ISSUES/TRENDS/POLICY

Question 1

You want to get more funding for your hospital’s Rapid Response Team. How should you present this issue to the committee?

Answer 1

Stress importance of the team (answer is worded as looking up evidence about how the team affects outcomes, like a meta-analysis)

Question 2

What is the best way for the AGACNP to get involved in policy making?

Answer 2

Join a hospital committee

Question 3

What is the best way for the AGACNP to demonstrate and advocate for full scope of practice?

Answer 3

Bill for independent services

Question 4

Which of the following is considered a high acuity role for the AGACNP

Answer 4

Cardiology office

Question 5

What is the best way to advocate for gay and lesbian population in your area?

Answer 5

Start at your facility
(answers are worded differently. One of them is “decrease bias in healthcare” and another is something like “create inservices in healthcare” and another is “obtain funding to increase access.”

Question 6

Which of the following is most important to evaluate statistical significance when reviewing the literature?

Answer 6

Consider the sample size

Question 7

When closing a practice, the NP is required to do all of the following:

Answer 7

The NP IS required to: Give the pt adequate time to find another provider, Keep all of the patient’s records for a minimum of five years and Provide names of other providers for future care

You are NOT required to: Send a certified letter with a return receipt requested (this is for discharging/firing a patient from your practice)

Question 8

Which of the following components of an evidenced based research process is the most important for NP to participate in?

Answer 8

Formulating the research problem

Question 9

A former pt of an NP is writing blog posts, sending emails, and distributing false, accusatory statements about the NP’s practice. Which of the following forms of defamation is this?

Answer 9

libel

Question 10

Can you tell the pt’s wife, for her protection, that her husband has HIV?

Answer 10

No, not without his permission.

Question 11

How can the ANCP prepare to get involved in future mass casualty event?

Answer 11

Pre-enroll in disaster volunteer program

Question 12

An 80-year-old male patient with dementia requires long-term care placement. To which funding agency does the patient apply after “spending down” to qualify?

Answer 12

Medicaid

Question 13

Your pt is worried about insurance coverage and asks you for advice on Medicaid. You instruct the patient that Medicaid

Answer 13

Pays after insurance and 3rd party payers have paid

Question 14

You are giving a dinner presentation to a group. The pharmaceutical rep calls you the night before and wants you to say that their drug is the only one that works. What ethical principles does this challenge?

Answer 14

Veracity and Fidelity

Question 15

Health Literacy average

Answer 15

Average American-8th grade education level

Question 16

What is Quality assurance

Answer 16

a process for evaluating the care of pts using established standards of care to ensure quality

Question 17

CPI measures what 3 measures to improve nursing?

Answer 17

Structure, processes, and outcomes

Question 18

A root cause analysis of a crisis situation in the ICU identified a lack of clinician-family communication as the basis for the resulting adverse outcome. As part of the performance improvement plan, the NP is asked to develop evidence-based polices to establish clinician-family communication standards in the unit. These policies should include:

Answer 18

guidelines for having discussions with family members that are geared toward establishing treatment goals.

Question 19

Which clinical scenario does the NP evaluate for a quality improvement process change?

Answer 19

An increased incidence of a problem..like postoperative sternal wound infections

Question 20

Goals set forth in “Healthy People 2020” by the United States Department of Health and Human Services include:

Answer 20

elimination of health disparities. (and ↑QOL/LOL)

Question 21

Based on the individual’s culture, ethnicity, and personal choices, the NP can optimize the therapeutic partnership w/the patient by

Answer 21

Tailoring his or her communication style to the patient’s preference.

Question 22

A 70-year-old pt with a hx of DM, HTN, OAs, and a new diagnosis of coronary artery disease, is being discharged. The adult-gerontology acute care nurse practitioner teaches the patient that the first point of contact for health care needs is the:

Answer 22

primary care provider

Question 23

The NP is asked to provide evidence to the hospital administration about the safety of NP placing central lines. Which resource provides the strongest level of evidence?

Answer 23

A systematic review (meta-analysis is even stronger)

Question 24

What legislation allowed nurse practitioners to be recognized Medicare providers in all geographical areas with their own provider number?

Answer 24

Balanced Budget Act

Question 25

True/False: restraining an unwilling patient is grounds for malpractice?

Answer 25

False, if they are a danger you can restrain

Question 26

Pt presents to the clinic for routine f/u and passes out. You revive the pt and admit overnight. Which of the following would qualify as incident-to-billing?

Answer 26

Temperature and weight recording

Question 27

The NP program initiated, primarily, because of what issue in healthcare at the time?

Answer 27

Pediatric physician shortage

Question 28

Elderly F pt takes a turn for the worse. The husband is crying when you enter the room and begins telling you what end-of-life care he prefers. What do you do?

Answer 28

Ask him to speak candidly with you

Question 29

Pt calls to complain about bills and states he has Medicare, which should cover all costs. You explain

Answer 29

Since you are healthy, exams are not covered.

Question 30

Doc calls from another center asking if you can tell him what kind of orders he should give for maintenance of patient

Answer 30

Nope, HIPPA

Question 31

Pt in ER not doing well, primary md calls

Answer 31

Give him info

Question 32

NP working on ESRD research project . A colleague renal specialist asks for pt info on your patients

Answer 32

HIPPA breach.

Question 33

Who enforces HIPPA

Answer 33

Office of Civil Rights /Dept. Health and Human Services

Question 34

Who ISN’T covered by HIPPA?

Answer 34

Law enforcement/Municipal Offices, CPS/Schools, Employers/Workman’s Comp, Life insurance

Question 35

Insurance company calling to verify some patient appointments.

Answer 35

You have to pick out that there is already a medical release signed by the patient. The answer is to give the requested information to them.

Question 36

Root Cause Analysis

Answer 36

very basic question where RCA is the answer and the question is the definition

Question 37

Benchmarking

Answer 37

how institution compares with similar organizations

Question 38

Managed Care

Answer 38

know what this is and how it has improved costs. Something about putting caps on payments…

Question 39

Peer review

Answer 39

timely, not anonymous, and NP knows how peer review will impact yearly evaluation

Question 40

Sensitivity vs

Answer 40

refers to a test’s ability to designate an individual with disease as positive.
A highly sensitive test means that there are few false negative results, and thus fewer cases of disease are missed. The specificity of a test is its ability to designate an individual who does not have a disease as negative.

Question 41

Specificity

Answer 41

he specificity of a test is its ability to designate an individual who does not have a disease as negative. A highly specific test means that there are few false positive results.

Question 42

Reliability

Answer 42

When implementing a new study… tested over and over. The consistency of a measurement, or the degree to which an instrument measures the same way over time

Question 43

Validity of results in an article:

Answer 43

P-value. Probability of falsely rejecting the null hypothesis. Want it to be low

Question 44

What is the most important to evaluate statistical significance when reviewing literature?

Answer 44

look at sample size ; p value.

Question 45

Medical futility

Answer 45

unlikely to produce any significant good for the pt

Question 46

Privileging

Answer 46

may be granted in full or part by the hospital. Credentialing committee is made of physicians.

Question 47

Institutional bylaws

Answer 47

may further restrict practice (Facility limited scope of practice)

Question 48

Informed Consent:

Answer 48

state indicating pt has received adequate instruction/information regarding aspects of care to make a prudent, personal choice regarding such Tx. Includes benefits and risks. Includes competence: pt. ability to CURD: communicate, understand, reason, differentiate good and bad

Question 49

Case management

Answer 49

Mobilize, monitor, and control resources that a pt uses during course of an illness while balancing quality and cost (“move pts thru the system appropriately”). There was a 50-60’s year old patient with a new diagnosis of cancer. To appropriately plan for discharge, what should the NP do? Options were to consult CM, consult SW, refer to Oncology, or I think refer to hospice

Question 50

Nondisclosure

Answer 50

not disclosing patient PHI without their permission (confidentiality)

Question 51

Negligence

Answer 51

failure of individual to do what any reasonable person would do, resulting in injury to the patient

Question 52

When serving as a nurse researcher, the NP is guided by which ethical principle to ensure that research participants are protected from harm or exploitation?

Answer 52

Nonmaleficence

Question 53

Quantitative

Answer 53

amount/numbers

Question 54

Qualitative

Answer 54

descriptive, like case studies

Question 55

difference between advanced directive and living will: Living will provides

Answer 55

Living will provides “POA/healthcare proxy”

Question 56

NP sees a pt for HF and performs an H & P. What % is expected to be paid?

Answer 56

Medicare pays 80% of the total bill, Pt pays 20%. NP is reimbursed 85% of what the MD is reimbursed for physician services, and for procedure is paid 80% of that 85%

Question 57

focus of palliative care

Answer 57

basic improvement in QOL of anyone with an illness at any stage

Question 58

Collaboration

Answer 58

“true partnership” in which all players have and desire power, share common goals, and recognize/accept separate areas of responsibility/activity

Question 59

4 Roles of a Nurse Practitioner

Answer 59

Education, Research, Clinician, Consultant/Collaborator

Question 60

Pt is getting dc and needs wound care, pulmonary, and follow up: NP’s role is:

Answer 60

to coordinate services

Question 61

Government is moving towards being cost effective. What is the best way?

Answer 61

Allow NP to treat a wider variety of pts.

Question 62

How should the ACNP stay up to date with current information

Answer 62

Evidence based guidelines

Question 63

What medicare level covers hospce

Answer 63

Medicare A

Question 64

A pt presents to the ER with c/o CP and SOB. The NP misinterprets the EKG and admits the pt for further monitoring without consulting Cardio. Later in the shift, the pt decompensates and goes into cardiac arrest. The pt. was resuscitated but sustained permanent brain damage. What grounds of malpractice is the NP accountable for?

Answer 64

Lack of skill

Question 65

Healthcare exchange

Answer 65

= health insurance marketplaces = orgs. in each state thru which pple can purchase health insurance,