a community center is presenting a nurse-led program on the Patient Protection and Affordable care act. Which statement made by the participant indicates a need for further teaching?
1. my small company will now offer the 75 employees health insurance or pay a penalty.
2. as long as my son is a full time student in college, i will be able to keep him on my health insurance until he is 26 years old.
3. i signed up for state health insurance exchange before the designated deadline to make sure i had health insurance
4. since i have now been diagnosed with diabetes, my health insurance plan cannot charge me higher premiums.
2
which activity performed by a nurse is related to maintaining a competency in nursing practice?
1. asking another nurse about how to change the settings on a medication pump
2. regularly attending unit staff meetings
3. participating as a member of the professional nursing council
4. attending a review course in preparation for a certification examination
4
a patient tells a nurse that she is enrolled in a preferred provider organization, but does not understand what that is. what is the nurse's best explanation of a PPO?
1. this health plan is for people who cannot afford their own health insurance
2. this health plan is operated by the government to provide health care to older adults
3. this health plan gives you a list of physicians and hospitals from which you can choose.
4. this a fee-for-service plan in which you can choose any physician or hospital
3
which of the following are examples of a nurse participating in primary care activities? (select all that apply)
1. providing prenatal teaching on nutrition to a pregnant woman during first trimester
2. assessing the nutritional status of older adults who come to the community center for lunch
3. working with patients in a cardiac rehab program
4. providing home wound care to a patient
5. teaching a class to parents at a local grade school about importance of immunizations
1,2,5
nurses on nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. they are outlining strategies that will prevent this in the future. this is an example of nurses working on what issues in the health care system?
1. patient safety
2. evidence-based practice
3. patient satisfaction
4. maintenance of competency
1
which of the following statements is true regarding Magnet status recognition for a hospital?
1. nursing is run by a Magnet manager who makes decisions for nursing units
2. nurses in Magnet hospitals make all the decisions on clinical units
3. Magnet is a term that is used to describe hospitals that are able to hire the nurses they need
4. Magnet is special designation for hospitals that achieve excellence in nursing practice.
4
a group of staff nurses notice an increased incidence of medication errors on their unit. after further investigation it is determined that the nurses are not consistently identifying the patient correctly. what type of quality improvement method would be most appropriate.
1.PDSA
2. six sigma
3. rapid improvement event (RIE)
4. a randomized controlled trial
3
which of the following are characteristics of managed care systems? (select all the apply)
1. provider receives a predetermined payment for each patient in the program
2. payment is based on a set fee for each service provided
3. system includes voluntary prescription drug program for an additional cost
4. system tries to reduce costs while keeping patients healthy
5. focus of care is on prevention and early intervention
1,4,5
which of the following nursing activities is provided in secondary health care environment?
1. conducting blood pressure for older adults at senior center
2. teaching a clinic patient with chronic obstructive pulmonary disease purse-lipped breathing techniques
3. changing the postoperative dressing for a patient on a medical- surgical unit
4. doing endotracheal suctioning for a patient on a ventilator in the medical ICU
3, 4
a nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. place the steps in the correct sequence for PDSA.
1. bedside change of shift report is piloted on two medical surgical units
2.patient satisfaction levels after implementation of the bedside report are compared to a patient satisfaction level before the change
3. the nursing council develops a strategy for bedside change of shift report
4. after modifications are made in shift report elements, bedside shift report is implemented on all nursing units
3,1,2,4
the nursing staff is developing a quality program. which of the following are nursing sensitive indicators from the national database of nursing quality indicators (NDNQI) that nurses can use to measure patient safety and quality for the unit? (select all that apply)
1. use of physical restraints
2. pain assessment, intervention, and reassessment
3. patient satisfaction with food preparation
4. registered nurse (RN) education and certification
5. number of outpatient surgical cases per year
1,2,4
a nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. which of the following is an appropriate goal for restorative care?
1. patient will be able to walk 200 feet without SOB
2. wound will heal without signs of infection
3. patient will express concerns related to return to home
4. patient will identify strategies to improve sleep habits
1
a nurse is presenting information to a management class of nursing students on the topic of financial reimbursement for achievement of established, measurable patient outcomes. the nurse is presenting information to class of which topic?
1. prospective payment system
2. pay for performance
3. capitation payment system
4. managed care system
2
a nurse is using data collected from the unit to monitor the incidence of falls after the unit implemented a new fall protocol. the nurse is working in which area.
1. quality improvement
2. health
care patient system
3. nursing informatics
4. computerized nursing network
1
the nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. they decide to initiate a quality improvement project using the plan do study act model. which of the following in an example of the do from that model?
1. implementing the new skin care protocol on all medicine units
2. reviewing the data collected on patients cared using the protocol
3. reviewing the quality improvement reports on the last six patients who developed ulcers over the last 3 months
4. based on findings from patients who developed ulcers, implementing evidence-based skin care protocol
4