ACHPN - Advanced Certified Hospice and Palliative Nurse Examination Non-Pain Symptom Assessment Questions and Answers

Question 1

An advanced practice nurse is caring for a 78-year-old male with end-stage COPD who is non-verbal.
The patient appears restless, with a respiratory rate of 28, use of accessory muscles, and a distressed facial expression.
Which of the following is the most appropriate tool to assess this patient's dyspnea?

Accepted Answer

Respiratory Distress Observation Scale (RDOS)

Answer

Numeric Rating Scale (NRS)

Answer

Edmonton Symptom Assessment System (ESAS-r)

Answer

Borg Scale

Question 2

A 65-year-old patient with advanced pancreatic cancer reports new-onset, persistent nausea without vomiting. The patient also complains of a constant feeling of fullness after eating very little. Which of the following is the most likely cause of this patient's nausea?

Accepted Answer

Impaired gastric emptying

Answer

Anxiety

Answer

Opioid medication side effect

Answer

Hypercalcemia

Question 3

The Memorial Delirium Assessment Scale (MDAS) is a clinician-rated tool used frequently in palliative care. What is its primary purpose?

Accepted Answer

To quantify the severity of delirium and monitor its course.

Answer

To differentiate delirium from dementia and depression.

Answer

To screen for underlying causes of cognitive changes.

Answer

To guide non-pharmacological interventions for confusion.

Question 4

When assessing a hospice patient for constipation, which piece of information is most crucial for the advanced practice nurse to obtain first?

Accepted Answer

The patient's usual and current bowel pattern.

Answer

The date of the last bowel movement.

Answer

The presence of bowel sounds in all four quadrants.

Answer

The patient's daily fluid and fiber intake.

Question 5

A patient is completing the Edmonton Symptom Assessment System-revised (ESAS-r). The nurse should instruct the patient to rate the severity of the symptoms based on their experience during which timeframe?

Accepted Answer

At this present moment ('now')

Answer

Over the past 24 hours

Answer

On average over the past week

Answer

At its worst in the past 3 days

Question 6

Which of the following is a key principle in the assessment of nausea and vomiting in a patient with a serious illness?

Accepted Answer

Identify the likely underlying cause and emetic pathway to guide treatment.

Answer

Initiate a broad-spectrum antiemetic before a full assessment is complete.

Answer

Nausea and vomiting should be considered a single symptom.

Answer

Prioritize objective signs like vomiting over the subjective report of nausea.