ANCC Nonclinical 2023 with 100% correct questions and answers

T-test Compares one variable (perhaps BP) between two groups P-value Represents the probability of error involved in accepting the observed results as a valid representative of the population. Think of P-value as statistical significance of a hypothesis. Standard deviation The measure of the spread or dispersion of a set of data from the average. Confidence interval Measures the reliability of an estimate. With defined limits at each end, this specifices the probability of including the parameter being estimated. The Nurse Practice Act is enacted by which organization? A. National Council of State Boards of Nursing B. Federal legislature C. State board of nursing D. State's legislature E. American Nurses Association C. State's legislature Cohort study Follows individuals with a particular condition over a period of time. Best design to obtain valid information about the prognosis of a condition. Randomized controlled trial Best design to determine the benefits/risks of an intervention. Cross-sectional study Best designs to evaluate a diagnostic test. Qualitative research Explores phenomena through descriptions or people and events. Subjective data Includes: case studies, field studies, participant observation, and ethnographic studies. Non-experimental research In non-experimental research the researcher cannot control, manipulate, or alter the predictor variable or subjects. Relies on interpretation, observation, or interactions to arrive to a conclusion. Includes: descriptive and ex-post facto/correlational research. Experimental research In experimental research, the researcher manipulates one or more variables and controls and measures any change in other variables. Quasi-experimental Similar to traditional experimental design but lacks the comparison group as well as randomization. This is not randomized (controlled but not random). Sentinel events An accident that results in death. Root cause analysis An approach designed to breakdown and analyze the cause of an adverse event. Patient-centered care Patient-centered care is involving the patient and their families in all aspects of their care. Care is provided in the manner the patient values, and decides. Clinical decision making should be led by the patient's decision. Experimental Random sampling is used to conduct experiment. Quantitative research Measurable. Relative risk The ratio of the probability of an event occurring in an exposed group to the probabilty of the event occuring in a comparision, non-exposed group. Systematic review Strongest level of evidence Randomized controlled trials Second strongest level of evidence Cohort studies Third strongest level of evidence Case reports Fourth strongest level of evidence Expert opinion Fifth strongest level of evidence (lowest) Hierarchy of Evidence Advocacy Advocating for patients and their families. Working to minimize the risk for the patient and the provider. Leadership Collaboration and Consultation Collaboration Action of working with someone to produce something. NP and MD collaborate together. Consultation When two people discuss and use expert knowledge for the patient's improvement. Conflict resolution Negotiation and Mediation Negotiation Process where two or more people work to come to a resolution. Mediation Process where a third person is involved to assist in resolving conflict. Specificity Ability of the test to correctly identify those with out the disease (negative;[-]). Sensitivity Abililty of test to correctly identify those with the disease (positive; [+]). Sensitivity has the most T's (+ for positive, t for sensitivity). Emancipated minor Minors active in the military or married. These are people under the age of 18 y/o but do not require an adult for consent. Health Belief Model Psychological model that attempts to explain and predict health behaviors. Licensure Legal right to practice as an NP. This is granted by a state government. Certification Process by which a nongovernmental agency validates, based on predetermined standards, an individual nurse's qualifications for practice in a defined functional or clinical area of nursing. Standards of Practice Developed by the ANA, provides guidelines for nursing performance. They are rules or definitions of what it means to provide competent care. State Nursing Practice Act Laws that define responsibilities of the nurse and "scope of practice". The range of activities and services as well as the qualifications for practice. The acts are intended to protect patients from harm as a result of unsafe or incompetent practice, or unqualified nurses. Actual law in place. Board of Nursing Protects the public's health and welfare by assuring that safe and competent nursing care is provided by licensed nurses. BON's achieve this mission by outlining the standards for safe nursing care and issuing licenses to practice nursing. HMO Health Maintenance Organization Plan provides coverage for providers in their network. A PCP is chosen from the network and this provider witll refer to you areas of need. PPO Preferred Provider Organization Selects own provider. Does not require specific network or PCP referral for specialist. Incident to Billing Are services supervised by certain non-physician practitioners such as PA, NP, CNS, nurse midwives, or clinical psychologist. To qualify as "incident to" services must be part of your patient's normal course of treatment, during which a physician personally performed an initial service and remains active. Medicare Federal health insurance program for people who are 65 and older, certain younger people with disabilities, and people with end stage renal disease. Medicare Part A Medicare plan that you receive if you are 65 or older, disabled, or have ESRD. Medicare Part B Voluntary program with monthly premiums. Provides coverage for outpatient needs: labs, surgeries, doctor visits, wheel chairs, walkers, etc. Medicare Part C "Choice" plan that includes for additional services: vision, dental. Can keep Medicare Part A and pay for Medicare Part B. Medicare Part D Prescription coverage Medicaid Health care program that assists low-income families or individuals in paying for long-term medical and custodial care costs. Joint program, funded primarily by the federal government and run at the state level, where coverage may vary. ICD 10 (Internation Classification of Diseases) Used to indicate the diagnosis, including family history disorders. Each disease is assigned an ICD-10 code. Global health information standard for mortality and morbidity statistics. Increasingly used in clinical care and research to define disease and study disease patterns, as well as manage health care, monitor outcomes and allocate resources. CPT (Current Procedural Terminology) List of descriptive identifying codes that are used to identify procedures and medical services. It owned by by the AMA. Medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies, and accreditation organizations. Occurrence based policy A policy covering claims that arise out of damage or injury that took place DURING the policy period, regardless of when claims are made. Claims based policy Policy that provides coverage when a claim is made against the policy, regardless of when the claim event took place. A claims-made policy is most likely to be purchased when there is a delay between when claims are filed when they occur. ONLY beneficial if a claim is made while your policy active. NPI A number used to identify healthcare providers and is used for billing purposes. HIPAA Health Insurance Portability and Accountability Act that was passed by Congress in 1996. Must keep all information confidential, do NOT need consent for consultation with other providers. Only healthcare providers that are active in the patients care can review any medical information. Electronic Medical Record Electronic version of the patient's chart; should remain confidential as the paper chart; providers should log out of patient identifying screens when away from the computer. HITECH ACT (Health Information Technology for Economic and Clinical Health) ACT approved in 2009 for the use of electronic health information. Telehealth Promotion of healthcare via telecommunications. Hospice Care provided in the home or in a hospice house for terminally ill patients. Requirements: under Medicare the patient must be deemed terminally ill by a provider in the next 6 months. Informed Consent Permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits. Durable Power of Attorney A legal document that gives someone you choose the power to act in you place. Advance Directive A written statement of a person's wishes regarding medical treatment, often including a living will, made to ensure those wishes are carried out should be the person be unable to communicate them to a doctor. Living Will A written statement detailing a person's desire regarding their medical treatment in circumstances in which they are no longer able to experss informed consent, especially an advance directive. Malpractice Illegal or negligence provided by a healthcare provider. Veracity Truth. Example: Patient recently diagnosed with advanced pancreatic cancer. Patient thinks that she has a very good chance of being cured. The oncologist explains to the patient her poor prognosis. The oncologist is being truthful and honest to the patient about her prognosis. Accountability Being held responsible for your actions. Dignity To treat with respect. Example: Hospital gowns should be secured correctly so when patients get up to walk, their backs are not visible. Confidentiality Ethical principle or legal right that a physician or other health professional will keep information private. Justice Fair; fair and equitable distribution of societal resources. Example: Low income individuals do not pay some types of taxes to the government but still have equal access to the public services supported by taxes. Nonmaleficence To do no harm. Example: Discussing risks vs. benefits of a treatment; working within SOP. Beneficence To do good. Example: Health promotion, education, smoking cessation. Cultural Awareness Foundation of communication and it involves the ability of standing back from ourselves and becoming aware of our cultural values, beliefs, and perceptions. Cultural Beliefs Religion, culture, beliefs, and ethical customs can influence how patients understand health concepts, how they take care of their health, etc. Cultural Competence Ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. Muslims Women must cover their head and hair; some wear a body cloak called the burka. Females are not allowed to be alone with males who are not family members. If a woman is seen by a male health provider, her husband or another male family member must be present in the room. Female patient may refuse to undress (examine with gown on). Male children are preferred. Male is in charge of the household. Qur'an forbids eating pork or blood or meat not slaughtered in the "halal" manner. Latinos/Hispanics "Susto" is a cultural illness. "Mal ojo" or the "evil eye" is a folk illness caused by an adult who stares with envy at the child. Family ties are important and several generations may live in the same household. Asians (China, Vietnam, Cambodia, Korea, Japan) Listening quietly without questioning is considered as a sign of respect. Value college education and have high regarding for doctors. Elderly are held in high esteem; opinion is highly respected. Kinship ties are very important. Vietnamese May stop taking prescription when symptoms are relieved; common to save larg quantities of left-over or half-used prescriptoin drugs. Blood tests and surgery are feared because they think that blood loss worses illness. Believes Western medicine will put the body out of balance. Traditional Chinese Medicine Life energy (chi or qi) imbalance or blockage is believed to be the cause disease. Yin is female; yang is male. Acupunture and cupping correct energy imbalance. Cupping will creatte large round reddened marks or bruises on back. Coining is when a coin is rubbed vigorously on skin to create welts. Jehovah's Witness Do not believe in blood transfusions; will accept plasma expanders. Amish/Mennonites Do not participate in Medicare or Social Security. Community pays for health care. Traditional roles for women. Prefer large families with several children Prefere giving birth (using midwives) and dying at home. Hospice Admission Criteria 1. Written order for hospice care. 2. Certifies that patient has a life expectancy of less than 6 months. 3. Patient gives consent to be admitted to a hospice program. .4. Patient agress no to use life-sustaining equipment if a life. Autonomy Mentally competent adult patients have the right to make their own health decisions and express treatment prefecences. Examples: An alert elderly female with periods of forgetfulness and who has breast cancer decides to have a mastectomy after discussing the treatment options with her oncologist. The woman's daughter tells the NP that she does not want her mother to have a mastectomy because she thinks her mother is too old and confused. The NP has the duty to respect the patient's decisions. This case is also a good example of the NP acting as the patient advocate. Paternalism Making decisions for patient (or for others) because you "believe" that it is for their best interest. The opinion (or desires) of the patient is minimized or ignored. Patient is "powerless". Example: 92-year-old male does not want to be on a ventilator if he codes. The son agress and quietly tells the NP and physician that he wants this father to be aggressively treated with life support, if it is necessary. Fidelity Dedication and loyalty to one's patients. Keeping one's promise. Example: A woman with terminal breast cancer does not want the NP to reveal her poor prognosis to her mother. The patient explains to the NP that her mother is very anxious and she wants to wait until the next week before she tells her mother news. If the NP keeps the prognosis is confidence from teh patient's mother, she is exercising the concept of fidelity. Utilitarianism Outcome of the action is what matter with utilitarianism. It also means to use a resource for the beneift of most. It may resemble justice, but it is not the same concept. Example: WIC program is only for pregnant women and children. It is not open to adults and elderly males. The reason maybe that it would cost society more if women (and their fetuses), infants, and children are harmed by inadequate food intake (affects the brain growth). Elements of Malpractice Lawsuits 1. A duty is owed (a legal duty exists) 2. The duty was breached (not following standard of care) 3. Breach caused an injury (proximate cause) 4. Damage occured ICD-10 "V-code" or Modifiers Indicate reason for visit. Scope and Standards of Practice Document that contains "authoritative statements" that are used to evaluate and measurethe nursing "quality of practice, service, or education". State Board of Nursing Responsible for enforcing the state's nurse practice act. Formal governmental agency that has the statutory authority to regulate nursing practice. Legal authority to license, monitor, and to discipline nurses. Authorized to revoke a nurse's license (after formal hearing) Descriptive Study Describes and measures the characteristics of a group or a phenomenon. Data are measurable, numerical, and evaluated by statistical testing. No correlation are measured between variables. Longitudinal Study A long-term study follows the same group of subjects (or subpopulation) over many years to observe and measure teh same variables over time. Observational study. IRB Protects the rights of the human subjects enrolled in the study. Assent Refers to minors not emancipated 18 y/o can choose to participated in study but parental consent is still needed. Vulnerable Populations Infant and children Pregnant women Prisoners At risk for suicide Impaired decision-making Independent Variable Variable that is not affected by the other variables. Variable that is manipulated. Dependent Variable Variable that is the result of the manipulation of the interdependent variable. Case Study Intensive and in-depth study of one person. Cohort Study Study of a group of individuals with one or more common characteristics. Cross-correlational Study Describes and measures the interrelationships among the the study's variables between two groups or more. Correlation Study Describes and measures the interrelationships among the study's variables