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The Ambulatory care Nurse is triaging a client whose chief complaint is chest pain. What is a priority action for the nurse to take? A. Complete full head to toe B. Administer ASA C. Perform Electrocardiogram (ECG) D. Call 911 - C. Perform an Electrocardiogram Which of the following is essential for the ambulatory care nurse to remind the client of when performing an Electrocardiogram? A. Take a deep breath during the test B. Hold you breath during the test C. Try not to move during the test D. You may keep your bra on during the test - C. Try not to move during the test The Ambulatory Care nurse is assessing a client. Which of the following questions will yield more information from the client? A. Are you feeling pain? B. What brought you in today? C. How many Children do you have? D. When was your last menstrual period? - B. What Brought you in today? The ambulatory care nurse is conducting an annual assessment of a client. The client denies frequent urination, blurry vision, excessive thirst or hunger. The clients Blood sugar is 500mg/dl by finger stick. What should the nurse do next? A. Transport client to the ER B. Notify the healthcare provider immediately C. Retest the Blood glucose D. Order a Hemoglobin A1c - C. Retest the blood glucose Which of the following laboratory test is most effective in monitoring a client with DM blood glucose level? A. Urine Glucose Level B. Glucometer blood glucose testing C. Hemoglobin A1C D. Creatinine Levels - C. Hemoglobin A1C The client complains of sporadic Abnormal heart rate. An ECG performed showed Normal Sinus rhythm. Labs were WNL and assessment revealed no cardiovascular abnormalities. Which of the following should the nurse anticipate the healthcare provider will order? A. Halter Monitoring
B. Admission to the hospital C. Continuous EEG D. Chest X-ray - A. Halter Monitoring The Ambulatory care nurse is preparing the client for the application of a Holter monitor. Which information is vital for the nurse to give the client? A. Check blood glucose during halter monitoring B. Maintain normal diet and exercising C. Avoid Microwaves and the use of cell phones D. Reduce exercise routine - B. Maintain normal Diet and exercise The Ambulatory care nurse is assessing a new graduate nurses' understanding of the importance of getting clients height and weight before chemotherapy. Which statement indicates they understand? A. Height and weight are seldom required B. height and weight are only needed when the chemotherapy regimen is changed C. Height and weight are needed to calculate the correct dosage of chemotherapy D. The chemotherapy dose will remain the same, even if there is an increase in the amount of eight lost. - C. Height and weight are needed to calculate the correct dosage of chemotherapy. The Ambulatory care nurse is performing a guaiac fecal occult blood test (gFOBT), Which of the following would indicate a positive result? A. Green reaction B. Red reaction C. Blue reaction D. Yellow reaction - C. Blue reaction The nurse in the Medical oncology clinic is assessing a client who is undergoing chemotherapy. The nurse obtained an oral temp of 102 degrees. which statement by the nurse indicates an understanding of the clients' condition? A. Since the client is feeling "ok" there is no further intervention B. A temp of 102 is an expected finding after chemotherapy C. Cal the MD to obtain an order of Tylenol as soon as possible D. The client is post chemo and at risk for neutropenia fever. This is an emergency and requires stat ABX or hospitalization - D. The client is post chemo and at risk for neutropenia fever. This is an emergency and requires stat ABX or hospitalization The Ambulatory care nurse is performing a physical assessment on a child who underwent chemotherapy. Which statement by the client indicates that further evaluation is needed? A. I ate my entire meal
There are three ethical principles for human research. Which of the following means the client has the right to elf determination? A. Respect B. Justice C. Beneficence D. Non maleficence - Which of the following organizations is responsible for evaluating proposed research studies prior to their commencement? A. Centers for disease control and prevention B. Department of Health and Human services C. Institution Review Board D. Office of Disease prevention and Health Promotion - C. Institution Review Board According to the Joint Commission standard, when should the initial assessment of the nurse competencies be conducted in a health care setting? A. During the orientation process B. Prior to the orientation process C. During Nursing school D. After the orientation process - A. During the orientation process The purpose of using Scope and Standards of Practice for Ambulatory Care Nursing includes which if the following? A. Use a guide to provide quality of care B. Use to prevent law suits C. Use to increase the income of the facility D. Use to train nurses - A. Use a guide to provide quality of care The ambulatory care nurse is teaching a client ho to change their wound dressing. Which of the following indicates emotional readiness to learn? A. The client accepts the need to learn the new skill B. The client has the psychomotor function to change the dressing C. The client is a wound care medical MD D. The client has dressed his/her own wound in the past - A. The client accepts the need to learn the new skill To educate the client the ambulatory care nurse needs a systematic and planned process that consists of teaching and learning. Which of the following factors could influence the education process? A. Culture B. Learner's readiness
C. Gender D. Socio-Economic Status - B. Learner's readiness The Ambulatory care nurse is discharging a 10-year-old child from the pediatric clinic. To whom should the nurse given the discharge teaching? A. The Child B. The mother C. Both the child and the caregiver D. the grandparents - C. Both the child and the caregiver The ambulatory care nurse is caring for a Native Hawaiian whose choice of food intake, health and wellbeing perception can pose barriers to life style modification. To be effective in getting the client to participate in dietary modification, which of the following steps should the nurse take? A. Give the client a brochure B. Teach the client about nutrition from a family framework perspective C. Give the client the web address for the dietary information D. Recommend a specific diet regimen - B. Teach the client about nutrition from a family framework perspective The Ambulatory care nurse is working in the client with a variety of clients from different racial and ethnic groups. When providing care, the nurse should know which group has the highest asthma prevalence of any racial/ethnic group in the USA? A. Hispanics B. Caucasian C. African Americans D. Asian - C. African Americans The Joint commission requires accredited healthcare organizations to develop and use a list of abbreviations that should not be used. Which of the following if documented by the ambulatory care nurse indicate understanding of the "Do not Use" list? A. QD B. U C. Unit D. IU - B. U A client fell in the clinic during the intake process. The ambulatory care nurse is documenting the occurrence. Which of the following indicates proper documentation of the incident? A. Document the incident in the patients chart B. Make no mention of the fall in the clients charts C. Report it the the risk management and they will document the incident
A. Give the child a nebulizer B. Give the child a spacer C. Recommend discontinuation of the medication D. Inform the parent that the medication is not important - B. Give the child a spacer The ambulatory care nurse is formulating a research question using the PICO format. the "C" in PICO stands for which of the following? A. Comparison B. Characteristics C. Culture D. Cure - B. Characteristics PICO (T) Format - Formula for creating answerable research questions. P: Population/patient - age, gender, ethnicity, individuals with a certain disorder I: Intervention/indicator (Variable of Interest) - exposure to a disease, risk behavior, prognostic factor C: Comparison/control - could be a placebo or "business as usual" as in no disease, absence of risk factor, Prognostic factor B O: Outcome - risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome T: Time - the time it takes for the intervention to achieve an outcome or how long participants are observed The ambulatory care nurse is teaching a client how to use the peak flow meter. Which statement indicates that teaching was effective? A. I Should move the indicator to the bottom of the number scale before suing the meter B. I Should blow out as slowly as possible C. I should blow multiple time in a meter during a single test D. I should lie down when using the meter - A. I Should move the indicator to the bottom of the number scale before suing the meter Which of the following if noted in the clients urine analysis would require further actions? A. Protein B. Bacteria C. Bilirubin D. White Blood Cells. - C. Bilirubin The client is being scheduled for a lower gastrointestinal study using double-contrast barium enema. Which of the following should be included in the clients teaching? A. The procedure will take 6 hours B. Have a low residual diet 1-2 days before the procedure C. Decrease fluid intake after the procedure
D. East a light meal the night before the procedure. - B. Have a low residual diet 1-2 days before the procedure The ambulatory care nurse reviews the clients lab results and notices that the creatinine is mg/dl. What action should the nurse take? A. Notify the healthcare provider immediately B. Collect urine ample C. Do nothing, The result is WNL D. Administer diuretics - C. Do nothing, The result is WNL A client wit a DX of bipolar disorder is being seen in the clinic. The healthcare provider prescribed Lithium. Which of the following is important for the ambulatory care nurse to teach a client? A. You can breast feed while taking the medication B. Low Sodium level can lead to toxicity C. Minimize fluid intake D. There is no need to use contraceptives while on this medication - B. Low Sodium level can lead to toxicity Which of the following statements if reported to the ambulatory care nurse indicates that the treatment for a client with CHF needs to be modified? A. The client gains 1 pound in hours B. The client now sleeps sitting up C. The clients BP is / D. Increased Activity tolerance. - B. The client now sleeps sitting up With the implementation of telemedicine, the method of triaging has changed. What components would an ambulatory care nurse utilize when triaging using the telephone? A. Take a quick and accurate history in order to make an accurate decision B. HIPPA law does not allow client to call ambulatory care facility with health issues C. Call 911 as soon as the client states there is a problem D. Give information that is general that can be applied to most clients. - A. Take a quick and accurate history in order to make an accurate decision The ambulatory care nurse is assessing a client. Which questions should the nurse ask to assess the clients health goals? A. It seems to me that you want to be healthy, Is that true? B. What are your health goals? C. Do you want to be healthy? D. Do you exercise? - B. What are your health goals?
If a patient is to have an arthrodesis and injection of corticosteroid into the right knee and the ambulatory care nurse is setting up equipment, the correct needle gauge syringe sizes are: A. 18G needle and 10-20ml syringe B. 20G needle and 20ml syringe C. 16G needle and 10-20ml syringe D. 19g needle and 50ml syringe - A. 18G needle and 10-20ml syringe The coding system that is used for outpatient procedure claims is: A. ICD-10-PCS B. HCPCS/CPT C. ICD-10-CM D. ICD-9 - B. HCPCS/CPT The issue of licensure portability is especially a concern with: A. Outreach programs B. Collaboration among medical facilities and programs C. Telemedicine D. Recruitment of healthcare personnel - C. Telemedicine If a leader wants to influence others in an organization to change attitudes, the first step is to: A. Provide incentives to change B. Outline disciplinary actions for failure to change C. Outline the desired change D. Model the desired change - D. Model the desired change When conducting a urine permanency test, the specimen should be: A. First voided in AM B. Second voiding the AM C. Obtained after the patient drinks 8 oz of liquid D. Obtained any time - A. First voided in AM In a crisis situation which decisions must be made quickly and effectively, the most effective leadership style is probably: A. Democratic B. Laissez-faire C. Authoritarian D. Bureaucratic - C. Authoritarian
The ambulatory care nurse is preparing electronic educational material to be viewed over the internet and plans to include both deep links to articles and inline links to images from commercial sites. The nurse should: A. Include the links as desired B. Ask permission to utilize links C. Provide a works cited list D. Provide the course link in the text - B. Ask permission to utilize links With problem based learning, the role of the instructor is that of: A. Leader B. Lecturer C. Observer D. Facilitator - A. Leader If delegating a task to staff person, the first issue to consider is whether the: A. Task is suitable for the individual B.. Individual has time to carry out the task C. Individual can be adequately supervised D. Individual wants to carry out the task - A. Task is suitable for the individual A family practice physician's office schedule is usually fully booked with patients scheduled every 15 minutes, but the MD routinely adds patients who have acute needs to the schedule resulting in delays in seeing patients, unpaid staff OT and staff complaints. The best solution for the nurse manager may be to: A. Schedule staff later in the day B. Suggest referring patient to ED C. As for payment for any OT D. Leave open slots in the schedule - D. Leave open slots in the schedule When conducting a test for the erythrocyte sedimentation (ESR) rate using the Sediplast kit rack, after the blood in the Sediplast tube is inserted into the vial, the results should be checked in: A. 10 min B. 30 min C. 60 Min D. 90 min - C. 60 min If a patient comes to the ambulatory care center with a 1inch gash on he left foot from a dog bite, the initial response should be to: A. Wash the wound area with soap and water B. Irrigate the wound with -ml of NS
If a physician is registered as a Vaccines for Children's (VFC) provider and plans to administer vaccines to four patients, which of the following patient would be eligible for the program? A. 6 year old whose health insurance is provided by Medicaid B. a 19 year old AA patient C. A 13 year old with insurance coverage for vaccines D. A 3 year old Polynesian patient with insurance but unpaid deductible - A. 6 year old whose health insurance is provided by Medicaid If an office practice has 3 FTE physicians, approximately how many FTE support staff persons are likely to be necessary? A. 5 B. 10 C. 15 D.20 - C. 15 ( 1 FTE physician requires 4.5-5.5 support staff) Which of the following ethnic groups is at the highest risk of stroke? A. Caucasians B. Hispanics C. Asians D. African Americans - D. African Americans The type of budget that is used for daily operations and general expenses, such as salaries associated with an ambulatory surgery center is the: A. Master budget B. Operating Budget C. Capitol Budget D. Cash balance Budget - B. Operating Budget According to the Spalding classifications system for disinfection and sterilization, an example of an item that would be classified as Semi-critical is: A. Bronchoscope B. Surgical instrument C. BP Cuff D. Bedpan - A. Bronchoscope If a patients nursing DX is "Activity intolerance" on the care plan and the desired outcomes are the for the patient to feel less tire and carry out activities without signs of physical distress, which of the following is an appropriate nursing intervention: A. Keep patient awake during daytime hours B. Limit activities to those that are essential
C. instruct patient in energy saving techniques D. Encourage patient to take mid-morning and mid afternoon naps. - C. instruct patient in energy saving techniques When preparing a budget for a community education project, the ambulatory care nurse needs to consider both direct and indirect costs. Indirect costs may include: A. Supplies and Equipment B. Salaries C. Employee benefits D. Housekeeping Services - D. Housekeeping Services The three goals of accreditation by the national committee for Quality Assurance are (1) better patient experience, (2) Better health and (3): A. Lower staff turnover B. Lower per capita cost C. Lower rates of medical errors D. Higher reimbursement rates - B. Lower per capita cost An Ambulatory care nurse reviewed clinic statistics regarding the number of patients who missed or came late to an appointment, established a telephone reminder system to improve attendance and then conducted a review each week and published findings for the staff showing the improvement. This is an example of: A. Internal benchmarking B. Functional Benchmarking C. External Benchmarking D. Competitive benchmarking - A. Internal benchmarking If when utilizing the Plan Do Study Act (PDSA) method of continuous quality improvement study of the outcomes of a trial indicates that the solution that was instituted was not effective, the next step is to: A. Return to plan step B. Return to DO step C. Discontinue the process D. Continue to Act step - A. Return to plan step Plan Do Study Act (PDSA) method of continuous quality improvement study - Plan: Define the problem, brainstorm and collect data Do: Generate solutions, choose one and implement a trial Study: Evaluate outcomes Act: Identify changes needed for full implementation and continue to monitor
When interviewing a patient who reports that everything is "fine" the ambulatory care nurse notes that the patients pupils are dilated, the patient is sweating profusely and the patient frequently licks the lips. According to these observations the nurse likely concludes that the patient is: A. actually fine B. withholding information C. Experiencing a physical health problem D. Afraid of the nurse - B. withholding information Under provisions of the Americans with Disabilities Act (ADA) in relation to access, which of the following is allowed: A. Examining a wheelchair bound patient in a wheelchair because an adjustable exam table is not available B. Refusing to treat a patient because accessible equipment is not available C. Asking a disabled person to bring a caregiver to assist with patients examination D. Having accessible equipment for patient with disabilities in some examination rooms but not all - D. Having accessible equipment for patient with disabilities in some examination rooms but not all Waste is considered corrosive and hazardous if it has a pH of: A. Less than 2 or greater than 12. B. Less than 4 or greater than 10. C. Between 6 and 12 D. Greater than 12.5 - A. Less than 2 or greater than 12. When reviewing a number of articles as part of development of Evidence-based practice guidelines, the first step to reading critically should be to: A. Review the authors credentials B. Consider the source C. Read the article conclusion D. Evaluate the overall article - A. Review the authors credentials The nursing hazard that is usually of most concern is an ambulatory surgical center is: A. Back injuries B. Slips and falls C. Exposure to bloodborne pathogens D. Latex Allergies - C. Exposure to bloodborne pathogens The HIPPA security rule applies to protected health information (PHI) that is transmitted: A. Orally
B. In Writing C. Electronically D. In Any Manner - C. Electronically In a therapeutic relationship between an ambulatory care nurse and a patient, the focus should be on the : A. Nurse's Needs B. Patient ideas and feelings C. Medical Needs D. Treatment Options - B. Patient ideas and feelings If the ambulatory care nurse is concerned about a potential influx of patients infected with the Zika Virus, the most appropriate response is to: A. Research the topic and obtain disease-focused date B. Express concerns to other staff members C. Complain about the lack of information D. Suggest Stockpiling mosquito repellant to patients - A. Research the topic and obtain disease-focused date If Medicare has denied a claim, how ling does the appellent have to file an appeal: A. 30 days B. 60 days C. 90 days D. 120 days - D. 120 days Health literacy is directly affected by general literacy, so when educating patients, the ambulatory care nurse should realize that the approximate percentage of adults in the US who are classified as illiterate or low literate is: A. 25% B. 40% C. 50% D. 70% - C. 50% The Ambulatory care nurse is participating in a community effort to screen for hypertension. Screening for disease is an example of what type of prevention: A. Primary B. Secondary C. Tertiary D. Quaternary - B. Secondary
- Promote independence after TBI
- Referral to support groups
- Rehab The three primary elements of motivational interviewing are: A. Collaboration, Evocation, and autonomy B. Orientation, identification and autonomy C. Input, Discussion and output D. Identification of barriers, conflict resolution and implementation - A. Collaboration, Evocation, and autonomy Collaboration: Working with the patient rather than confronting the patient in order to resolve issues Evocation: Drawing out ideas from the patient about problems and solutions rather than imposing ideas of an interviewer Autonomy: Recognizing that the patient is the one who is responsible for making changes and respecting the patients choices. Female patients should generally be advised to begin breast cancer screening with routine mammos at about the age: A. 20- B. 30- C. 40- D. 50-60 - C. 40- One of the primary indications that a patient is ready to learn is when the patient: A. Appears confused B. Expresses frustration C. Admits lack of knowledge D. Asks a question - D. Asks a question When assessing a patient over the telephone, the ambulatory care nurse is unsure what the client is saying because the patient's explanation is confusing. Which of the following is the best response? A. Could you explain that again, I just want to make sure I understand B. That was so confusing, Could you repeat it? C. I'm afraid I didn't understand what you were saying D. Is there someone else present who could explain this to me - A. Could you explain that again, I just want to make sure I understand If a female patient at an ambulatory care clinic speaks only Arabic and is accompanied by her 8 year old daughter and a male neighbor who both peak English and Arabic, the best way to communicate is: A. Use pantomime to help the patient communicate
B. Ask the daughter to translate C. Ask the neighbor to translate D. Arrange for a medical Translator - D. Arrange for a medical Translator When providing anticipatory guidance to a patient who has recently been diagnosed with DM type I, the most important information that the ambulatory care nurse should cover is how to deal with: A. Weight loss B. Changes in Activity C. Diabetic ketoacidosis D. HTN - C. Diabetic ketoacidosis Which of the following infectious agents is only transmitted through direct contact, such as when the infectious agent is present on an environment surface? A. C-Diff B. Lyme disease C. Rubella Virus D. Varicella -Zoster virus - A. C-Diff If an ambulatory care nurse wants to determine if there is a recall for a specific medications, the nurse should seek information from the? A. CDC B. Consumer product safety commission C. Agency for toxic substance and disease registry D. Food and Drug Administration - D. Food and Drug Administration If a patient is scheduled for a colonoscopy, the patient should be advised that the procedure will generally require the patient to withhold which of the following medications for 7-14 days before the test A. Iron supplements B. Antihypertensive C. Acetaminophen D. Levothyroxine - A. Iron supplements A Patient is to undergo the MOHS procedure for a removal of a squamous cell carcinoma from the left face. The patient should be advised that following the initial excision of the lesion, the patient will be expected to A. Stay flat for 72 hours B. Wait for the results of the tissue analysis C. Be discharged from the facility
