AMBULATORY CARE NURSE CERTIFICATION EXAM (ANCC) NEW TRIAL EXAM QUESTIONS AND ANSWERS 100 P | Exams Nursing | Docsity (2024)

Download AMBULATORY CARE NURSE CERTIFICATION EXAM (ANCC) NEW TRIAL EXAM QUESTIONS AND ANSWERS 100 P and more Exams Nursing in PDF only on Docsity! AMBULATORY CARE NURSE CERTIFICATION EXAM (ANCC) NEW TRIAL EXAM QUESTIONS AND ANSWERS 100% PASSED SOLUTION 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 - ANS 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 - ANS 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? - ANS 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 - ANS 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 Leve l B. Glucometer blood glucose testing C. Hemoglobin A1C D. Creatinine Levels - ANS 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 - ANS 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 - ANS 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. - ANS 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 - ANS 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 has dressed his/her own wound in the past - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS B. Take vital signs and obtain ECG Which of the following is used to determine the type and the numbers of staff needed in an ambulatory clinic? A. Only the volume of client B. Nurses; years of experience C. Nurses college degree D. The complexity and the number of clients - ANS D. The complexity and the number of clients Which action by the ambulatory care nurse indicates that he/she is compliant with the client self-determination Act? A. Asking the client if they have a Advanced Directives B. Completing a head to toe assessment C. Reviewing the clients care plan D. Complying with the client's right to refuse medication - ANS A. Asking the client if they have a Advanced Directives Which of the following medications does the ambulatory care nurse anticipate the MD will prescribe for a client with chronic Asthma for long-term treatment A. Fluticasone (Flovent) B. Albuterol ( Ventolin) C. Ipratropium (Atrovent) D. Levalbuterol (Xopenex) - ANS A. Fluticasone (Flovent) The Ambulatory care nurse asses a client with Shortness of breath, lack of energy, and dry mouth. Which of the following disease should the ambulatory care nurse suspect? A. COPD B. Congestive Heart Failure C. Asthma D. Respiratory Failure - ANS A COPD The parent of an eight year old child reports that the child cannot efficiently use the metered dose inhaler. Which of the following actions should the nurse take? 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 - ANS 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 - ANS B. Characteristics PICO (T) Format - ANS 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 - ANS 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. - ANS C. Bilirubin B. Warning patients in advanced that these problems may occur C. Providing patents with complaint forms D. Establishing protocols for dealing with complaints - ANS D. Establishing protocols for dealing with complaints 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 B. Remind the patient of the right to refuse test C. Tell the patient not to worry because most test are negative D. Discuss the implications of the test with the patient first. - ANS D. Discuss the implications of the test with the patient first. According to the CDCs infection prevention and control assessment tool for outpatient settings, the organization's written infection prevention policies and procedures should be reassessed at least every: A. month B. 6 months C. 12 months 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS D. Establish a staff training program 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 - ANS 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 - ANS 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 12.5 B. Less than 4 or greater than 10.5 C. Between 6 and 12 D. Greater than 12.5 - ANS A. Less than 2 or greater than 12.5 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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% - ANS 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 - ANS B. Secondary Primary prevention examples - ANS - Discuss a low-fat diet and the need for regular physical exercise with clients. 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS D. Assess the patients and/or caregiver health literacy If a patient with severe joint pain and swelling has been diagnosed w/ Rheumatoid Arthritis and has failed to follow through with referral to a rheumatologist, the ambulatory care nurse should: A. Take no action, this is the patients choice B. Explain how the treatment can help prevent further deterioration and relive pain C. Advise the patient that he or she is exercising bad judgement D. Remind the patient that RA an cause severe damage - ANS B. Explain how the treatment can help prevent further deterioration and relive pain If a patient asks, "Should I continue w/ chemotherapy or stop?" and the nurse responds with "How do you feel about stopping chemotherapy?" this is an example of: A. Redirection B. Diversion C. Reflection D. Restatement - ANS C. Reflection When entering the examining room of a patient who is deaf and facing away from the door, the ambulatory care nurse should A. Approach from the direction the patient is facing B. Say the patients name C. Approach and touch the patient D. Clap hands or tap your foot. - ANS D. Clap hands or tap your foot. (Sensitive to vibrations) if a patient with severe dysarthria because of MS but with good cognition is admitted to B. Tobramycin, Intal, Albuterol C. Albuterol, Flovent, Tobramycin D. Intal, Tobramycin, Albuterol - ANS C. Albuterol, Flovent, Tobramycin (bronchodilator first to open, Corticosteroid to reduce inflammation, ABX last to make sure more can be absorbed) Telephone triage may be a responsibility of the ambulatory care nurse. What are the appropriate components of telephone triage? A. The nurse should state that he or she is unable to discuss medical information and refer the patient to the PCP B. The nurse must clearly identify him or herself, take a quick and accurate history and quickly be able to make a decision C. The nurse should call 911 D. The nurse should give generic information and leave the responsibility to the patient or caller - ANS B. The nurse must clearly identify him or herself, take a quick and accurate history and quickly be able to make a decision What are the best question types to ask when gaining inforation from a patient? A. Specific, open ended questions regarding current symptoms and medical history B. General questions with a yes or no answer C. Questions related to childhood diseases D. Demographics questions - ANS A. Specific, open ended questions regarding current symptoms and medical history IN what order would the nurse prioritize the care of the following patients presenting to the clinic at the same times: A parent carrying a smiling infant with a fever, a pale and sweaty male wit flank pain for 2 days, a carpenter with a nail in his thumb, and a 3 year old with vomiting A. Flank pain, Infant with fever, 3 year old vomiting, man with nail B. Flank pain, 3 year old vomiting, infant with fever, man with nail C. 3 year old vomiting, infant with fever, flank pain, man with nail D. 3 year old with vomiting, flank pain, man with nail, and infant with fever - ANS B. Flank pain, 3 year old vomiting, infant with fever, man with nail Mom has described her childs symptoms as fever for 3 days, and vomiting for the last 24 hours. She states the child has been very sleepy for the last 2-3 hours. What subtle symptom alerts the nurse that this child needs to be seen as soon as possible A. 3 days of fever B. 3 days of fever , 1 day of vomiting C. 1 day of vomiting D. very sleepy for 2-3 hours with fever for 3 days. - ANS D. very sleepy for 2-3 hours with fever for 3 days. The ambulatory care nurse takes a phone call from the daughter of a 60 year old man stating that he isn't himself today. When questioned further the nurse discovers that the man has had periods of slurred speech for a few minutes on 2 occasions in the last 24 hours. What is your recommendation for this caller regarding what should be done. A. You understand that slurred speech may be the result of too much alcohol or lack of sleep and you encourage her to call back again if it occur B. You advise her to come to the clinic in the next 24-48 hours for some blood work C. You advise her that slurred speech may b a symptoms of TIA or impending stroke, especially in relation to him not being himself and to go to nearest ER D. You tell her you will call her ack when you can contact the MD for advise. - ANS C. You advise her that slurred speech may b a symptoms of TIA or impending stroke, especially in relation to him not being himself and to go to nearest ER A 70 year old female presents to the ambulatory care clinic complaining of fatigue. You begin you triage assessment and he has a HR of 50, Respiratory rate of 24, and BP 70/40. She denies Chest pain but you notice she rubs her elbows and states her arthritis is acting up. What would be your first priority when caring for this patient A. Offer her Tylenol and send her to the waiting room B. offer her Motrin for pain C. Continue her triage and history and finish the paperwork D. place her in a room, do an EKG and notify the MD to see her first - ANS D. place her in a room, do an EKG and notify the MD to see her first A mother presents to the clinic with a very wheezy 3 year old in her arms. You notice the child is pale and listless. What is your immediate response A. Triage the infant before the other patients waiting B. Bring the child to an exam room and wait for MD C. Bring the child to an exam room to finish triage in the privacy of a room D. Bring the child to a room, Get the MD, and prepare to give Nebulizer treatment and possible transfer to acute facility - ANS D. Bring the child to a room, Get the MD, and prepare to give Nebulizer treatment and possible transfer to acute facility What nonverbal clues would indicate that a patient of any age is having difficulty breathing A. Change in color, retractions and noisy breathing B. laughing and joking during triage assessment C. Slight wheezing when lifting heavy objects D. Sweating in a warm room with exertion - ANS A. Change in color, retractions and noisy breathing What would be the most appropriate order of importance for information an adult client shares when coming to a clinic visit. A. Past medical, past surgical, medications, allergies and insurance information B. Current complaints, past 24-48 ours leading to complaint, meds, allergies and past medical history C. Current meds, allergies, past medical and past surgical D. Current demographics, current insurance, complaint, medical history and surgical history - ANS B. Current complaints, past 24-48 ours leading to complaint, meds, allergies and past medical history A 50 year old male comes to the clinic stating he cannot shake this "flu" you observe that he is clammy, pale and has an irregular HR. He is a large man with rugged appearance. He is friendly and apologetic for bothering you with his silly complaints. What is your plan of care for this patient A. You suspect he ahs a low tolerance for being ill and offer him Tylenol while he waits to see the MD B. You suspect he has the newest flu going around and offer him hot tea while he waits to see the MD C. You suspect there is more to his complaint than he states and immediately begin a cardiac workup by placing him in a room and ordering EKG D. You finish the triage and send him to the waiting room understanding - ANS C. You suspect there is more to his complaint than he states and immediately begin a cardiac workup by placing him in a room and ordering EKG The ambulatory care setting must include which of the following for the nurse to be able to properly triage a patient. A. Television B. Vending machines C. Private room for triage D. Computer - ANS D. Computer The nurse working in the ambulatory care setting must have which of the following skills to perform the role of triage nurse A Assessment and typing skills B. Assessment and communication skills C. A competitive drive D. The desire to help others - ANS B. Assessment and communication skills The triage nurse is responsible for screening, assessment and the initial patient contact in the ambulatory care setting. It is important to look for verbal and nonverbal cues when doing a triage assessment. What important information should the triage nurse screen for with every patient during every visit regardless of complaint A. Marital status B. Signs of Abuse C. Financial Status C. signed release of information D. no need for anything but a phone call from the facility - ANS B. fax cover sheet and signed release of information Which of the following influence how nurses practice? A. Suggestions from other colleagues B. Clinical Pathways C. Evidence-based practice D. Organization policy - ANS C. Evidence-based practice What database should the ambulatory clinic nurse use when searching for nursing articles A. Medscape B. Webmd C. Google Chrome D. CINHAHL - ANS D. CINHAHL The ambulatory care nurse is developing a care plan for a client. The client is at risk for ineffective breathing related to COPD, where on the care plan should the nurse put this information A. Under nursing DX B. Under the goal C. Under intervention D. Under evaluation - ANS A. Under nursing DX Which of the following is the cause of Type I DM A. Insulin Resistance B. Glucose Intolerance w/first trimester C. Alpha cell destruction D. Beta Cell Destruction - ANS D. Beta Cell Destruction Which of the following indicates that the client is adhering to plan of care A. Hemoglobin A1C B. Polyuria C. Polydipsia D. Increased Ketone Levels - ANS A. Hemoglobin A1C A client with a post op hip replacement has the following information on the care plan: Client will achieve a decrease in pain to a level 3 by discharge. Where on the care plan should the nurse put this information A. Under Nursing DX B. Under goal Section C. Under intervention/implementation D. Under evaluation - ANS B. Under goal Section Which of the following is an early sign of compartment syndrome A. Increased Pain B. No Pulse C. Muscle Weakness D. Swelling of the Extremities - ANS A. Increased Pain The client with a cough and fever is coming in the ambulatory care clinic for care. Which information should the nurse give the receptionist prior to the clients arrival A. Give the client a mask as soon as the client arrives B. Give everyone in the clinic a ask before the client arrives C. Cancel the appointment and tell the client to reschedule D. Place the client in close proximity to the other clients for comfort - ANS A. Give the client a mask as soon as the client arrives The ambulatory care nurse is conducting the medication reconciliation for a client who was recently prescribed warfarin. What medication should the nurse tell the client to discontinue A. Iron Supplements B. Vitamin D C. Metoprolol D. Gingko Biloba - ANS D. Gingko Biloba Which of the following statements made by the client about primary care prevention of Type I DM is correct A. If I take metformin as ordered I will be ok B. The only thing I need to do is to lower my calories C. If I increase my physical activities I will reduce my chance of having Type I DM D. There are no interventions that can prevent Type I DM - ANS D. There are no interventions that can prevent Type I DM Which of the following should the ambulatory care nurse teach a client with Type II DM A. Soak foot in hot water B. Wear slippers or shoes both indoor and outdoor C. Decrease physical Activity D. Examine feet monthly - ANS B. Wear slippers or shoes both indoor and outdoor A client who enrolled in a research study informs the ambulatory clinic nurse that he/she no longer wants to be part of the study. What actions should the nurse take A. Enquire about the reason for withdrawal B. Educate the client on the importance of the study C. Inform the research team of the clients withdrawal D. increase the incentive for participating in the study - ANS C. Inform the research team of the clients withdrawal If a patient plans to travel overseas to an area where "Travelers diarrhea" is common and plan to take bismuth Subsalicylate (pepto-Bismol) as prophylaxes, the patient should be warned that it may A. Alter Intestinal Flora B. Turn Stools Black C. Cause intestinal Bleeding D. Cause severe constipation - ANS B. Turns Stool black The plaque formation that is found with coronary artery disease results from accumulation of : A. LDL Particles B. HDL particles C. Triglycerides D. Amino Acids - ANS A. LDL Particles If a patient is scheduled for a right breast biopsy, but no site markings are visible when the patient is draped, the ambulatory care nurse should A. Assume the surgeon knows the correct site B. Stop the procedure until correct site is confirmed C. Make a note to remind staff to mark surgical sites D. Ask surgeon if the side is correct - ANS B. Stop the procedure until correct site is confirmed When reviewing data as part of process improvement, the ambulatory care nurse notes an improvement in patient satisfaction from 78-92% after the addition of a new staff, this change is probably a A. Random Event B. Common cause Variation C. Special Cause Variation D Statistical Aberration - ANS C. Special Cause Variation When assessing key performance measures as part of the ambulatory care process improvement assessment, which of the following relates to access of care A. FTE support staff per MD B. Rejection/Denial rate of insurance C. Immunization rates D. Average telephone wait time - ANS D. Average telephone wait time Which of the following is a nonverbal clue that a patient may be anxious