Advanced Certified Hospice and Palliative Nurse
(ACHPN) Practice Examination Questions &
100% Verified Answers # Ace Your 2026 RN ATI
Med-Surg Proctored Exam with Confidence!
Question 1.
A patient with advanced cancer reports severe dyspnea at rest. Which initial
pharmacologic intervention is most appropriate?
A. Nebulized saline
B. Oral lorazepam
C. Parenteral morphine
D. Inhaled corticosteroid
Answer: C
Rationale: Opioids, particularly parenteral morphine, are firstline for severe
dyspnea in advanced illness, reducing respiratory drive and the sensation of air
hunger without hastening death. Benzodiazepines may be adjunctive but are not
primary.
Question 2.
The hospice nurse is visiting a patient who has just died at home. The family is
present. The nurse's priority action is to:
A. Call the funeral home immediately
,B. Pronounce death according to state law and agency policy, then provide grief
support
C. Remove all medications from the home
D. Leave the family alone to grieve
Answer: B
Rationale: The hospice nurse pronounces death (if permitted by law), confirms
absence of vital signs, and then supports the family with immediate grief care and
guidance on next steps. Medication disposal occurs later per policy.
Question 3.
Which ethical principle is most directly upheld when a nurse ensures a competent
patient's advance directives are honored?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Answer: C
Rationale: Autonomy is the right to selfdetermination. Honoring advance
directives respects the patient's previously expressed wishes. Beneficence is doing
good, nonmaleficence is avoiding harm, justice is fairness.
, Question 4.
A patient with endstage heart failure has a new onset of confusion and
restlessness. The nurse should first:
A. Administer haloperidol as ordered
B. Assess for reversible causes such as hypoxia, infection, urinary retention, or
medication side effects
C. Restrain the patient to prevent falls
D. Immediately notify the family to say goodbye
Answer: B
Rationale: Delirium at end of life may have reversible components. Assessment
for underlying causes (e.g., hypoxia, constipation, UTI) is the first step. Symptom
management follows if no reversible cause is found.
Question 5.
Which class of medication is considered firstline for neuropathic pain in palliative
care?
A. NSAIDs
B. Opioids alone
C. Antidepressants (e.g., duloxetine) and anticonvulsants (e.g., gabapentin)
D. Benzodiazepines
Answer: C
, Rationale: Adjuvant analgesics such as gabapentinoids (gabapentin, pregabalin)
and serotoninnorepinephrine reuptake inhibitors (duloxetine) are firstline for
neuropathic pain. Opioids may be added if inadequate.
Question 6.
A patient receiving hospice care develops nausea and vomiting. The nurse
recommends an antiemetic based on the most likely cause. For nausea due to
opioid therapy, which antiemetic is appropriate?
A. Ondansetron (5HT3 antagonist)
B. Metoclopramide (prokinetic)
C. Haloperidol (dopamine antagonist)
D. Scopolamine patch
Answer: C
Rationale: Opioidinduced nausea is largely mediated by dopamine receptors in
the chemoreceptor trigger zone; haloperidol, a dopamine antagonist, is effective.
5HT3 antagonists target chemotherapyinduced nausea, prokinetics help with
gastric stasis.
Question 7.
The Palliative Performance Scale (PPS) score of 40% indicates:
A. Fully ambulatory, normal activity
(ACHPN) Practice Examination Questions &
100% Verified Answers # Ace Your 2026 RN ATI
Med-Surg Proctored Exam with Confidence!
Question 1.
A patient with advanced cancer reports severe dyspnea at rest. Which initial
pharmacologic intervention is most appropriate?
A. Nebulized saline
B. Oral lorazepam
C. Parenteral morphine
D. Inhaled corticosteroid
Answer: C
Rationale: Opioids, particularly parenteral morphine, are firstline for severe
dyspnea in advanced illness, reducing respiratory drive and the sensation of air
hunger without hastening death. Benzodiazepines may be adjunctive but are not
primary.
Question 2.
The hospice nurse is visiting a patient who has just died at home. The family is
present. The nurse's priority action is to:
A. Call the funeral home immediately
,B. Pronounce death according to state law and agency policy, then provide grief
support
C. Remove all medications from the home
D. Leave the family alone to grieve
Answer: B
Rationale: The hospice nurse pronounces death (if permitted by law), confirms
absence of vital signs, and then supports the family with immediate grief care and
guidance on next steps. Medication disposal occurs later per policy.
Question 3.
Which ethical principle is most directly upheld when a nurse ensures a competent
patient's advance directives are honored?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Answer: C
Rationale: Autonomy is the right to selfdetermination. Honoring advance
directives respects the patient's previously expressed wishes. Beneficence is doing
good, nonmaleficence is avoiding harm, justice is fairness.
, Question 4.
A patient with endstage heart failure has a new onset of confusion and
restlessness. The nurse should first:
A. Administer haloperidol as ordered
B. Assess for reversible causes such as hypoxia, infection, urinary retention, or
medication side effects
C. Restrain the patient to prevent falls
D. Immediately notify the family to say goodbye
Answer: B
Rationale: Delirium at end of life may have reversible components. Assessment
for underlying causes (e.g., hypoxia, constipation, UTI) is the first step. Symptom
management follows if no reversible cause is found.
Question 5.
Which class of medication is considered firstline for neuropathic pain in palliative
care?
A. NSAIDs
B. Opioids alone
C. Antidepressants (e.g., duloxetine) and anticonvulsants (e.g., gabapentin)
D. Benzodiazepines
Answer: C
, Rationale: Adjuvant analgesics such as gabapentinoids (gabapentin, pregabalin)
and serotoninnorepinephrine reuptake inhibitors (duloxetine) are firstline for
neuropathic pain. Opioids may be added if inadequate.
Question 6.
A patient receiving hospice care develops nausea and vomiting. The nurse
recommends an antiemetic based on the most likely cause. For nausea due to
opioid therapy, which antiemetic is appropriate?
A. Ondansetron (5HT3 antagonist)
B. Metoclopramide (prokinetic)
C. Haloperidol (dopamine antagonist)
D. Scopolamine patch
Answer: C
Rationale: Opioidinduced nausea is largely mediated by dopamine receptors in
the chemoreceptor trigger zone; haloperidol, a dopamine antagonist, is effective.
5HT3 antagonists target chemotherapyinduced nausea, prokinetics help with
gastric stasis.
Question 7.
The Palliative Performance Scale (PPS) score of 40% indicates:
A. Fully ambulatory, normal activity
