Find and steal a piece of poo
After 15 long years of anticipation, hype, and delays, countless fans expected Duke Nukem Forever to bust out of the gates with crazy action. Instead, they led with a poop joke. Well, actually, the very first thing you do is use a urinal, but the first possible Achievement you can unlock involves grabbing a turd from a nearby toilet.
Once you have a hand on the human waste, the Achievement is all yours, though you can follow that reward up with some turd tossing and quips from the Duke about the dookie. Boy, isn't it great that this game finally came out?