Wilkes University FNP NSG554 Exam 1 85 questions and answers
New model for primary care - answer collaborative health care, NPs, Pas, patient coordination.
Policy to reduce adverse events associated with care transitions - answer -Hospital Readmissions Reduction Program (HRRP)
- provides hospitals with an incentive to improve their communication and care coordination and work more successfully with patients and caregivers on post-discharge planning
IDEAL -I- include the patient and family as full partners in the discharge planning proces
-D- discuss with the patient and family five key areas to prevent problems at home:
1. describe what home life will be like
2. review medications
3. highlight warning signs and problems
4. explain test results
5. make follow up appointments
-E- educate the patient and family in plain language about the patient's condition, discharge process and next steps at every opportunity -A- Asses how well doctors and nurses explain the diagnosis condition and care to the patient and family
-L- listen to and honor the patient and families goals, preferences observations and concerns
Accountable Care Organization designation - answer Accountable care organization (ACO) are groups of doctors, hospitals and other health care providers that come together voluntarily to give coordinated high-quality care to the medicare patients that they serve. Advisory Board survey (2014) findings - answer patients' preferences for low-acuity complaints in primary care included 24/7 access to care, a walk-in setting with the ability to be seen within 30 minutes, and close proximity to home
Health literacy test - answer PEMAT, REALM-SF, Ask Me 3, Newest Vital Sign
· A person's capacity to find, discuss, and comprehend health info
· To be able to use that knowledge to make informed decisions about all aspects of health.
· Individuals with low health literacy = risk for poor health outcomes.
· Health literacy assessments are available for primary care settings.
-(REALM-SF) - seven-item instrument that has been validated to be used with a variety of populations, medical word recognititon, -Ask Me 3 - encourages patients/caregivers to ask 3 questions: what is my main problem? What do I need to do? Why is it important for me to do this?
Culturally responsive care - answer care that is centered on the client's cultural point of view and integrates the client's values and beliefs into the plan of care
· An individual's cultural context determines how, when, and to what degree he or she will seek care and what interventions are considered acceptable.
· Guidelines for Delivery of Culturally Responsive Care
Ø Address Cultural Variations Among Diverse Patient Groups
Ø Create a Patient-Centered Friendly Environment
Ø Minimize Clinician Bias
Ø Overcome Patient Language Barriers
Adolescence behaviors. - answer · Early (10-14): challenge authority, mood swings, reject activities, ideation of childhood, argumentative, disobedient, more privacy.
· Middle (15-17): strong influence from peers, "tired teenager", increased sex drive, fad behaviors. · Late (18-21): assimilate adult roles, abstract thinking matures, realistic goals, understand consequences.
Signs of puberty in adolescents - answer (Sexual Maturation Scale (SMS) or Tanner Stages).
· Girls: breast development, menarche, complete body development.
· Boys: testicular enlargement, wet dreams, voice changing, arm pit and facial hair.
Medical diagnostic terms to diagnose LGBTQ+ - answer Lesbian- Women who form romantic and/or sexual relationships with other women
Gay - Men who form romantic and or sexual relationships with people of the same sex
Bisexual -- People with the capacity for romantic and or sexual relationships with both men and women
Asexual - a person who does not feel sexual atraction towards others
Transgender - a person whose gender identity differs from their assigned biological sex
Cisgender - A person whose gender identity is the same as their biological sex
intersex - a person who has discordance in their sexual organs
Outdated/inappropriate terms: Homosexual, dyke, queen, fag, sexual preference, transvestite, cross-dresser, transsexual, hermaphrodite
Pregnant and breast feeding women vaccine recommendations - answer When caring for a patient that is planning to become pregnant, I would recommend that they make sure all their vaccinations are up to date prior to becoming pregnant, as the MMR and varicella vaccines are not recommended during pregnancy. Generally, live vaccines are not recommended during pregnancy because they can cause fetal viremia or bacteremia
When caring for a patient that is in their third trimester of pregnancy, I would recommend that they should receive their annual flu shot and COVID booster in addition to the TDAP vaccine. Receiving the TDAP vaccine in the third trimester of pregnancy can help protect the baby from whooping cough once they are born through passive immunity
Human trafficking symptoms to watch for - answer · Avoids eye contact
· Younger than stated age
· Submissive
· Disoriented to time/place
· Incongruent expensive items
· Inconsistent story
· Controlling CG
· Fearfullness
· S/S of abuse
· Substance use
· Unusual tattoos
Vulnerable Populations:
Business employees in ethnic communities (e.g., massage)
History of childhood abuse/neglect
Justice system involvement
Learning disabilities
Mental health
No address
Poverty
Runaway or throwaway youth
Once a provider has potentially identified a trafficked victim, a complete screening needs to occur.
