Madge is an 88 year-old with end stage colon cancer, who is transitioning. She has been minimally responsive for the past six hours, but opens her eyes in response to her name. She is restless at times with furrowing of her brow. She is still swallowing her secretions, and sucks on the oral sponge when mouth care is provided. Prior to her change in status, she was receiving Oxycontin 40 mg po tablets q12 hr ATC with liquid oxycodone 8-12 mg po q2hrs prn for breakthrough pain. In light of Madge's change in level of consciousness, what changes should be made to her pain management regimen?

The Certified Hospice and Palliative Nurse certification exam is a 3 hour exam covering 150 multiple choice questions. It focuses on five domain practice areas: Life-limiting Conditions in Adult Patients, Pain Management, Symptom Management, Patient and Family Care and Practical Issues.