Frances Guide Test Questions with 100% Complete Solutions, Rated A+

You want to get more funding for your hospital's Rapid Response Team. How should you present this issue to the committee? - cORRECT sOLUTION Stress importance of the team (ex. looking up evidence about how the team affects outcomes, like a meta-analysis) What is the best way for the AGACNP to get involved in policy making? - cORRECT sOLUTION Join a hospital committee What is the best way for the AGACNP to demonstrate and advocate for full scope of practice? - cORRECT sOLUTION Bill for independent services Which of the following is considered a high acuity role for the AGACNP? - cORRECT sOLUTION Cardiology office What is the best way to advocate for gay and lesbian population in your area? - cORRECT sOLUTION Start at your facility Which is most important to evaluate statistical significance when reviewing the literature? - cORRECT sOLUTION Consider the sample size When closing a practice, the NP is not required to? - cORRECT sOLUTION Send a certified letter with a return receipt requested (this is for discharging/firing a patient from your practice) Which component of an evidenced based research process is the most important for the NP to participate in? - cORRECT sOLUTION Formulating the research problem A former patient of an NP is writing blog posts, sending emails, and distributing false accusatory statements about the NP's practice. What form of defamation is this? - cORRECT sOLUTION Libel Can you tell the patient's wife, for her protection, that her husband has HIV? - cORRECT sOLUTION No, not without his permission How can the AGACNP prepare to get involved in a future mass casualty event? - cORRECT sOLUTION Pre-enroll in a disaster volunteer program 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? - cORRECT sOLUTION Medicaid Your patient is worried about insurance coverage and asks you for advice on Medicaid. You instruct the patient that Medicaid: - cORRECT sOLUTION Medicaid pays after insurance and 3rd party payers have paid 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 once that works. What ethical principles dose this challenge? - cORRECT sOLUTION Veracity and Fidelity Health literacy for the average american? - cORRECT sOLUTION 6th-8th grade education level Quality Assurance (QA) - cORRECT sOLUTION A process for evaluating the care of patients using established standards of care to ensure quality Continuous Process Improvement (CPI) measures what three measures to improve nursing? - cORRECT sOLUTION Structures, processes of care, and outcomes 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 policies to establish clinician-family communication standards in the unit. These policies should include: - cORRECT sOLUTION Guidelines for having discussions with family members that are geared toward establishing treatment goals Which clinical scenario does the NP evaluate for a quality improvement process change? - cORRECT sOLUTION An increased incidence of postoperative sternal wound infections Goals set forth in "Healthy People 2020" by the United States Department of Health and Human Services include: - cORRECT sOLUTION Elimination of health disparities; increase in quality of life; increase in length of life Based on the individual's culture, ethnicity, and personal choices, the NP can optimize a therapeutic partnership with the patient by: - cORRECT sOLUTION Tailoring his or her communication style to the patient's preference A 70-year-old patient with a history of DM, HTN, OA, and a new diagnosis of CAD is being discharged. The AGACNP teaches the patient that the first point of contact for health care needs is: - cORRECT sOLUTION The primary care provider and cardiologist The AGACNP is asked to provide evidence to the hospital administration about the safety of the AGACNP placing central lines. Which resource provides the strongest level of evidence? - cORRECT sOLUTION A systematic review (meta-analysis is even stronger); hand-washing techniques What legislation allowed nurse practitioners to be recognized Medicare providers in all geographical areas with their own provider number? - cORRECT sOLUTION The Balanced Budget Act True or false: restraining an unwilling patient is grounds for malpractice? - cORRECT sOLUTION False, if they are a danger you can restrain Patient presents to the clinic for routine follow up and passes out. You revive the patient and admit overnight. What would qualify as incident-to-billing? - cORRECT sOLUTION Temperature and weight recording The NP program initiated, primarily, because of what issue in healthcare at the time? - cORRECT sOLUTION Pediatric physician shortage An elderly female patient 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? - cORRECT sOLUTION Ask for advance directives; ask to speak candidly with you Patient calls to complain about bills and states he has Medicare, which should cover all costs. You explain: - cORRECT sOLUTION Since you are healthy, exams are not covered Doctor calls from another center asking if you can tell him what kind of orders he should give for maintenance of a patient. - cORRECT sOLUTION This is a HIPAA violation- tell him to consult another doctor at the SNF A patient in the ER is not doing well- his primary care doctor calls for information. - cORRECT sOLUTION It does not violate HIPAA to give him information Who enforces HIPAA? - cORRECT sOLUTION The Office of Civil Rights/Department of Health and Human Services Who isn't covered by HIPAA? - cORRECT sOLUTION Law enforcement/municipal offices, CPS/schools, employers/workman's comp, life insurance An insurance company calls the NP to verify some patient appointments. - cORRECT sOLUTION Give the requested information to them (there already is a medical release signed by the patient) Root Cause Analysis - cORRECT sOLUTION A tool for identifying prevention strategies to ensure safety. A process that is part of the effort to build a culture of safety and move beyond a culture of blame Benchmarking - cORRECT sOLUTION How an institution compares with similar organizations Peer review - cORRECT sOLUTION Timely, not anonymous, impacts yearly evaluation Sensitivity - cORRECT sOLUTION True positives; the degree to which those who have a disease screen/test positive Specificity - cORRECT sOLUTION True negatives; the degree to which those who do not have a disease screen/test negative Patient has a multi-nodular goiter and wants to know why the NP is not going to do periodic U/S and fine needle biopsy in monitoring for cancer/complications - cORRECT sOLUTION These tests are not very specific to detect cancer/complications Reliability - cORRECT sOLUTION The consistency fo a measurement or the degree to which an instrument measures the same way over time Validity of results - cORRECT sOLUTION Probability of falsely rejecting the null hypothesis; p value should be low to show significance Statistical significance - cORRECT sOLUTION Indicated by sample size and p value Medical futility - cORRECT sOLUTION Unlikely to produce any significant good for the patient Privileging - cORRECT sOLUTION May be granted in full or part by the hospital. Credentialing committee is made of physicians Practice restrictions - cORRECT sOLUTION Institutional bylaws may further restrict practice; facility-limited scope of practice Informed consent - cORRECT sOLUTION A state indicating that the patient has received adequate instruction/information regarding aspects of care to make prudent, personal choice regarding such treatment. Includes benefits and risks, as well as competence. Competence (for patient) - cORRECT sOLUTION CURD: patient able to communicate, understand, reason, differentiate good and bad Case management - cORRECT sOLUTION Mobilize, monitor, and control resources that a patient uses during the course of an illness while balancing quality and cost. (move patients through the system appropriately) 50-60 year old patient with a new diagnosis of cancer. To appropriately plan for discharge, what should the NP do? - cORRECT sOLUTION Consult case management Nondisclosure - cORRECT sOLUTION Not disclosing patient PHI without their permission (confidentiality) Negligence - cORRECT sOLUTION Failure of an individual to do what any reasonable person would do, resulting in injury to the patient 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? - cORRECT sOLUTION Nonmaleficence Quantitative - cORRECT sOLUTION Amount/numbers Qualitative - cORRECT sOLUTION Descriptive research Patient not doing well and family is at bedside- what is the next step for the NP? - cORRECT sOLUTION Address decision making with the healthcare proxy Advanced directive - cORRECT sOLUTION Written statement of a patient's intent regarding medical treatment. The Patient Self-Determination Act of 1990 requires that all patients entering a hospital should be advised of their right to execute an advanced directive Living will - cORRECT sOLUTION Written compilation of statements in document format that specifies which life-prolonging measures one does and does not want to be taken if she/he becomes incapacitated; Often include granting durable power of attorney to a significant other to act as a proxy/agent/attorney-in-fact of the patient in making healthcare decisions should the patient become incapacitated Billing - cORRECT sOLUTION NP is reimbursed 85% of what the MD is reimbursed for physician services; for a procedure, the NP is paid 80% of that 85% NP sees a patient for heart failure and performs a history/physical. What percent is expected to be paid? - cORRECT sOLUTION Medicare pays 80% of total bill, and the patient pays 20% The focus of palliative care - cORRECT sOLUTION Basic improvement in quality of life of anyone with an illness at any stage Scope of practice - cORRECT sOLUTION Integration of care across the acute illness continuum with collaboration, coordination of care, research-based clinical practice, clinical leadership, family assessment, discharge planning Collaboration - cORRECT sOLUTION True partnership in which all players have and desire power, share common goals, and recognize/accept separate areas of responsibility/activity Four roles of a nurse practitioner - cORRECT sOLUTION Education, research, clinician, consultant/collaborator A patient is getting discharged and needs wound care, pulmonary, and follow-up. The NP's role is to: - cORRECT sOLUTION Coordinate services What is the best way for the government to move towards being cost effective? - cORRECT sOLUTION Allow NPs to treat a wider variety of patients