professional nursing

A focus of the ACA is disease prevention.

A nurse is teaching a client about the Affordable Care Act (ACA). Which of the following information should the nurse include?

Acute care hospital Acute care facilities specialize in clients who require short term treatment, such as IV medications, diagnostic procedures, and dressing changes.

A nurse in a clinic is caring for a client who is going to require 7 days of IV antibiotics and dressing changes for cellulitis. Which of the following care facilities should the nurse anticipate the client be admitted to?

PRN

A nurse in a clinic is reviewing a client's prescriptions prior to discharge. The nurse should instruct the client that which of the following abbreviations indicates the medication can be taken as needed?

Precertification The nurse is obtaining precertification from the client's insurance company prior to scheduling the client's MRI. Before an elective surgery, hospital admission, or procedure such as a magnetic imaging study, a client needs to obtain precertification or authorization approval from the insurance company, or the service can risk denial of payment.

A nurse in a provider's office is calling a client's insurance company to obtain permission prior to scheduling a magnetic resonance imaging (MRI) test. Which of the following is the nurse obtaining?

"CPOE systems can increase the speed of care delivery." CPOE systems allow provider prescriptions to be transmitted more quickly from one department to another, which can increase the speed of care delivery for clients.

A nurse is discussing computerized provider order entry (CPOE) systems with staff. Which of the following statements from a staff member indicates an understanding of a CPOE system?

Facilitate transfer of clients to meet the required level of care.

A nurse is hired to be a case manager in a facility. Which of the following services should the nurse expect to perform?

"Personnel can be terminated for breaching a client's confidentiality." The nurse should plan to inform the group that strong penalties exist for HIPAA violations, which include breaching client confidentiality. Penalties include termination from the facility, imprisonment, loss of professional licensure, or fines.

A nurse is preparing an in-service about HIPAA. Which of the following information should the nurse plan to include?

By mouth

A nurse is preparing to administer morphine 15 mg PO every 4 hr PRN pain for a client who has a new prescription. By which of the following routes should the nurse plan to administer the medication?

TJC ensures organizations remain up-to-date with state guidelines. TJC monitors state legislative and regulatory changes and updates its standards accordingly. This monitoring acts as a two-part system to ensure that accredited organizations remain current with state requirements.

A nurse is teaching a newly licensed nurse about The Joint Commission (TJC). Which of the following information should the nurse include?

The HCAHPS tool is issued to measure client satisfaction with the health care service. The HCAHPS tool is issued to measure client satisfaction with the health care service. The information is publicly reported and ensures the accountability and transparency of the facilities that participate. The HCAHPS tool uses a broad range of questions issued to the client regarding their care. This information is published publicly to show how the facility is performing and their accountability.

A nurse is teaching a newly licensed nurse about the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) tool. Which of the following information should the nurse include?

"Your income will determine if you are eligible for Medicaid."

A nurse is teaching about Medicaid to a client who is concerned about paying for health care. Which of the following statements should the nurse make?

Synthroid 100 mg PO every morning ac This medication entry is written correctly because both PO and ac are commonly used abbreviations and do not appear on The Joint Commission's Do Not Use list.

A nurse manager is reviewing the documentation of four newly licensed nurses. Which of the following medication entries should the nurse identify as being written correctly?

Long-term care hospital (LTCH) LTCHs specialize in hospitalization for long-term care, such as clients who have severe burns, trauma, or ventilation needs. LTCHs provide a higher level of care than a SNF, such as is required for a client who is receiving mechanical ventilation.

A nurse working in an acute care facility is caring for a client who has a total brain injury and is receiving mechanical ventilation. Which of the following facilities should the nurse anticipate the client to be transferred to for further treatment?

ensuring health care providers comply with regulations

nurse is discussing regulatory agencies during a staff meeting. which of the following tasks should nurse identify as responsibility of state licensing boards

Immunization data The nurse should include that a health record contains any information that could influence a client's health, such as immunization status. Other information includes medications, allergies, and demographic data.

A charge nurse is discussing health records with a newly licensed nurse. Which of the following information should the nurse identify as a component of a health record?

Rebound tenderness noted in RLQ of the abdomen. Objective data is information the nurse gathers when collecting data about the client, such as through physical assessment or diagnostic testing.

A charge nurse is reviewing SOAP documentation with a group of newly licensed nurses. Which of the following chart entries should the nurse include as an example of objective data?

Reduces medical errors is correct. The charge nurse should inform the staff that electronic documentation systems can help reduce medical errors. Makes client medical history more easily available is correct. The charge nurse should include that electronic records help to make client information readily available to health care professionals. Increases accuracy of coding procedures is correct. The charge nurse should inform the staff that electronic records can lead to more reliable coding and billing for client conditions.

A charge nurse is reviewing characteristics of electronic documentation with staff at a provider's office. Which of the following characteristics should the charge nurse plan to include? (Select all that apply.)

Poor air quality The nurse should identify that poor air quality is a physical determinant of health. Physical determinants of health are related to the client's physical environment. Other physical determinants of health can include leaky pipes, lead paint, housing that requires maintenance, and living in a confined area with multiple families.

A community health nurse is teaching a newly licensed nurse about social determinants of health. Which of the following should the newly licensed nurse identify as a physical determinant of health?

The facility has practices in place that lead to a healthy workplace environment is correct. Pathway to Excellence® recognized facilities are committed to providing a healthy, supportive environment for their staff. The facility emphasizes shared governance is correct. Shared governance is one strength of the Pathway to Excellence® Program. The facility emphasizes practices that positively affect a nurse's well-being is correct. Having structures in place that positively affect the nurse's well-being promotes a healthy workplace environment.

A graduate nurse notes that a hospital with Pathway to Excellence® recognition is hiring staff. Which of the following should the nurse expect from this facility? (Select all that apply.)

Respite care The nurse should recommend that the client's partner consider placing the client in respite care. Respite care is a benefit offered under hospice care that allows clients to receive up to 5 days of care. This can help provide client caregivers relief and rest from the duties of caring for their loved one.

A home health nurse is caring for a client who is receiving hospice care. The client's partner reports feeling overwhelmed from caring for the client. Which of the following types of facilities should the nurse recommend?

Charting by exception With charting by exception (CBE), health care professionals only chart unexpected findings. This can be done on a flowsheet or through narrative notes.

A newly licensed nurse is orienting to a facility's documentation system. The facility requires staff to only document variations from an expected set of findings when performing a physical assessment. The nurse should identify this system as which of the following documentation methods?

Initiatives to reduce health care disparities is correct. Initiatives to reduce health care disparities is a component of the Healthy People program. The overall goal of the program is to address the physical and social well-being of people.Activities to improve social determinants of health is correct. Activities to improve social determinants of health is a component of the Healthy People program. The overall goal of the program is to address the physical and social well-being of people. Improving access to health care is correct. Improving access to health care is a component of the Healthy People program. The overall goal of the program is to address the physical and social well-being of people.

A nurse at a community health center is providing an in-service for a group of residents about the Healthy People program. Which of the following information should the nurse include? (Select all that apply.)

email The nurse should inform the client that they will receive a Press Ganey survey via email following their office visit. The Press Ganey survey evaluates client satisfaction with health care delivery and is sent to all clients who receive care.

A nurse in a provider's office is speaking with a client about a Press Ganey survey. The nurse should inform the client that this survey will be conducted by which of the following methods?

Advanced practice registered nurse (APRN) is correct. An APRN is a primary care provider who can diagnose and treat clients, as well as write prescriptions. Some APRNs can work independently, while others must work under a physician's license depending on their state's scope of practice. Physician assistant (PA) is correct. PAs can treat, diagnose, and prescribe medication for clients. They work under the direction and supervision of a physician. Physician is correct. Many primary care providers are physicians. A physician diagnoses and treats illness, and can prescribe medication and therapies as needed.

A nurse in a provider's office is speaking with a client who needs a refill for a prescription that has expired. The nurse should identify that which of the following team members can assist the client with the refill? (Select all that apply.)

The admitting provider is correct. The nurse should identify that health care professionals who are directly involved in the client's care, such as admitting or consulting providers, are allowed access to the client's records.The charge nurse on the unit is correct. The nurse should identify that health care professionals who are directly involved in the client's care, such as those who supervise client care (charge nurse, nursing supervisor), are allowed access to the client's records. The client is correct. The nurse should recognize that the client has the right to view their own medical record at any time.

A nurse is caring for a client following a stroke. The nurse should recognize that which of the following individuals is allowed access to the client's medical record without obtaining special consent from the client first? (Select all that apply.)

Dietitian is correct. Dietitians assist clients with food choices, nutrition, and therapeutic diets related medical conditions. Physical therapist is correct. Physical therapists offer services to improve clients' movement and alleviate pain. This can include exercises, stretching, and joint manipulation to improve function and mobility and can be provided in the client's home. Occupational therapist is correct. Occupational therapists assist clients with their ADLs due to an illness, surgery or injury. ADLs can include bathing, dressing and eating.

A nurse is caring for a client who has Parkinson's disease and needs assistance with ADLs. Which of the following referrals should the nurse anticipate the provider to prescribe?

Economic stability Social determinants of health are economic and social conditions that affect health promotion and disease prevention. Economic stability is a social determinant of health that encompasses employment. Lack of employment can lead to food insecurity, housing instability, and poverty.

A nurse is caring for a client who reports that they have recently lost their job and do not have insurance coverage. Which of the following social determinants of health is challenging for this client?

Input from members of the client's interdisciplinary team is correct. The MDS assessment is an interdisciplinary document used by the Centers for Medicare & Medicaid Services (CMS) to determine reimbursement. It should include input from the client's interdisciplinary team members to ensure that the facility receives the correct payments. The client's cognitive status is correct. The MDS assessment is an interdisciplinary document used by the Centers for Medicare & Medicaid Services (CMS) to determine reimbursement. It should include the cognitive status of the client, the need for assistance with activities of daily living, and the number of treatments and therapies provided. Each physical therapy visit is correct. The MDS assessment is an interdisciplinary document used by the Centers for Medicare & Medicaid Services (CMS) to determine reimbursement. It should include the cognitive status of the client, the need for assistance with activities of daily living, and the number of treatments and therapies provided.The client's need for assistance with activities of daily living is correct. The MDS assessment should include information such as the cognitive status of the client, the need for assistance with activities of daily living, and the number of treatments and therapies provided.

A nurse is completing the Minimum Data Set (MDS) assessment for a resident in a skilled-nursing facility. Which of the following information should the nurse include in the assessment? (Select all that apply.)

Provide care for a client who has less than 6 months to live.

A nurse is discussing hospice care with a newly licensed nurse. Which of the following should the nurse identify as the goal of hospice care?

Facilities can establish their own rules for documentation methods. The nurse should inform the AP that each facility can establish rules for documentation and use of medical records.

A nurse is discussing legal regulations regarding medical records with a newly hired assistive personnel (AP). Which of the following information should the nurse include?

A problem-oriented medical record promotes information sharing among members of the interdisciplinary team. A problem-oriented medical record uses progress notes, which promotes information sharing among members of the interdisciplinary team.

A nurse is discussing problem-oriented medical records with a group of newly licensed nurses. Which of the following information should the nurse include?

Access to foods that support healthy eating patterns is correct. The nurse should identify that access to foods that support health eating patterns is a part of the neighborhood and built environment determinant category, which is one of the five social determinants of health according to Healthy People 2020. Crime and violence is correct. The nurse should identify that crime and violence are a part of the neighborhood and built environment determinant category, which is one of the five social determinants of health according to Healthy People 2020. Environmental conditions is correct. The nurse should identify environmental conditions are a part of the neighborhood and built environment determinant category, which is one of the five social determinants of health according to Healthy People 2020.

A nurse is discussing social determinants of health with a newly licensed nurse. The nurse should include that which of the following factors contribute to the neighborhood and built environment determinant category? (Select all that apply.)

The Institute of Medicine The nurse should identify that the Institute of Medicine is the agency that recommended nationwide use of EHRs in 1997. The recommendation was driven by the belief that it would increase safety in client health care.

A nurse is discussing the history of electronic health records (EHRs) during a staff in-service. The nurse should identify that which of the following agencies advocated for nationwide use of EHRs?

The "S" in SOAP The "S" in the acronym SOAP represents "subjective." This documentation entry by the nurse contains information from the client about their feelings of pain.

A nurse is documenting information in a client's chart and makes the entry "client reports abdominal pain on exertion." Which of the following documentation formats describes this entry?

Cooperation is correct. Cooperation is one of the five competencies identified by the IOM that health care professionals need in order to reduce errors. Communication is correct. Communication is one of the five competencies identified by the IOM that health care professionals need in order to reduce errors. Coordination is correct. Coordination is one of the five competencies identified by the IOM that health care professionals need in order to reduce errors.

A nurse is reviewing a report by the Institute of Medicine (IOM). Which of the following competencies should the nurse identify health care professionals need in order to reduce errors? (Select all that apply.)

MSO4 is correct. This abbreviation for morphine appears on The Joint Commission's Do Not Use list because it can be mistaken for magnesium sulfate. The medication should be written out as "morphine sulfate." IU is correct. This abbreviation for international units appears on The Joint Commission's Do Not Use list because it can be mistaken for IV or the number 10. The word "unit" should be written out in full. qhs is correct. This abbreviation for "every night" appears on The Joint Commission's Do Not Use list because it can be mistaken for qhr, or "every hour." The abbreviation should be written out as "nightly."

A nurse is reviewing documentation guidelines with a newly licensed nurse. Which of the following abbreviations should the nurse note as being on The Joint Commission's Do Not Use List? (Select all that apply.)

A nurse who delegates a task to an AP will review the charting for that task. Registered nurses (RNs) and licensed practical nurses (LPNs) have authority to delegate certain tasks in certain situations. Part of delegation includes following up to ensure that the task was documented correctly in the client's record.

A nurse is reviewing documentation principles with a group of newly hired assistive personnel (AP). Which of the following information should the nurse include?

"The client vomited 240 mL of clear emesis but denies pain or nausea." According to ANA standards, documentation should be factual and complete. Information charted here includes measurements, visual observations, and client data.

A nurse is reviewing the documentation of a newly licensed nurse. Which of the following entries should the nurse identify as meeting the American Nurses Association (ANA) standards for documentation?

The system alerts providers of possible actions that could cause client harm. Many electronic documentation systems contain clinical alerts, which can prompt providers regarding potential errors, such as a medication error or duplicate tests.

A nurse is taking an admission history from a client who is concerned about the facility using an electronic documentation system. Which of the following information should the nurse include as a benefit of electronic documentation?

"I will be able to track my health information." The nurse should recognize that one benefit of EHRs is that clients are able to access their health information from various encounters with health care providers.

A nurse is talking with a client about their electronic health record (EHR) at the facility. Which of the following client statements indicates an understanding of EHRs?

The HACRP links Medicare payments to health care quality. The HACRP reduces reimbursement to facilities that have poor outcomes related to five different hospital-acquired infections. Centers for Medicare & Medicaid Services will not reimburse the facility for the costs associated with treatment for the infection and the extended stay of the client. The HACRP was implemented to incentivize hospitals to provide high-quality care for their clients.

A nurse is teaching a class about the Hospital-Acquired Condition Reduction Program (HACRP). Which of the following information should the nurse include?

"I understand that services provided will include just what is needed to keep me comfortable."

A nurse is teaching a client about hospice care. Which of the following statements by the client indicates an understanding of the teaching?

Reimbursement amounts will be adjusted for clients who contract hospital-acquired conditions (HAC). To encourage hospitals to provide quality care to their clients, Medicare requires payment reduction to facilities that have poor outcomes related to hospital-acquired infections.

A nurse is teaching a newly licensed nurse about Medicare reimbursement. Which of the following should the nurse include in the teaching?

"I can take a telephone prescription if a provider is directing a code for an unresponsive client." Telephone prescriptions should be reserved for use only in emergency situations, because there is a risk for misunderstanding details about the prescription during verbal communication. An unresponsive client is an emergency, so it is appropriate for a nurse to receive a telephone prescription in this situation.

A staff nurse is evaluating a newly licensed nurse's understanding of telephone prescriptions. Which of the following statements by the newly licensed nurse indicates an understanding of the information?

put date and time on all enteries document objective data leaving out opinions

a charge nurse is reveiwing documentation with a group of newly licensed nurses. which of the following legal guidelines should be followed when documenting in a clients record

medication error needlesticks omission of prescription

a nurse is discussing occurences that require completion of an incident report with a newly licensed nurse. which of the following should the nurse include in the teaching

home health care rehabilitation facilities skilled nursing facilities

a nurse is discussion restorative care with a newly liscensed nurse. what examples should be included in teaching

ICU, oncology treatment center, burn center

a nurse is explaining various levels of hc services to a group of newly licensed nurses. which examples of care or care setting should the nurse classify as tertiary care?

bone scan scheduled for today

a nurse is preparing information for a change of shift report. which of the info should the nurse include in the report

repeat the details of the prescription back to the provider have another nurse listen to the telephone prescription obtain the providers signature on the prescription within 24 hrs

a nurse is recieving a providers perscription by telephone for morphine for a client who is reporting moderate to severe pain. which nursing action is appropriate

family members should provide a code prior to recieving client health info. Communication of client health info can occur at nurses station A client can request a copy of medical record A nurse can photocopy a clients medical record for transfer to another facility

a nurse manager is discussing HIPPA privacy rule with a group of newly hired nurses during orientation. which of the following info should the nurse manager include

medicare medicaid

nurse is explaining various types of healthcare coverage. which hc financing mechanism should nurse include as federally funded

collaborating with providers to perform obesity screening during routine office visits

nurse manager is developing strategies of care for clients with obesity. which action should nurse include as a primary health care strategy