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The Safe & Effective Care Environment: The
Management of Care PracticeQuestions
Which of the following patient care tasks is coupled with
the appropriate member of the nursing care team in terms of
their legal scope of practice?
A. An unlicensed staff member who has been “certified” by the employing
agency to monitor telemetry: Monitoring cardiac telemetry
L
B. An unlicensed assistive staff member like a nursing assistant who has been
urinary catheter
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“certified” by the employing agency to insert a urinary catheter: Inserting a
C. A licensed practical nurse: The circulating nurse in the perioperative area
EN
D. A licensed practical nurse: The first assistant in the perioperative area
Correct Response: A
An unlicensed staff member who has been “certified” by the employing agency to
ID
monitor telemetry can monitor cardiac telemetry; they cannot, however, interpret
these cardiac rhythms and initiate interventions when interventions are indicated.
Only the nurse can perform these roles.
NF
Unlicensed assistive staff member like a nursing assistant cannot under any
circumstances be certified” by the employing agency to insert a urinary catheter or
insert a urinary catheter because this is a sterile procedure and, legally, no sterile
procedures can be done by an unlicensed assistive staff member like a nursing
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assistant.
Lastly, the role of the circulating nurse is within the exclusive scope of practice for
the registered nurse and the role of the first assistant is assumed only by a
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registered nurse with the advanced training and education necessary to perform
EXAM QUESTIONS AND ANSWERS
competently in this capacity. Neither of these roles can be delegated to a licensed
practical nurse or an unlicensed assistive staff member like a nursing assistant or a
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surgical technician.
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,RASMUSSEN COLLEGE OF NURSING NUR 2407
EXAM QUESTIONS AND ANSWERS
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You are providing care to a permanently disabled Iraqi
war veteran who is 28 years of age. When he returned home
from the war at the age of 24 years of age 2 years ago he
was deemed permanently disabled by both the Veterans
Administration (VA) and the Social Security Administration.
He receives a substantial monthly service connected
disability check from the Veterans Administration and he has
L
no spouse or legal dependents. Which type of governmental
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health insurance is he now entitled to?
A. Only the VA health care services because he is not 65 years of age
B. Medicare because he has been deemed permanently disabled for 2
EN
years
C. Medicaid because he is permanently disabled and not able to work
ID
D. Choices B and C
Correct Response: B
NF
This client is legally eligible for Medicare because he has been deemed permanently
disabled for more than 2 years in addition to the VA health care services. People
over the age of 65 and those who are permanently disabled for at least two years,
according to the Social Security Administration, are eligible for Medicare.
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Based on the information in this scenario, the client is not eligible for Medicaid
because has a “substantial” VA disability check on a monthly basis and is not
indigent and with a low income.
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EXAM QUESTIONS AND ANSWERS
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EXAM QUESTIONS AND ANSWERS
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You are a registered nurse who is performing the role of a
case manager in your hospital. You have been asked to
present a class to newly employed nurses about your role,
your responsibilities and how they can collaborate with you
as the case manager. Which of the following is a primary case
management responsibility associated with reimbursement
that you should you include in this class?
L
A. The case manager’s role in terms of organization wide performance
improvement activities
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B. The case manager’s role in terms complete, timely and accurate
documentation
EN
C. The case manager’s role in terms of the clients’ being at the appropriate
level of care
D. The case manager’s role in terms of contesting denied reimbursements
ID
Correct Response: C
Registered nurse case managers have a primary case management responsibility
NF
associated with reimbursement because they are responsible for insuring that the
client is being cared for at the appropriate level of care along the continuum of care
that is consistent with medical necessity and the client’s current needs. A failure to
insure the appropriate level of care jeopardizes reimbursement. For example, care
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in an acute care facility will not be reimbursed when the client’s current needs can
be met in a subacute or long term care setting.
Nurse case managers do not have organization wide performance improvement
activities, the supervision of complete, timely and accurate documentation or
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challenging denied reimbursements in their role. These roles and responsibilities
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are typically assumed by quality assurance/performance improvement, supervisory
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staff and medical billers, respectively.
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EXAM QUESTIONS AND ANSWERS
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Select the nurse case management model used for
patient care delivery that is accurately paired with one of its
descriptors:
A. The ProACT Model: Registered nurses perform the role of the primary nurse
in addition to the related coding and billing functions
B. The Collaborative Practice Model: The registered nurse performs the role of
the primary nurse in addition to the role of the clinical case manager with
L
administrative, supervisory and fiscal responsibilities
TIA
C. The Case Manager Model: The management and coordination of care for
clients throughout a facility who share the same DRG or medical diagnosis
ID EN
NF
CO
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