ACHPN : Advanced Certified Hospice and Palliative Nurse (HPNA) Exam

Question: 1
When providing palliative care to a pediatric patient, which of the following populations may have unique needs that require specialized interventions?
A. Older adults
B. Adolescents
C. Young adults
D. Neonates
Answer: D
Explanation: Neonates, or newborn infants, may have unique needs that require specialized interventions in pediatric palliative care. Neonates have distinct physiological, developmental, and psychosocial characteristics that need to be considered when providing care. Older adults, adolescents, and young adults may also have specific needs, but neonates often require specialized attention due to their vulnerability and unique healthcare requirements.
Question: 2
A patient with advanced cancer is being evaluated using a standardized assessment and prognostic tool. The tool incorporates clinical parameters, laboratory values, and performance status to estimate the patient's prognosis. Which of the following tools is commonly used for this purpose?
A. Glasgow Coma Scale (GCS)
B. Karnofsky Performance Status (KPS)
C. Modified Rankin Scale (MRS)
D. Barthel Index (BI)
Answer: B Explanation: The Karnofsky Performance Status (KPS) is commonly used as a standardized assessment and prognostic tool in palliative care. It measures the patient's functional status and performance ability, providing an estimate of their prognosis. The Glasgow Coma Scale (GCS), Modified Rankin Scale (MRS), and Barthel Index (BI) are used for different purposes, such as assessing neurological status, disability, and activities of daily living, respectively.
Question: 3
A palliative care nurse is conducting a psychosocial and spiritual assessment on a patient. Which of the following questions would be most appropriate to assess the patient's spiritual beliefs and practices?
A. "How would you describe your mood on a daily basis?"
B. "Do you have any concerns about your physical health?"
C. "What gives your life meaning and purpose?"
D. "Are you experiencing any financial difficulties?"
Answer: C
Explanation: The question "What gives your life meaning and purpose?" would be most appropriate to assess the patient's spiritual beliefs and practices. It explores the patient's values, beliefs, and sources of inspiration, providing insights into their spiritual well-being. Questions about mood, physical health concerns, and financial difficulties are important but focus on different aspects of the patient's psychosocial well-being.
Question: 4
Which of the following signs and symptoms is considered a red flag indicating serious illness in palliative care?
A. Mild fatigue
B. New-onset confusion
C. Occasional nausea
D. Transient muscle aches
Answer: B
Explanation: New-onset confusion is considered a red flag indicating serious illness in palliative care. It can be a manifestation of various underlying causes, such as infection, metabolic disturbances, medication side effects, or central nervous system pathology. Mild fatigue, occasional nausea, and transient muscle aches are common symptoms that may not necessarily indicate serious illness.
Question: 5
During a functional assessment of an elderly patient, the nurse notes difficulties with activities of daily living (ADLs) such as bathing, dressing, and meal preparation. Which of the following interventions would be most appropriate?
A. Referral to a physical therapist for gait training
B. Prescribing assistive devices for mobility
C. Arranging home health aide assistance with ADLs
D. Scheduling regular follow-up appointments for monitoring
Answer: C
Explanation: Arranging home health aide assistance with ADLs would be the most appropriate intervention for an elderly patient experiencing difficulties with ADLs. Home health aides can provide hands-on assistance and support with bathing, dressing, meal preparation, and other ADLs, helping the patient maintain independence and quality of life. Referral to a physical therapist, prescribing assistive devices, and scheduling follow-up appointments may be appropriate in other situations but do not directly address the patient's current ADL challenges.
Question: 6
A hospice nurse is caring for a patient with end-stage heart failure. The patient experiences increased dyspnea, orthopnea, and edema, despite optimal medical management. These signs and symptoms are indicative of:
A. Disease progression
B. Disease remission
C. Disease stabilization
D. Disease resolution
Answer: A
Explanation: Increased dyspnea, orthopnea, and edema in a patient with end-stage heart failure despite optimal medical management indicate disease progression. These symptoms suggest worsening heart function and fluid retention, which are characteristic of advanced heart failure. Disease stabilization, remission, and resolution are not expected outcomes in end-stage heart failure.
Question: 7
A patient with a history of chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea, cough, and increased sputum production. On physical examination, decreased breath sounds and wheezing are noted. Which of the following findings would be most consistent with acute exacerbation of COPD?
A. Increased forced expiratory volume in 1 second (FEV1)
B. Elevated arterial oxygen saturation (SaO2)
C. Decreased peak expiratory flow rate (PEFR)
D. Normal chest X-ray
Answer: C
Explanation: Decreased peak expiratory flow rate (PEFR) is a characteristic finding in acute exacerbation of COPD. It reflects the limitation of airflow due to airway inflammation and bronchoconstriction. Increased FEV1 and elevated SaO2 would not be expected in an acute exacerbation, as they indicate better lung function. Normal chest X-ray would also be unlikely, as it may show signs of hyperinflation or consolidation in acute exacerbation of COPD.
Question: 8
A patient in the final stages of a terminal illness exhibits signs of imminent death. Which of the following signs is commonly observed during this phase?
A. Increased appetite
B. Increased urine output
C. Increased muscle strength
D. Decreased respiratory rate
Answer: D
Explanation: Decreased respiratory rate is commonly observed as a sign of imminent death in a patient in the final stages of a terminal illness. As the body shuts down and organ systems begin to fail, the respiratory rate often slows down, leading to shallow breathing and periodic pauses between breaths. Increased appetite, increased urine output, and increased muscle strength are not typical signs in this phase.
Question: 9
A patient with a terminal illness expresses interest in advance care planning. Which of the following components is essential to include in advance care planning discussions?
A. Selection of a funeral home
B. Prescription of specific medications
C. Determination of financial arrangements
D. Identification of a surrogate decision-maker
Answer: D
Explanation: Identification of a surrogate decision-maker is an essential component of advance care planning discussions. It involves identifying a trusted individual who can make healthcare decisions on behalf of the patient if they become unable to do so. Prescription of specific medications, determination of financial arrangements, and selection of a funeral home are notconsidered essential components of advance care planning discussions. They may be important in other contexts, but the primary focus of advance care planning is ensuring that the patient's healthcare preferences and goals are understood and can be honored.

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