The Advanced Certified Hospice and Palliative Nurse exam, or the ACHPN exam, is for registered nurses who wish to further their career and have experience in hospice and palliative care. This specialization allows registered nurses to care for patients that are dealing with end of life issues as well as helping the family of the patient.
The ACHPN exam consists of 175 multiple choice questions; 25 of which are pretest questions and will not be counted against your final score. To register for the ACHPN exam, you will have a $465 registration fee. Members of the HPNA have a $345 registration fee.
There are five content areas of the ACHPN exam:
1. Nursing Process in Caring for Adult Patients and Families
b. Diagnosis and Planning
c. Intervention and Evaluation
2. Scientific Knowledge (biomedical, clinical, and psychosocial-behavioral)
a. Disease Processes
b. Diagnostic Tests and Procedures
d. Responses to Illness, Loss, Grief, Bereavement
3. Education and Communication
a. Education (Patients, Families, Health Care Communities)
b. Scope, Standards, and Guidelines
c. Self-Care and Collegial Support
d. Leadership and Self-Development
5. Systems Issues
a. Resource Access, Utilization, and Continuum of Care
b. Quality Improvement
When you receive your scores for the ACHPN exam, your score report will indicate either a “pass” or “fail”. You will receive a scaled score ranging between 0 to 99. To be considered as passing for the ACHPN, you must receive a minimum score of 75.
ACHPN Exam Practice Questions
1.A patient complains of inability to sleep because of persistent severe restless legs syndrome. Which of the following medications is most indicated?
2. For which of the following diagnoses may a patient be eligible for hospice care on diagnosis if the patient chooses to forego treatment?
b. Small cell lung cancer.
c. Amyotrophic lateral sclerosis.
d. Multiple myeloma.
3. If the advanced practice registered nurse is using the Palliative Performance Scale (PPS) to assess a patient with severe heart disease and finds the patient is now completely bedridden, requires total care, oral intake of both food and fluids is reduced, and the patient is responsive but very drowsy, the PPS score would be
- A: While various drugs have been used to treat restless legs syndrome, drugs that are FDA-approved for RLS and that are usually well-tolerated are pramipexole (Mirapex®) and Ropinirole (Requip®). The initial dose of pramipexole is usually 0,25 mg PO 2 to 3 hours before bedtime with dosage increased in 4 to 7 days if needed. Levo-dopa sometimes causes worsening of symptoms over time. Cabergoline is associated with severe adverse effects, and gabapentin may provide some relief of mild to moderate RLS but is associated with numerous adverse effects as well.
2. B: A patient may be eligible for hospice care on the diagnosis of small cell lung cancer if the patient chooses to forego treatment because the prognosis is so poor and the average life expectancy is about 2 to 3 months. Other diagnoses that also may make a patient foregoing treatment eligible include pancreatic cancer, which results in a life expectancy of 4 to 8 months, and brain tumor (such as glioblastoma multiforme) with a life expectancy of about 6 to 8 months.
3. D: If the advanced practice registered nurse is using the Palliative Performance Scale to assess a patient with severe heart disease and finds the patient is now completely bedridden, requires total care, oral intake of both food and fluids is reduced, and the patient is responsive but very drowsy, the PPS would be 30. Once a patient becomes bedridden, the highest possible score is 30. Scores of 50 and below indicate that disease is extensive and condition deteriorating.