into practice standards (e.g., HPNA standards, ANA standards, NHPCO standards) and guidelines (e.g., National Consensus Project, WHO ladder, CDC)

- Identify and incorporate legal regulations into practice (e.g., OSHA, Hospice Medicare Conditions of Participation, HIPAA)

- Adhere to documentation standards for levels of care

- Participate in evaluating educational materials for patients and family

- Participate in quality assurance, performance improvement processes

- Demonstrate awareness and knowledge of LPN/LVN scope of practice



- Professional Development

- Maintain boundaries between patient/family and staff

- Contribute to development of peers, colleagues, and others as preceptor, educator, or mentor

- Participate in self-care (e.g., stress management)

- Read professional journals to remain current in practice

- Maintain personal continuing education plan to update knowledge

- Identify ethical concerns related to the end-of-life

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