CHPNA common mistakes
CHPNA · Understand the traps and how to avoid them.
Choosing the answer that describes the correct clinical goal but omits the step of reporting the change to the supervising RN or hospice team.
Candidates focus on what comfort measure they can perform independently and treat the nursing assistant role as fully autonomous, forgetting that scope-of-practice boundaries require escalation of changes in condition.
What to do instead
For any scenario where a symptom, skin area, intake, or behavior has changed, scan the options for one that includes notifying the RN or hospice team and prefer it over one that only describes a hands-on action; memorize that assessment and care planning belong to the RN.
Answering pain questions by selecting the option that says to wait until the next scheduled dose or until pain is severe before acting.
Candidates carry over the idea that analgesics should be minimized or delayed, which conflicts with hospice comfort-focused philosophy and the principle of treating pain promptly.
What to do instead
When a patient reports pain, choose the option that acknowledges the report, uses the patient's own words or a valid pain scale, and reports it promptly to the RN so the plan can be adjusted rather than deferring care.
Treating a patient's stated wish or cultural practice as something to be corrected toward the assistant's own values.
Candidates answer from personal or dominant-culture norms about food, modesty, family involvement, or end-of-life rituals instead of the patient's expressed preferences.
What to do instead
Ask yourself which option follows the patient's and family's stated values even if it differs from your own; select the answer that accommodates the practice within safety limits and involves the patient or family in the decision.
Selecting an option that withholds honest information or uses vague euphemisms when a dying patient asks a direct question about their prognosis.
Candidates want to protect the patient from distress and default to reassurance or deflection, missing that honest, gentle communication respecting the patient's readiness is the standard.
What to do instead
Choose the response that first explores what the patient wants to know, answers truthfully and simply at the patient's pace, and offers to involve the RN, social worker, or chaplain for deeper discussion.
Missing that a dying patient's reduced intake and refusal of food or fluids is an expected part of the dying process rather than a problem to force-feed.
Candidates equate eating and drinking with caring and choose options that encourage or pressure intake, which can cause choking, aspiration, or discomfort.
What to do instead
For actively dying patients, select comfort-focused mouth care and honoring refusal over pushing food or fluids, and report intake changes to the RN without attempting to force nutrition.
Answering positioning and skin questions with a single repositioning interval or technique applied to every patient regardless of risk.
Candidates memorize one number (for example, every two hours) and apply it rigidly instead of individualizing based on skin condition, pressure risk, comfort, and the care plan.
What to do instead
Choose options that follow the individualized turning schedule in the care plan, use pressure-relieving devices and proper body mechanics, inspect skin at each turn, and report any redness or breakdown that does not resolve.
Failing to recognize that after death, the family's presence, cultural rituals, and emotional needs continue to require respectful support and coordination.
Candidates treat death as the end of the care episode and overlook post-mortem care steps, family support, and required notifications.
What to do instead
For after-death scenarios, select answers that provide dignified care of the body per policy and cultural wishes, notify the RN and appropriate authorities, support the family, and document accurately.
Skipping or loosely following standard precautions such as hand hygiene and PPE because the patient is dying or the task feels routine.
Candidates deprioritize infection control when emotionally focused on comfort, or assume hospice care carries lower infection risk.
What to do instead
Treat hand hygiene before and after every contact and appropriate PPE as non-negotiable in every scenario; choose the option that maintains standard precautions while still preserving dignity and comfort.
Documenting or acting on subjective impressions rather than objective, observable findings, or documenting care that was not actually performed.
Candidates conflate what they think or assume with what they observed, and may fill in charting based on routine rather than actual events.
What to do instead
Select options that record only what was directly observed or performed, use objective descriptions and the patient's own words for reports, note the time and who was notified, and never chart in advance or for another caregiver.
Ignoring signs of compassion fatigue and caregiver burnout in oneself, or choosing to push through without using support resources.
Candidates view self-care as secondary or selfish in hospice work and underestimate how unaddressed stress affects patient care and judgment.
What to do instead
Choose answers that recognize personal limits, use team debriefing, employee assistance, supervision, and peer support, and seek help early; frame self-care as a professional responsibility that protects patients and the caregiver.