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PROFESSIONAL ISSUES- Fitzgerald
Question and answers verified to pass
APRN definition - correct answer ✔competencies of RN by demonstrating a greater depth and breadth of knowledge, a greater analysis and synthesis of data, increase complexity of skills and interventions and greater role of autonomy nurse practice act - correct answer ✔a law that is enforces by each state's nursing boards qualifications for licensure protected nurse scope of practice scope of practice - correct answer ✔varies STATE TO STATE (roughly 54 practice acts) and can vary very differently ex. if moving to another state, need to check that’s states practice act to determine independence actions taken if scope of practice is not followed credentialing - correct answer ✔confirm HCP meets practice authority
defines clinical/hospital privileges done in all settings enables insurance reimbursement schedule I drugs - correct answer ✔illegal for prescription ex. heroin, PCP only select researchers can register to receive small amount under specific conditions never relates to NP schedule II drugs - correct answer ✔legal to prescribe, significant abuse potential ex. morphine, fentanyl, methadone, oxycodone, hydrocodone, Adderall schedule III drugs examples - correct answer ✔testosterone, butalbital (fioricet), tyl with codeine schedule IV drug examples - correct answer ✔all benzo's Ambien, sleep meds
***all adults are competent until - correct answer ✔proven otherwise justice - correct answer ✔fairness utilitarianism - correct answer ✔best is good for the greatest number of people what is the most cost effective form of health care - correct answer ✔primary prevention ex. vaccines veracity - correct answer ✔honesty **components of informed consent - correct answer ✔capacity to make an informed decision is able to comprehend info can ask questions about proposed treatment HCP role in informed consent - correct answer ✔must be able to provide benefits and risks presumed consent - correct answer ✔appropriate in limited situations such as emergency situations where pt near death/ unconscious and no surrogate decision maker available
**components of competency - correct answer ✔communicate a choice understand info appreciate consequences reason about tx choice determining competency vs. incompetency - correct answer ✔only court can declare this usually not needed if family/proxy can agree does pt need to be fully cognitively intact to be competent - correct answer ✔depends on situation ex. moderate dementia doesn't know date, year or president but understands situation----yes they are competent ex. situation of consent when sedated-----need clarification advance directive def. - correct answer ✔durable statement of intent based upon the patients written healthcare wishes ex. living will, 5 wishes who should have a health care proxy - correct answer ✔anyone >18, regardless of health spouse as proxy - correct answer ✔considered de facto if no other has been appointed
protection from evil eye - correct answer ✔red ribbon on babies wrist/ankle wearing an amulet (form of beads with an eye) tx of evil eye - correct answer ✔usually through traditional healer rubbing an egg on child malpractice def. - correct answer ✔failure to exercise such care as would a REASONABLY PRUDENT HEALTH CARE PROFESSIONAL UNDER THE SAME OR SIMILAR CONSEQUENCES duty def. - correct answer ✔relationship between HCP and pt breach of duty - correct answer ✔providers violates accepted standards when rendering care **occurrence basis professional liability insurance - correct answer ✔during period the policy was active, regardless if policy is renewed or continues claims made professional liability insurance - correct answer ✔covers providers only if injury occurs within policy period and if claim filed during the policy period is in effect Medicare overview---who qualifies - correct answer ✔> <65 with certain disabilities ESRD Medicare part A - correct answer ✔hospital and religiously ass. facilities
Medicare part b - correct answer ✔supplemental insurance outpatient, home health how can NPs be reimbursed under Medicare part b - correct answer ✔as long as services are "physician like" services not RN Medicare part c - correct answer ✔Medicare advantage offered by private companies HMO/PPO Medicare part d - correct answer ✔drug coverage need parts A&B a premium is charged NPs are able to bill only services_____ - correct answer ✔"medically necessary" ****"incident to" billing - correct answer ✔100 % reimbursement at MD rate NP must be employed by MD MD must be in office MD must initiate tx NP under MD supervision independent NP reimbursed at what rate - correct answer ✔85 % of MD
ex. 95 % (95 % confident that your results are a reliable indicator) (leaves you with a 5% confidence interval) absolute risk reduction - correct answer ✔risk in control group/general population minus the risk in a treatment group relative risk reduction - correct answer ✔% of risk removed by tx answer is always higher than ARR ie 1000 people not wearing seat belts crash into a tree at 50mph 600 (60%) die 1000 people wearing seat belts do the same. 200 (20%) die 600-200=400 (40%) absolute risk reduction 40%/60%=66% risk reduction (ARR/risk in gen population) non probability sampling - correct answer ✔purposive, generally easier to enroll, validity increased by eliminating bias reliability - correct answer ✔results can be repeated and are not just a fluke they are reproducible
validity - correct answer ✔the results indicate what the researchers think they do. external validity-does it measure cause and effect ie 2 beers/day causes alcoholism you measured that all alcoholics reported drinking 2 beers/day internal validity- measures what its supposed to. ie survey attitudes of men on fitness if only survey men at a gym it wont represent all men dependent variable - correct answer ✔outcome (weight loss) independent variable - correct answer ✔manipulated variable (cell phone app) CPT stands for - correct answer ✔current procedural terminology what does a valid ICD code contain - correct answer ✔includes a letter followed by 2 digits with a 1-2 decimal suffix ex. K25. CPT codes overview - correct answer ✔contain 5 digits (99201 or 99203) are the codes that get reimbursed the 4th digit (0) represents provider/patient interaction (1) implies a returning pt the 5th digit indicates level of complexity with 1 the least
level 2 - correct answer ✔straight forward ex. URI with symptomatic tx level 3 - correct answer ✔low complexity (99213) Requires 2: -expanded problem-focused history -expanded problem-focused exam -low complexity medical decision-making ex. rapid strep with anti's level 4 - correct answer ✔moderate complexity multi system chronic dx level 5 - correct answer ✔high complexity 2: comprehensive hx comprehensive exam high complexity medical or clinical decision making ie 72 yo male with CHF, renal impairment, and poorly controlled HTN with new-onset dyspnea wellness code for well child - correct answer ✔Z00. wellness code for well adult - correct answer ✔Z00.
patient centered care def. - correct answer ✔healthcare that establishes partnership among practitioner, pt, families accountable care organizations* - correct answer ✔group of HC organizations and clinicians who come together voluntarily to give coordinated high quality care to Medicare pt's
