TEST BANK FOR PRIMARY CARE : A COLLABORATIVE
PRACTICE,6TH EDITION BY BUTTARO.ISBN-13: 978-
0323570152 | ALL CHAPTERS WITH ANSWERS AND
RATIONALS
A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1
ACO. What is part of this designation?
a. Bonuses based on achievement of benchmarks
b. Care coordination for chronic diseases
c. Standards for minimum cash reserves
d. Strict requirements for financial reporting - ANSWER: ANS: A A Level 1 ACO has the least amount of
financial risk and requirements, but receives shared savings bonuses based on achievement of
benchmarks for quality measures and expenditures. Care coordination and minimum cash reserves
standards are part of Level 2 ACO requirements. Level 3 ACOs have strict requirements for financial
reporting.
What was an important finding of the Advisory Board survey of 2014 about primary care preferences
of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
c. Ease of access to care
d. The ratio of providers to patients - ANSWER: ANS: C As part of the 2014 survey, the Advisory Board
learned that patients desired 24/7 access to care, walk-in settings and the ability to be seen within 30
minutes, and care that is close to home. Associations with hospitals, costs of care, and the ratio of
providers to patients were not part of these results.
Which assessments of care providers are performed as part of the value-based purchasing (VBP)
initiative? (Select all that apply.)
a. Appraising costs per case of care for Medicare patients
b. Assessing patients' satisfaction with hospital care
c. Evaluating available evidence to guide clinical care guidelines
d. Monitoring mortality rates of all patients with pneumonia
e. Requiring advanced IT standards and minimum cash reserves - ANSWER: ANS: A, B, D Value-based
purchasing looks at five domain areas of processes of care, including efficiency of care (cost per case),
experience of care (patient satisfaction measures), and outcomes of care (mortality rates for certain
conditions). Evaluation of evidence to guide clinical care is part of evidence-based practice. The
requirements for IT standards and financial status are part of Accountable Care Organization
standards.
What is the purpose of Level II research?
a. To define characteristics of interest of groups of patients
b. To demonstrate the effectiveness of an intervention or treatment
c. To describe relationships among characteristics or variables
d. To evaluate the nature of relationships between two variables - ANSWER: C
Which is the most appropriate research design for a Level III research study?
a. Epidemiological studies
b. Experimental design
c. Qualitative studies
d. Randomized clinical trials - ANSWER: B
What is the purpose of clinical research trials in the spectrum of translational research?
a. Adoption of interventions and clinical practices into routine clinical care
,b. Determination of the basis of disease and various treatment options
c. Examination of safety and effectiveness of various interventions
d. Exploration of fundamental mechanisms of biology, disease, or behavior - ANSWER: C
Which statement made by a health care provider demonstrates the most appropriate understanding
for the goal of a performance report?
a. "This process allows me to critique the performance of the rest of the staff."
b. "Most organizations require staff to undergo a performance evaluation yearly."
c. "It is hard to be personally criticized but that's how we learn to change."
d. "The comments should help me improve my management skills." - ANSWER: D
Which assessment question would a health care provider ask when engaging in the previsit stage of
the new model for primary care? (Select all that apply.)
a. "Are you ready to discuss some of the community resources that are available?"
b. "Are you experiencing any side effects from your newly prescribed medications?"
c. "Do you anticipate any problems with adhering to your treatment plan?"
d. "Are you ready to discuss the results of your laboratory tests?"
e. "Do you have any questions about the lab tests that have been ordered for you?" - ANSWER: B, C, E
To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
a. Mandates for communication among primary caregivers and hospitalists
b. Penalties for failure to perform medication reconciliations at time of discharge
c. Reduction of payments for patients readmitted within 30 days after discharge
d. Requirements for written discharge instructions for patients and caregivers - ANSWER: C
According to multiple research studies, which intervention has resulted in lower costs and
fewer rehospitalizations in high-risk older patients?
a. Coordination of posthospital care by advanced practice health care providers
b. Frequent posthospital clinic visits with a primary care provider
c. Inclusion of extended family members in the outpatient plan of care
d. Telephone follow-up by the pharmacist to assess medication compliance - ANSWER: A
Which advantages are provided to the chronically ill patient by personal electronic
monitoring devices? (Select all that apply.)
a. Helps provide more patient control their health and lifestyle
b. Eliminates need for regular medical and nursing follow-up visits
c. Helps the early identification of patient health-related problems
d. Helps health care providers in keeping track of the patient's health status
e. Cost is often covered by Medicare - ANSWER: A, C, D, E
A primary care provider administers the "Newest Vital Sign" health literacy test to a patient
newly diagnosed with a chronic disease. What information is gained by administering this
test?
a. Ability to calculate data, along with general knowledge about health
b. Ease of using technology and understanding of graphic data
c. Reading comprehension and reception of oral communication
d. Understanding of and ability to discuss health care concerns - ANSWER: A
What is the main reason for using the REALM-SF instrument to evaluate health literacy?
a. It assesses numeracy skills.
b. It enhances patient-provider communication.
c. It evaluates medical word recognition.
d. It measures technology knowledge. - ANSWER: C
A female patient who is from the Middle East schedules an appointment in a primary care
office. To provide culturally responsive care, what will the clinic personnel do when
, meeting this patient for the first time?
a. Ensure that she is seen by a female provider.
b. Include a male family member in discussions about health care.
c. Inquire about the patient's beliefs about health and treatment.
d. Research middle eastern cultural beliefs about health care. - ANSWER: C
A primary care provider is providing care for a postsurgical client who recently immigrated to the
United States and speaks English only marginally. What intervention will provide the most effective
means of communicating postdischarge information to the client? a. Postpone discharge until the
client is fully recovered from the surgery. b. Requesting that a family member who speaks English be
present during the teaching session c. Providing the necessary information in written form in the
client's native language d. Requesting the services of a professional interpreter fluent in the client's
native language - ANSWER: D
What question asked by the client newly diagnosed with congestive heart failure
demonstrates the effectiveness of previous education concerning the Ask Me 3 health
literacy tool? (Select all that apply.)
a. "Where can I get assistance with the cost of my medications?"
b. "Why is it important for me to take this newly prescribed medication?"
c. "Is it true that high blood pressure isn't causing my problem?"
d. "Is congestive heart failure curable with appropriate treatment?"
e. "Would watching my intake of salt help me manage this problem? - ANSWER: B, C, E
A patient expresses concern that she is at risk for breast cancer. To best assess the risk for
this patient, what is the best initial action?
a. Ask if there is a family history of breast cancer.
b. Gather and record a three-generation pedigree.
c. Order a genetic test for the breast cancer gene.
d. Recommend direct-to-consumer genetic testing. - ANSWER: B
A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell
the patient?
a. It is not useful for identifying genetic diseases.
b. Much of the information does not predict disease risk.
c. The results are shared with the patient's insurance company.
d. The results must be interpreted by a provider. - ANSWER: B
What is an important part of patient care that can minimize the risk of a formal patient
complaint even when a mistake is made?
a. Ensuring informed consent for all procedures
b. Maintaining effective patient communication
c. Monitoring patient compliance and adherence
d. Providing complete documentation of visits
ANS: B - ANSWER:
What are some causes for failures or delays in diagnosing patients resulting in malpractice
claims? (Select all that apply.)
a. Failing to recognize a medication complication
b. Failing to request appropriate consultations
c. Improper performance of a treatment
d. Not acting on diagnostic test results
e. Ordering a wrong medication
ANS: B, D - ANSWER:
A patient prescribed a beta blocker medication is in the emergency department with reports of
syncope, shortness of breath, and hypotension. A cardiac monitor reveals a heart rate of 35
beats per minute. Which medication may be used to stabilize this patient?
PRACTICE,6TH EDITION BY BUTTARO.ISBN-13: 978-
0323570152 | ALL CHAPTERS WITH ANSWERS AND
RATIONALS
A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1
ACO. What is part of this designation?
a. Bonuses based on achievement of benchmarks
b. Care coordination for chronic diseases
c. Standards for minimum cash reserves
d. Strict requirements for financial reporting - ANSWER: ANS: A A Level 1 ACO has the least amount of
financial risk and requirements, but receives shared savings bonuses based on achievement of
benchmarks for quality measures and expenditures. Care coordination and minimum cash reserves
standards are part of Level 2 ACO requirements. Level 3 ACOs have strict requirements for financial
reporting.
What was an important finding of the Advisory Board survey of 2014 about primary care preferences
of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
c. Ease of access to care
d. The ratio of providers to patients - ANSWER: ANS: C As part of the 2014 survey, the Advisory Board
learned that patients desired 24/7 access to care, walk-in settings and the ability to be seen within 30
minutes, and care that is close to home. Associations with hospitals, costs of care, and the ratio of
providers to patients were not part of these results.
Which assessments of care providers are performed as part of the value-based purchasing (VBP)
initiative? (Select all that apply.)
a. Appraising costs per case of care for Medicare patients
b. Assessing patients' satisfaction with hospital care
c. Evaluating available evidence to guide clinical care guidelines
d. Monitoring mortality rates of all patients with pneumonia
e. Requiring advanced IT standards and minimum cash reserves - ANSWER: ANS: A, B, D Value-based
purchasing looks at five domain areas of processes of care, including efficiency of care (cost per case),
experience of care (patient satisfaction measures), and outcomes of care (mortality rates for certain
conditions). Evaluation of evidence to guide clinical care is part of evidence-based practice. The
requirements for IT standards and financial status are part of Accountable Care Organization
standards.
What is the purpose of Level II research?
a. To define characteristics of interest of groups of patients
b. To demonstrate the effectiveness of an intervention or treatment
c. To describe relationships among characteristics or variables
d. To evaluate the nature of relationships between two variables - ANSWER: C
Which is the most appropriate research design for a Level III research study?
a. Epidemiological studies
b. Experimental design
c. Qualitative studies
d. Randomized clinical trials - ANSWER: B
What is the purpose of clinical research trials in the spectrum of translational research?
a. Adoption of interventions and clinical practices into routine clinical care
,b. Determination of the basis of disease and various treatment options
c. Examination of safety and effectiveness of various interventions
d. Exploration of fundamental mechanisms of biology, disease, or behavior - ANSWER: C
Which statement made by a health care provider demonstrates the most appropriate understanding
for the goal of a performance report?
a. "This process allows me to critique the performance of the rest of the staff."
b. "Most organizations require staff to undergo a performance evaluation yearly."
c. "It is hard to be personally criticized but that's how we learn to change."
d. "The comments should help me improve my management skills." - ANSWER: D
Which assessment question would a health care provider ask when engaging in the previsit stage of
the new model for primary care? (Select all that apply.)
a. "Are you ready to discuss some of the community resources that are available?"
b. "Are you experiencing any side effects from your newly prescribed medications?"
c. "Do you anticipate any problems with adhering to your treatment plan?"
d. "Are you ready to discuss the results of your laboratory tests?"
e. "Do you have any questions about the lab tests that have been ordered for you?" - ANSWER: B, C, E
To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
a. Mandates for communication among primary caregivers and hospitalists
b. Penalties for failure to perform medication reconciliations at time of discharge
c. Reduction of payments for patients readmitted within 30 days after discharge
d. Requirements for written discharge instructions for patients and caregivers - ANSWER: C
According to multiple research studies, which intervention has resulted in lower costs and
fewer rehospitalizations in high-risk older patients?
a. Coordination of posthospital care by advanced practice health care providers
b. Frequent posthospital clinic visits with a primary care provider
c. Inclusion of extended family members in the outpatient plan of care
d. Telephone follow-up by the pharmacist to assess medication compliance - ANSWER: A
Which advantages are provided to the chronically ill patient by personal electronic
monitoring devices? (Select all that apply.)
a. Helps provide more patient control their health and lifestyle
b. Eliminates need for regular medical and nursing follow-up visits
c. Helps the early identification of patient health-related problems
d. Helps health care providers in keeping track of the patient's health status
e. Cost is often covered by Medicare - ANSWER: A, C, D, E
A primary care provider administers the "Newest Vital Sign" health literacy test to a patient
newly diagnosed with a chronic disease. What information is gained by administering this
test?
a. Ability to calculate data, along with general knowledge about health
b. Ease of using technology and understanding of graphic data
c. Reading comprehension and reception of oral communication
d. Understanding of and ability to discuss health care concerns - ANSWER: A
What is the main reason for using the REALM-SF instrument to evaluate health literacy?
a. It assesses numeracy skills.
b. It enhances patient-provider communication.
c. It evaluates medical word recognition.
d. It measures technology knowledge. - ANSWER: C
A female patient who is from the Middle East schedules an appointment in a primary care
office. To provide culturally responsive care, what will the clinic personnel do when
, meeting this patient for the first time?
a. Ensure that she is seen by a female provider.
b. Include a male family member in discussions about health care.
c. Inquire about the patient's beliefs about health and treatment.
d. Research middle eastern cultural beliefs about health care. - ANSWER: C
A primary care provider is providing care for a postsurgical client who recently immigrated to the
United States and speaks English only marginally. What intervention will provide the most effective
means of communicating postdischarge information to the client? a. Postpone discharge until the
client is fully recovered from the surgery. b. Requesting that a family member who speaks English be
present during the teaching session c. Providing the necessary information in written form in the
client's native language d. Requesting the services of a professional interpreter fluent in the client's
native language - ANSWER: D
What question asked by the client newly diagnosed with congestive heart failure
demonstrates the effectiveness of previous education concerning the Ask Me 3 health
literacy tool? (Select all that apply.)
a. "Where can I get assistance with the cost of my medications?"
b. "Why is it important for me to take this newly prescribed medication?"
c. "Is it true that high blood pressure isn't causing my problem?"
d. "Is congestive heart failure curable with appropriate treatment?"
e. "Would watching my intake of salt help me manage this problem? - ANSWER: B, C, E
A patient expresses concern that she is at risk for breast cancer. To best assess the risk for
this patient, what is the best initial action?
a. Ask if there is a family history of breast cancer.
b. Gather and record a three-generation pedigree.
c. Order a genetic test for the breast cancer gene.
d. Recommend direct-to-consumer genetic testing. - ANSWER: B
A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell
the patient?
a. It is not useful for identifying genetic diseases.
b. Much of the information does not predict disease risk.
c. The results are shared with the patient's insurance company.
d. The results must be interpreted by a provider. - ANSWER: B
What is an important part of patient care that can minimize the risk of a formal patient
complaint even when a mistake is made?
a. Ensuring informed consent for all procedures
b. Maintaining effective patient communication
c. Monitoring patient compliance and adherence
d. Providing complete documentation of visits
ANS: B - ANSWER:
What are some causes for failures or delays in diagnosing patients resulting in malpractice
claims? (Select all that apply.)
a. Failing to recognize a medication complication
b. Failing to request appropriate consultations
c. Improper performance of a treatment
d. Not acting on diagnostic test results
e. Ordering a wrong medication
ANS: B, D - ANSWER:
A patient prescribed a beta blocker medication is in the emergency department with reports of
syncope, shortness of breath, and hypotension. A cardiac monitor reveals a heart rate of 35
beats per minute. Which medication may be used to stabilize this patient?
