Healthcare Practices and Procedures: A Comprehensive Guide, Exams of Nursing

Download Healthcare Practices and Procedures: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! 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 developing, causative and related factors, and signs and symptoms. Nursing diagnoses should never contain medical diagnoses. Rather, the nursing diagnosis is a statement of the patient's actual health status, risks for condition CERTIFICATION 2023 LATEST EXAM ANCC AMBULATORY CARE NURSING 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 C - Pediatrics D - All of the above - Answer D - All of the above Which of the following would FDA stands for? A - Food and Drug Administration B - Food Depression Association C - Fixed Depression Administration D - None of the above - Answer a - Food and Drug Administration This is an agency which regulates both the development and sale of drugs. Endoscopes are cleaned and . A - High level disinfected. B - Sterilized. C - Low level disinfected. D - Intermediate level disinfected. - Answer A - High level disinfected. Endoscopes are critical items. Critical items are normally sterilized after being cleaned. Endoscopes cannot be sterilized and require high level disinfection. Which of the following is considered an independent nursing action? A - teaching a patient about the new diet she has been prescribed for management of her condition B - assisting the speech therapist by helping the patient practice speech exercises C - administering pain medication to the patient D - giving the patient a backrub - Answer D - giving the patient a back rub Independent nursing actions are those which do not require a physician's order. Giving a backrub is one of these independent nursing actions. In the age of managed care, actions which arise from collaborative care plans are known as interdependent actions. Which of the following is a digitalis medicine? A -Lanoxin B - Bumex 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 An older patient presents with swelling in the lower extremities. Which of the following should be ordered to rule out heart failure? A - CBC B - Spirometry study C - Brain natriuretic peptide test D - Ketone balances - Answer C - Brain natriuretic peptide test (BNP) The BNP measures levels of protein made by your heart will be higher than normal since it is produced by your blood vessels in your heart. Nurse Grace knows that the most effective way to educate her patient and assist in her patient care plan is to do what? A - Insist the patient follow the plan exactly as instructed. B - Create a schedule for the patient of future office visits and scheduled treatments. C - Establish a team effort with the patient in the teaching and learning process. D - Ask the patient to involve family members in her care planning. - Answer C - Establish a team effort with the patient in the teaching and learning process. Of the following, which would not be considered an objective symptom for tuberculosis? A - Headaches B - Night sweats C - Weight loss D - Fever - Answer A - Headaches Some of the objective symptoms for tuberculosis would be: Night sweats, Weight loss, Fever, Cough which progresses, Hemoptysis (cough up blood) An order is being written for insulin, how should the dosage order be written? A - 10 ml subq B - 10 units subq C - 10 u subq D - None of the above - Answer B - 10 units subq U for unit is on The Joint Commission's official " Do Not Use" list of abbreviations. 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. It is important to note that you cannot assess a person's health literacy just by looking. In fact, the majority of people with low health literacy, according to a recent study, are middle class Caucasians. POCT and which of the following terms are often used interchangeably? A - Diagnosing B - Referrals C - Consultations D - Onsite testing - Answer D - Onsite testing would be the feeling of distress, suffering, and/or discomfort that is considered a symptom of a condition? A - Temperature 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 - 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. Factors which could have the potential to promote communication would include all but which of the following? A - Respect B - Space C - Caring D - Openness - Answer B - Space Some of the factors which could have the potential to promote communication would include: Respect, Caring, Openness, Disposition, Warmth/friendliness, Empathy, Honesty, Competence would be when a leader aligns themselves with others to help obtain information, ideas, advice, power, and influence? A - Consensus-building D - Development - Answer C - Networking Details which should be focused on when choosing a glucometer would include all but which of the following? A - The type of lancing device B - Coding the machine C - The look of the meter D - The color of the meter - Answer D - The color of the meter There are 7 details which should be focused on when choosing a glucometer: The type of the lancing device, Coding of the machine, The look/display of the meter, The memory capacity of the meter, The sample size which will be needed, How long does it take for a result, Are there any additional features Which of the following emphasizes preventive services like notification of contacts for patients with infectious diseases, screenings, and immunization at the local level? B - Negotiation C - Networking A - Local schools B - Local pharmacies C - Public Health departments D - State disease control - Answer C - Public Health departments Public Health departments emphasize preventive services like notification of contacts for patients with infectious diseases, screenings, and immunization at the 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 A - congestive heart failure B - benign heart murmur 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 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? B - peanut C - orange 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 - Sulfonamides B - Glucocorticoids and corticosteroids C - Thyroid hormones D - Nitrates - Answer C - Thyroid hormones Thyroid hormones contain "thy. "Glucocorticoids and costicosteroids end with "sone." Nitrates contain "nitr." Sulfonamides include "sulf." 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. While all the choices listed are risk factors, lack of cognitive stimulation is most strongly associated with childhood obesity. Healthcare education and screening must thus address this issue. 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 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 C - The nurse should state that he or she is unable to discuss medical information and refer the patient to the primary care physician D - The nurse must clearly identify him- or herself, take a quick and accurate history, and quickly be able to make a decision - Answer D - The nurse must clearly identify him- or herself, take a quick and accurate history, and quickly be able to make a decision What are the best question types to ask when gaining information from a patient? A - specific, open-ended questions regarding current symptoms and medical history B - general questions with yes or no answers C - questions related to childhood diseases D - demographics questions - Answer A - specific, open-ended questions regarding current symptoms and medical history In what order would the nurse prioritize the care of the following patients presenting to the clinic at the same time: a parent carrying a smiling infant with a fever, a pale and sweaty male with flank pain for two days, a carpenter with a nail in his thumb, and a three-year-old with vomiting. A - flank pain, three-year-old with vomiting, infant with a fever, and man with the nail B - three-year-old with vomiting, flank pain, man with the nail, and infant with fever C - flank pain, infant with fever, three-year-old with vomiting, and man with the nail D - three-year-old with vomiting, infant with fever, flank pain, and man with the nail - Answer A - flank pain, three-year-old with vomiting, infant with a fever, and man with the nail Mom has described her child's symptoms as fever for three days and vomiting for the last 24 hours. She states the child has been very sleepy for the last two to three hours. What subtle symptom alerts the nurse that this child needs to be seen as soon as possible? A - three days of fever B - three days of fever, one day of vomiting C - very sleepy for two to three hours with a fever for three days D - one day of vomiting - Answer B - three days of fever, one day of vomiting A 70-year-old female presents to the ambulatory care clinic complaining of fatigue. You begin your triage assessment, and she has a heart rate of 50, a respiratory rate of 24, and a blood pressure of 70/40. She denies chest pain, but you notice she rubs her elbows and states her arthritis is acting up. What would be your first priority when caring for this patient? A - Offer her Motrin for pain B - Offer her Tylenol for pain and send her to the waiting room C - Continue her triage and history and finish the paperwork D - Place her in a room, do an electrocardiogram (EKG), and notify the physician to see her before the other patients in the clinic because of the possibility of a heart problem - Answer D - Place her in a room, do an electrocardiogram (EKG), and notify the physician to see her before the other patients in the clinic because of the possibility of a heart problem What nonverbal clues would indicate that a patient of any age is having difficulty breathing? A - sweating in a warm room with exertion B - slight wheezing when lifting heavy objects C - laughing and joking during a triage assessment D - change in color, retractions, and noisy breathing - Answer D - change in color, retractions, and noisy breathing 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 While all the choices given indicate that the patient's platelet count is lower than the acceptable range, not all the counts are low enough to cause concern for increased bleeding. Platelet counts below 20,000/mm3 do put patients at increased risk of bleeding, A disinfectant solution needs to be marked with the name, . A -Date prepared and the date expired. B -Date prepared. C -Date expired. D -Solution density. - Answer A - Date prepared and the date expired. A nurse encourages a patient with diabetes to eat healthier and exercise using open ended questions and encouragement. What type of interview is she using? A -Community education. B -Motivational interview. C -Group education. D -Aligning with the patient. - Answer B -Motivational interview. 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 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. What are the 5 steps of the nursing process? - Answer Assessment Diagnosis Planning Implementation Evaluation The preparation of a patient for "anticipated developmental or situational crisis" is known as . A -Anticipatory guidance. B -Preventative care. C -Anticipatory care. D -Preemptive care. - Answer A -Anticipatory guidance. Anticipatory guidance is a nursing intervention in which nurses attempt to prepare patients and/or caregivers for potential developments or situations in treatment. This can involve educating them about potential side effects and negative outcomes. 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? D -Standard 3 - Answer B -Standard 1 Standard 1 in the Standards of Professional Clinical Practice for ambulatory care culture. nursing would include the identification of barriers to promote optimal care. These would include such barriers as language, behavioral health issues, and A -Standard 6 B -Standard 1 C -Standard 4 A -Lack of cognitive stimulation. B -Poverty. C -Parental divorce. D -Parental Education. - Answer A -Lack of cognitive stimulation. Which of the following falls within the normal range for BUN:Cr? 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. 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. A -40 mg/dL B -15 mg/dL C -55 mg/dL 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? A -Pulseless ventricular tachycardia B -Atrial tachycardia C -Second degree block D -Sinus bradycardia - Answer A -Pulseless ventricular tachycardia A defibrillator would be used for: Pulseless ventricular tachycardia & Ventricular fibrillation Objectives of ambulatory care nursing would include all but which of the following? A - To help minimize suffering B - To decrease the cost of the patient's healthcare C -To prevent injury D -To protect the patient's health - Answer B - To decrease the cost of the patient's healthcare 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? C -Capital budget D -Malpractice insurance. - Answer B -Personnel budget The acronym "ABCD" (associated with written objectives) stands for which of the following? A -Ambition, behavioral, confusion, and diffusion B -Audience, behavioral, condition, and degree of attainment C -Analysis, benign, commission, and district D -Able, believable, conditioning, and delivery - Answer B -Audience, behavioral, condition, and degree of attainment A nurse is examining a skin growth on one of her patients. The patients hasn't felt any symptoms but has noticed the growth is starting to look abnormal. This type of examination is considered what type of prevention? A -Infectious B -Secondary C -Primary D -Primordial. - Answer B -Secondary Secondary Examining the abnormal skin growth is an example of secondary prevention due to the fact the patient has already come forward with an abnormality or possible illness and the nurse is examining it to ensure there are no further complications from it. Although the patient is not having symptoms at this time, the nurse will monitor the growth to see if he will in the future. A -Operating budget B -Personnel budget A parent with whom you are discussing immunizations says that she refuses to vaccinate her child because vaccines cause autism. What model of health are you encountering in this situation? A -Clinical model B -Holistic model. C -Health belief model D -Total wellness model. - Answer C -Health belief model In the health belief model, a patient (or in this case, parent) will choose to comply with treatment based on the beliefs he or she holds about the disease and the benefits and risk of the treatment. You are asked to phone a patient with the results of her maternal serum screening test. This patient's results are abnormal. What should be the next step in her care? A -follow up visit for re-testing B -referral to a genetic counselor C -schedule of an emergency C-section D -continuance of her initial prenatal care regimen - Answer B -referral to a genetic counselor Because the maternal serum screening test (also known as the triple marker test) is used to detect risk for genetic abnormalities, patients with abnormal results should be referred to a genetic counselor. Nurse Teresa is assessing a patient who has been diagnosed with congestive heart failure. She leans in to listen to his breathing and knows his breath sounds should sound like what? A -deep, coarse breaths B -raspy gasps C -chest rubbing D -fine crackling - Answer D -fine crackling A fine crackling sound can be heard in patient breathing for patients that have been diagnosed with heart failure. This noise is made due to fluid in the alveoli and the expansion of elastic fibers as air goes in and out. 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 -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. C -The Recommended Dietary Allowance (RDA) is the average daily dietary nutrient intake level sufficient to meet nutrient requirements of nearly all healthy individuals. D -The Tolerable Upper Intake Level (TUIL) is the highest number of calories allowed for a certain weight. - Answer D -The Tolerable Upper Intake Level (TUIL) is the highest number of calories allowed for a certain weight. The Tolerable Upper Intake Level is the highest average daily nutrient intake level that is likely to pose no risk of adverse effects to almost all individuals of the general population. The 6 clinical practice standards for the ambulatory care nursing would include all but which of the following? A -Financial B -Nursing diagnosis C -Planning D -Evaluation - Answer A -Financial There are 6 clinical practice standards for the ambulatory care nursing: Assessment, Nursing diagnosis, Identification of expected outcomes/goals, Planning, Implementation, Evaluation The more common side effects of anticholinergics would include all but which of the following? A -Hyperpyrexia B -Dry lips C -Blurred vision D -Schizophrenia - Answer D -Schizophrenia With learning, the person typically changes which of the following because of knowledge that is new? A -Occupations B -Behavior C -Physical functional status D -Financial process - Answer B -Behavior Learning helps the person to change the following as a result of exposure to knowledge that is new: Behavior, Emotional, functioning, Mental The ANP recognizes the danger signals for skin disease. Which of the following skin diseases is characterized (among other things) by a petechial rash appearing on the wrist and ankles and spreading rapidly toward the trunk and the face on the second to third day of the disease? A -Rocky Mountain Spotted Fever B -Shingles C -Meningococcemia D -Actinic Keratosis - Answer A -Rocky Mountain Spotted Fever petechial rash appears starting on the wrist and ankles and spreads rapidly toward the trunk and the face. Which of the following does principalism use? A -Nonmalefience B -Fidelity C -Veracity D -All of the above - Answer D -All of the above Principalism uses: Nonmalefience, Fidelity, Veracity, Beneficence, Autonomy, Justice 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. This disease has an acute onset of high fever and myalgia (muscle pain), severe headache, fatigue, nausea and vomiting and rash. By the second to third day, a 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. Some more common symptoms of hypercalcemia would include: Anorexia, Headaches, Nausea, Vomiting, Confusion The ANP knows that the influenza vaccination is recommended annually for certain high risk groups. Which of the following would have the GREATEST need for this vaccine? A -dialysis patients B -healthcare employees C -adults with chronic disease D -residents of long-term care facilities - Answer D -residents of long-term care facilities The outbreak of influenza may affect 60% of those in long-term care and the mortality rates related to this are high. The medical term for expectoration of blood or blood-stained sputum is what? A -hemopexis B -hemoptysis C -tuberculosis D -hemorrhage - Answer B -hemoptysis Hemoptysis is the expectoration of blood from the trachea. A hemorrhage is an internal or external bleed and hemopexis is a blood coagulation. What is a method to ensure evidence based nursing practices? 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 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. 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. 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 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? A -White non-Hispanic B -African-American B -1.04 C -1.02 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? D -3 - Answer C -4 A -2 B -1 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 Your patient brings you some information about her condition that she has printed off of the Internet. Which of the following should give you concerns about its validity? A -It is from WebMD. B -It is from the website of a university with a well known medical school. C -No references are listed. D -The article focuses on the negative outcomes of your patient's condition. - Answer C -No references are listed. The "Generation X" was born between 1960 and 1980. Which of the following would not be considered a key value for them? A -Optimism B -Flexibility C -Self-reliance D -Diversity - Answer A -Optimism The key values for the "Generation X" would include: Diversity Self-reliance Practicality Work/life balance Flexibility Skepticism In an ambulatory care environment, keeping data in a central location so that it can be maintained in the library and retrieved by other healthcare professionals for use in deciding care is referred to as which of the following? A -History based tracking D -Symptom tracking system - Answer B -Evidence based medicine This allows other doctors to be more informed about the things that are going on in the area and adapt to them. Patient Joseph comes into the ER admitting he may have overdosed on something. Nurse Cheryl observes how the patient is very tense and irritable and suspects he may have overdosed on which of the following? A -over the counter pain relievers B -clinical sedatives C -amphetamines D -barbiturates - Answer C-Amphetamines are stimulants that affect the central nervous system and are prone to addiction or abuse due to the feeling of wakefulness or euphoria it produces. If an overdose occurs, tension and irritability are increased and can lead to poor body function and even death. How long are items considered sterile if they were unwrapped when autoclaved? A -One week, as long as they are kept in a sterile container. B -One week. C -As long as they remain dry and covered. B -Evidence based medicine C -Evidence tracking system 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. Report a problem with this question The ANP knows that certain persons may require additional immunizations. The following are all in this category except for: A -food handlers B -animal workers C -factory workers D -travelers - Answer C -factory workers What determines how nurse practitioners bill for reimbursement? A -Federal law. B -Insurance coding. C -Clinic studies. D -State law. - Answer D -State law. The role of nurse practitioners is regulated by the state. Nurse practitioners may bill for services rendered under a doctor or by themselves. It depends on state law. The sharing of information and best practices with the goal of improving care is known as what? A -Quality assurance. B -Health literacy. C -Evidence based nursing. D -Benchmarking. - Answer D -Benchmarking. Benchmarking is the process of sharing information and best practices to improve care. This is different from simply sharing information in that the stated goal of benchmarking is to improve standards of care, rather than just sharing information that is "good to have." Which of the domains of learning would be the ways of knowing? A -Cognitive domain B -Independent domain C -Current domain D -Affective domain - Answer A -Cognitive domain The cognitive domain would be the ways of knowing. The affective domain would be the ways of feeling. You are conducting an assessment with a patient who reports difficulty urinating, though her bladder always feels full. There is a burning sensation when she does urinate. She says that she tries to avoid going to the bathroom because it is so uncomfortable. Which of the following is an appropriate nursing diagnosis for this patient? A -urinary elimination: altered, r/t pain on urination B -urinary tract infection C -decreased urination D -bathroom habits, altered - Answer A -urinary elimination: altered, r/t pain on urination This nursing diagnosis indicates that the patient has altered her elimination patterns. It also indicates that the pain is a key factor in that alteration. You are providing patient education to a patient who will undergo CABG. Which of the following is NOT a potential side effect of surgery that your patient should be educated about? A -depression B -mood swings C -weight gain 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? 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. A -24-28 gauge B -20-23 gauge C -16-20 gauge If the elderly patient is admitted with the main complaint of swelling in their lower extremities, the differential diagnosis which could potentially be considered would include which of the following? A -Hepatic venous obstruction B -Local venous obstruction C -Idiopathic edema D -All of the above - Answer D -All of the above You are listening to a patient's breath sounds. They are high-pitched and whistling. Which of the following is the best way to describe these breath sounds? A -wheezing B -sibilant C -Sonorous. D -stridor - Answer B -sibilant Behavioral theory (behaviorism) focuses on which of the following? A -Measurable behavior B -Provisional behavior C -Concurrent behavior D -Extreme behavior - Answer A -Measurable behavior With behaviorism, behavioral theory focuses on: Measurable behavior, Observable behavior, Overt behavior When a patient is taking feverfew and needs to stop taking it, it should be tapered off. If not tapered, it can cause which of the following symptoms of feverfew syndrome? A -Joint pain B -Stiffness C -Muscle pain D -All of the above - Answer D -All of the above Which of the following nursing theorists is known to consider the general systems theory as the philosophic orientation to her model? 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. 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. B -There are two dimensions of behavior: cooperativeness and assertiveness. C -The 5 modes of conflict response would include accommodating, avoiding, 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?