ACHPN study guide
ACHPN · Work through your exam, one topic at a time.
The Advanced Certified Hospice and Palliative Nurse (ACHPN) credential is awarded by the Hospice and Palliative Credentialing Center (HPCC) to nurses who practice at an advanced level with seriously ill patients and their families. It is typically pursued by advanced practice registered nurses-clinical nurse specialists and nurse practitioners-who assess and manage pain and non-pain symptoms, lead goals-of-care conversations, and coordinate care across an interdisciplinary team, in hospice settings, palliative care programs, and acute or outpatient services. The ACHPN study guide has 9 sections and about 2,850 words.
01Interdisciplinary Team Collaboration and Palliative Care Practice Models
The hospice Conditions of Participation require an interdisciplinary group (IDG) made up of the hospice medical director or physician designee, a registered nurse, a medical social worker, and at least one other discipline (commonly the chaplain); the attending physician participates when one is identified. The IDG must review and revise each plan of care at least every 15 days, and it must actually convene - teleconference counts, a single nurse's chart review does not.
364 words, about 2 min02Communication, Goals-of-Care Discussions, and Advance Care Planning
The exam favors structured tools: SPIKES for breaking bad news, Ask-Tell-Ask and NURSE for responding to emotion, REMAP for goals-of-care conversations, teach-back for confirming understanding, and motivational interviewing for behavior change. Name the emotion before giving information; silence and open questions accomplish more than premature reassurance.
321 words, about 2 min03Pain Assessment and Management
Self-report is the gold standard. For patients who cannot report, use validated behavioral tools (PAINAD, FLACC, PACSLAC, DOLOPLUS-2), collateral from caregivers, and a time-limited analgesic trial.
307 words, about 2 min04Non-Pain Symptom Assessment and Management
Low-dose opioids are first-line for refractory dyspnea regardless of oxygen saturation. Supplemental oxygen helps only the hypoxemic patient; a fan, open window, positioning, and paced activity help the rest.
286 words, about 1 min05Psychosocial, Cultural, and Spiritual Care
Psychosocial assessment covers emotional state, family system and caregiving capacity, finances, housing, legal concerns, spirituality, and culture. Structured tools help: FICA or HOPE for spiritual history, the Zarit Burden Interview for caregivers, PHQ-2/9 for depression.
311 words, about 2 min06Care of the Patient at End of Life and After-Death Care
Look for the last-days pattern: decreasing oral intake and urine output, mottling and cool extremities, Cheyne-Stokes breathing, terminal secretions, increasing sleep, restlessness, and changes in level of consciousness. These are expected, not emergencies.
299 words, about 1 min07Grief, Loss, and Bereavement Support
Grief is not a linear sequence of stages; the stage model is a teaching metaphor that questions penalize when applied rigidly. Normal grief oscillates - the dual-process model describes moving between loss-oriented (crying, reviewing, yearning) and restoration-oriented (tasks, roles, distraction) coping.
326 words, about 2 min08Ethical, Legal, and Regulatory Issues in Hospice and Palliative Care
Autonomy, beneficence, nonmaleficence, justice, veracity, and fidelity anchor most items. Jonsen's four-box method - medical indications, patient preferences, quality of life, contextual features - organizes complex cases.
322 words, about 2 min09Education, Quality Improvement, Leadership, and Research Utilization
Adult learning theory (Knowles) says learners need relevance, problem-centered content, and immediate application. Use teach-back and return demonstration for competency, scaffold new staff with preceptors and simulation, and validate skills rather than assuming attendance equals learning.
314 words, about 2 min