NR 661- Professional Issues Comprehesive Exam.

NR 661- Professional Issues Comprehesive Exam.A liability policy that pays claims even after the policy is no longer active is termed -claims made policy' -tail coverage -liability protection -"all protect" - answertail coverage A nurse practitioner's scope of practice in influenced by a number of factors. Which one does not influence scope of practice? -code of ethics -state and federal laws governing practice -court of law -educational preparation - answercourt of law A patient you are examining in the clinic states that he has medicare part A only. What does this mean? -your visit will be reimbursed by the federal government -your visit will be reimbursed if you bill incident to a physician -only hospital visits are covered -he desires a cost-effective medication - answeronly hospital visits are covered A nurse practitioner is taking care of a patient who has chronic perennial allergic rhinitis. The patient has health insurance. The NP has become aware that the patient is not using her prescribed allergy medications. Instead, the patient is giving the medication to her husband because he does not have insurance. What should the NP do? -prescribe the medication only once more -only prescribe the medication if the patient promises to use it -stop prescribing the medication to the patient -continue to prescribe the medication - answeronly prescribe the medication if the patient promises to use it Prescriptive authority -is a right of every practicing nurse practitioner -varies from state to state -is not part of the consensus model -is dependent on certification - answervaries from state to state Standards of practice are established to: -regulate and control nurse practitioner practice -limit liability of nurse practitioners -protect nurse practitioners from frivolous law suits -promote autonomous practice - answerregulate and control nurse practitioner practice An octogenarian asks the nurse practitioner if its OK for him to have an alcoholic beverage in the evenings. There is no obvious contraindication. How should the nurse practitioner respond? -yes, but not more than 4 days/week -yes, but not more then 1-2 drinks per day -no, you will increase your risk of falling and injury -it depends of the type of alcohol you would like to consume - answeryes, but not more then 1-2 drinks per day An older adult male with moderately severe dementia presents with his caregiver daughter. His BMI is 18. His clothes have food stains on them and he looks as though he hasn't been bathed in days. How should the nurse practitioner handle this the NP should comment to the daughter about his poor care the NP should report this as potential elder abuse the patient should be asked about his care the daughter should be asked about the type of care he receives - answerthe NP should report this as potential elder abuse The name given to subjects in a research study who do not have the disease of condtition being studied, but who are included in the study for comparison are: studied subjects controls case series cross sectionals - answercontrols How would you creat a therapeutic relationship with a patient tell the patient that he can trust you at the end of the visit, tell the patient you enjoyed taking care of him ask open-ended questions touch the patient during the interview - answerask open-ended questions you are volunteering at a clinic that cares for homeless patients. What is the most important aspect of a patient's first visit a complete head to toe exam establish trust take an excellent history ask about problems with alcohol - answerestablish trust What should the nurse practitioner recommend to any elderly taking medications? have someone check your medications prior to taking them never take your medicine on an empty stomach keep a list of all your medications with you have a pharmacist review your list once a year - answerkeep a list of all your medications with you Which study listed below is considered an experimental study case series cross-sectional study cohort study meta-analysis - answermeta-analysis A nurse practitioner knows that she is HIV positive. She is employed in a private clinic and performs wellness exams on ambulatory adults. The nurse practitioner is; obligated to inform her employer of her HIV status is obligated to inform her patients of her HIV status is under no obligation to inform anyone is under obligation to inform the patient if she performs invasive procedures - answeris under no obligation to inform anyone A nurse practitioner works in an HIV exclusive practice. In talking with a patient, the NP learns that the patients sister lives next door to the nP. When the NP sees her neighbor (the patient's sister) the NP states that she met her sister in the clinic today. The neighbor replies "don't you work in an HIV clinic" how can this situation be characterized this is negligence this is a breach of confidentiality this is not a breach of confidentiality the nP has no liabiliey - answerthis is a breach of confidentiality A nurse practitioner examined a patient who had been injured by a cat. A 4-cm gaping laceration was present on the patient's forearm. The nurse practitioner sutured the laceration. the patient subsequently became infected, needed hospital admission and required IV antibiotics and incision and drainage. How can this situation be characterized? this is a clinical judgement with an unexpected complication the nurse practitioners actions followed standard of care the act of suturing this type of wound represents malpractice This is poor judgement but not malpractice - answerthe act of suturing this type of wound represents malpractice Licensure is used to establish a designated level of professional competence contingent on certification intended to limit entry into the profession necessary for reimbursement - answerused to establish a designated level of professional competence An older adult was screened for colorectal cancer and had a positive screen. She went on to have a colonoscopy that was normal. She does not have colorectal cancer. the screen was a: false negative false positive true negative true positive - answerfalse positive The research design that provides the strongest evidence for concluding causation is randomized control trials cohort studies case controlled studies prospective studies - answerrandomized control trials A patient you are caring for in your clinic has Medicare part B. What does this mean? the federal government will pay for his visit to your clinic today his medicare benefit covers outpatient services he will have a copay for his visit today his prescriptions will be partly paid for today - answerhis medicare benefit covers outpatient services At what age should hearing screening take place in oler adults according to Assessing Care in Vulnerable Elders (ACOVE-2)? 60 years 65 years 70 years 75 years - answer75 years The NP is examining an older adult with dementia. She is noted to have bruises on her arms and on her posterior thoracic area. The NP suspects elder abuse, but cannot be certain. The daughter of this oler adult is her caregiver. The daughter is a patient of the NP. What should the NP do? do not report the abuse until the NP is certain of it rule out elder abuse since her daughter is the caregiver report it to the appropriate authorities ask the daughter if she is abusing her mother - answerreport it to the appropriate authorities The Framingham study of cardiovascular disease initiated in the early 1970's is an example of a: randomized clinical trial cohort study case control study sequential control study - answercohort study Two common causes of weight loss in older adults are: anorexia and depression depression and malignancy malignancy and social isolation financial limitations ad hyperthyroidism - answerdepression and malignancy A liability policy that pays claims only during the period that the policy is active is termed: claims made policy tail coverage liability protection bobtail coverage - answerclaims made policy Who certifies nurse practitioners? the state where they practice state board of medicine or nursing a state board of nursing a nurse practitioner certifying body - answera nurse practitioner certifying body Mr. Bowers, a 97-year old is not able to make an informed decision due to mental incapacity. He does not have advanced directives, only a durable power of attorney (DPA). How should the NP proceed? allow the family to make a decision regarding medical care allow the DPA to make a decision based on the patient's known values Allow the NP to make a decision if there is disagreement between the family and DPA have the family and DPA come to an agreement regarding care - answerallow the DPA to make a decision based on the patient's known values A NP has worked for a large hospital as an RN. As a new nurse practitioner, she has developed a nurse practitioner managed clinic for hospital employees and is employed by the hospital. The NP i