ACHPN Cheat Sheet 2026

The 30 highest-yield ACHPN facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which approach best supports effective communication between the palliative care team and a family from a culture with collectivist decision-making values? → Invite designated family decision-makers while still exploring the patient's wishes
2. Which family meeting strategy best supports informed decision-making in a palliative care context? → Explore family values and goals before presenting medical options
3. An ACHPN is assessing a patient's prognosis using the Palliative Prognostic Score (PaP). Which variable is included in this tool? → Karnofsky Performance Status
4. Which tool is specifically validated for assessing pain in cognitively impaired hospice patients who cannot self-report? → PAINAD (Pain Assessment in Advanced Dementia)
5. Which of the following is a key principle in the assessment of nausea and vomiting in a patient with a serious illness? → Identify the likely underlying cause and emetic pathway to guide treatment.
6. Which of the following best describes the role of the ACHPN in an interdisciplinary palliative care team (IDT)? → Coordinating complex symptom management and bridging communication among team members
7. A hospice patient has increasing episodes of dyspnea, especially after exertion. The position of comfort that is most likely to reduce the dyspnea is: → leaning slightly forward in a chair with arms supported.
8. A hospice caregiver reports she has not slept more than 3 hours nightly for two weeks. Which action should the ACHPN take first? → Assess for respite care needs and connect with the interdisciplinary team
9. Which lab value trend is most useful in assessing declining renal function in a palliative patient on opioids? → Serum creatinine
10. If a patient with chronic bowel disease has developed persistent diarrhea, the treatment most indicated to control the diarrhea is: → loperamide.
11. The primary goal of palliative sedation in the imminently dying patient is to: → Relieve intractable and refractory symptoms causing distress.
12. Which of the following is considered a significant risk factor for developing complicated grief? → The death was sudden, unexpected, and traumatic
13. The Memorial Delirium Assessment Scale (MDAS) is a clinician-rated tool used frequently in palliative care. What is its primary purpose? → To quantify the severity of delirium and monitor its course.
14. Which cultural consideration is most important when supporting diverse families in a hospice setting? → Assess individual family beliefs, practices, and preferences regarding death and dying
15. Which diagnostic criterion differentiates terminal delirium from dementia in a hospice patient? → Acute onset and fluctuating course
16. Which intervention by the ACHPN best supports a family caregiver who insists on continuing curative treatment against the palliative care team's recommendation? → Explore the family's fears and hopes underlying their request using empathic communication
17. If using the ask-tell-ask framework to educate a patient about self-care, the advanced practice registered nurse would begin by: → asking the patient what he/she knows and wants to know.
18. From an ethical standpoint, the distinction between withholding and withdrawing life-sustaining treatment, such as artificial nutrition and hydration, is that: → There is no inherent ethical or legal difference between the two actions.
19. Which of the following disease trajectories is most commonly associated with advanced organ failure, such as end-stage COPD or congestive heart failure? → A long-term limitation with intermittent, serious, and life-threatening exacerbations
20. A palliative patient newly reports difficulty swallowing medications. Which assessment should the ACHPN prioritize? → Swallowing function and ability to use alternative medication routes
21. The palliative care IDT is conducting a quality improvement review of care transitions. Which metric is MOST relevant to assess? → Rate of unplanned emergency department visits within 72 hours of hospice enrollment
22. When assessing a patient's decision-making capacity in palliative care, which four elements must be established? → Understanding, appreciation, reasoning, and ability to communicate a choice
23. Which factor most increases the risk of complicated grief in a bereaved family caregiver? → A history of depression or prior traumatic losses
24. Which finding during an ACHPN assessment most strongly suggests existential distress rather than clinical depression? → Loss of meaning and will to live without neurovegetative symptoms
25. The factor that most indicates a risk of drug abuse or misuse after beginning chronic opioid therapy is: → personal/family history of substance abuse.
26. Which validated tool is most appropriate for conducting a comprehensive palliative care needs assessment in a hospice patient? → Palliative Performance Scale (PPS)
27. A 46-year-old male with HIV/AIDS has anorexia and marked weight loss. Which of the following drugs may be indicated to relieve nausea and improve appetite? → Dronabinol
28. When performing a spiritual assessment using the FICA tool in a palliative patient, what does the 'A' stand for? → Address in care
29. When assessing a hospice patient for constipation, which piece of information is most crucial for the advanced practice nurse to obtain first? → The patient's usual and current bowel pattern.
30. An ACHPN identifies a family caregiver showing signs of compassion fatigue. Which initial response is most appropriate? → Acknowledge caregiver distress and offer referral to counseling or support services