ACHPN - Advanced Certified Hospice and Palliative Nurse Examination Psychosocial and Spiritual Care Questions and Answers

Question 1

An ACHPN is caring for a patient with metastatic cancer who states, "I used to be so religious, but now I feel like God has abandoned me.
I don't see the point in anything anymore." The patient is tearful and withdrawn but denies suicidal ideation.
This presentation is most characteristic of:

Accepted Answer

Spiritual distress.

Answer

Major Depressive Disorder.

Answer

Anticipatory grief.

Answer

Complicated bereavement.

Question 2

An ACHPN is using the FICA tool to conduct a spiritual history. When the nurse asks, "Are you part of a spiritual or religious community, and is it a source of support for you?" which component of the acronym is being assessed?

Accepted Answer

Community

Answer

Faith

Answer

Importance

Answer

Address

Question 3

A patient with end-stage heart failure tells the ACHPN, "I feel like my whole life was a waste. I haven't left anything important behind for my children." Which therapeutic intervention would be most appropriate to directly address this patient's existential distress?

Accepted Answer

Initiating Dignity Therapy or a legacy-making project.

Answer

Referring the patient for an antidepressant trial.

Answer

Reassuring the patient that their family loves them.

Answer

Administering an anxiolytic for symptom relief.

Question 4

During a home visit, the ACHPN observes that the primary caregiver for a patient with advanced dementia appears exhausted, irritable, and tearful. The caregiver admits to feeling overwhelmed and guilty, stating, "I just can't do this anymore." What is the ACHPN's priority action?

Accepted Answer

Assess the caregiver for burnout and explore options for respite care.

Answer

Recommend the caregiver join a local support group.

Answer

Provide education on the dementia disease trajectory to manage expectations.

Answer

Teach the caregiver stress reduction techniques like deep breathing.

Question 5

An ACHPN is assessing a patient who reports hopelessness and a feeling of being trapped by their illness. However, the patient still enjoys watching movies with family and denies pervasive anhedonia. This clinical picture, characterized by existential anguish without the loss of pleasure, is most consistent with:

Accepted Answer

Demoralization Syndrome.

Answer

Major Depressive Disorder.

Answer

Adjustment Disorder.

Answer

Normal sadness.

Question 6

The family of a devout Muslim patient who is imminently dying requests that the patient's bed be repositioned. As the ACHPN, you understand this request is likely so the patient can face the Qibla (the direction of Mecca). What is the most culturally competent response?

Accepted Answer

Work with the family and staff to reposition the bed as requested.

Answer

Explain that facility policy does not allow for rearranging patient rooms.

Answer

Ask the family to wait until after the death to perform their rituals.

Answer

Tell the family you must consult the ethics committee before making changes.