ACHPN Palliative Care Assessment and Diagnosis 2

Question 1

Which diagnostic criterion differentiates terminal delirium from dementia in a hospice patient?

Accepted Answer

Acute onset and fluctuating course

Answer

Terminal delirium is distinguished from dementia by its acute onset and fluctuating course, whereas dementia involves gradual, progressive cognitive decline.

Question 2

An ACHPN is assessing a patient's prognosis using the Palliative Prognostic Score (PaP). Which variable is included in this tool?

Accepted Answer

Karnofsky Performance Status

Answer

The Palliative Prognostic Score (PaP) includes Karnofsky Performance Status along with clinical symptoms and lab values to estimate survival probability.

Question 3

When assessing a palliative patient for depression, which factor complicates using standard DSM criteria?

Accepted Answer

Somatic symptoms of depression overlap with symptoms of serious illness

Answer

Somatic symptoms such as fatigue, anorexia, and sleep disturbance overlap between depression and serious illness, making standard DSM criteria less reliable in palliative assessment.

Question 4

Which tool is specifically validated for assessing pain in cognitively impaired hospice patients who cannot self-report?

Accepted Answer

PAINAD (Pain Assessment in Advanced Dementia)

Answer

The PAINAD scale is validated for assessing pain in patients with advanced dementia who cannot reliably self-report, using behavioral observations.

Question 5

A hospice patient presents with new urinary retention. Which assessment step should the ACHPN perform first?

Accepted Answer

Assess for opioid-induced urinary retention or spinal cord compression

Answer

New urinary retention in a hospice patient should first prompt assessment for opioid side effects or spinal cord compression, both of which are urgent and treatable.

ACHPN - Advanced Certified Hospice and Palliative Nurse Examination Practice Test

ACHPN - Advanced Certified Hospice and Palliative Nurse Examination Practice Test

ACHPN Palliative Care Assessment and Diagnosis 2