AGACNP - Based on Frances Guide Review Materials Questions with 100% Complete Solutions, Rated A+

What is the best way to advocate for gay and lesbian population? a. participate in a high state or national level b. join a non-profit advocacy group c. consider lobbying the government d. start at your facility - cORRECT sOLUTION d. start at your facility Answers are worded differently. "decrease bias in healthcare" "create in-servises in healthcare" "obtain funding to increase access" Which of the following is most important to evaluate statistical significance when reviewing the literature? a. consider the sample size b. make sure the confidence interval is tight c. see if the p-value is less than the alpha-coefficient d. determine the error rate - cORRECT sOLUTION a. consider the sample size When closing a practice, the NP is required to do all of the following except a. give the patient adequate time to find another provder b. keep all of the patient's records for a minimum of five years c. send a certified letter with a return receipt requested d. provide names of other providers for future care - cORRECT sOLUTION c. send a certified letter with a return receipt requested Which of the following components of an evidenced based research process is the most important for NP to participate in? a. specifying methods of data collection b. formulating the hypothesis c. carefully reviewing the literature d. formulating the research problem - cORRECT sOLUTION d. formulating the research problem Can you tell the patient's wife, for her protection, that her husband has HIV? - cORRECT sOLUTION No, not without his permission An 80 year old male patient with dementia requires long-term care placement. To which funding agency does the patient apply after "spending down" to qualify? - cORRECT sOLUTION Medicaid Your patient is worried about insurance coverage and asks you for advice on Medicaid. You instruct the patient that Medicaid: - cORRECT sOLUTION Pays after insurance and 3rd party payers have paid You are giving a dinner presentation to a group. The pharmaceutical rep calls you the night before and wants you to say that their drug is the only one that workds. What ethical principles does this challenge? - cORRECT sOLUTION Veracity and fidelity Health literacy - cORRECT sOLUTION Average american: 8th grade level Quality assurance - cORRECT sOLUTION A process for evaluating the care of patients using established standards of care to ensure quality CPI - cORRECT sOLUTION Measures structure, processes, and outcomes A root cause analysis of a crisis situation in the ICU identified a lack of clinician-family communication as the basis for the resulting adverse outcome. As part of the performance improvement plan, the NP is asked to develop evidence-based policies to establish clinician-family communication standards in the unit. These policies should include: - cORRECT sOLUTION Guidelines for having discussions with family members that are geared toward establishing treatment goals Which clinical scenario does the NP evaluate for a quality improvement process change? - cORRECT sOLUTION An increased incidence of postoperative sternal wound infections Goals set forth in healthy people 2020 by the US department of Health and Human services include: - cORRECT sOLUTION elimination of health disparities (and increased QOL/LOL) Based on the individual's culture, ethnicity, and personal choices, the NP can optimize the therapeutic partnership with the patient by: - cORRECT sOLUTION Tailoring his or her communication style to the patient's preference A 70 year old patient with a history of DM, HTN, OAs, and a new diagnosis of CAD, is being discharged. The adult-gerontology acute care NP teaches the patient that the first point of contact for health care needs is the: - cORRECT sOLUTION PCP The NP is asked to provide evidence to the hospital administration about the safety of NP placing central lines. Which resource provides the strongest level of evidence? - cORRECT sOLUTION A systematic review (meta analysis) What legislation allowed NPs to be recognized Medicare providers in all geographical areas with their own provider number? - cORRECT sOLUTION Balanced Budget act True/false: restraining an unwilling patient is grounds for malpractice? - cORRECT sOLUTION False, if they are a danger you can restrain Patient presents to the clinic for routine f/u and passes out. You revive the patient and admit overnight. Which of the following would qualify as incident to billing? - cORRECT sOLUTION Temperature and weight recording The NP program initiated, primarily, because of what issue in healthcare at the time? - cORRECT sOLUTION Pediatric physician shortage Elderly patient takes a turn for the worse. The husband is crying when you enter the room and begins telling you what end-of-life care he prefers. What do you do? - cORRECT sOLUTION Ask him to speak candidly with you Patient calls to complain about bills and states he has Medicare, which should cover all costs. You explain: - cORRECT sOLUTION Since you are healthy, exams are not covered Doc calls from another center asking if you can tell him what kind of orders he should give for maintenance of patient... - cORRECT sOLUTION No, HIPPA Patient in ER not doing well, primary MD calls: - cORRECT sOLUTION Give him info NP working on ESRD research project. A colleague renal specialist asks for patient info on your patients: - cORRECT sOLUTION HIPAA breach Who enforces HIPAA? - cORRECT sOLUTION Office of Civil Rights/Dept Health and Human Services Who isn't covered by HIPAA? - cORRECT sOLUTION Law enforcment/municipal offices, CPS/Schools, employers/workman's comp, life insurance Insurance company calling to verify some patient appointments? - cORRECT sOLUTION Answer by picking out that there is already a medical release signed by the patient and give the requested information to them Benchmarking - cORRECT sOLUTION How institution compares with similar organizations Managed care - cORRECT sOLUTION Know what this is and how it has improved costs, something about putting caps on payments Peer review - cORRECT sOLUTION Timely, not anonymous, and NP knows how peer review will impact yearly evaluation Sensitivity vs specificity - cORRECT sOLUTION Sensitivity: true positives, specificity: true negatives There was a question where a patient had a multinodular goiter and wanted to know why the NP was not going to do periodic US and fine needle biopsy in monitoring for some kind of cancer or complication. The answer I picked was that these tests were not very specific to detect the cancer Reliability - cORRECT sOLUTION When implementing a new study, tested over and over, the consistency of a measurement or the degree to which an instrument measures the same way over time Validity of results in an article - cORRECT sOLUTION P-value, probability of falsely rejecting the null hypothesis, want it to be 0.05 Statistical significance - cORRECT sOLUTION Look at sample size and and low p value Privileging - cORRECT sOLUTION May be granted in full or part by the hospital, credentialing committee is made of physicians Who determines scope of practice? - cORRECT sOLUTION State practice acts but institutional bylaws may further restrict practice (facility limited scope of practice) Informed consent - cORRECT sOLUTION A state indicating patient has received adequate instruction/information regarding aspects of care to make a prudent, personal choice regarding such, includes risks and benefits, competence: ability to communicate, understand, reason, differentiate good and bad