Clinical CHP 1 Chronic Questions and
Answers With Rationale
1. Which of the following provides nursing interventions that are selected to achieve
patient outcomes for which nursing is accountable? Answer- Nursing diagnosis
The nursing diagnosis provides nursing interventions that are selected to achieve
patient outcomes for which nursing is accountable. NANDA-I is the organization that
develops and maintains the standard classification system for nursing diagnosis.
The nursing assessment is part of the nursing process. The NOC is a list of patient
outcomes developed to evaluate the effects of interventions provided by nurses.
2. A nurse reviewing charts is participating in what part of the system of quality
improvement? Answer- Data collection plan
A nurse reviewing charts is participating in the data collection plan part of the quality
improvement system. Measures refer to the assessment of how well the healthcare
team performed. Aim is a measurable description of the desired improvement. Goals
are the proficiencies that need to be met.
3. The registered nurse (RN) is delegating tasks to the licensed practical nurse
(LPN) and unlicensed assistive personnel (UAP). Which statement reflects
inappropriate delegation? Answer- RN delegates to LPN: Complete admission
assessment and documentation on a new patient.
The RN cannot delegate an admission assessment to an LPN, as this is not within
the LPN's scope of practice. LPNs can gather data but cannot assess a patient. All
admission assessments must be done by the RN. Obtaining and recording vital
signs is within the scope of practice for the UAP. The LPN is legally permitted to
administer oral medications, intramuscular medications, subcutaneous medications,
simple intravenous (IV) fluids, and IV antibiotics. The UAP can assist a patient in
ambulating to the bathroom.
4. A nurse is caring for a patient on the cardiac care unit. A cardiologist who lives in
another city consults with the health care team through videoconferencing. What
is this process known as? Answer- Telehealth
Telehealth is the use of technology such as videoconferencing to provide care when
patients and their health care providers are geographically separated. Electronic
health records are health records maintained by clinics or hospitals in an electronic
format. Evidence-based practice is a problem-solving approach used to answer
, clinical questions. Online health management is the use of the Internet and
technology for managing health.
5. In the Medicare program, the payment for hospital services is based on flat fees.
These are determined by the diseases and problems treated during the hospital
admission. For example, the hospital will receive a fixed amount of $45,000 for
the care of a patient who had a total knee replacement. What is the term for this
type of payment? Answer- Prospective payment system
A prospective payment system was established in the Medicare program to
reimburse hospitals using a flat fee based on the disease and problems treated
during the admission. Value-based purchasing programs base reimbursement to
health care providers on their performance on certain quality measures. Preferred
provider organizations and health maintenance organizations are programs through
which charges are negotiated in advance of the delivery of care using predetermined
reimbursement rates or capitation fees.
6. What communication tool will the nurse utilize to provide safe, effective care
when reporting a change in a patient's condition? Answer- Situation-Background-
Assessment-Recommendation (SBAR) tool
The SBAR tool is a structured technique that provides a way for members of the
healthcare team to talk about a patient's condition. A nursing diagnosis provides a
basis for selecting nursing interventions to achieve patient outcomes for which a
nurse is accountable. A nursing care plan is a guide for routine nursing care. A
clinical pathway is an interprofessional nursing care plan that specifies care and
desired outcomes during a specific time period for patients with particular diagnoses
or health conditions.
7. Telehealth nursing is using the nursing process to provide nursing care to
patients and increase access to care to those who may not be able to afford
transportation to the nearest health care facility. What methods are considered
telehealth nursing? Select all that apply. Answer- Telehealth nursing provides
nursing care to patients through telecommunication technologies, such as
satellite, wireless, video communications, and high-speed Internet. Telephone
conversation is not a method for telehealth nursing.
8. A patient with a diagnosis of aggression secondary to psychosis has been
admitted to the critical care unit. The nurse consults with the mental health team
to provide a set of planned interventions to meet certain goals regarding the
aggression. This is an example of what type of care plan? Answer- Patient care
protocols
Patient care protocols are developed to provide a consistent application of
nursing to ensure outcomes are met. Nursing diagnosis, evaluation, and SMART
goals should be developed for each patient to individualize patient care.
Answers With Rationale
1. Which of the following provides nursing interventions that are selected to achieve
patient outcomes for which nursing is accountable? Answer- Nursing diagnosis
The nursing diagnosis provides nursing interventions that are selected to achieve
patient outcomes for which nursing is accountable. NANDA-I is the organization that
develops and maintains the standard classification system for nursing diagnosis.
The nursing assessment is part of the nursing process. The NOC is a list of patient
outcomes developed to evaluate the effects of interventions provided by nurses.
2. A nurse reviewing charts is participating in what part of the system of quality
improvement? Answer- Data collection plan
A nurse reviewing charts is participating in the data collection plan part of the quality
improvement system. Measures refer to the assessment of how well the healthcare
team performed. Aim is a measurable description of the desired improvement. Goals
are the proficiencies that need to be met.
3. The registered nurse (RN) is delegating tasks to the licensed practical nurse
(LPN) and unlicensed assistive personnel (UAP). Which statement reflects
inappropriate delegation? Answer- RN delegates to LPN: Complete admission
assessment and documentation on a new patient.
The RN cannot delegate an admission assessment to an LPN, as this is not within
the LPN's scope of practice. LPNs can gather data but cannot assess a patient. All
admission assessments must be done by the RN. Obtaining and recording vital
signs is within the scope of practice for the UAP. The LPN is legally permitted to
administer oral medications, intramuscular medications, subcutaneous medications,
simple intravenous (IV) fluids, and IV antibiotics. The UAP can assist a patient in
ambulating to the bathroom.
4. A nurse is caring for a patient on the cardiac care unit. A cardiologist who lives in
another city consults with the health care team through videoconferencing. What
is this process known as? Answer- Telehealth
Telehealth is the use of technology such as videoconferencing to provide care when
patients and their health care providers are geographically separated. Electronic
health records are health records maintained by clinics or hospitals in an electronic
format. Evidence-based practice is a problem-solving approach used to answer
, clinical questions. Online health management is the use of the Internet and
technology for managing health.
5. In the Medicare program, the payment for hospital services is based on flat fees.
These are determined by the diseases and problems treated during the hospital
admission. For example, the hospital will receive a fixed amount of $45,000 for
the care of a patient who had a total knee replacement. What is the term for this
type of payment? Answer- Prospective payment system
A prospective payment system was established in the Medicare program to
reimburse hospitals using a flat fee based on the disease and problems treated
during the admission. Value-based purchasing programs base reimbursement to
health care providers on their performance on certain quality measures. Preferred
provider organizations and health maintenance organizations are programs through
which charges are negotiated in advance of the delivery of care using predetermined
reimbursement rates or capitation fees.
6. What communication tool will the nurse utilize to provide safe, effective care
when reporting a change in a patient's condition? Answer- Situation-Background-
Assessment-Recommendation (SBAR) tool
The SBAR tool is a structured technique that provides a way for members of the
healthcare team to talk about a patient's condition. A nursing diagnosis provides a
basis for selecting nursing interventions to achieve patient outcomes for which a
nurse is accountable. A nursing care plan is a guide for routine nursing care. A
clinical pathway is an interprofessional nursing care plan that specifies care and
desired outcomes during a specific time period for patients with particular diagnoses
or health conditions.
7. Telehealth nursing is using the nursing process to provide nursing care to
patients and increase access to care to those who may not be able to afford
transportation to the nearest health care facility. What methods are considered
telehealth nursing? Select all that apply. Answer- Telehealth nursing provides
nursing care to patients through telecommunication technologies, such as
satellite, wireless, video communications, and high-speed Internet. Telephone
conversation is not a method for telehealth nursing.
8. A patient with a diagnosis of aggression secondary to psychosis has been
admitted to the critical care unit. The nurse consults with the mental health team
to provide a set of planned interventions to meet certain goals regarding the
aggression. This is an example of what type of care plan? Answer- Patient care
protocols
Patient care protocols are developed to provide a consistent application of
nursing to ensure outcomes are met. Nursing diagnosis, evaluation, and SMART
goals should be developed for each patient to individualize patient care.
