policy Flashcards
(137 cards)
1
Q
What are the two main goals of HP 2020?
A
Increase quality and years of healthy life
eliminate health disparities
2
Q
Test that measures a patient’s risk of falling
A
Get-up and Go Test
3
Q
pain assessment tool for non-communicating patients
A
Critical Care Pain Observation Tool
CPOT
4
Q
What are the 5 behaviors that are assessed in the Pain assessment in advanced dementia scale?
A
breathing negative vocalization facial expression body language consolability
5
Q
Type of Advance Directive that may or may not include a living will
A
Healthcare Directive
6
Q
What assessment tool identifies if a complete assessment for anxiety is needed
A
Generalized Anxiety Disorder 7
7
Q
In case of emergency call?
A
security
8
Q
What are nursing informatics roles
A
Practice
Education
Government
Industry
9
Q
Scale that assess the severity of pain and impact of daily functions
A
Brief Pain Inventory
10
Q
What supersedes the right to confidentiality
A
duty to warn
11
Q
Equipment and supplies ordered by a healthcare provider for everyday or extended use
A
Durable Medical Equipment
12
Q
What is the life expectancy of DME
A
at least 3 years
13
Q
What are the principles of Benchmarking
A
Maintaining quality
Improving customer satisfaction
improving patient safety
continuous improvement
15
Q
When initiating change, where do you begin?
A
most local, move upward and outward.
hospital, community, region, state and then national
16
Q
What is the key to therapeutic communication
A
LISTEN MORE THAN YOU TALK
17
Q
Examples of HIPAA protected information
A
written medical record
conversations about treatment
patient billing information
18
Q
What assessment tool identifies the need for further assessment for alcohol or drug screening
A
CAGE-AID
19
Q
Assessment tool for dementia and delirium
A
Mini-mental state exam
20
Q
What are examples of meaningful use in electronic medical records
A
improved quality, reduced disparities, engage patients, improve care coordination, maintain privacy
22
Q
What are methods or establishing rapport and therapeutic relationships with patients?
A
non-judgmental approach
mutual trust
professional boundaries
confidentiality
23
Q
A written statement of a patient’s intent regarding medical treatment
A
Advance Directive
Self Determination Act 1990
24
Q
What is the strongest method to evaluate teaching
A
return demonstration
25
Q
What is the initiative that provides future nurses with the knowledge, skills and attitude to ensure continuous improvement in quality
A
QSEN
Quality and Safety Education for Nurses Initiative
26
Q
Who are the covered entities that are required to follow HIPAA
A
Health plans
Health care providers
Healthcare clearinghouses
27
Who makes patient safety goals
Joint Commission
28
What acts must be reported
criminal acts
acts with dangerous weapon
suspected or actual child abuse
suspected or actual elder abuse
29
What assessment tool screens for behavioral health symptoms
Patient Stress Questionairre
30
Peer review is required for?
Magnet recognition
30
What are examples of those not required to follow HIPAA
life insurers
employers
workers comp
state agencies
33
Supplemental insurance that covers physician services, outpatient hospital services, labs and diagnostic procedures
Medicare B
34
A limited exam of the affected body area or organ system
expanded problem focused
35
What complementary medicine (alternative medicine) can aid with coordination in Parkinsons?
Tai Chi
36
Who enforces HIPAA
The Office for Civil Rights
37
What is the comparison and measurement of healthcare organization's services against other national healthcare organizations
Benchmarking
38
scale that assess the conscious state of a patient
Ramsay Sedation Scale
38
Who do you work for?
the patient
39
Used to assess the progression of illness, need for care and effectiveness of rehab/treatment
Katz Index of ADL
40
10 point Scale that assess the levels of anxiety, Agitation and sedation
Richmond Agitation Sedation Scale
41
What is the most common screening tool for depression
PHQ9
| Patient Health Questionairre 9
42
Provides limited prescription drug coverage
Medicare D
43
HIPAA title 2 covers who
confidentiality provisions- sets national standards for the security of electronic protected health information
44
In acute grief or crisis offer?
self...and acknowledge feelings
45
CAGE
Cut down drinking
Annoyed by people
Guilt about drinking
Eye opener
46
an extended exam of the affected body area or organ system and other symptomatic areas
detailed
47
HIPAA Title 1 covers who
The patient. This is COBRA
| Comprehensive Omnibus Reconciliation Act
49
Act that establishes a voluntary reporting system to enhance the data available to asses and resolve patient safety and health care quality issues
The Patient Safety and Quality Improvement Act
| provides confidentiality
50
A written compilation of statements in a document that specifies which life prolonging measures? Often grants durable power of attorney to a significant other with incapacaitation
Living Will
51
Do you delay discharge for routine exams?
no, refer to their primary provider
52
What are the three principles of instruction
Mentoring, role modeling and counseling
52
What diagnoses must be reported in most states?
```
Gonorrhea
Chlamydia
Syphilis
HIV
TB
```
53
What is the most powerful data collected?
Subjective data from the patient
54
Type of Medicare that covers inpatient
Medicare A
56
What is the process by which registered nurses systematically access, monitor and make judgment about the quality of nursing care by peers?
Peer review
57
A general multi-system exam or a complete exam of a new patient
comprehensive
58
What is the AGACNP's role in tests and procedures?
facilitate the scheduling
educate the patient
perform or assist with the procedure
assess the patient for adverse reactions
59
Does Medicare cover hearing aids?
no
59
What are the goals of technology in nursing?
capture the tasks performed
enhance scope of practice
make practice knowledge driven
59
Who sets the standards for reimbursement and cutting costs
Medicare
61
A limited exam of the affected body part
problem focused
61
Medicare that reimburses 85% of physician for services provided with collaboration of physician
Medicare B
62
When treating patients, what first?
medical conditions before psychosocial
63
What promotes self-regulation in practice
peer review
64
What does drawing a clock assess
cognitive impairment
64
Assess for depression in the geriatric
Geriatric depression scale
65
The legal responsibility the NP has for actions that fail to meet the standard of care
liability
66
failure of an individual to do what a reasonable person would do- resulting in injury
negligence
67
failure of an individual to render services with the degree of care, diligence and precaution
malpractice
68
fear of harm
assault
69
actual harm
battery
70
communication that causes damaged reputation
defamation
71
defamation by written material
libel
72
defamation by speech
slander
73
true positives; the degree to which those who have a disease screen or test positive
sensitivity
74
true negatives; the degree to which those who have a disease or test negative
specificity
75
The frequency with which a disease appears in a population
incidence
76
The proportion of a population that is affected by a disease
prevalence
77
level of prevention that promotes health
primary
78
level of prevention that focuses on the early identification
secondary
79
level of health that includes rehabilitation and restoration of health
tertiary
80
This contributes to the elimination of racial and ethnic health disparities and to improve the health of all Americans
Culturally and Linguistically Appropriate Services
| CLAS
81
HC organizations must offer language assistance services
Standard 5
82
HC organizations must provide notices in preferred language
Standard 6
83
HC organizations must assure competence of language- not using family/friends to translate
Standard 7
84
Services that do not meet Medicare's definition of physician services
regular physical exam
health maintenance screenings
counseling for well patients
85
In the OFFICE setting, services billed under the physicians provider number to get the full physician fee
Incident to billing- not allowed in the inpatient setting
86
This is federally funded and benefits vary from state to state
Medicaid
87
QA, QI and CPI all do what?
monitoring, evaluating and continuous review for the improvement of quality in health care
88
This is a tool for identifying prevention strategies to ensure safety- moves beyond the culture of blame
Root Cause Analysis
89
Who determines the scope of practice?
The individual state nurse practice act
90
Who identifies the standards of advanced practice
the American Nurses Association
91
Who dictates the level of prescriptive authority
the state
92
This ensures the required level of education, licensure and certification
credentials
93
This means you are qualified
licensure
94
This means you have a mastery of knowledge
certification
95
in 1983 the JC did what?
allowed non-physicians to admit to the hospital
96
Who sets forth privileges?
the hospital credentialing committee
97
The likelihood that an intervention will benefit the patient is extremely poor
quantitative futility
98
The quality of the benefit of an intervention to the patient is poor
qualitative futility
99
This implies that the patient is able to understand, reason, differentiate good and bad and communicate
competence
100
Do no harm
nonmaleficence
101
The duty to prevent harm and promote good
beneficence
102
the duty to be fair
justice
103
the duty to be faithful
fidelity
104
The duty to be truthful
veracity
105
the duty to respect an individuals thoughts and actions
autonomy
106
the right act is the one that produces the greatest good to the greatest number
utilitarianism
107
What are the steps in discharging a patient from a practice
1. certified letter
| 2. provide coverage for first 15-30 days post termination
108
What are the obligations in closing a practice?
1. give the patient time to find another provider
2. keep files for a min of 5 years
3. provide timely notification and names of other providers for future care
109
When was the NP role developed
the early 1960s
110
What was the first NP program
pediatric NP
111
What expanded the role of the NP
managed care
decrease in medical residency programs
hospital reconstruction
112
What is the best way for the AGACNP to get involved in policy making
Join a hospital committee
113
What is the best way for the AGACNP to demonstrate and advocate for full scope of practice?
Bill for independent services
114
Which of the following is considered a high acuity role for the AGACNP?
a. Primary care clinic
b. Cardiology office**
c. Community health department
d. Minute Clinic
115
6. Which of the following is most important to evaluate statistical significance when reviewing the literature?
Consider the sample size
116
When closing a practice, the NP is required to do all of the following except
a. Give the pt adequate time to find another provider
b. Keep all of the patient’s records for a minimum of five years
c. Send a certified letter with a return receipt requested (this is for discharging/firing a patient from your practice)**
d. Provide names of other providers for future care
117
Which of the following components of an evidenced based research process is the most important for NP to participate in?
Formulating the research problem
118
A former pt of an NP is writing blog posts, sending emails, and distributing false, accusatory statements about the NP’s practice. Which of the following forms of defamation is this?
libel
119
Can you tell the pt’s wife, for her protection, that her husband has HIV?
No, not without his permission.
120
How can the ANCP prepare to get involved in future mass casualty event
Pre-enroll in disaster volunteer program
121
An 80-year-old male patient with dementia requires long-term care placement. To which funding agency does the patient apply after "spending down" to qualify?
Medicaid
122
Your pt is worried about insurance coverage and asks you for advice on Medicaid. You instruct the patient that Medicaid:
Pays after insurance and 3rd party payers have paid
123
You are giving a dinner presentation to a group. The pharmaceutical rep calls you the night before and wants you to say that their drug is the only one that works. What ethical principles does this challenge?
Veracity and Fidelity
124
Quality assurance
a process for evaluating the care of pts using established standards of care to ensure quality
125
CPI measures what 3 measures to improve nursing?
Structure, processes, and outcomes
126
A root cause analysis of a crisis situation in the ICU identified a lack of clinician-family communication as the basis for the resulting adverse outcome. As part of the performance improvement plan, the NP is asked to develop evidence-based polices to establish clinician-family communication standards in the unit. These policies should include:
guidelines for having discussions with family members that are geared toward establishing treatment goals.
127
Which clinical scenario does the NP evaluate for a quality improvement process change
An increased incidence of postoperative sternal wound infections
128
Goals set forth in "Healthy People 2020" by the United States Department of Health and Human Services include
elimination of health disparities. (and ↑QOL/LOL)
129
Based on the individual's culture, ethnicity, and personal choices, the NP can optimize the therapeutic partnership w/the patient by
Tailoring his or her communication style to the patient’s preference.
130
A 70-year-old pt with a hx of DM, HTN, OAs, and a new diagnosis of coronary artery disease, is being discharged. The adult-gerontology acute care nurse practitioner teaches the patient that the first point of contact for health care needs is the:
primary care provider
131
The NP is asked to provide evidence to the hospital administration about the safety of NP placing central lines. Which resource provides the strongest level of evidence?
A systematic review (meta-analysis is even stronger)
132
What legislation allowed nurse practitioners to be recognized Medicare providers in all geographical areas with their own provider number?
Balanced Budget Act
133
True/False: restraining an unwilling patient is grounds for malpractice
False, if they are a danger you can restrain
134
Pt presents to the clinic for routine f/u and passes out. You revive the pt and admit overnight. Which of the following would qualify as incident-to-billing?
Temperature and weight recording
135
The NP program initiated, primarily, because of what issue in healthcare at the time?
Pediatric physician shortage
136
Elderly F pt takes a turn for the worse. The husband is crying when you enter the room and begins telling you what end-of-life care he prefers. What do you do?
Ask him to speak candidly with you
137
Pt calls to complain about bills and states he has Medicare, which should cover all costs. You explain:
Since you are healthy, exams are not covered.
