Ambulatory Care Nursing Certification 240 Questions and Answers with Rationales 2023/24, Exams of Nursing

Download Ambulatory Care Nursing Certification 240 Questions and Answers with Rationales 2023/24 and more Exams Nursing in PDF only on Docsity! AMBULATORY CARE NURSING CERTIFICATION 240 QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES 2023/2024 GRADED A+ How many medications does it typically take to be considered "polypharmacy?" A -Three B -Ten C -Twenty-four D -Five or more - ANSWER- D -Five or more The ANP knows that it is her responsibility to report certain things to the proper authorities. Which of the following is NOT required to be reported? A - gunshot wound B - suspected child abuse C - drug abuse D - stab wounds - ANSWER- C - drug abuse Drug abuse is not required by law to be reported. Gunshot wounds, stab wounds, and child abuse (actual or suspected) are required to be reported to the proper authorities. Prior to undergoing an abdominal sonogram, the patient should do what? A - refrain from food and water for 12 hours B - empty his or her bladder C - drink a liter of water D - empty his or her bowels - ANSWER- C - drink a liter of water Prior to an abdominal sonogram, the patient is asked to drink water. In addition fasting for 8 to 12 hours prior to the procedure is often required. Which of the following is NOT part of a nursing diagnosis? A - statement of the patient's actual health status B -signs of illness C - medical diagnosis (such as stroke or pulmonary blockage) D - symptoms of illness - ANSWER- C - medical diagnosis Nursing diagnoses should never contain medical diagnoses. Rather, the nursing diagnosis is a statement of the patient's actual health status, risks for condition developing, causative and related factors, and signs and symptoms. Primary care would be considered the cornerstone of ambulatory care with nurses practicing in which of the following areas of healthcare? A - Telehealth services B - Internal medicine What is true regarding the respiratory synctical virus (RSV) immune globin? A - This is indicated for children less than 2 years of age with chronic lung disease, and infants <32 weeks. B - Contraindications include a reaction to neomycin or streptomycin products. C - This is indicated for adults without a history of RSV. D - Palivizumab (Synagis) provides permanent immunity for high-risk infants. - ANSWER- A - This is indicated for children less than 2 years of age with chronic lung disease, and infants <32 weeks. Palivizumab (Synagis) provides temporary, passive immunity for high-risk infants, not adults. The polio vaccine (IPV) is contraindicated for those who have had a reaction to neomycin or streptomycin. A nurse finishes a follow up visit with one of her elderly patients and gives him the influenza vaccine before he leaves. This is an example of what type of prevention? A - primary B - secondary C - tertiary D - annual - ANSWER- A - primary Primary prevention, such as an immunization, aims to prevent health problems before they start. Secondary prevention promotes early detection and treatments of diseases. Tertiary prevention is designed to help a patient cope with a current problem or prevent relapse. "Annual" is not a type of prevention. For successful communication, the major criteria would include? A - Forcefulness B - Flexibility C - Evaluation D - Developmental - ANSWER- B - Flexibility The 4 major criteria for successful communication would include: Feedback, Appropriateness, Efficiency, Flexibility A person's knowledge is sometimes measured by which of the following verbs? A -Recall B - List C - Remember D - All of the above - ANSWER- D - all of the above Some of the verbs which might be used to measure a person's knowledge could include: Recall, List, Remember, Identify, State, Define A key value in association with "Baby Boomers" would be considered which of the following? A - Sacrifice B - Duty C -Respect for authority D - Involvement - ANSWER- D - Involvement There are 3 key values that are associated with "Baby Boomers:" Involvement, Personal growth, Team You are assessing a patient prior to surgery and want to check for her surgical risk due to alcohol consumption. That patient tells you that her alcohol use varies and she does not seem willing to discuss how much she drinks. Which of the following is an appropriate strategy for getting the information you need? A -Present the patient with graphic images of the internal organs of people who abuse alcohol. B -Shame the patient into telling you what you need to know. C - Refer the patient to a social worker at the hospital. D - Ask a family member, such as the patient's spouse, about the patient's alcohol use. - ANSWER- D - Ask a family member, such as the patient's spouse, about the patient's alcohol use. Which of the following is NOT a concern when developing health literacy education for patients? A - Literacy level. B - Cultural background. C - Language. D - Gender - ANSWER- D - Gender When learning in the affective domain, it would involve internalization or commitment to which of the following? A - Feelings B - Interests C - Cognitive D - Both A and B - ANSWER- D - Both A and B When a person is learning in the affective domain, it would involve internalization or commitment to: Feelings, Interests, Attitudes, Beliefs, Values Of the following, which would be considered the name for when it would reflect the chemical structure of a drug? A - Generic name B - Common name C - Trade name D - Chemical name - ANSWER- D - Chemical name B - Pain C - Management D - Cultural - ANSWER- B - Pain Pain would be the feeling of distress, suffering, and/or discomfort that is considered a symptom of a condition. In 1968, McCafferty defined pain as "Pain is whatever the patient that is experiencing the pain says it is." Nurse Agnes has just finished assessing her pregnant patient who has been diagnosed with gestational diabetes in the second half of her pregnancy. What does the nurse need the patient to do to help dietary and insulin needs? A - increase her insulin doses B - increase calorie intake C - decrease her insulin doses D - decrease calorie intake - ANSWER- B - increase calorie intake When a pregnant woman increases her caloric intake in the latter half of her pregnancy, glucose will cross the placenta but the insulin will not. The fetus has a high demand for glucose and when that is paired with the patient's changing hormones, the result is an elevated blood glucose level. During which of the following situations is full barrier precautions likely to be required? A - Treating a patient with pneumonia. B - Treating a patient with chicken pox. C - Treating a patient who is suspected of having avian flu. D - Treating a patient with an open wound. - ANSWER- C - Treating a patient who is suspected of having avian flu. Treating a patient who is suspected of having avian flu CDC guidelines recommend full barrier precautions for all known and suspected cases of avian flu, due to the high degree of transmission of the disease. Full barrier precautions are also used in treating patients with known or suspected cases of SARS and pandemic influenza, as well as hemorrhagic diseases ___________ would be considered the nurse's competency that results from training. A - Education B - Language C - Culture D - Proficiency - ANSWER- D - Proficiency The ambulatory care nurse's role would have all except which of the following role dimensions? A - Workload B - Risk management C - Benefits D - Leadership - ANSWER- C - Benefits Some of the role dimensions for the ambulatory care nurse would include: Workload, Risk management, Leadership, Staffing, Competency concerns, Workplace regulatory compliance Which of the following is NOT a nonmedical expense? A - Linen. B - Uniform. C - Office supplies. D - Hypodermics. - ANSWER- D - Hypodermics. Of the following, which would not be a predisposing factor that might cause a patient to develop a tubercle bacillus infection? A - Cirrhosis B - Alcoholism C - Poor nutrition D - The health care workers that care for low-risk patients - ANSWER- D - The health care workers that care for low-risk patients The ______ is supposed to protect the patients' rights, help them to participate in their healthcare decisions, and provide adequate healthcare education. A - Teacher B - Advocate C - Administrator D - None of the above - ANSWER- B - Advocate When identifying barriers such as language which can obstruct the provision of optimal patient care, which standard of care with the Standards of Professional Clinical Practice for the Ambulatory Care Nurse would it be considered? A - Standard 6 B - Standard 1 C - Standard 4 D - Standard 3 - ANSWER- B - Standard 1 These would include such barriers as language, behavioral health issues, and culture. Nurse Terri is assessing a female patient with red, itchy spots on various parts of the body. She mentions she has no allergies but has recently switched soaps and is trying a new detergent. Terri suspects this is what type of irritation? local level. The public health department plays an integral Lowell Community Health. What is the MOST effective form of research a nurse can do before establishing a diabetes prevention course for patients? A - Making a list of the local endocrinologists that are currently treating diabetic patients. B - Estimating what age groups would attend the course. C - Documenting what causes diabetes and why. D - Finding diabetic-friendly recipes to share with the class. - ANSWER- C - Documenting what causes diabetes and why. When a nurse is planning an event to raise awareness of preventing a disease, the first types of research that should be done is what causes the disease and why. Once this information is documented, the nurse can build her lesson around methods of prevention, warnings signs, etc. One of the more important steps for the ambulatory care nurse during diagnosis would be which of the following? A - Documentation of information B - CT equipment C - State disease control D - X-ray equipment - ANSWER- A - Documentation of information Which of the following abnormal heart sounds is a result of the blood flowing past the normally closed valve? A - valve regurgitation B - valvular stenosis C - ventricular or atrial failure D - electrical conduction defects - ANSWER- A - valve regurgitation The sound of valvular regurgitation is known as a murmur. Murmurs can have a blowing or swishing sound and are categorized in a degree of I to VI. Grade I murmurs are very soft, while grade VI murmurs are extremely loud and can be heard with the stethoscope one inch away from the chest wall. Each person has how many intelligences (according to Howard Garner's multiple intelligence theory)? A - 8 B - 12 C - 3 D - 38 - ANSWER- A - 8 According to the Howard Garner's multiple intelligence theory, each individual has 8 intelligences. These intelligences form the basis for the individuals learning throughout their life. You are conducting an assessment with a male patient. It is important to know that a normal prostate is the size of what? A - grape B - peanut C - orange D - walnut - ANSWER- D - walnut A normal prostate is the size of a walnut. An enlarged prostate can be a sign of prostate cancer or other health conditions. What type of budget should be done for a new practice? A - Zero based. B - Hyperlink Process. C - Historical based budget. D - Capital budget. - ANSWER- A - Zero based. Established practices used historical based budgets that are based off previous years. Zero based budgets are used with new practices and requires expenses to be tracked and managed carefully. You are performing an assessment with a patient. On auscultation of heart sounds, you hear a scratching, creaking sound. Which of the following conditions might this heart sound indicate? A - congestive heart failure B - benign heart murmur C - pericarditis D - pneumothorax - ANSWER- C - pericarditis. Patients with pericarditis will often have a scratching or creaking sound. This is known as a pericardial friction rub and results from inflammation of the pericardium. The 5 M's of categorizing information (according to the Failure Mode and Effect Analysis) would include all but which of the following? A - Materials B - Maneuvering C - Methods D - Machines - ANSWER- B = Maneuvering The 5 M's of categorizing information (according to the Failure Mode and Effect Analysis) would include: Machines, Management, Manpower, Materials, Methods D - Aligning with the patient. - ANSWER- B - Motivational interview. All of the answers are teaching strategies. A motivational interview is used to educate patients and guide them to change unhealthy behavior. Some primary indications for a patient to have a pacemaker implanted? A - Heart block B - Bradyarrhythmias C - Asystole D - All of the above - ANSWER- D - All of the above The following indications would be for the patient that is symptomatic or those refractory to pharmacological therapy. Some of the primary indications for a patient to have a pacemaker implanted would include: Asystole, Sick-sinus syndrome, Atrial tachyarrhythmias, Bradyarrhythmias, Heart block. The principles of MI (motivational interviewing) would include all of the following except? A - Avoid argumentation CC C - Express empathy D - Roll with resistance - ANSWER- B - Argue with the person The five principles of MI would include: Avoid argumentation, Express empathy, Roll with resistance, To develop discrepancy, Support self-efficacy Which of the following steps is LEAST likely to alleviate the hazards associated with changing between day and night shifts? A - Giving employees plenty of advance notice of schedules. B - Putting nurses on either permanent day or permanent night shifts. C - Keeping schedules as regular as possible. D - Encouraging employees to avoid caffeine, alcohol, and other substances that might interfere with sleep. - ANSWER- B - Putting nurses on either permanent day or permanent night shifts. Shiftwork carries numerous risks, including sleep deprivation and resulting health issues such as immune system depression and digestive problems. Changing shifts often carries problems, but keeping employees on permanent night shifts also carries risks including loss of family time, health problems resulting from difficulties sleeping during the day, sleep deprivation, and emotional problems. Tips for the ambulatory care nurse in association with communication would not include? A- Use open ended questions B - Don't gather feedback from staff members C - Conduct communication at the proper time and place D - Use fewer words - ANSWER- B - Don't gather feedback from staff members Communication tips would include: Use open ended questions. Gather feedback from staff members. Conduct communication at the proper time and place. Use fewer words. Watch language used, avoid using technical terms and acronym which might not be understood by all. Respect the viewpoints and opinions of other's. Use body language to show interest. Use communication to build "USA" - understanding, support, and acceptance At what point in the autoclaving process are wrapped items considered sterile? A - As soon as they reach the recommended temperature. B - Immediately on removal from the autoclave, even if wrapping is still wet. C - As soon as the wrapping is dry. D - As soon as they reach room temperature after removal from the autoclave and all wrappings are dry. - ANSWER- D - As soon as they reach room temperature after removal from the autoclave and all wrappings are dry. It may take several hours for items to be fully dry and cool to room temperature after removing them from the autoclave. Wet packs must at all times be considered non-sterile, even if they have cooled to room temperature. In a clinical workflow chart, what is the link that moves the workflow forward between processes? A - Dynamic connector. B - Hyperlink Process. C - On-page connector. D - Off-page connector. - ANSWER- B - Hyperlink Process. The hyperlink process is also called the hot link. It moves the workflow forward between processes. Which of the following is meant to standardize the patient care practices? A - OSHA regulations B - Respiratory Care protocols C - MSDS sheets D - USGS protocols - ANSWER- B - Respiratory Care protocols __________ would be when a nurse is talking with a patient and their verbal communication doesn't match their non-verbal communication? A - Incongruent B - Congruent C - Discongruent D - Non-congruent - ANSWER- A - Incongruent Which of the following classifications of medications contain "thy?" A - 40 mg/dL B - 15 mg/dL C - 55 mg/dL D - 100 mg/dL - ANSWER- B - 15 mg/dL The normal range for BUN:Cr is 10 - 20 mg/dL. Ratios above 20 may indicate some kidney injury. Screening for cancer in the geriatric population includes all of the following recommendations except: A - prostate cancer B - cervical cancer C - skin cancer D - colon cancer - ANSWER- B - cervical cancer Cervical cancer is not likely in the elderly female. The geriatric population should be screened for heart disease, hearing, vision, and dental problems, hyperlipidemia, hypertension, menopause, osteoporosis, hypothyroidism, and dementia. Cancer screenings include breast, colon, prostate, and skin. A patient is speaking with a telephone nurse and explains that she has had increased acid reflux from a recently diagnosed ulcer. The nurse's first question is to ask if the patient has had what kind of food lately? A - Dairy products. B - Acidic fruits such as oranges or lemons. C - Beans or lentils. D - Alcoholic or caffeinated beverages. - ANSWER- D - Alcoholic or caffeinated beverages. The nurse should explain to the patient beverages with alcohol or caffeine can stimulate gastric acid production and irritate gastric lining. The nurse should advise the patient to avoid these type of foods and for the patient to see their physician if symptoms persist. _________ would be considered the federal law which helps to protect the privacy of student educational records? A - FMLA B - ADA C - FERPA D - HIPAA - ANSWER- C - FERPA FERPA stands for Family Educational Rights and Privacy Act. This is a federal law which helps to protect the privacy of student educational records. When defibrillating a patient, the second shock is typically at which dose? A - 100 B - 360 C - 200 to 300 D - 300 - ANSWER- C - 200 to 300 When defibrillating a patient, the shock levels are typically:First-200 joules, Second-200 to 300 joules, All of the rest-360 joules In the clinic, which step of the nursing process does Nurse Betty use to determine if the patient understands the health information he was just presented? A - implementation B - evaluation C - assessment D - goal planning - ANSWER- B - evaluation The evaluation step of the nursing process includes the nurse observing the patient and asking questions to get a better idea of the person as a whole and to ensure he is learning the health information needed. This also gives the patient a chance to ask questions and clear up any misunderstandings. A hospitalized patient is diagnosed with pressure ulcers. What is one type of independent nursing intervention that can be used to help the patient? A - Apply a drying agent to reduce moisture at the site. B - Change the patient's positions to minimize pressure on the ulcers. C - Order surgical removal of the necrotic tissue. D - Soak the areas in Epsom salt. - ANSWER- B - Change the patient's positions to minimize pressure on the ulcers. Changing a patient's position reduces stress and pressure to the ulcer site and promotes healing. Applying a drying agent would not be effective since wounds need moisture to heal, and soaking would not relieve pressure and could spread infection. Surgical removal of the tissue would need to be prescribed and performed by a physician. The nurse is educating an adult patient regarding medications for asthma. Which order would be the most appropriate for administration? A - Albuterol, Flovent, Tobramycin B - Flovent, Intal, Tobramycin C - Tobramycin, Intal, Albuterol D - Intal, Tobramycin, Albuterol - ANSWER- A - Albuterol, Flovent, Tobramycin Telephone triage may be a responsibility of the ambulatory care nurse. What are the appropriate components of telephone triage? A - The nurse should give generic information and leave the responsibility to the patient or caller B - The nurse should immediately call 911 What would be the most appropriate order of importance for information an adult client shares when coming to a clinic visit? A - Current medications, allergies, past medical history, and past surgical history B - past medical history, past surgical history, medications, allergies, and insurance information C - current demographics, current insurance, complaint, medical history, and surgical history D - current complaint, past 24-48 hours leading up to complaint, medications, allergies, and past medical history - ANSWER- D - current complaint, past 24-48 hours leading up to complaint, medications, allergies, and past medical history The ambulatory care setting must include which of the following for the nurse to be able to properly triage a patient? A - television B - computer C - vending machines D - private room for triage - ANSWER- D - private room for triage A 50-year-old male comes to the clinic stating he cannot shake this "flu." You observe that he is clammy, pale, and has an irregular heart rate. He is a large man with a rugged appearance. He is friendly and apologetic for bothering you with his silly complaints. What is your plan of care for this patient? A - You suspect there is more to his complaint than he states and immediately begin a cardiac workup by placing him in a room and ordering an EKG B - You suspect he has the newest flu going around and offer him hot tea while he waits to see the physician C - You suspect he has a low tolerance for being ill and offer him Tylenol while he waits to see the physician D - You finish the triage and send him to the waiting room, understanding that the flu affects everyone differently - ANSWER- A - You suspect there is more to his complaint than he states and immediately begin a cardiac workup by placing him in a room and ordering an EKG Each person has how many intelligences (according to Howard Garner's multiple intelligence theory)? - ANSWER- 8 - According to the Howard Garner's multiple intelligence theory, each individual has 8 intelligences. These intelligences form the basis for the individuals learning throughout their life. You are conducting an assessment with a male patient. It is important to know that a normal prostate is the size of what? A -grape B -peanut C -orange D -walnut - ANSWER- D - Walnut What type of budget should be done for a new practice? A- Zero based B -Hyperlink Process C -Historical based budget D -Capital budget. - ANSWER- A - Zero based - Zero based budgets are used with new practices and requires expenses to be tracked and managed carefully. You are performing an assessment with a patient. On auscultation of heart sounds, you hear a scratching, creaking sound. Which of the following conditions might this heart sound indicate? A -congestive heart failure B -benign heart murmur C -pericarditis D -pneumothorax - ANSWER- C - pericarditis - Patients with pericarditis will often have a scratching or creaking sound. This is known as a pericardial friction rub and results from inflammation of the pericardium. The 5 M's of categorizing information (according to the Failure Mode and Effect Analysis) would include all but which of the following? A -Materials B -Maneuvering C -Methods D -Machines - ANSWER- B - maneuvering is not 5 Ms-Machines, Management, Manpower, Materials, Methods Where is the submental lymph node located? A -in the hollow of the clavicle B -right below the chin C -junction between back of head and neck D -behind the ears - ANSWER- B - right below the chin The supraclavicular lymph node is in the hollow of the clavicle. The suboccipital lymph node is located in the junction between the back of the head and neck. The postauricular lymph node is behind the ears. Which of the following platelet counts puts your patient at serious risk of bleeding? A -15,000/mm3 B -50,000/mm3 C -100,000/mm3 D -145,000/mm3 - ANSWER- A - 15,000 A brief account by the patient of any signs or symptoms he or she is experiencing is known as what? A -functional assessment B -focused assessment C -review of systems D -systemic review - ANSWER- C -review of systems In the review of systems, the patient tells the nurse in his or her own words what signs or symptoms he or she has experienced in various body systems. It is important that these be in a patient's own words to perform the most complete and accurate assessment. Of the following, which is the greatest risk factor for childhood obesity? A -Lack of cognitive stimulation. B - Poverty. C -Parental divorce. D -Parental Education. - ANSWER- A -Lack of cognitive stimulation. A person's knowledge is sometimes measured by which of the following verbs? A -Recall B -List C -Remember D -All of the above - ANSWER- D -All of the above Which of the following is NOT a "red flag" of low health literacy in a patient? A -The patient pours pills into his or her hand to identify them by sight. B -The patient is not Caucasian. C - The patient consistently asks you to read healthcare information because he or she has forgotten eyeglasses at home. D -The patient does not ask questions during the appointment. - ANSWER- B -The patient is not Caucasian. The ambulatory care nurse's role would have all except which of the following role dimensions? A -Workload B -Risk management C -Benefits D -Leadership - ANSWER- C -Benefits Some of the role dimensions for the ambulatory care nurse would include: Workload, Risk management, Leadership, Staffing, Competency concerns, Workplace, regulatory compliance When identifying barriers such as language which can obstruct the provision of optimal patient care, which standard of care with the Standards of Professional Clinical Practice for the Ambulatory Care Nurse would it be considered? A -Standard 6 B -Standard 1 C -Standard 4 D -Standard 3 - ANSWER- B -Standard 1 Standard 1 in the Standards of Professional Clinical Practice for ambulatory care nursing would include the identification of barriers to promote optimal care. These would include such barriers as language, behavioral health issues, and culture. How far out do most health care facilities' capital budgets plan? A -5-10 years. B -Less than 1 year. C -20 years. D -1-3 years. - ANSWER- D -1-3 years. Because they deal with long-life items, most capital budgets plan for 1-3 years out from the present. It is important for nurses who work on budgets to be aware of their facility's capital budget plans for the next years so that they can appropriately request budget resources for their own units. would be when a leader aligns themselves with others to help obtain information, ideas, advice, power, and influence? A -Consensus-building B -Negotiation C -Networking D -Development - ANSWER- C -Networking Networking would be when a leader aligns themselves with others to help obtain information, ideas, advice, power, and influence. The most effective negotiation process would have a win-win outcome. What is the MOST effective form of research a nurse can do before establishing a diabetes prevention course for patients? A -Making a list of the local endocrinologists that are currently treating diabetic patients. B -Estimating what age groups would attend the course. C -Documenting what causes diabetes and why. D -Finding diabetic-friendly recipes to share with the class. - ANSWER- C - Documenting what causes diabetes and why. When a nurse is planning an event to raise awareness of preventing a disease, the first types of research that should be done is what causes the disease and why. The normal range for BUN:Cr is 10 - 20 mg/dL. Ratios above 20 may indicate some kidney injury. A patient is speaking with a telephone nurse and explains that she has had increased acid reflux from a recently diagnosed ulcer. The nurse's first question is to ask if the patient has had what kind of food lately? A -Dairy products. B -Acidic fruits such as oranges or lemons. C -Beans or lentils. D -Alcoholic or caffeinated beverages. - ANSWER- D -Alcoholic or caffeinated beverages. The nurse should explain to the patient beverages with alcohol or caffeine can stimulate gastric acid production and irritate gastric lining. Your patient indicates that she has stopped taking her antidepressant because she experienced blinding headaches while taking the drug. Of the following, which is the BEST way to promote this patient's compliance with her medication regimen? A -Investigate whether a different anti-depressant that does not carry the risk of headaches is available. B -Educate the patient about the potential negative outcomes of untreated depression. C -Investigate whether another drug can be prescribed to ease the patient's headaches. D -Investigate whether natural remedies for depression are appropriate for this patient. - ANSWER- A -Investigate whether a different anti-depressant that does not carry the risk of headaches is available. _________ would be considered the federal law which helps to protect the privacy of student educational records? A -FMLA B -ADA C -FERPA D -HIPAA - ANSWER- C -FERPA FERPA stands for Family Educational Rights and Privacy Act. This is a federal law which helps to protect the privacy of student educational records. When defibrillating a patient, the second shock is typically at which dose? A -100 B -360 C -200 to 300 D -300 - ANSWER- C -200 to 300 When defibrillating a patient, the shock levels are typically: First-200 joules Second-200 to 300 joules All of the rest-360 joules You are conducting an assessment with a patient who says that sometimes she feels as though she should have been born male. She prefers to dress in men's clothing and feels disgust toward the overtly female parts of her body. Which of the following is an appropriate nursing diagnosis for this patient? A- delusions B -thought processes, altered C -gender dysphoria D -personal identity disturbance - ANSWER- C -gender dysphoria This patient is demonstrating gender dysphoria. Gender dysphoria is the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics. What is the overarching vision of Healthy People 2020? A -To provide universal health care. B- To promote a society in which all people live long, healthy lives. C -To eliminate poverty worldwide. D -To reduce healthcare costs. - ANSWER- B- To promote a society in which all people live long, healthy lives. Which of the following is a qualitative method used in nursing research? A -Charting changes in blood pressure over time. B -Survey questions that ask patients to rate their satisfaction on a scale of 0 to 10. C -Analyzing patient narratives to discover what education they received about their diagnoses. D -Data charting the number of nursing hours per patient day over the last two years. - ANSWER- C -Analyzing patient narratives to discover what education they received about their diagnoses. Qualitative research looks at the patient's response to his actual or potential medical issues. This method looks at the "why" and "how" of decision-making. NIC would stand for which of the following? A -Neurology Institute Classes B -Nerve Institute Commission C -Nursing Interventions Classifications D -Neuropathy Insurance Classes - ANSWER- C -Nursing Interventions Classifications A defibrillator would be used for which of the following cardiac rhythms? B -Pregnant women are at the greatest risk for both new and continuing domestic violence. C -Concern for the welfare of the unborn child. D -Such screenings are covered by insurance when part of prenatal care. - ANSWER- B -Pregnant women are at the greatest risk for both new and continuing domestic violence. Because they represent a group with the high risk of domestic violence, all pregnant women should be screened for domestic violence even if they have not reported violence before. Violence may begin during pregnancy, or a woman may be more willing to report violence out of concern for her child than she might have been previously. When judging the quality of care, which method evaluates performance after the patient is released? A -Quality improvement. B -A retrospective nursing audit. C -Qualitative research. D -A concurrent nursing audit . - ANSWER- B -A retrospective nursing audit. Nursing audits are done to improve the quality of care. There are two types of audits, concurrent and retrospective. A retrospective nursing audit is done after a patient is released. What is indirect cost subtracted from the contribution margin? A -Gross income. B -Volume projection. C -Net income. D -Capital budget. - ANSWER- C -Net income. The net income is the contribution margin minus the indirect costs. This indicates how much money is left after all expenses are paid. The ambulatory care nurse should know that critical thinking would require all BUT which of the following skills? A -Synthesis B -Inferences C -Explanation D -Interpretation - ANSWER- A -Synthesis The skills used for critical thinking would be: Inferences, Explanation, Interpretation, Analysis If the ambulatory care nurse is looking at a chest x-ray, the posterior ribs will appear as? A -Circular angle B -At a sharper downward angle C -At a curved downward angle D -At a curved upward angle - ANSWER- B -At a SHARPER downward angle The stages of Kohlberg's Stages of Moral Reasoning would include?A - Preconventional B -Ultraconventional C -Concurrent D -Provisional - ANSWER- A -Preconventional The 3 stages of Kohlberg's Stages of Moral Reasoning as a function of cognitive development: Preconventional, Conventional, Postconventional Which of the following would be considered the branch of pharmacology that includes the use of the medications to treat, prevent or diagnose? A -Pharmacogenetics B -Pharmacotherapeutics C -Pharmacokinetics D -None of the above - ANSWER- B -Pharmacotherapeutics The branch of pharmacology that includes the use of medications to treat, prevent or diagnose would be considered pharmacotherapeutics. Pharmacology would be considered the study of medications, which also includes the medications interactions with living systems. __________ would be when the patient's verbal communication matches their non- verbal communication? A -Discongruent B -Congruent C -Non-congruent D -Incongruent - ANSWER- B -Congruent The term which would be used to mean the art of teaching adults would be considered which of the following? A -Andragogy B -Visions C -Consultation D -Instructing - ANSWER- A -Andragogy Which of the following is the largest category of expenditure for most health care facilities? A -Operating budget B -Personnel budget Successful communication requires the use of simple, clear words delivered at a pace suitable for the participants. This is known as which of the following? A -Efficiency B -Feedback C -Evaluation D -Implementation - ANSWER- A -Efficiency Efficiency would be considered correct for a type of major criteria that is associated with successful communication where there are simple, clear words delivered at a pace that is suitable to the participants. Several control measures exist with prevention of disease. The following are all accurate statements regarding control measures except: A -Measures directed against the reservoir include isolation, quarantine, and insect spraying. B -Measures that interrupt the transmission of organisms include water purification, milk pasteurization, and barrier protection during sexual intercourse. C -Measures that reduce host susceptibility include immunization, appropriate use of antibiotics, and improved nutrition. D -Measures that cure disease include adequate diagnosis, appropriate treatment regimen, and necessary follow-up and homecare. - ANSWER- D -Measures that cure disease include adequate diagnosis, appropriate treatment regimen, and necessary follow-up and homecare. While curative measures are important, they are not part of the control measures. Which of the following patients is an appropriate candidate for TEE? A -a female patient with dysphagia B -a male patient who is obese C -a male patient who has a history of gastroesophageal disease D -a patient who is allergic to topic anesthetic - ANSWER- B -a male patient who is obese TEE is often used with patients who are obese because obesity can make it difficult to get a clear picture of the heart with regular echocardiography. Patients with a history of gastroesophageal disease, who have dysphagia, and who are allergic to topic anesthetics are not considered candidates for TEE. Which of the following methods is MOST effective for measuring the effectiveness of a community program to reduce childhood obesity?A -Compare national rates of childhood obesity from before and after program implementation. B -Compare citywide rates of childhood obesity from before and after program implementation. C -Follow up with program participants after 6 months to see if they have experienced weight loss. D -Conduct a new survey to see how many children in the community are overweight. - ANSWER- C -Follow up with program participants after 6 months to see if they have experienced weight loss. This strategy is most likely to indicate the effectiveness of the program because if measures effects on those who actually participated in the program. Comparing national or citywide rates does not reveal whether a specific intervention had any effect on childhood obesity. Which of the following is an example of objective data? A -Patient reports feeling chills. B -Patient has a fever. C -Patient has a temperature of 102° F. D -Patient has as elevated temperature. - ANSWER- C -Patient has a temperature of 102° F. Objective data must be measurable and verifiable. Simply saying the patient has a fever or an elevated temperature does not tell the health care team very much. Providing a direct measurement of the patient's temperature is far more useful in crafting a care plan and diagnosis. How many liters does interstitial fluid need to exceed before it becomes apparent? A -2.5 to 3.5 liters B -4.0 to 5.5 liters C -2.5 to 3 liters D -1.0 to 1.5 liters - ANSWER- C -2.5 to 3 liters The patient's interstitial fluid needs to exceed 2.5 to 3 liters before it becomes apparent. This edema is typically caused by expansion of the interstitial fluid volume. Nurse Nicole's patient has been diagnosed with severe poison ivy rash. Which of the following statements is not accurate advice Nurse Nicole might give to her patient? A -Resist scratching as it can cause the rash to spread. B -Take short, lukewarm baths or cool showers. C -Apply calamine lotion or hydrocortisone cream to itchy patches. D -Cover with cool compresses for several minutes at a time. - ANSWER- A -Resist scratching as it can cause the rash to spread. As an ANP, you will have to counsel on dietary intake. The following are accurate statements regarding dietary intake except for: A -The EAR is the Estimated Average Requirement. B -Adequate Intake (AI) is the recommended average daily intake level based on observed or experimentally determined estimates of nutrient intakes by a group of healthy people. Which of the following is true regarding current factors that support the greater emphasis on health promotion and disease prevention? A - Only 20% of illness and disease is related to lifestyle and unhealthy decisions. B -Healthy People 2020 was developed as a outline of prevention agenda by the American Nurses Association. C -Tobacco use, substance use, and obesity are considered some of the leading health indicators. D -Preventive services include treating active diseases that could spread out into the community. - ANSWER- C -Tobacco use, substance use, and obesity are considered some of the leading health indicators. Which of the following factors would not influence the area that the nurse would choose to take the patient's temperature? A -Age B -Convenience C -Education D -Safety - ANSWER- C -Education A drug that has the ability to only attack those systems which are found in foreign cells would be considered? A -Selective toxicity B -Half-life C -Orphan drugs D -Short-life drugs - ANSWER- A -Selective toxicity There are some drugs such as penicillin that has special abilities. These abilities are considered selective toxicity which attack only those systems found in foreign cells. You are providing care to a patient who uses a wheelchair and has been treated for decubitus ulcers. The patient asks what he can do to prevent future ulcers. Which of the following is NOT appropriate patient education for this patient? A -The patient should attempt to shift positions on his own every 15 minutes or so. B -The patient should do wheelchair pushups if he has sufficient upper-body strength. C -The patient should restrict his fluid intake. D -The patient should take steps to stay adequately hydrated. - ANSWER- C -The patient should restrict his fluid intake. Good hydration may actually help prevent pressure ulcers. Wheelchair users should also shift position every 15 minutes or so, or use pressure-release wheelchairs, to help lower their risk of ulcers. Patients with sufficient upper-body strength can also do wheelchair pushups to relieve pressure. Nurse Jan is examining a patient in the clinic who has been recently diagnosed with emphysema. While in the office he becomes short of breath and restless. What is the best instruction Jan can provide with her assessment? A -to take deep breaths very slowly B -to hold his breath for 15 seconds or until he is calm C -to take rapid shallow breaths to increase air flow D -to perform pursed lip breathing. - ANSWER- D -to perform pursed lip breathing. The process of pursed lip breathing is designed to prevent the collapse of the lung and lung tissues. This breathing also helps the patient control his own rate and depth of his breathing, which calms and soothes the patient during stressful moments. Which of the following is an example of indirect costs? A -Medical equipment. B -Gas. C -Salaries. D -Insurance. - ANSWER- B -Gas. According to Bloom's Taxonomy in 1956, which of the following would be considered a learning domain? A -Concurrent B -Release C -Affective D -Assumption - ANSWER- C -Affective According to Bloom, the 3 learning domains would be: Cognitive, Affective, Psychomotor The limitations when using technology for learning would include all but which of the following? A -There would be face-to-face training time B -Computer literacy of learner and instructor C -Content not appropriate for technology D -The cost is high - ANSWER- A -There would be face-to-face training time You are providing pre-procedural care to a patient who will undergo TEE. Which of the following is NOT part of patient preparation for this procedure? A -The patient should fast for 6 hours prior to the procedure. B -The back of the patient's throat is sprayed with topical anesthetic. C -The patient should remove dentures. D -The patient is put under general anesthetic. - ANSWER- B -The back of the patient's throat is sprayed with topical anesthetic. A -Diagnostic codes. B -Ambulatory care. C -Mentorship. D -Clinical pathways. - ANSWER- C -Mentorship. Mentorship is a method that ensures evidence based nursing is passed on. Research and clinical support also ensure that evidence based nursing continues. A patient with an Mean Corpuscular Volume (MCV) of 60 fL is likely suffering from which of the following? A -Hemolytic anemia B -Iron deficiency anemia C -Pernicious anemia D -Macrocytic anemia - ANSWER- B -Iron deficiency anemia An MCV of 60 is considered quite low, and is a sign of iron deficiency anemia. All the other choices listed here are associated with higher than normal MCV. You are conducting an assessment with a patient. The patient tells you during the assessment that he is sure that the gastrointestinal discomfort he is experiencing is the result of the nurses in his long-term care facility poisoning his food. Which of the following is an appropriate nursing diagnosis for this patient? A -delusional B -impaired mentation C -altered nutrition D -disturbed thought processes - ANSWER- D -disturbed thought processes Which of the following medicines should be used sparingly in the elderly because as people get older, their kidneys are less able to excrete it? A -antihypertensives B -Digoxin C -analgesics D -antidiabetic drugs - ANSWER- B -Digoxin Analgesics - Cause confusion or dizziness. Antidiabetic drugs - lower blood sugar levels for extended period of time. Antihypertensives - slow the heart rate and worsen depression. Digoxin - less able to excrete as people get older. Which of the following is NOT likely to present a barrier to patient learning? A -Pain. B -Anxiety about paying for treatment. C -Lack of information about the diagnosis on the part of the patient. D -Negative past experiences with medical care. - ANSWER- C -Lack of information about the diagnosis on the part of the patient. Which of the following is used to sterilize medical equipment that is sensitive to heat or moisture? A -Autoclave. B -Ethylene Oxide. C -Peracetic acid. D -Microwaves. - ANSWER- B -Ethylene Oxide. Ethylene oxide gas is used to sterlize items that are sensitive to heat and moisture. A patient who is suffering from dehydration would be expected to have which of the following urine specific gravities? A -1.010 B -1.04 C -1.02 D -1.004 - ANSWER- B -1.04 Urine specific gravity increases when the concentration of solutes in urine increases. This occurs with dehydration. A urine specific gravity of greater than 1.035 is considered a sign of frank dehydration. You are conducting an assessment with a patient who is 50 pounds over his recommended weight. In the course of the interview, you discuss what he eats in a day. He appears to regularly be consuming nearly twice the recommend number of calories. Which of the following nursing diagnoses is appropriate for this patient? A -altered nutrition B -nutrition, more than body requires C -nutrition, more than body requires, altered D -risk for obesity - ANSWER- B -nutrition, more than body requires Because the patient appears to eat an excess of calories regularly, this is not an altered pattern. You need to record the temperature and ____ of dry-heat oven with each use. A -Items cleaned. B -Chemical indicators. C -Time. D -Biological indicators. - ANSWER- C -Time. A log should be filled in each time that a dry-heat oven is used. This should include the temperature and duration of use. Of the following, which ethnic/racial group has the lowest effectiveness rate when using interferon treatments for chronic hepatitis C treatment? does not know how she will feel about her husband having to take over day-to-day parenting tasks during that time. Which of the following is an appropriate diagnosis for this patient? A -parental role confusion B -risk for parental role confusion C -parental role conflict D -Self-esteem deficit. Situational, r/t confusion over parental role performance - ANSWER- D -Self-esteem deficit. Situational, r/t confusion over parental role performance Though the patient is anxious about parental responsibilities, what she is experiencing is not parental role conflict or confusion. Rather, she is experiencing confusion about her own role in parenting during recovery. This is manifesting in feelings of guilt and low self-esteem. Report a problem with this question Which of the following has NOT been shown to improve workflow and reduce medication errors? A -Reducing the distance nurses must travel during shift to administer care. B -Reducing the number of interruptions that occur during the administration of care. C -Increased education for nurses on proper procedures for administering medication. D -Using mobile medication systems. - ANSWER- C -Increased education for nurses on proper procedures for administering medication. Cytotec is an example of which type of drug? A -Sucralfate B -Proton pump inhibitor C -Prostaglandin analog D -H2-receptor blocker - ANSWER- C -Prostaglandin analog Cytotec (Misoprostol) is approved for use in the prevention of NSAID induced gastric ulcers. Drug metabolism is often referred to as which of the following? A -Critical concentration B -Biotransformation C -Drug abuse D -Half-life - ANSWER- B -Biotransformation This is the enzymatic alteration of the drug structure which often takes place in the liver. You are caring for a patient who has arrived at the emergency room after fainting in his kitchen. Which of the following is the BEST test to determine whether your patient's fainting spell was common or malignant? A -stress test B -tilt table test C -blood oxygen test D -CAT scan - ANSWER- B -tilt table test The tilt table test is considered the most reliable way to determine whether fainting spells are common or malignant. This noninvasive test measures the way the patient's blood pressure and heart rate respond to changes in position. How many hours of work is .1 FTE? A -2 B -1 C -4 D -3 - ANSWER- C -4 Four hours make up .1 FTEs. A single FTE is 40 hours of work or a full time work week. Which of the following would be considered the fundamental belief that the moral rightness of an action would be determined solely by it's consequences? A -Deontology B -Utilitarianism C -Autonomy D -Virtue ethics - ANSWER- B -Utilitarianism Utilitarianism is often used as the basis for deciding how healthcare dollars should be used. In the United States, which ethnic/racial group has the highest incidence of asthma? A -Hispanic B -White-non Hispanic C -African-American D -Chinese - ANSWER- C -African-American When performing a test, its reliability can be affected by all but which of the following? A -The type of test items B -Group variability C -The number of test items D -The difficulty of the test items - ANSWER- A -The type of test items C -Calcium D -Tumeric - ANSWER- A -Garlic Although garlic is felt to help reduce blood cholesterol and blood pressure, it is also considered an anticoagulant. When taken in addition to warfarin it has the potential to cause abnormal bleeding. You are conducting an assessment with a patient who has several burns in various stages of healing on her forearms. When asked, she mentions that she often burns herself when cooking because she does not feel hot temperatures well. Which lobe of her brain likely has a dysfunction? A -frontal B -temporal C -parietal C -occipital - ANSWER- C -parietal Dysfunction or injury to this lobe can impair patients' ability to feel hot temperatures. It is also important to assess patients with multiple burns for risk for self-injury, especially if the burns are not consistent with the explanation the patient gives for them. A patient complains that her stools have been liquid or semi-liquid in form for several days. She also reports a drop in appetite. The ACNP can safely diagnosis her symptoms as indicating what? A -regular constipation B -common diarrhea C -fecal impaction D -stomach virus - ANSWER- C -fecal impaction How long after a needlestick injury should you be retested for Hepatitis C? A -One week. B -One month. C -Six weeks. D -One year. - ANSWER- C -Six weeks. ________ would be considered a liquid form of a herb which is brewed from root, seeds or bark? A -Decoction B -Tincture C -Extract D -Tea - ANSWER- A -Decoction Of the following medications, which is a calcium blocking agent? A -Lanoxin B -Bumex C -Zestril D -Adalat - ANSWER- D -Adalat Lanoxin is a digitalis medicine commonly used in patients with heart conditions. Bumex is a loop diuretic. Zestril is an ACE inhibitor. The culture that would be at a lower risk to develop diabetes mellitus would be considered? A -Non-Hispanic white B -Hispanic American C -Native American D -African American - ANSWER- A -Non-Hispanic white Native Americans, African Americans, and Hispanic Americans are more prone to develop diabetes mellitus. The method of adding a video camera to a fluoroscope in order to have a photographic record of the diagnostic procedure is known as what? A -radiography B -cineradiography C -ultrasonography D -videography - ANSWER- B -cineradiography In cineradiography, a video camera is attached to the fluoroscope. In this way, there is photographic/video documentation of the movement the fluoroscopy is designed to examine, allowing for better diagnosis. In the United States, which organization regulates the development and sale of medications? A -DOJ B -OSHA C -USDHHS D -AMA - ANSWER- C -USDHHS stands for United States Department of Health and Human Services. This is the organization which regulates the development and sale of medications. They help assure safety and efficacy. Which of the following is effective at treating pernicious anemia? A -Nembutal B -Hydroxocobalamin IM C -Azulfidine D -Esidrix - ANSWER- B -Hydroxocobalamin IM Nembutal is used for status epilepticus; and Azulfidine, rheumatoid arthritis. Esidrix treats diabetes insipidus. D -decreased appetite - ANSWER- C -weight gain. Patients who have undergone CABG are likely to have a decreased appetite, and thus are unlikely to experience weight gain. Depression and mood swings are common after CABG and patients should be educated about this, including being told that these conditions usually dissipate as the patient returns to normal activities. The correct gauge of needle that is used for an IM injection would be considered which of the following? A -24-28 gauge B -20-23 gauge C -16-20 gauge D -14-18 gauge - ANSWER- B -20-23 gauge The length of the needle would be a 1-1.5 inch according to the size of the patient. The gauge of the needle that would be used for an intramuscular injection would be a 20-23 gauge needle. Which of the following is NOT a type of HLD (high level disinfection)?A -Boiling. B -Moist heat. C -Chemical disinfection. D -Autoclave. - ANSWER- D -Autoclave. An autoclave is used to sterilize equipment. The other answers are types of high level disinfection. What is a process that describes task details? A -Quality improvement. B -Clinical workflow. C -Pathways. D -Supply budget. - ANSWER- B -Clinical workflow. Clinical workflow describes work tasks. It explains task priorities, how they are done, who does them, and their order sequence. __________ would be considered a medications trade name? A -Lowercased B -Capitalized C -Italicized D -None of the above - ANSWER- B -Capitalized The generic name of a drug would be lowercased. The trade name of a drug would be capitalized. The factors which health literacy can be dependent on would include all of the following except? A -Culture B -Demands of the situation C -Financial status D -Communication skills of lay persons/professional - ANSWER- C -Financial status In association with ambulatory care nursing, the sources of law would include all but which of the following? A -Regulations B- Statues of code C -Civil law D -City codes - ANSWER- D -City codes All of the following are true regarding developmental theory except: A -The pace of development varies among individuals. B -Stress does not impact development. C -All development is patterned, orderly, and predictable with both a purpose and a direction. D -Development is continuous throughout life, although the degree of change in many areas decreases after adolescence. - ANSWER- B -Stress does not impact development. Which of the following pharmacological treatments is more efficient for an African American with hypertension that has been taking Lisinopril? A -Beta blockers B -Thiazide diuretic C -Fast acting vacillator D -Prinivil - ANSWER- B -Thiazide diuretic Thiazide diuretic is more efficient for an African American with hypertension that has been taking Lisinopril. This type of medication blocks the reabsorption of sodium and chloride ions in the kidney's tubules. Areas of risks which might cause legal problems for ambulatory care nurse could include? A -Standards of nursing practice B -Documentation accuracy C -Collection of data D -All of the above - ANSWER- D -All of the above Which of the following is an abnormal heart sound state in which a mitral or tricuspid creates a murmur during diastole? A -Rosemarie Parse B -Betty Neuman C -Sister Callista Roy D -Martha Rogers - ANSWER- B -Betty Neuman Betty Neuman's Health Care Systems Model is based on the general systems theory. Others based on this include Dorothy Johnson's Behavioral Systems Model and Imogene King's Systems Interaction Model. Parse's and Rogers' models are based on a humanistic developmental framework. Roy's model is based on stress and adaptation as the framework. Nurse Debbie is assessing a patient's abdomen. Which finding would the nurse document as abnormal? A -recurring bowel sounds B -muscle cramps C -dull muscles over the liver D -shifting dullness over different parts of the abdomen - ANSWER- D -shifting dullness over different parts of the abdomen Shifting dullness over the abdomen could indicate ascites, or fluid in the peritoneal cavity. All other symptoms are normal factors of the abdomen. In the workplace, conflict will occasionally occur. Which of the following would not be considered correct regarding conflict management? A -There are only three modes of response to conflict. B -There are two dimensions of behavior: cooperativeness and assertiveness. C -The 5 modes of conflict response would include accommodating, avoiding, competing, collaborating, and compromising. D -Each person should be capable of the 5 different modes of response to conflict. - ANSWER- A -There are only three modes of response to conflict. A nurse is speaking with a patient who has been tested for a Vitamin D deficiency. Along with vitamin supplement pills, the nurse explains how the patient can get more Vitamin D from his diet, including which of the following foods? A -Oranges and bananas. B -Fish and eggs. C -Carrots and lettuce. D -Red meats and beans. - ANSWER- B -Fish and eggs. Vitamin D deficiencies are common among people who do not get enough in their diet or from the sun. When a patient has been diagnosed with this deficiency, they are encouraged to eat more food rich in Vitamin D, such as most fish, eggs, and leafy green vegetables. Of the following drugs, which can be used for Influenza Type A? A -Amantadine B -Foscarnet C -Ribavirin D -Acyclovir - ANSWER- A -Amantadine In addition to Amantadine, rimantadine, oseltamavir and zanimavir treat Influenza Type A. Foscarnet treats Cytomegalovirus; and Ribavirin, respiratory syncytial virus. Acyclovir treats herpes simplex. The side effects of acetaminophen would include all but which of the following? A -Severe headache B -Angioedema C -Hives D -Liver damage - ANSWER- A -Severe headache Some of the more common side effects of acetaminophen would include: Angioedema, Hives, Anemia if it is used long-term, Liver damage, Dyspnea if prolonged high doses are used, Itching You are conducting an assessment with a patient who expresses concern about a mole on her forearm. The mole has gotten a bit larger over the last year. The edges are irregular and the mole varies from light to dark brown. Which of the following procedures is likely to be recommended for this patient? A -excisional biopsy B -punch biopsy C -scrape biopsy D -shave biopsy - ANSWER- A -excisional biopsy. Because an excisional biopsy removes the full lesion, it is preferred for cases of suspected malignancy. Glucatrol is to glipizide as Prandin is to what? A - repaglinide B -troglitazone C -acarbose D -metformin - ANSWER- A - repaglinide Glucatrol is the brand name for Glipizide. Prandin is the brand name for repaglinide. What is generally the largest payer? A -Consumers B -Employers. C -Government organizations. D -Private insurance. - ANSWER- C -Government organizations.