ACHPN - Advanced Certified Hospice and Palliative Nurse Examination Advanced Practice Professional Issues Questions and Answers

Question 1

An ACHPN provides a 40-minute, face-to-face advance care planning (ACP) discussion for a patient with Medicare Part B coverage.
The patient's health status has changed, necessitating this discussion, which is documented separately from the office visit.
Which CPT® codes should the ACHPN use to bill for this service?

Accepted Answer

CPT® code 99497 for the first 30 minutes and add-on code 99498 for the additional time.

Answer

A single code for an extended office visit (e.g., 99215).

Answer

A prolonged services code in addition to a standard office visit code.

Answer

CPT® code 99497 only, as it covers the entire encounter.

Question 2

An ACHPN working in a skilled nursing facility needs to complete a POLST (Physician Orders for Life-Sustaining Treatment) form with a patient who has decisional capacity. The ACHPN's legal authority to sign the POLST form, making it a valid medical order, is primarily determined by which of the following?

Accepted Answer

The state's Nurse Practice Act and relevant statutes.

Answer

The policies of the patient's health insurance carrier.

Answer

Federal regulations established by the Centers for Medicare & Medicaid Services (CMS).

Answer

The internal bylaws of the skilled nursing facility.

Question 3

An ACHPN feels increasingly emotionally exhausted and cynical after caring for several patients where family demands for non-beneficial, life-prolonging treatments conflicted with the ACHPN's professional duty to alleviate suffering. The ACHPN knows the ethically appropriate action but feels constrained by the situation. This specific type of psychological distress is best defined as:

Accepted Answer

Moral distress.

Answer

Compassion fatigue.

Answer

Secondary traumatic stress.

Answer

Professional burnout.

Question 4

An ACHPN is leading an interdisciplinary team (IDT) that wants to implement a quality improvement (QI) project to reduce delays in hospice admissions. Using the Plan-Do-Study-Act (PDSA) model, what is the most appropriate first step for the team to take?

Accepted Answer

Formulate a specific aim statement, define what will be measured, and make a prediction.

Answer

Immediately implement a new, streamlined referral process for a small number of patients.

Answer

Analyze data from the past six months to see how the new process affected admission times.

Answer

Educate all hospital case managers on the new hospice referral criteria.

Question 5

Which of the following is a key regulatory distinction between palliative care services billed under Medicare Part B and services provided under the Medicare Hospice Benefit (MHB)?

Accepted Answer

The MHB requires the patient to forgo curative-intent treatments for their terminal illness.

Answer

Palliative care under Part B is only for patients with a cancer diagnosis.

Answer

Bereavement support is a mandated service only under Medicare Part B palliative care.

Answer

Only services under the MHB can be provided in the patient's home.

Question 6

During an interdisciplinary team (IDT) meeting, the social worker and chaplain have a disagreement about a family's primary source of distress, leading to a tense discussion. As the ACHPN facilitating the meeting, which action is most effective for managing the conflict and refocusing the team?

Accepted Answer

Validate both perspectives and guide the conversation back to the patient's and family's stated goals.

Answer

End the discussion and address the conflict with each member privately after the meeting.

Answer

Ask the team to vote on which assessment is more likely correct to move forward.

Answer

Request that the medical director make the final decision on the plan of care.