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ACHPN REAL EXAM QUESTIONS AND CORRECT ANSWERS ALREADY
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APRN begins to overly identify with pain and suffering of patients; skips lunch, trouble concentrating,
nightmares
A. depression
B. compassion fatigue
C. anxiety
D. empathy - answer-B. compassion fatigue
Patient with chronic bowel disease has developed persistent diarrhea, treatment most indicated to treat
is:
A. loperamide
B. codeine
C. diphenoxylate
D. methylcellulose - answer-A. loperamide- indicated for nonspecific diarrhea but should be avoided if
gross bloody stool or temp above 101 degrees or if C. diff expected. 4mg initially, then 2mg after each
loose stool, NTE 16mg/day.
When utilizing the SPIRIT pneumonic, as a spiritual assessment tool for a hospice patient, the first
question to ask for "S" part is:
A. does spirituality play a part in your personal life?
B. restrictions that affect healthcare decisions?
C. how does faith affect how you feel about death?
D. do you have a normal religious affiliation? - answer-D. Spiritual: formal religious affiliation?
Personal: practices/beliefs, daily life?
Integration: spiritual community
Ritual: specific practices that affect healthcare
Implication: aspects of care to keep in mind
Terminal events: does faith affect feelings about death?
,Obese patient, diabetes; underwent surgery for bowel obstruction 6 days ago and has persistent N/V.
Feels "popping" sensation at incision site-->intestinal evisceration. Initial response:
A. administer opioid, no intervention
B. semi-fowler's knees up, notify surgeon
C. explain what is happening, ask for guidance
D. supinate patient, cover with dry sterile gauze - answer-B. INITIAL RESPONSE: notify surgeon Next-
cover sterile soaked gauze, IV site, O2
76 year old female, generally good health, new pathologic fracture of proximal femur. pt states it
occurred while walking- most likely cause:
A. abuse
B. multiple myeloma
C. osteoporosis
D. bone cyst - answer-C. osteoporosis- DEXA scan gold standard; T-score -2 indicates osteoporosis
When collaborating with patient and family on POC, it's important for them to understand:
A. rights and responsibilities
B. limitations
C. organizations philosophy
D. difference between goals and objectives - answer-A. rights and responsibilities- ask them what goals
and expectations are, what is important to them
Native American patient, stage IV multiple myeloma, on hospice in extended care facility. Reportedly
little pain AEB does not request medicine but does lay in fetal position and refuses food and fluids. APRN
should advise nursing staff:
A. pt probably comfortable without pain medication
B. pt may avoid outward expressions of pain
C. staff nurse should be more aware of pt needs
D. pt probably prefers to suffer than take medications - answer-B. pt may avoid outward expressions of
pain, but his body language indicates otherwise
, Middle Eastern hospice pt, cared for at home by sisters and daughters. On exam, rows of circular slightly
reddened areas up and down back. Most appropriate response:
A. notify APS of abuse
B. tell family hospice pts cannot receive cupping
C. acknowledge use of cupping
D. provide supportive care for pressure sores - answer-C. acknowledge cupping- ancient form of healing
that releases toxins
Pt with progressive onset MS has chronic bladder dysfunction with spasms, frequency, incontinence. He
takes ER oxybutynin. Which dietary restrictions should APRN advise?
A. simple carbs
B. citrus fruits
C. apples and apple juice
D. caffeine and alcohol - answer-D. caffeine and alcohol are bladder irritants and promote diuresis
Family reports patient has not attended mass in 50 years. Pt is nearing death but remains responsive
and not requested priest. APRN should:
A. assume pt will not want to see a priest
B. ask priest on call to visit
C. ask the patient if he/she wants to see a priest
D. ask the family if priest should be called - answer-C. ask the patient, never make assumptions
When educating a patient or family about disease or treatment, the first step is to begin by assessing the
patient's:
A. emotional status
B. knowledge base
C. experience
D. physical condition - answer-B. knowledge base- first assess by asking "can you tell me what you know
about your illness"?
Indications that the spouse of a patient who died is suffering from traumatic grief include prolonged
period (>60 days):
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