HPNA ACHPN Test Bank Questions With Complete
Solutions
1. A 55-year-old woman with metastatic lung cancer, who was
initiated on steroids for pain, develops delirium. Which of the
following symptoms signals acute delirium?
A. Disturbance in attention and awareness
B. Cognitive changes
C. Sleep-wake cycle disturbance
D. All of the above Correct Answer D. All of the above
1. A patient has lung cancer with multiple sites of bone
metastases. He has decided not to have any more
treatment. He is not yet eligible for hospice but is seen
by the palliative care service. He presents to the clinic
today reporting that he has been hearing voices in the
last twenty-four hours. An irregular heart rate is noticed
during the physical exam that was not present at his clinic
visit two weeks ago. Which lab test does the advanced
practice nurse order?
A. albumin level
B. calcium level
C. phosphorus
D. platelet count Correct Answer B. calcium level
1. A patient in the intensive care unit has acute kidney injury d
cardiogenic shock after a myocardial infarction. Renal funct is
most likely to improve with which of the following treatme
A. Replacing fluid volume losses
B. Pressor support, avoiding hypotension
C. Hemodialysis
,D. Continuous renal replacement therapy Correct Answer B.
Pressor support, avoiding hypotension
1. A patient under your care with advanced pancreatic cancer,
type 2 diabetes, and history of prior cerebrovascular accident
(CVA) is experiencing new onset of confusion, tachycardia, and
agitation 30 minutes after his lunch. He has had poor appetite,
and you note that he received Humalog insulin pre-meal. You
suspect which of the following?
A. Recurrent CVA due to neurologic symptoms
B. Postprandial hypoglycemia due to poor intake
C. End-of-life delirium
D. Hypercalcemia of malignancy Correct Answer B.
Postprandial hypoglycemia due to poor intake
1. According to the Rome Criteria III, defining functional or
chronic idiopathic constipation, which of the following
symptoms must accompany the diagnosis?
A. Oozing stool and diarrhea
B. Flatus and belching
C. Lumpy or hard stools
D. Vomiting and nausea Correct Answer C. Lumpy or hard
stools
1. All of the following describe advance care planning
EXCEPT?
A. Advance directive
B. Will and testament
C. Healthcare proxy
D. Code status Correct Answer B. Will and testament
,1. Alzheimer's disease is diagnosed by which of the following?
A. Stereotactic brain biopsy
B. Serial magnetic resonance imaging showing a decline over
time
C. Genetic testing
D. Clinical diagnosis, confirmed on autopsy Correct Answer D.
Clinical diagnosis, confirmed on autopsy
1. Anorexia and cachexia are syndromes that are commonly
experienced by patients in advanced disease. The following
statements about these syndromes are true, EXCEPT?
A. They are different syndromes.
B. Both syndromes involve complex mechanisms.
C. Both syndromes cause psychosocial distress for patients and
families.
D. Anorexia and cachexia are reversible. Correct Answer D.
Anorexia and cachexia are reversible.
Anorexia without cachexia results in loss of adipose tissue and is
potentially by treating possible causes. Cachexia is weight loss
associated with loss of muscle, with or without loss of fat mass,
and is unlikely reversible.
1. Assessment of fatigue should include which of the following
assessments?
A. A comprehensive review of medical history, nutritional
history, and current medications, as well as a fatigue assessment
tool.
B. A comprehensive review of medical history, nutritional
history, and current medications, as well as a sexual history.
, C. A comprehensive review of medical history, nutritional
history, and current medications, as well as a cognitive
assessment.
D. A comprehensive review of medical history, nutritional
history, and current medications, as well as a psychiatric
evaluation. Correct Answer A. A comprehensive review of
medical history, nutritional history, and current medications, as
well as a fatigue assessment tool.
1. Before entering the inpatient palliative care unit, you meet
your patient's 8-year-old grandchild in the waiting area. To
prepare the child to see their grandparent, it is important to do
which of the following?
A. Defer to a social worker or child life specialist, as it is not
within the role of an adult palliative APRN to talk to children.
B. Tell a story about how the hospital is an adventure land, and
the child's grandparent is an explorer, in hopes of making the
hospital less scary.
C. With the parents present, use clear and developmentally
appropriate language to calmly describe the hospital room.
D. Enter the room, talk to the child alone and then, based on the
child's reaction, explain what to expect. Correct Answer C.
With the parents present, use clear and developmentally
appropriate language to calmly describe the hospital room.
1. Common physiologic changes in aging include:
A. Increased cardiac reserve
B. Decreased glomerular filtration rate (GFR)
C. Increased taste
D. Decreased serum inflammatory mediators Correct Answer
B. Decreased glomerular filtration rate (GFR)
Solutions
1. A 55-year-old woman with metastatic lung cancer, who was
initiated on steroids for pain, develops delirium. Which of the
following symptoms signals acute delirium?
A. Disturbance in attention and awareness
B. Cognitive changes
C. Sleep-wake cycle disturbance
D. All of the above Correct Answer D. All of the above
1. A patient has lung cancer with multiple sites of bone
metastases. He has decided not to have any more
treatment. He is not yet eligible for hospice but is seen
by the palliative care service. He presents to the clinic
today reporting that he has been hearing voices in the
last twenty-four hours. An irregular heart rate is noticed
during the physical exam that was not present at his clinic
visit two weeks ago. Which lab test does the advanced
practice nurse order?
A. albumin level
B. calcium level
C. phosphorus
D. platelet count Correct Answer B. calcium level
1. A patient in the intensive care unit has acute kidney injury d
cardiogenic shock after a myocardial infarction. Renal funct is
most likely to improve with which of the following treatme
A. Replacing fluid volume losses
B. Pressor support, avoiding hypotension
C. Hemodialysis
,D. Continuous renal replacement therapy Correct Answer B.
Pressor support, avoiding hypotension
1. A patient under your care with advanced pancreatic cancer,
type 2 diabetes, and history of prior cerebrovascular accident
(CVA) is experiencing new onset of confusion, tachycardia, and
agitation 30 minutes after his lunch. He has had poor appetite,
and you note that he received Humalog insulin pre-meal. You
suspect which of the following?
A. Recurrent CVA due to neurologic symptoms
B. Postprandial hypoglycemia due to poor intake
C. End-of-life delirium
D. Hypercalcemia of malignancy Correct Answer B.
Postprandial hypoglycemia due to poor intake
1. According to the Rome Criteria III, defining functional or
chronic idiopathic constipation, which of the following
symptoms must accompany the diagnosis?
A. Oozing stool and diarrhea
B. Flatus and belching
C. Lumpy or hard stools
D. Vomiting and nausea Correct Answer C. Lumpy or hard
stools
1. All of the following describe advance care planning
EXCEPT?
A. Advance directive
B. Will and testament
C. Healthcare proxy
D. Code status Correct Answer B. Will and testament
,1. Alzheimer's disease is diagnosed by which of the following?
A. Stereotactic brain biopsy
B. Serial magnetic resonance imaging showing a decline over
time
C. Genetic testing
D. Clinical diagnosis, confirmed on autopsy Correct Answer D.
Clinical diagnosis, confirmed on autopsy
1. Anorexia and cachexia are syndromes that are commonly
experienced by patients in advanced disease. The following
statements about these syndromes are true, EXCEPT?
A. They are different syndromes.
B. Both syndromes involve complex mechanisms.
C. Both syndromes cause psychosocial distress for patients and
families.
D. Anorexia and cachexia are reversible. Correct Answer D.
Anorexia and cachexia are reversible.
Anorexia without cachexia results in loss of adipose tissue and is
potentially by treating possible causes. Cachexia is weight loss
associated with loss of muscle, with or without loss of fat mass,
and is unlikely reversible.
1. Assessment of fatigue should include which of the following
assessments?
A. A comprehensive review of medical history, nutritional
history, and current medications, as well as a fatigue assessment
tool.
B. A comprehensive review of medical history, nutritional
history, and current medications, as well as a sexual history.
, C. A comprehensive review of medical history, nutritional
history, and current medications, as well as a cognitive
assessment.
D. A comprehensive review of medical history, nutritional
history, and current medications, as well as a psychiatric
evaluation. Correct Answer A. A comprehensive review of
medical history, nutritional history, and current medications, as
well as a fatigue assessment tool.
1. Before entering the inpatient palliative care unit, you meet
your patient's 8-year-old grandchild in the waiting area. To
prepare the child to see their grandparent, it is important to do
which of the following?
A. Defer to a social worker or child life specialist, as it is not
within the role of an adult palliative APRN to talk to children.
B. Tell a story about how the hospital is an adventure land, and
the child's grandparent is an explorer, in hopes of making the
hospital less scary.
C. With the parents present, use clear and developmentally
appropriate language to calmly describe the hospital room.
D. Enter the room, talk to the child alone and then, based on the
child's reaction, explain what to expect. Correct Answer C.
With the parents present, use clear and developmentally
appropriate language to calmly describe the hospital room.
1. Common physiologic changes in aging include:
A. Increased cardiac reserve
B. Decreased glomerular filtration rate (GFR)
C. Increased taste
D. Decreased serum inflammatory mediators Correct Answer
B. Decreased glomerular filtration rate (GFR)
