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AMBULATORY CARE NURSING CERTIFICATION 240 QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES 2023/2024 GRADED A+
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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 Nursing diagnoses should never contain medical diagnoses. Rather, the nursing diagnosis is a statement of the patient's actual health status, risks for condition developing, causative and related factors, and signs and symptoms. 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
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 C - Zestril D - Adalat - ANSWER- A - Lanoxin (Digoxin) A digitalis medication is a cardiac glycoside that treats CHF and arrhythmias also for BP support. Bumex is a loop diuretic. Zestril is an ACE inhibitor. Adalat is a calcium blocking agent. Which of the following is not one of the steps in evidence-based practice? A - Constructing the clinical question B - Patient selection C - Appropriate selection of resources D - Appraise the validity of the evidence - ANSWER- B - Patient selection Patent selection is not one of the steps in evidence-based practice. The steps in evidence-based practice consist of 1 - Patient assessment 2 - Constructing the clinical question 3 - Appropriate selection of resources 4 - Appraise the validity of the evidence 5 - Apply the integrated patient preferences, evidence, and clinical expertise 6 - Performance evaluation with patience
What is true regarding the respiratory synctical virus (RSV) immune globin? A - This is indicated for children less than 2 years of age with chronic lung disease, and infants <32 weeks. B - Contraindications include a reaction to neomycin or streptomycin products. C - This is indicated for adults without a history of RSV. D - Palivizumab (Synagis) provides permanent immunity for high-risk infants. - ANSWER- A - This is indicated for children less than 2 years of age with chronic lung disease, and infants <32 weeks. Palivizumab (Synagis) provides temporary, passive immunity for high-risk infants, not adults. The polio vaccine (IPV) is contraindicated for those who have had a reaction to neomycin or streptomycin. A nurse finishes a follow up visit with one of her elderly patients and gives him the influenza vaccine before he leaves. This is an example of what type of prevention? A - primary B - secondary C - tertiary D - annual - ANSWER- A - primary Primary prevention, such as an immunization, aims to prevent health problems before they start. Secondary prevention promotes early detection and treatments of diseases. Tertiary prevention is designed to help a patient cope with a current problem or prevent relapse. "Annual" is not a type of prevention. For successful communication, the major criteria would include? A - Forcefulness B - Flexibility C - Evaluation D - Developmental - ANSWER- B - Flexibility
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
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 - Treating a patient with an open wound. - ANSWER- C - Treating a patient who is suspected of having avian flu. Treating a patient who is suspected of having avian flu CDC guidelines recommend full barrier precautions for all known and suspected cases of avian flu, due to the high degree of transmission of the disease. Full barrier precautions are
also used in treating patients with known or suspected cases of SARS and pandemic influenza, as well as hemorrhagic diseases would be considered the nurse's competency that results from training. A - Education B - Language C - Culture D - Proficiency - ANSWER- D - Proficiency 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 Which of the following is NOT a nonmedical expense? A - Linen. B - Uniform. C - Office supplies. D - Hypodermics. - ANSWER- D - Hypodermics.
A - irritant contact dermatitis B - cellulitis C - allergic purpura D - psoriasis - ANSWER- A - irritant contact dermatitis Irritant contact dermatitis is a type of rash that is caused by exposure to external irritants such as cosmetics, plants, or even fabrics, and is usually diagnosed when known allergies are not present. Patients can often experience this type of dermatitis when trying new cosmetics and laundry soaps and the problem will often be resolved once the use of this product is discontinued. How far out do most health care facilities' capital budgets plan? A - 5-10 years. B - Less than 1 year. C - 20 years. 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 B - Negotiation C - Networking 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? 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
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 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 B - peanut C - orange 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? A - congestive heart failure B - benign heart murmur C - pericarditis D - pneumothorax - ANSWER- C - pericarditis. Patients with pericarditis will often have a scratching or creaking sound. This is known as a pericardial friction rub and results from inflammation of the pericardium. The 5 M's of categorizing information (according to the Failure Mode and Effect Analysis) would include all but which of the following? A - Materials B - Maneuvering C - Methods D - Machines - ANSWER- B = Maneuvering The 5 M's of categorizing information (according to the Failure Mode and Effect Analysis) would include: Machines, Management, Manpower, Materials, Methods
The development of trust in negotiations would include: Maintain and share notes. Observe for behavior reflecting dishonesty. Research and prepare beforehand. Develop plans. Demonstrate respect Which of the following is NOT one of the key questions of the Ask Me 3 Model? A - What is my main problem? B - What is the mortality rate for my problem? C - What do I need to do? D - Why is it important for me to do this? - ANSWER- B - What is the mortality rate for my problem? The Ask Me 3 model provides three questions that patients should be able to answer at the end of a health care visit. The mortality rate of a given health problem may be a concern, but this model is more centered on ensuring patient understanding of the condition and the necessary next steps. 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. Everything needs to be clearly labeled when sterilizing equipment. Solutions needs to be labeled with their names, the date they are made, and their expiration date. 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. 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.