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Exam Code: ACHPN
Exam Name: Advanced Certified Hospice and Palliative Nurse
Total Questions: 175 multiple-choice questions (each with 4 options, only 1 correct answer). 150 scored questions, 25 unscored pretest questions
Time Allotted: 3.5 hours (210 minutes) to complete the exam.
Passing Criteria: A scaled score of 500 (on a scale of 200–800) is required to pass.

- Nursing Process in Caring for Patients and Families
- Conduct a comprehensive patient assessment in the context of serious illness including functional and nutritional status, patient/caregiver knowledge, emotions and coping strategies, support systems, resources/needs, and environmental factors
- Collect patient information (e.g., medical & psychosocial history, spiritual & cultural preferences, comprehensive review of systems, advance care planning documents, medical decision makers)
- Perform a systems-based physical examination
- Identify past and present goals of care and expectations in the context of health beliefs, values, and practices

- Diagnosis and Planning
- Formulate and prioritize differential diagnoses and apply findings to develop the plan of care
- Identify expected outcomes in relation to patient/caregiver goals of care, prognosis, and the improvement of quality of life
- Develop interventions based on patient/caregiver values, goals, and preferences, prognosis, level of care, available resources, and expected risks and benefits
- Establish safe, multimodal pain management plans

- Intervention and Evaluation
- Collaborate with the interdisciplinary team to develop, implement, evaluate, and modify the plan of care based on changing functional status, illness trajectory, care system, and patient/caregiver goals
- Communicate diagnoses, progression of disease, expected prognosis, and plan of care with the patient/caregiver and interdisciplinary health care team
- Recommend strategies to address psychosocial needs (minimize caregiver burden, patient/caregiver vulnerability, coping, bereavement, emotional and spiritual health)
- Implement pharmacologic therapies and facilitate nonpharmacologic interventions (e.g., palliative surgery, procedures, radiation, counseling, psychological therapy, complementary and alternative interventions)
- Facilitate advance care planning and care coordination with inpatient and outpatient teams

- Biomedical, Clinical, and Psychosocial-Behavioral Knowledge
- Explain the disease process and understand evidence-based palliative management for serious diseases and conditions
- Recognize hospice and palliative care emergencies (e.g., spinal cord compression, hemorrhage, seizures, superior vena cava syndrome) and provide evidence-based management
- Identify signs and symptoms associated with serious diseases and conditions and provide evidence-based management
- Understand psychosocial, emotional, and spiritual needs and provide evidence-based management
- Determine prognosis using evidence-based tools and comprehensive patient assessment
- Serious Illness, Loss, Dying, Grief, and Bereavement
- Identify common tenets of major religions and cultures in relation to serious illness, dying, and death
- Address issues related to loss, bereavement, grief, and mourning in the context of culture, ethnicity, race, and other factors

- Education and Communication
- Education (Patients, Caregivers, Health Care Communities)
- Establish a therapeutic environment and apply age-appropriate teaching methods tailored to the needs of the patient, family, and other caregivers
- Develop, implement, and evaluate formal and informal education

- Communication
- Analyze own communication (verbal and nonverbal) and possible interpretations
- Recognize and incorporate cultural differences when discussing hospice and palliative care
- Create an environment for effective communication and demonstrate therapeutic presence while maintaining professional boundaries
- Use appropriate principles and techniques to communicate serious news
- Initiate and facilitate conferences among patient, family, caregivers, medical and interdisciplinary team members, and other key stakeholders

- Professionalism
- Promote principles of biomedical ethics
- Address ethical issues related to withholding or withdrawing treatment, and non-beneficial treatment
- Address ethical issues related to palliative sedation, medical aid in dying, and suicide
- Scope, Standards, and Guidelines
- Identify and resolve issues related to scope of practice and practice protocols
- Incorporate national hospice and palliative standards and guidelines into advanced nursing practice
- Leadership and Self-Development
- Share knowledge through publications, presentations, precepting, and mentoring
- Educate local, state, and national organizations, institutions, and individuals about hospice and palliative care (e.g., differentiate palliative care from hospice care)
- Develop practice guidelines to advance hospice and palliative care
- Identify and address burnout, compassion fatigue, and moral distress in self and others

- Systems Issues
- Resource Access, Utilization, and Continuum of Care
- Advocate for timely access to palliative care and hospice services
- Develop hospice and palliative care programs and services
- Identify potential barriers and resources to promote continuity of care across all settings
- Maintain current knowledge of trends in legislation, policy, health care delivery, and reimbursement as they impact hospice and palliative care
- Quality Improvement
- Participate in continuous quality improvement
- Provide value-based, quality care