Ambulatory Care Nursing Certification Exam With 100% Correct Answers 2024, Exams of Nursing

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Ambulatory Care Nursing Certification Exam With 100% Correct Answers 2024 The ambulatory care nurses function under 3 major roles - Correct Answer-Organizational Professional Clinical Organizational roles include - Correct Answer-Policies and procedures Professional roles include - Correct Answer-Evidence-based practice Clinical roles include - Correct Answer-Assessment and critical thinking Social workers - Correct Answer-Provide PSYCHOSOCIAL assessments, ongoing counseling & tx Serve as a consultant to the team Dietician - Correct Answer-Nutritional screen/assessments Definition of Case Management - Correct Answer-The collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options & services to meet an individual's needs 5 Rights of delegation - Correct Answer-Right Task Right Circumstance Right Person Right Directions/communication Right supervision & evaluation If a task is not w/in the scope of nursing practice, it cannot be delgated - Correct Answer-No Definition of Staffing Ratio - Correct Answer-Ratio of nurses or nursing personal to providers Airborne dz - Correct Answer-Chicken Pox Measles TB Supplies Medications Definition of Indirect Costs - Correct Answer-Costs within a service unit that are not incurred for direct pt care Example of Indirect Costs - Correct Answer-Clerical support staff Rent Laundry Housekeeping Utilities Definition of Revenue - Correct Answer-Total amount of income received or that is entitles to be received based on services rendered Definition of Relevant Range - Correct Answer-Normal range of an expected activity for a cost center Example of Relevant Range - Correct Answer-Anticipated # of pt office visits monthly or yearly Definition of Fixed Costs - Correct Answer-Costs that are fixed in the context of a Relevant Range. Cost does not change with a change in visit volumes Example of Fixed costs - Correct Answer-Manager salary rent Minimum staff Support staff requirements Definition of Variable Costs - Correct Answer-Costs that vary w/ changes in volumes of service units Examples of Variable Costs - Correct Answer-Meds Supplies Direct staffing Beyond minimum OT Definition of Mixed Costs - Correct Answer-Costs that include both fixed and variable costs Examples of mixed costs - Correct Answer-Utilities Minimum costs are fixed, but may vary based on weather extremes or need fo periodic extended hours Staffing: minimum level is fixed, w/ variation r/t volume Definition of Relative Value Unit - Correct Answer-Used to approximate work done by physicians based on knowledge & skills required EST by HCFA/CMS The 3 elements of a Relative Value Unit - Correct Answer- Values for the physician work The practice expense Malpractice expense for delivery of service Government Funds or Provides health plans (Fed/state/local) - Correct Answer-Medicare Medicaid Trickle Indian Health Service Root Cause Analysis - Correct Answer-Method to determine the fundamental reason that causes variations in performance Focuses on SYSTEMS. Vs individuals Objective six of TB - Correct Answer-Fever Night sweats Cough (worsening) He Optus is Wt loss Should you admin to pts w/ hx of Positive Mantoux Test? - Correct Answer-No Potential cross rxns to TB skin testing - Correct Answer-W/ antigens started b/w myobacteria & prior vaccination w/ Bacillus Calmette-Gudrun (live) How big should TB wheel be? - Correct Answer-6-10mm Basis of reading for TB test - Correct Answer-Depends on absence/presence of induration Not always visible, sweep in 2-inch diameter Positive TB test shows - Correct Answer->5mm w/ risk factors High incidence group >15mm Systolic Pressure - Correct Answer-Condition of heart & great arteries Diastolic pressure - Correct Answer-Arteriolar or Peripheral vascular Resistance Correct size of BP cuff - Correct Answer-Bladder width should cover 40% of arm circumfrance @ midpoint Bladder length should cover 80-100% of upper arm or thigh circumfrance Ends should not overlap If a cuff is too small/narrow - Correct Answer-Could give a falsely high reading Contraindications for BP in an extremity - Correct Answer- Mastectomy Serious injury Lymph node dissection AV fistula Where to place the stethoscope head when taking BP - Correct Answer-Antecubital fossa Korotkoff's Sound represents - Correct Answer-Systolic pressure Where to take a pulse in infant or child - Correct Answer- Apical EKG leads - Correct Answer-V1 - 4th intercostal,R sterna border V2 - 4th intercostal, L sterna border V3 - Midway b/w V2 and V4 V4 - 5th intercostal, L midclavicular line V5 - 5th intercostal, anterior axillary line V6 - 5th intercostal, L midaxillary line Red - <50% Signals danger, take quick-relief med and emergent care if not improved Definition of Cultural Awareness - Correct Answer-Conscious learning process through which he individual becomes appreciative of & sensitive to the cultures of other people Definition of Cultural knowledge - Correct Answer-Process of understanding the key aspects of a group's culture, especially r/t interpretations of health illness, & healthcare practices Definition of Cultural skill - Correct Answer-Ability to collect relevant data regarding health hx's & performing a culturally specific assessments Definition of Cultural encounter - Correct Answer-Cross- cultural interactions Mal d' ojo - Correct Answer-Evil eye Hispanic Which culture may avert their eyes when listening or talking to a superior? - Correct Answer-Arab Which culture may consider it impolite if you speak with your hands in your pockets? - Correct Answer-South America Zones for space for different interactions - Correct Answer- Intimate Personal Public Definition of Collectible - Correct Answer-The actual amount received Categories in which fees are determined - Correct Answer- customary usual reasonable Definition of customary fee - Correct Answer-based on the percentile of aggregated fees charged in a given geographic area for the same service Defitiniton of deductible - Correct Answer-amount an insured individual must pay before insurance covers costs Medicare - Correct Answer-coverage for hospital expenses (Part A) & physician services (Part B) for individuals over age 65 or other individuals who meet qualifying crieria medicaid - Correct Answer-Plan jointly funded by state & federal governments to cover indigent populations & managed by the state providing coverage Resource-based relative value scale - Correct Answer-used by CMS to determine payment to physicians for the services rendered to Medicare patients HCPCS Level 1 coding - Correct Answer-Internationally recognized Reports medical services & procedures Evaluation & management codes CPT 99211 Capital budget plans - Correct Answer-Plan for the acquisition of investments outside of operational planning that will be sued by the organization beyond the year in which they are acquired Typically include high-dollar items that will be paid for over several yeas (buildings/renovations, equipment) Operating budget - Correct Answer-plan for the day-to-day operating activity statistics, revenue, & expenses for an organization & are prepared for 1 year Statistical or activity budget - Correct Answer-measures of workload or activity for each operational area expense budget - Correct Answer-projection of expected costs r/t specific programs or departments & based upon their anticipated volume of activity (such as payroll or supplies) Indirect costs - Correct Answer-spread across multiple programs proportionate to their size & activity, such as building & equipment depreciation, & bad debt estimates Balanced score cards measure which 4 areas? - Correct Answer-customer service financial perspective internal processes Learning & growth Therapeutic Technologies in the ambulatory care setting - Correct Answer-laser/cryosurgery pharmacotherapeutics MRI Electronic monitoring devices Information technologies - Correct Answer-Electronic health record The AAACN metric - Correct Answer-Accuracy authorship attribution currency Nursing practice relevance (POEM - pt-oritented evidence that matters) Examples of Criminal Law conduct for nursing - Correct Answer-practice of nursing w/out a license illegal prescription or use of controlled substances; drug diversion fraud, assisted suicide failure to report child or elder abuse, or neglect Civil law - Correct Answer-Can be enforced by private parties (patients, employees for discriminatory practices or violation of workplace safety rules) Nurse Practice Acts - Correct Answer-Each state enacts & administers it's own laws & regulations Enforced by "boards of nursing" responsible for investigating complaints Nurse Licensure Compact - Correct Answer-Allows nurses to practice across states lines unless one is under discipline, monitoring Must comply with the laws in which they are practicing in APRNs not included Present-oriented people - Correct Answer-focus on acivities that meet current demands may not agree with vaccines or asymptomatic dz Future-oriented people - Correct Answer-conduct activities in light of their contributions to achieving goals taking steps to promote health or use preventative cares services Someone with an internal locus of control - Correct Answer- believe his/her actions can evoke events Someone with external locus of control - Correct Answer- events occur by change, karma, luck or fate and that he/she has little control over what happens Which ethnicity cannot convert codeine into morphine-like metabolites - Correct Answer-chinese making them less likely to receive adequate pain relief Some anti-htn dxs (catopril & losartan) may be less effective in? - Correct Answer-African Americans vs caucasians But thiazide diuretics are more effective Who has the highest asthma prevalence of any racial/ethnic group in the U.S? - Correct Answer-African Americans Stages of change - Correct Answer-precontemplation comtemplation preparation action maintenance termination SMART goal - Correct Answer-specific measurable attainable/achievable relevant/realistic timebound 3 learning domains from Bloom's taxonomy - Correct Answer- cognitive affective psychomotor Infant & toddler (0-2 yrs) - Correct Answer-trust vs mistrust; autonomy vs shame teddy bear/doll first Early childhood (3-5 years) - Correct Answer-initiative vs guilt dolls middle-late childhood (6-11) - Correct Answer-industry vs inferiority encourage indpendence adolescents (12-19) - Correct Answer-identify vs role young adult (20-40) - Correct Answer-intimacy vs isolation Middle aged adulthood (41-64) - Correct Answer-Generativity vs self-absorption & stagnation Social cognitive theory opportunities for use - Correct Answer- community-wide program for preventing & reducing alcohol use among adolescents, health education programs to increase vegetable/fruit consumption by elementary school- age children Stages of change via Transtheoretical model & stages of change - Correct Answer-precontemplation contemplation preparation action maintenance termination processes of change - Correct Answer-consciousness raising dramatic relief self-re-evaluation environmental re-evaluation self-liberation helping relationships counter-conditioning reinforcement management stimulus control social liberation SMART Goals for objectives - Correct Answer-specific measurable attainable/achievable relevant/realistic time bound Primary Prevention - Correct Answer-Prevention of a dz before it occurs Ex of primary prevention - Correct Answer-health education & couseling immunizations hand washing water purification wearing seatbelts bicycle helmets Secondary prevention - Correct Answer-prevention of exacerbations of recurrences of dz already present but w/out sx and dysfunction Examples of secondary prevention - Correct Answer-screening for bp mammography sigmoidoscopy Tertiary prevention - Correct Answer-occurs when long-term dx or disability is already dx Prevention methods aim to achieve the highest level of function, minimize complications & reduce disability examples of tertiary prevention - Correct Answer- occupational/PT after stroke wearing proper shoes for DM appropriate diet post surgery to promote healing Long-term stress indicators - Correct Answer-HAs change in eating/sleep patterns persistent feelings of anger smoking use of oral corticosteroids for >3months estrogen deficiency<45y.o dementia poor health/fratility Risk factors for HTN and dyslipidemia - Correct Answer-family hx smoking sedentary lifestyle drinking alcohol excessively being overweight DM Metabolic syndrome criteria - Correct Answer-waist circumference >/ 35 inches in women, or 40inch in men TRGL> 150 HDL <50 for women or <40 for men BP >130/85 Fasting glucose>100 Optimal screening interval for lipids (normal values) - Correct Answer-Q 5 years beginning at 20 year of age DASH Diet - Correct Answer-lowers BP moderation of caffeine, alcohol, and sodium reduction What BMI is associated with elevations in BP? - Correct Answer->27 3 most common Cancers in men - Correct Answer-prostate lung colon 3 most common cancers in women - Correct Answer-breast colon lung Bladder cancer has increased incidence with which habit? - Correct Answer-smoking does NOT require routine screening Breast cancer screening - Correct Answer-recommended mammography Q 2 years for women ages 50-74 Cervical Ca screening - Correct Answer-Q 3 years from 21-65 When is pap screening not recommended? - Correct Answer- women older than 65 if previous pap screens were normal women who had a hysterectomy for benign disease Colorectal ca screening - Correct Answer-men and women age 50-75 FOBT annually Flexible sigmoidoscopy q 5 years & high sensitivity FOBT Q 3 years colonoscopy Q 10 years Prostate ca screening - Correct Answer-if screening is desired; should be performed on men 50-70 or over 45 with high risk Restrictive bariatric procedures - Correct Answer-laparoscopic gastric banding Ventrical banded gastroplasty Flumist (live flu vaccine) - Correct Answer-May be given to healthy, non-pregnant adults free of chronic illness up through age 49 Implantation presencey sx - Correct Answer-light bleeding w/ mild cramping the may appear 12-15 days after fertilization Newbown/infant screening labs - Correct Answer- Phenulketonura hypothyroidism sickle cell anemia Measuring length if infant - Correct Answer-measure on flat surface w/ infant on back length generally increases by 50% by 1 year of age Wt increase in infants - Correct Answer-generally doubles by age 6 months triples by 1 year of age Head circumference measurements - Correct Answer-measure broadest part across forehead and occiput average growth is 1cm/month for first year When is the first dental screening? - Correct Answer-age 1 Atonic phases in seizure - Correct Answer-loss of muscle tone absence seizure (petit mal) - Correct Answer-type of seizure resulting in brief loss of consciousness, usually 10 seconds or less, w/ absence of hypertonicity or musclaujlr contracture. predominantly in children aura - Correct Answer-subjective indication of oncoming seizure change in tase, vision, or smell focal seizure - Correct Answer-seizure activity initiating from one side of the brain seizure activity on opposite side of the body epilepsy - Correct Answer-dx for congenital or acquired brain dz resulting in seizure actvity tonic clonic seizure (grand mal) - Correct Answer-increased neuronal activity in the brain w/ presenting loc, muscle rigidity, involuntary muscular twitching, & incontinence Status epilepticus - Correct Answer-increased neuronal activity in the b rain resulting in seizure activity that continues for >10minutes medical emergency 3 types of causes for sz activity - Correct Answer-physiological iatrogenic idiopathic Most common seizure medications - Correct Answer- phenytoin carbamazepine topiramate Use of PPE safe injection practices safe handling of potentially contaminated equipment or surfaces in the patient environment respiratory hygiene/cough etiquette When should you notify nearest OSHA facility after a fatal accident or one that results in the hospitalization of 3 or more employeees? - Correct Answer-within 8 hours The Healthcare effectiveness Data & information set is divided into which 5 areas - Correct Answer-Effectiveness of care access/availability of care satisfaction w/ the experience of care use of services cost of care Risk Management - Correct Answer-an organization-wide program to identify risks, control occurrences, prevent damage, & control legal liability Where risks of the institution are evaluated and controlled "shared governance" at the unit level Omnibus Reconciliation bill of 2010 (COBRA) - Correct Answer- offers premium assistance to cover workers involuntary terminated Patient Protection & affordable car act focus - Correct Answer- Health insurance reform health promotion/quality better access organizational standards include - Correct Answer-policies/procedures position descriptions performance standards standards of care decision support tools Nursing process w/ Telehealth nursing - Correct Answer-1. assessment/data collection 2. Analyze and plan (includes nursing dx) 3. implementation 4. evaluation urgent medical care within - Correct Answer-4-6 hours non-urgent medical care within - Correct Answer-24 hrs to home/self care A leader with emotional intelligence will have - Correct Answer-self-awareness mindfulness "be present" openness to new ideas impulse control willpower & courage compassionate & value-driven passionate optimism resilience & reflection Thomas-kilmann index (TKI) - Correct Answer-conflict mode index that identifies preferred conflict management strategies from a set of 5 options protected subjects - Correct Answer-legally/mentally incompetent subjects neonates pregnant women' children prisoners terminally ill subjects QA approach - Correct Answer-problem focused defensive/reactive Clinical indicators - Correct Answer-reflect eh adherence to known standards of care or clinical guidelines pap smear mammo immunization rates Administrative indicators - Correct Answer-reflect efficiency & productivity revenue, expenses operational indicators - Correct Answer-measures of access to care visit volumes data, no shows, cancellations perception of care indicators - Correct Answer-measures of patients satisfaction waiting times attributes of caring by staff Common-cause variation - Correct Answer-Variation that occurs due to chance normal variation Special-cause variation - Correct Answer-factor intermittently & unpredictably induces variation that is not a normal part of the process When is a process considered "in control" - Correct Answer- when data within 2 standard deviations from the statistical mean and no data runs or trends are noted mechanisms to improve quality - Correct Answer- benchmarking RCA Benchmarking - Correct Answer-comparison measurement of a process, product, or service in comparisionto those of the toughest competitor, or those considered industry leaders, or to those considered to have best practice (external benchmarking) or to similar activities I the organization (internal benchmarking) 3 types of benchmarking - Correct Answer-internal external functional Internal benchmarking - Correct Answer-process of examining internal performance & gauging improvement over time external or competitive benchmarking - Correct Answer- measurement of performance of a given organization w/ reliable & valid indicators against that of another similar organization using identical indicators frontal maxillary more women thanment organs in the RUQ of abdomen - Correct Answer-liver gallbladder duodenum R kidney hepatic flexure of colon LUQ organs - Correct Answer-stomach spleen L kidney pancreas splenic flexure of colon RLQ organs - Correct Answer-cecum appendix R ovary/tube LLQ of abdomen - Correct Answer-sigmoid colon l ovary/tube Fevers in children - Correct Answer-newborn <4 weeks old w/ fever>100.4 No Tylenol younger than 12 weeks No ibuprofen younger than 6 months no aspirin due to Reye's syndrome `Alternating Tylenol/ibuprofen for Fever - Correct Answer- NOT recommended unless fever is over 104C & child unresponsive to meds alone acute otitis media - Correct Answer-middle ear effusion with evidence of acute inflammation (purulent effusion or red tympanic membrane) primary prevention of otitis media - Correct Answer- pneumococcal conjugate vaccine administration annual influenza vaccine administration ablative - Correct Answer-removal of a diseased body part Minimal sedation (Anxiolysis) - Correct Answer-pt responds normally to verbal commands cognitive fun & coordinate may be impaired Moderate sedation - Correct Answer-results in amnesia/analgesia responds purposefully to verbal commands maintains airway deep sedation & analgesia - Correct Answer-dx induced depression of conscciousness pt cannot be immediately aroused painful stimuli possible assistance for patent airway Fasting guidelines - Correct Answer-clear liquids (2 hours min) breast milk (4 hrs min) infant formula (6 hrs min) Light meal (6 hrs min) massive doses of IV dantrolene sodium oxygenate correct acidosis Ginger - Correct Answer-possible anti-emetic effect not recommended w/ warfarin d/c scoring post-op - Correct Answer-phase I Pacu : minimum 8-10 Home discharge requires minimum of 18 4 MI processes - Correct Answer-engaging guiding evoking planning HTN in adults - Correct Answer->140/90 HTN emergency - Correct Answer->180/120 DASH diet - Correct Answer-evidence-based eating plan that is low in saturated fat, cholesterol, & total fat reduced consumption of red meats, sweets, sugar-containing beverages NA: 1500-2400mg/day target organ damage of htn - Correct Answer-heart brain eyes kidney Criteria for dx dm (one must exist) - Correct Answer-hgba1c of 6.5 or greater fasting plasma glucose >126 (at least 8 hours fasting) 2-h plans glucose 200mg/dl C-peptide testing in adults - Correct Answer-to determine DM 1 or 2