ACHPN study plan

Classify pain by mechanism (nociceptive, neuropathic, mixed) and match each classification to an appropriate analgesic strategy

Perform equianalgesic conversions among morphine, oxycodone, hydromorphone, and transdermal fentanyl, applying a 25-50% reduction for incomplete cross-tolerance when rotating opioids

Construct a titration plan for severe acute pain that includes a breakthrough dose equal to 10-20% of the 24-hour baseline

Recognize and outline management of opioid adverse effects including constipation, sedation, myoclonus, and opioid-induced neurotoxicity

Select adjuvant analgesics for neuropathic pain, bone pain, and visceral pain, stating the rationale for each

Assess and grade dyspnea and initiate a stepwise plan that includes nonpharmacologic measures and low-dose opioids

Select an antiemetic by matching the patient's presenting pattern to the affected emetic pathway (chemotherapy, vestibular, gastric stasis, raised intracranial pressure)

Design a prophylactic bowel regimen for any patient starting an opioid and adjust it for inadequate response

Screen for delirium with a validated tool, list reversible contributors, and prescribe a nonpharmacologic-first management plan

Differentiate depression, anxiety, and existential distress in a seriously ill patient and state a first-line treatment for each

Conduct a structured goals-of-care conversation that elicits the patient's values, illness understanding, and acceptable functional outcomes before discussing specific treatments

Deliver news of a poor prognosis using a stepwise protocol and respond to emotional cues with empathic statements rather than immediate problem-solving

Explain the scope, limitations, and portability of advance directives, living wills, and portable medical orders for life-sustaining treatment

Facilitate a family meeting with a defined pre-meeting, meeting, and debrief structure, including management of conflict

Document a goals-of-care discussion so that a covering clinician could act on the documented preferences without clarifying calls

Screen for psychosocial distress using a validated instrument and triage findings to social work, psychology, or chaplaincy

Distinguish normal grief from major depression and from demoralization, and state the referral threshold for each

Perform a spiritual assessment that identifies sources of meaning, belief, and ritual, and document it in a form the team can act on

Adapt communication and care planning for cultural and health-literacy differences, including interpreter use

Describe the roles and referral triggers for each core interdisciplinary team member (physician, nurse, social worker, chaplain, aide, therapist, pharmacist)

Run an interdisciplinary team meeting that produces documented, owner-assigned problem-based care plan updates

Apply hospice eligibility criteria and prognostication tools to determine appropriateness and recertification readiness for a given patient

Identify the clinical signs of actively dying and prescribe an end-of-life symptom plan for pain, dyspnea, secretions, and agitation

Distinguish palliative sedation from euthanasia and articulate the doctrine of double effect in a clinical scenario

Explain the process and ethical reasoning for withdrawing a life-sustaining intervention such as dialysis or ventilation

Perform post-death care procedures including pronouncement documentation, family notification, and culturally appropriate body care

Complete required post-death documentation including death certificate cause-of-death entries and hospice discharge documentation

Administer a validated bereavement risk assessment and stratify survivors into universal, targeted, or specialized support

Design a bereavement follow-up schedule for a hospice family across the first 13 months, including the components of a condolence contact

Identify complicated grief criteria and state the referral pathway and evidence-supported treatment

Apply the ethical principles of autonomy, beneficence, nonmaleficence, and justice to capacity, surrogate decision-making, and confidentiality scenarios

Differentiate the regulatory requirements of the Medicare hospice benefit including election, revocation, levels of care, and recertification

Design a small quality-improvement project using a measurable indicator, a data source, and a PDSA cycle

Appraise a palliative care research article for study design, bias, and applicability to practice, and translate one finding into a practice change

Explain how to teach a symptom-assessment skill to a colleague using a learner-centered approach with an evaluation component

Complete a timed full-length practice examination under test-day conditions and score each domain separately

Re-study the two lowest-scoring domains using the error log and targeted primary sources

Rehearse rapid recall of high-yield numbers, equianalgesic ratios, screening tools, and regulatory timeframes

Assemble a one-page summary sheet of personally missed concepts for final pre-exam review