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Ambulatory Care Nurse Certification
Exam (ANCC)
Q&A 2023
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 - Correct Answer-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 - Correct Answer-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? - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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. - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 B. My ears are ringing
A. Respect B. Justice C. Beneficence D. Non maleficence - Correct Answer- 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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 D. Document the occurrence of the fall in the organization's incident reporting system - Correct Answer-D. Document the occurrence of the fall in the organization's incident reporting system Which of the following actions should the ambulatory care nurse implement for a client who presents tot he clinic with chest pain? A. Refer the client immediately to the ER B. Take vital signs and obtain ECG C. Take detailed history D. Call the EMS for transport - Correct Answer-B. Take vital signs and obtain ECG
PICO (T) Format - Correct Answer-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 - Correct Answer-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. - Correct Answer-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. - Correct Answer-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 - Correct Answer-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 - Correct Answer-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. - Correct Answer-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. - Correct Answer- 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? - Correct Answer-B. What are your health goals? The ambulatory care nurse is caring for an elderly client. The nurse caring for the client should know what about elder abuse? A. All victims of elder abuse are victims of poly-victimization B More than 3 in 5 victims are men and 75 years or older C. Elder abuse can be the result of intentional or unintentional neglect D. elder abuse is not an issue, the nurse should not be concerned about. - Correct Answer-C. Elder abuse can be the result of intentional or unintentional neglect The ambulatory care nurse is caring for a 30 year old married woman in the clinic who was accompanied by her husband. Upon assessment, the nurse noted bruises on the clients arm. What action should the nurse take? A. Conduct further assessment without the clients husband in the room. B. Ask both the husband and the client what happened C. Call 911 D. Inform the client to leave her husband for safety - Correct Answer-A. Conduct further assessment without the clients husband in the room. When coding for visits of new patients, the key component that must be included to document the correct level of evaluation and management (E/M) are: A. History, physical and medical decision making B. Physical exam and medical decision making
B. Outline disciplinary actions for failure to change C. Outline the desired change D. Model the desired change - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 C. Irrigate the wound with - ml of hydrogen peroxide D. Soak the foot in povidone-iodine/NS (50/50) solution - Correct Answer-D. Soak the foot in povidone-iodine/NS (50/50) solution If one of the patients nursing diagnosis on the care plan is "Self care deficit" which of the following is an appropriate desired outcome? A. The patient will achieve maximal physical activity B. The patient will perform self care within physical limitations and activity restrictions C. The patient exhibit increased ability to engage in activities D. The patient will need no assistance with persona care - Correct Answer-B. The patient will perform self care within physical limitations and activity restrictions If the ambulatory care nurse is interviewing an adolescent patient with autism spectrum disorder and the patient states at the wall and repeatedly states, "You don't want to be here," this likely means that the patient: A. Senses the nurse doesn't want to be there B. Wants the nurse to leave C. Doesn't want to be there D. Is just repeating a random phrase - Correct Answer-C. Doesn't want to be there An ambulatory surgery center that has received accreditation and deemed status from the Joint Commission: A. Does not need to undergo the CMS certification process B. Must still undergo the CMS certification process C. Must undergo an abbreviated CMS certification process D. Can opt to pay a fee rather than undergo CMS certification - Correct Answer-A. Does not need to undergo the CMS certification process If the Ambulatory nurse is carrying out a point of care rapid HIV test on a patient, the nurse should: A. Advise the patient that the test is simply routine
C. BP Cuff D. Bedpan - Correct Answer-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. - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-A. Return to plan step Plan Do Study Act (PDSA) method of continuous quality improvement study - Correct Answer-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 If a patient is scheduled for a routine serum creatinine to evaluate renal function, the patient should be advised to prepare for this test by: A. Carrying out routine activities B. Fasting for 12 hours C. Avoid Strenuous exercise D. Avoid eating meat products for two days - Correct Answer-C. Avoid Strenuous exercise The ambulatory care nurse is reviewing a patient's history to determine if the patient is a candidate for an intrauterine device (IUD). Contraindications for an IUD include: A. Menorrhagia B. History of pelvic inflammatory disease 3 years previously C. History of renal Cancer D. History of ectopic pregnancy - Correct Answer-D. History of ectopic pregnancy The purpose of an Advanced Beneficiary Notice is to: A. Identify beneficiaries of a wall B. inform Medicare Patients of non coverage C. Inform patients of Medicaid eligibility D. Inform patients of insurance coverage - Correct Answer-B. inform Medicare Patients of non coverage Which of the following are excluded from the Nurse Licensure compact A. RNs B. LVNs C. LPNs D. APRNs - Correct Answer-D. APRNs (They must get a license in each state they plan to work in) When setting up a dashboard to show progress towards meeting goals, the first consideration when determining which information to include should be: A. Relevance to goals B. Method of Display C. Frequency of needed updates D. Ease of gathering data - Correct Answer-A. Relevance to goals The first step in development of a safety and health program to meet OSHA's guidelines is to: A. Takes steps to reduce hazards B. Establish a medical management program C. Conduct a workplace analysis D. Establish a staff training program - Correct Answer-D. Establish a staff training program
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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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% - Correct Answer-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 - Correct Answer-B. Secondary Primary prevention examples - Correct Answer-- Discuss a low-fat diet and the need for regular physical exercise with clients.
- when a nurse provides health education and training for daycare workers about issues of health and hygiene, such as proper hand hygiene, diapering, and food preparation and storage
- Immunizations, importance of wearing seatbelts, taking folic acid supplementation at preconception to prevent neural tube defects, fluoridation of water supplies to prevent dental caries, and actions taken to reduce human exposure to agents that may cause cancer
- Implement a community level program like walking for exercise to assist citizens in improving health behaviors related to lifestyle.
- Use the Code of Ethics for Nurses to guide your nursing practice
- Use the information exchange process to increase the client's understanding of how to use the health care system and the health promotion strategies that will maintain health.
- Complete a family genogram and assess health risks with the family to contract for family health activities to prevent diseases from developing Secondary prevention examples - Correct Answer-- Implement blood pressure and cholesterol screening; give a treadmill stress test.
- Health screenings
- teach an asthmatic client to recognize and avoid exposure to asthma triggers and assist the family to implement specific protection strategies such as replacing carpets, keeping air systems clean and free of mold, staying inside when the pollution level is high, and avoiding pets.
- mammography to detect breast cancer, Papanicolaou (Pap) smears to detect cervical cancer, colonoscopy for early detection of colon cancer, prenatal screening of pregnant women to screen for gestational diabetes
- Provide mental health interventions after stressful events.
- The public health nurse provides toxin screenings for migrant workers who may be exposed to pesticides.
- Implement a family-planning program to prevent unintended pregnancies for young couples who attend the local community health center.
- Encourage clients who are pregnant to participate in prenatal care and Special Supplemental Nutrition Program for Women, Infants and Children to increase the number of healthy babies and reduce the costs related to preterm baby care.
- Use case finding to identify existing health problems in your caseload and the population served by your agency. Timely, holistic assessments and interventions can slow disease trajectories and promote healing and health.
- Assess disaster victims and triage for care.
- Investigate an outbreak of flulike illness in a local school.
- Provide programs in child development and behavior management for families who have not yet abused their children but whose children are brought to the attention of social authorities for aggressive behavior problems.
- Develop a way for homeless individuals to read their TB skin test, if necessary, and to transfer the results back to the facility at which the skin test was administered.
- To prevent the spread of disease
- Notify partners and trace contacts (HIV) tertiary prevention examples - Correct Answer-1. Prevent pressure ulcers after SCI
- Promote independence after TBI
- Referral to support groups
- Rehab The three primary elements of motivational interviewing are: A. Collaboration, Evocation, and autonomy
B. Changes in Activity C. Diabetic ketoacidosis D. HTN - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 - Correct Answer-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 D. Consult a plastic surgeon for repair - Correct Answer-B. Wait for the results of the tissue analysis Which of the following conditions of the breast may pose the greatest risk for the development of breast cancer A. Lipoma B. Cyst C. Epithelial related calcifications D. Atypical ductal hyperplasia - Correct Answer-D. Atypical ductal hyperplasia As part of the hazard vulnerability assessment, the family practice clinic has noted a number of areas (earthquake, fire, infant abduction and bomb threats) in which their risk is moderate to high. The next step is to A. Identify cost related to decreasing risk
B. Increase staff education regarding risk C. Assess preparedness for each risk element D. Hire a consultant to advise clinic on reducing risk - Correct Answer-C. Assess preparedness for each risk element The ambulatory care nurse is educating a patient one-on-one to manage clean intermittent catheterization (CIC) independently. The best method to assess the effectiveness of teaching i to ask the patient to A. Describe the procedures involved B. Take a quiz about the procedure C. Do a return demonstration D. Keep a log of CICs and problems involved - Correct Answer-C. Do a return demonstration In written materials for patients, which of the following sentences is likely to be the most easily understood by the general public A. A low sodium diet is recommended for cardiovascular disease B. High blood pressure can lead to a stroke C. People who smoke cigarettes' are prone to pulmonary disease D. Remain NPO for 6 hours prior to the procedure - Correct Answer-B. High blood pressure can lead to a stroke When a patient is angry and aggressive but not yet violent, the first method to use in changing the behavior is to A. Ignore B. Redirect C. Reward D. Interrupt - Correct Answer-D. Interrupt The ambulatory care nurse wants to participate in outreach to a largely Spanish speaking population of Mexican immigrants by setting up booths in the community to screen for High blood pressure and Diabetes. The best places to set up booths are probably: A. Parks and recreation areas B. Churches and shopping areas C. Hospitals and clinics D. police departments and social services offices - Correct Answer-B. Churches and shopping areas When orienting a patient and/or caregiver to the healthcare delivery system, the first step is to: A. Explain the structure of the healthcare delivery system B. Provide literature regarding the healthcare delivery system C. Ask what the patient and/or caregiver wants to know D. Assess the patients and/or caregiver health literacy - Correct Answer-D. Assess the patients and/or caregiver health literacy
