FREE ACHPN Intervention and Management Questions and Answers

Question 1

A patient complains of inability to sleep because of persistent severe restless legs syndrome. Which of the following medications is most indicated?

Accepted Answer

Pramipexole

Answer

Explanation:
While various drugs have been used to treat restless legs syndrome, drugs that are FDA-approved for RLS and that are usually well-tolerated are pramipexole (Mirapex®) and Ropinirole (Requip®). The initial dose of pramipexole is usually 0.25 mg PO 2-3 hours before bedtime with dosage increased in 4-7 days if needed. Levo-dopa sometimes causes worsening of symptoms over time. Cabergoline is associated with severe adverse effects, and gabapentin may provide some relief of mild to moderate RLS but is associated with numerous adverse effects as well.

Question 2

The factor that most indicates a risk of drug abuse or misuse after beginning chronic opioid therapy is:

Accepted Answer

personal/family history of substance abuse.

Answer

Explanation:
The factor that most indicates a risk of drug abuse or misuse after beginning chronic opioid therapy is personal/family history of substance abuse. Patients with this history should be educated thoroughly about risks and monitored carefully. Other risk factors for abuse or misuse include a younger age and psychiatric comorbidity.

Question 3

For which of the following diagnoses may a patient be eligible for hospice care on diagnosis if the patient chooses to forego treatment?

Accepted Answer

Small cell lung cancer

Answer

Explanation:
A patient may be eligible for hospice care on diagnosis of small cell lung cancer if the patient chooses to forego treatment because the prognosis is so poor and the average life expectancy is about 2-3 months. Other diagnoses that also may make a patient foregoing treatment eligible include pancreatic cancer, which results in a life expectancy of 4-8 months, and brain tumors (such as glioblastoma multiforme) with a life expectancy of about 6-8 months.

Question 4

An 80-year-old non-diabetic patient with renal failure who has refused hemodialysis and is not a candidate for kidney transplantation has requested hospice services. Which of the following laboratory findings supports admission to hospice?

Accepted Answer

Creatinine clearance <10 mL/min and serum creatinine >8.0 mg/dL.

Answer

Explanation:
If an 80-year-old non-diabetic patient with renal failure who has refused hemodialysis and is not a candidate for kidney transplantation has requested hospice services, the laboratory findings that support admission to hospice are creatinine clearance < 10 mL/min and serum creatinine >8.0 mg/dL. Requirements for diabetic patients with renal failure are slightly different: creatinine clearance <15 mL/min and serum creatinine >6.0 mg/dL. The patient must also have documentation that outlines signs and symptoms consistent with chronic or acute renal failure.

Question 5

A patient with AIDS has a CD4+ count of 24, a viral load of 110,000, and a 35% drop in lean body mass. The Karnofsky Performance Scale score needed to qualify the patient for hospice care is:

Accepted Answer

<50.

Answer

Explanation:
If a patient with AIDS has a CD4+ count of 24, a viral load of 110,000, and a 35% drop in weight, the Karnofsky Performance Scale score needed to qualify the patient for hospice care is less than 50, which indicates that the patient is in need of assistance with activities of daily living and requires frequent medical care. The KPS classifies patients according to their functional ability, and a low score indicates a low chance of survival.

ACHPN - Advanced Certified Hospice and Palliative Nurse Examination Practice Test

ACHPN - Advanced Certified Hospice and Palliative Nurse Examination Practice Test

FREE ACHPN Intervention and Management Questions and Answers