Practice Test Q & A.docx

  When choosing a community vendor to supply Durable Medical Equipment (DME) to a client, the most important factor is A-reliability, B-Proximity, C-Quality, D-Cost - Correct Answers: A-Reliability When conducting a survey or program evaluation, the easiest way to quantify are A-Descriptive informational questions, B-yes-no questions; C-Multiple choice questions, D-Rating scale - Correct Answers: B-yes no questions The primary purpose of the Caseload Matrix is caseload calculations to A-Differentiate activities and interventions; B-measure specific outcomes; C-determine accuracy of caseload calculations; D-identify variables in various settings affecting caseloads - Correct Answers: D-identify variables in various settings affecting caseloads Using a 4 point Likert scale to assess clients with low self-care, a client with severe risk of failing to adhere to medical regiments/treatments is classified as: A-Level 1; B-Level 2; C-Level 3; D-Level 4 - Correct Answers: C-Level 3 A young adult in the emergency department for attempted suicide with three previous attempts should be: A-referred to outpatient mental health services; B-treated and discharged to family; C-asked to sign a no suicide contract before discharge; D-admitted to the hospital - Correct Answers: D-admitted to the hospital The 3 midnight rule for extended Medicare benefits applies to clients transferring to: A-skilled nursing facilities; B-home health agency services; C-long-term care facilities for rehabilitation; d-assisted living facilities - Correct Answers: A-skilled nursing facilities The InterQual utilization management tool, which is used to determine if interventions are appropriate and properly sequenced, is considered to be: A-a retrospective monitoring tool; B-clinical evidence summaries; C-level of care criteria tools; D-care planning criteria tools - Correct Answers: D-care planning criteria tools Identifying the need for environmental modifications in a client's home is a role of the CCM under the domain of: A-Outcomes evaluation/case closure; B-utilization management; C-vocation concepts & strategies; D-clinical care management - Correct Answers: C-vocation concepts & strategies A set of expected behaviors and consequences related to a CCMs place in particular social structure, such as an acute hospital is: A-process; B-role; C-activity; D-function - Correct Answers: B-role Under the CMS Quality Framework for Home & Community Based Services, participant safeguards include: A-licensure and certification of staff; B-right to make decisions; C-incident reporting; D-surveys of outcomes - Correct Answers: C-incident reporting The most significant challenge to community based CCMs is: A-The acutely ill; B-pediatric clients; C-mothers and infants; D-the chronically ill - Correct Answers: D-the chronically ill The primrary purpose of negotiation in CCM practice is to: A-control costs and provide medically necessary services; B-avoid conflict and promote cooperation; C-educate participants; D-represent the payor's interests - Correct Answers: A-control costs and provide medically necessary services A requirement for participation in a pharmacy assistance program usually includes: A-prescription insurance coverage or Medicare D; B-generic prescriptions only; C-U.S. residency; D-income of less than 200% of Federal poverty level - Correct Answers: D-income of less than 200% of Federal poverty level Under InterQual's ISD criteria of severity of illness (SI) reflecting the need for acute hospitalization, onset of symptoms within one week is categorized as: A-acute/sudden onset; B-recently or newly discovered; C-recent onset; D-newly discovered. - Correct Answers: C-recent onset With mandatory beneficiary ownership of capped rental durable medical equipment (DME) once ownership has based to the beneficiary, Medicare will pay for: A-routine service & maintenance; B-only repairs necessary to make DME serviceable; C-all routine service & repairs; D-no service or repairs. - Correct Answers: B-only repairs necessary to make DME serviceable If a client in an acute hospital has comorbidities of prostate cancer, Type I diabetes, hypertension and pneumonia, the priority treatment is: A-prostate cancer; B-Type 1 diabetes; C-hypertension; D-pneumonia - Correct Answers: D-pneumonia Denial or non-certification of services may result from: A-extended hospitalization because of postoperative myocardial infarction; B-extended hospitalization because PT is not available on weekends; C-change in policy after services rendered; D-client's death - Correct Answers: B-extended hospitalization because PT is not available on weekends The best place for a 47 year old male with an IQ of 68 who cannot live along is probably: A-group home; B-skilled nursing facility; C-assisted living facility; D-mental health facility - Correct Answers: A-group home The average length of stay (LOS) in an acute hospital for a complete knee replacement is approximately: A-3 days; B-4 days; C-7 days; D-10 days. - Correct Answers: B-4 days If a client has outpatient surgery in the morning and stays overnight for extended observation, the client become inpatient: A-At midnight; B-after 8 hours; C-when the physician order inpatient services; D-after 24 hours. - Correct Answers: C-when the physician orders inpatient services A CCM is in the emergency department (ED) must consider national indicators for ED crowding such as: A-need for follow up appointments; B-acute hospitalization; C-diversions; D-unsafe discharges - Correct Answers: D-unsafe discharges The CCM in the admitting department services essentially as: A-gatekeeper; B-negotiator; C-communicator; D-supervisor - Correct Answers: A-gatekeeper When a client is receiving occupational therapy in the home, documentation must include: A-costs; B-client preference; C-realistic and measurable goals; D-indirect supervision of unlicensed staff. - Correct Answers: C-realistic and measurable goals The best initial method of ensuring correct medication dosage for a home client who wants to remain independent but sometimes forgets to taker her morning medications or takes a double dose is: A-hiring an aide to come in daily and give medications; B-providing an electronic alarmed medication delivery device; C-placing the client in an assisted living facility; D-arranging for someone to telephone daily - Correct Answers: B-providing an electronic alarmed medication delivery device; The Older Americans Act provides: A-hospital services; B-pharmacy assistance; C-home and community services; D-financial assistance to older adults - Correct Answers: C-home and community services Initial symptom management of shortness of breath in a palliative care client usually includes: A-elevating the head and using a fan aimed toward the person's face; B-corticosteroids; C-oxygen by nasal cannula; D-bronchodilators - Correct Answers: A-elevating the head and using a fan aimed toward the person's face In Kurt Lewin's change theory, the first stage, motivation to change, is also referred to as: A-freezing; B-unfreezing; C-unfrozen; D-refreezing - Correct Answers: B-unfreezing A person who is resistant to seeing a psychologist for severe emotional problems because of personal belief that prayer will heal may benefit most from: A-pastoral counseling; B-personal meditation; C-medications; D-spiritual instructions - Correct Answers: A-pastoral counseling For a trauma patient who will need long-term care and has no coverage and no financial resources beyond Social Security Income, the acute care CCM should explore: A-charity organizatations; B-extended acute care; C-home health agency care; D-state long-term care programs - Correct Answers: D-state long-term care programs To facilitate the continuum of care after a client is discharged from an acute hospital, the most important relationship for a CCM to develop is with: A-physician's staff; B-HMO clinicians; C-skilled nursing facilities and home health agencies; D-acute hospital administrators - Correct Answers: C-skilled nursing facilities and home health agencies A tool that provides a client's self-assessment of functional health and quality of life issues is: A-Health Status Survey (SF-36); B-Patient Health Questionnaire (PHQ); C-Post Deployment Clinical Assessment Tool (PDCAT); D-Barthel Index - Correct Answers: A-Health Status Survey (SF-36) The type of group therapy that aims to help members who share a common problem learn to cope is; A-education group; B-self-help group; C-psychotherapy group; D-support group - Correct Answers: D-support group The national organization that may provide the best information for the family of a young man who suffered a third concussion as a football injury is: A-American College of Sports Medicine; B-American Association of Physical Medicine and Rehabilitation; C-Brain Trauma Foundation; D-Orthopedic Research Society - Correct Answers: C-Brain Trauma Foundation The primary purpose of a health coach is to: A-prescribe treatment; B-guide clients to discuss concerns regarding recover; C-Counsel clients; D-ensure treatment compliance - Correct Answers: B-Guide clients to discuss concerns regarding recovery The best intervention for a 68 year old man with COPD who lives alone and manages his won care been eating only candy and snack foods is: A-nutritional counseling; B-admission to assisted living facility; C-home delivery meals (Meals on Wheels); D-referral to occupational therapist - Correct Answers: C-home delivery meals (Meals on Wheels) The first step in crisis intervention is: A-devising a plan; B-assessing the problem and triggering event; C-teaching coping mechanisms; D-evaluating resources - Correct Answers: B-assessing the problem and the triggering event Older adults with chronic illnesses that result in pain and/or physical limitation should often be evaluated for: A-dementia; B-depression; C-drug abuse; D-alcoholism - Correct Answers: B-depression The coping mechanism that involves actively searching for a way to reduce stress and cope is: A-problem solving; B-avoidance; C-physical activity; D-spirituality - Correct Answers: A-problem solving The best response to a dying Hmong patient states that a shaman is coming to heal her is: A-"That is not realistic in your condition." B-"If you believe, then a cure is possible." C-"You will need your doctor's permission.; D-"What can I do to help?" - Correct Answers: D-"What can I do to help?" For a person with a dual diagnosis, the initial treatment usually focuses on: A-detoxification; B-rehabilitation; C-mental health treatment; D-coping strategies - Correct Answers: A-detoxification Healthy literacy primarily requires: A-basic reading, numerical and comprehension and communications skills; B-a thorough understanding of disease and appropriate treatments; C-an above-average intellectual capacity; D-motivation to learn about health - Correct Answers: A-basic reading, numerical and comprehension and communications skills Bereavement is: A-a normal response to loss; B-the public expression of grief; C-change of mood and feeling of sadness; D-the time period of mourning - Correct Answers: D-the time period of mourning An alert elderly home care patient who complains that items have been disappearing from her home is most likely a victim of: A-elder abuse; B-psychological abuse; C-financial abuse; D-physical abuse - Correct Answers: C-financial abuse Before making a telephone call to a client to review his status, the CCM should: A-prepare a script; B-outline the objectives of the call; C-send a mail notification; D-notify the physician - Correct Answers: B-outline the objectives of the call Under the Case Management Society of America (CMSA)Standards of Practice, the standard of facilitation, coordination, and collaboration can be demonstrated by: A-documentation of termination of care; B-documentation of ongoing efforts at collaboration with the client; C-use of screening for high-risk individuals; D-use of mediation/negotiation - Correct Answers: D-use of mediation/negotiation If all shelters are full and an indigent uninsured client with planned discharge in three days is placed on a waiting list for a preferred shelter, then the CCMs next action should be to: A-call daily to determine where the client is on the list; B-place the client on a second waiting list; C-plan transfer to a skilled nursing facility under shelter placement is possible; D-refer the problem to social services - Correct Answers: B-place client on a second waiting list Bloodshot eyes, sniffing repeatedly, altered sleeping habits, and marked weight loss are indications of: A-excessive smoking; B-cocaine abuse; C-alcoholism; D-marijuana abuse - Correct Answers: B-cocaine abuse For a patient recovering from a brain injury, the Glasgow coma score that indicates potential for rehabilitation is: A-2; B-5; C-8; C-8; D-10 - Correct Answers: D-10 Upon discharge from an acute hospital, the most appropriate placement for a client who has slight demential and requires a simple daily dry dressing change but is medically stable and ambulates independently with a cane is: A-subacute/rehabilitation facility; B-skilled nursing facility; C-intermediate care facility; D-assisted living/custodial care facility - Correct Answers: D-assisted living/custodial care facility An example of unskilled care is: A-administering sliding scale insulin; B-instructing a client on a low sodium diet; C-instructions in the use of assistive devices; D-taking and reporting routine vital signs, - Correct Answers: D-taking and reporting routine vital signs A client's or parent's refusal of care may be overridden if: A-the physician orders the care provided despite client objections; B-the client is mentally incompetent; C-the patient is elderly; D-the client is a minor child - Correct Answers: B-the client is mentally incompetent A risk factor for malnutrition is: A-poverty; B-recent weight loss of 5 pounds; C-recent weight gain of 5 pounds; D-dentures - Correct Answers: A-poverty A psychosocial evaluation is indicated for a client with: A-chronic heart disease; B-homelessness; C-unintentional overdose; D-limited financial resources - Correct Answers: C-unintentional overdose The legal element of negligence that refers to a failure to carry out duties in accordance with accepted and usual standards of practice is: A-duty; B-breach; C-causation; D-harm - Correct Answers: B-breach Job accommodations for an office worker with fine moter impairment might include: A-providing speech recognition program for computer access; B-modifying workstation to increase accessibility; C-providing standing/lean stools; D-providing rolling safety ladders - Correct Answers: A-providing speech recognition program for computer access During case selection, the client that is most likely to need and benefit from case management services is: A-12 year old child having tonsillectomy; B-67 year old man having a transurethral resection of the prostate (TURP); C-47 year old Type 2 diabetic with severe insulin reaction after a bout of food poisoning with vomiting and diarrhea; D-72 year old woman with postoperative wound infection after hip replacement. - Correct Answers: D-72 year old woman with postoperative wound infection after hip replacement. When a facility is converting to the interoperable electronic healthcare delivery system the most important aspect to consider is: A-equipment choice; B-time needed for conversion; C-staff training; D-staff preference - Correct Answers: C-staff training The client centered model of care in which a primary care physician manages, facilitates and coordinates all levels of care, including care provided by specialists is: A-Chronic care model; B-Medical home model; C-Planned care model; D-expanded care model - Correct Answers: B-medical home model Using real tasks or simulated work-related tasks and progressive exercises to strengthen and condition a person to return to work is an example of: A-job coaching; B-work adjustment; C-transitional employment; D-work hardening - Correct Answers: D-work hardening A client being discharged from an acute hospital with an infusuion pump for multiple intravenose medications can be transferred to: A-sub-acute rehabilitation facilities; B-skilled nursing facility; C-sub-acute and skilled nursing facilities; D-intermediate care facility - Correct Answers: A-sub-acute rehabilitation facilities During assessment and problem identification for a client with multiple physicians, if inconsistencies in medical data are found, the CCM should first: A-consult with the client; B-accept the latest information as most accurate; C-consult with the source of inconsistent data; D-ask for a medical review of client care. - Correct Answers: C-consult with the source of inconsistent data The level of care that provides people with moderate assistance in activities of daily living and periodic supervision for some activities is: A-custodial care; B-intermediate care; C-skilled nursing; D-acute care - Correct Answers: B-intermediate care Criteria for Medicare coverage of home oxygen for a client receiving oxygen at 5L/minute includes drawing arterial blood gases with client: A-receiving oxygen at 5L/minute; B-receiving oxygen at 3L/minute; C-receiving oxygen at 4L/minutes; D-breathing room air - Correct Answers: C-receiving oxygen at 4L/minute The correct elbow angle for an officer worker when sitting in a chair and using a computer keyboard is: A-45 degrees; B-60 degrees; C-90 degrees; D-120 degrees - Correct Answers: C-90 degrees Durable medical equipment (DME) classified as assistive devices include: A-electric beds; B-handrails; C-crutches; D-apnea/sleep monitores - Correct Answers: B-handrails Underutilization may result from: A-delays in performing necessary diagnostic procedures; B-client's insistence on expensive procedures; C-client's being in a teaching hospital; D-physician's concern about liability - Correct Answers: A-delays in performing necessary diagnostic procedures The type of insurance plan that offers the most flexibility is the: A-health maintenance organization; B-managed indemnity plans; C-indemnity plans; D-point-of service plans - Correct Answers: C-indemnity plans Underutilization management services, the review that determines whether hospitalization is justified is: A-telephonic review; B-retrospective review; C-concurrent review; D-prospective review - Correct Answers: D-prospective review When conflicts arise over coverage for treatment, the CCM's primary responsibility is to: A-the payor; B-the client; C-the utilization review committee; D-the care provider - Correct Answers: B-the client The National Quality Forum (NQF) measures that determine if correct actions, such as cervical cancer screening, have been completed are: A-process measures; B-outcomes measures; C-patient experience measures; D-structural measures - Correct Answers: A-process measures The Instrumental Activities of Daily Living (ADL) tool includes assessment of: A-bathing; B-toileting; C-ascending and descending stairs; D-financial responsibility - Correct Answers: D-financial responsibility The type of variance that occurs when durable medical equipment for home care is unavailable is: A-community variance; B-practitioner variance; C-institution/systems variance; D-client/family variance - Correct Answers: A-community variance The type of assessment that evaluates hazards in the home, such as loose carpets, rotting food, or piles of paper on the floor, is: A-physical assessment; B-functional assessment; C-environmental assessment; D-psychosocial assessment - Correct Answers: C-environmental assessmeny A learner outcome for teaching diabetics about insulin reaction is: A-identify different types of insulin; B-list and describe the symptoms of insulin reaction; C-identify foods high in carbohydrates; D-explain the difference in Type 1 and Type 2 diabetes - Correct Answers: B-list and describe the symptoms of insulin reaction Case management differs from managed care in that case management is primarily: A-people oriented; B-systems oriented; C-regulation oriented; D-nursing oriented - Correct Answers: A-people oriented After complicated labor and Caesarean, a woman must be covered for hospitalization by her insurance carrier for: A-24 hours; B-96 hours; C-48 hours; D-36 hours - Correct Answers: B-96 hours For employment experience to be accepted for CM certification, the applicant must: A-perform at least 6 or 8 essential activities related to client contact; B- be licensed or certified to practice independently; C-practice management experience at last 25% of the tine; D-perform work in at least for of six core components of case managment - Correct Answers: B-be licensed or certified to practice independently A Medicare client who was hospitalized for a brain injury may be eligible for home health care to provide: A-nursing care 24 hours a day; B-home delivered meals; C-personal care (bathing, dressing) alone; D-occupational therapy - Correct Answers: D-occupational therapy When evaluating outcomes data for evidence based practice, the type of data that includes measures of mortality, longevity and cost-effectiveness is: A-clinical; B-psychosocial; C-integrative; D-physiological - Correct Answers: C-Integrative The primary focus of Worker's Compensation is to: A-prevent economic hardship; B-return people to work; C-contain costs; D-promote worker's safety - Correct Answers: B-return people to work A case mix group, as defined by the Health Insurance Perspective Payment System (HIPPS) is: A-a classification system based on utilization of resources; B-a data set containing elements to review for a comprehensive assessment of client function: C-a classification system based on clinical characteristics of clients; D-a data set used by home health agencies to measure outcomes and risk factors - Correct Answers: C-a classification system based on clinical characteristics of clients If a client has insurance from a self-funded, employer sponsored health plan and questions of coverage arises, the CCM should contact: A-the plan's benefit manager; B-the employer; C-the client; D-the physician - Correct Answers: A-the plan's benefit manager The primary purpose of pharmacy benefit management is to: A-increase use of generic drugs; B-reduce cost of drugs; C-promote drug safety; D-provide a drug formulary for clients - Correct Answers: B-reduce the costs of drugs The level of independence or care in the hone for an adult female indicated by a discharge Functional Independence Measure (FIM) score is 63, with scores in all areas ranging from 3 to 4 is: A-complete independence in care; B-modified independence, including use of assistive devices and activity modification; C-supervision only (standby without physically assisting; D-minimal to moderate contract assistance (physically assisting) - Correct Answers: D-minimal to moderate contract assistance (physically assisting) The first step in doing a cultural assessment is: A-explain the purpose of a cultural assessment; B-ask permission to do a cultural assessment; C-take thorough notes during communication; D-establish trust - Correct Answers: D-establish trust Intensive case management for assertive community treatment is focused on providing care for: A-brain injuries; B-mental health issues; C-spinal cord injuries; D-Alheimer's disease - Correct Answers: B-mental health issues Palliative care can begin when: A-a client is diagnosed with a life-threatening illness; B-a client's life expectancy is less than 1 year; C-a client's life expectancy is six months or less; C-a client requests palliative care - Correct Answers: A-a client is diagnosed with a life-threatening disease When healthcare providers disagree about the best plan of care, the first step in resolving this conflict is to: A-allow both individuals to present their side of the conflict without bias; B-encourage them to reach a compromise; C-tell they the are violating professional standards of conduct; D-make a decision about the matter - Correct Answers: A-allow both individuals to present their side of the conflict without bias According to the Consolidated Omnibus Budget Reconciliation Act (COBRA), the usual duration for which an ex-employee may have continued insurance coverage is: A-12 months; B-18 months; C-24 months; C-36 months - Correct Answers: B-18 months The primary criterion for referal to a hospice program is: A-severe intractable pain; B-life-threatening disease; C-probability that death will occur within 6 months; D-DNR order - Correct Answers: C-probability that death will occur within six months An example of hard savings that can result from case management: A-avoiding hospital readmission; B-avoiding home health care; C-preventing medical errors; D-changing length of stay - Correct Answers: D-changing length of stay The most appropriate addition to an interdisciplinary care team (ICT) to assist in coordinating care for increasing numbers of pediatric clients would be: A-child life specialist; B-occupational therapist; C-dietician; D-play therapist - Correct Answers: A-child life specialist When determining burden of proof for acts of negligence, risk management would classify willfully providing inadequate care while disregarding the safety and security of another as: A-negligent conduct; B-gross negligence; C-contributory negligence; D-comparative negligence - Correct Answers: N-gross negigence If the CCM at a hospital determines that a client does not need a discharge plan for transition of care, but the physician orders one, the hospital; A-can choose to omit the discharge plan; B-must develop the plan; C-may develop a simplified discharge plan; D-may subsitute with general information materials - Correct Answers: B-must develop the plan A legal document that specifically designates someone to make decision regarding medical and end of life care if a client is mentally incompetent is a: A-advance directive; B-do not resuscitate order; C-durable power of attorney; D-general power of attorney - Correct Answers: C-durable power of attorney If 2 clients need a hospital bed, but only one is available, the decision regarding which client to transfer should be based on the ethical principle of: A-non-malficence; B-beneficence; C-justice; D-autonomy - Correct Answers: C-justice The theory that states that a change is one family member's behavior will effect others in the family is: A-Health Belief Model (Rosenstock); B-Theory of Planned Behavior (Ajzen); C-Family Systems Theory (Bowen); D-Theory of Reasonee Action (Fishbein & Ajzen) - Correct Answers: C-Family Systems Theory (Bowen) Kolb's mode of experiential learning is best described as: A-knowledge develops from experience interacting with cognition and perception; B-knowledge and experience are equally important; C-experience precedes knowledge in learning; D-learning cannot be acquired without experience and perception - Correct Answers: A-knowledge develops from experience interacting with cognition and perception When a client's spouse asks for information about another client, the response that complies with the Health Insurance Portability and Accountability Act (HIPPA) is: A-the law doesn't allow me to give out any information about clients in order to protect their privacy and safety; B-His wife is in the lounge, you can go ask her; C-why are you asking; D-He has bipolar disease, like your husband. - Correct Answers: A-the law doesn't allow me to give out any information about clients in order to protect their privacy and safety A prevention strategy that encourages physicians, nurses and other healthcare providers to discuss smoking cessation with all adolescents is an example of: A-secondary prevention; B-universal primary prevention; C-indicated primary prevention; D-targeted primary prevention - Correct Answers: D-targeted primary preventon The method used to determine monetary savings resulting from planned interventions is: A-cost/benefit analysis; B-cost-effective analysis; C-efficacy study; D-cost/utility analysis - Correct Answers: A-cost/benefit analysis For quality/performance improvement, the best tool to determine methods to streamline processes is: A-root cause analysis; B-tracer methodology; C-family survey; D-staff survey - Correct Answers: B-tracer methodology A violation of professional boundaries on the part of the CCM is: A-accepting a box of chocolates to be shared by all unit staff from a client's daughter; B-confiding to the client the he, like the client, is getting divorced, so he understand's the client's stress; C-Assisting a client in placing a call to his landlord so the client can explain that he cannot pay his rent on time; D-noticing that a client is crying and placing his hand on the client's shoulder - Correct Answers: B-confiding to the client the he, like the client, is getting divorced, so he understand's the client's stress The most critical skill for a CCM collaborating in an interdisciplinary team is; A-patience; B-assertiveness; C-empathy with others; D-willingness to compromise - Correct Answers: D-willingness to compromise If a 24 year old Asian client states a treatment preference but plans to leave the decision to her family members, the CCM should: A-try to convince the client to assert herself; B-recognize that cultural values regarding individualism vary, and respect the client's right to be guided by family; C-tell the family that the client should be the one to make the decision; D-ask the ethics committee to intervene - Correct Answers: B-recognize that cultural values regarding individualism vary, and respect the client's right to be guided by family The following act prevents transfer of a client from the ED until the client stabilizes: A-the Health Insurance Portability and Accountability Act (HIPPA); B-The Emergency Medical Treatment and Active Labor Act (EMTALA); C-American with Disabilities Act (ADA); D-Older Americans Act (OAA) - Correct Answers: B-The Emergency Medical Treatment and Active Labor Act (EMTALA) An example of documentation that is currently on the Joint Commission's "Do Not Use" list is: A-5 mg; B-0.5 mg; C-15 U; D-@ - Correct Answers: C-15 U If all clients develop urinary infections with urinary catheters are evaluated per urine culture and sensitivities for microbial resistance, but only those clients with clinically evident infections are included, this is an example of: A-information bias; B-selection bias; C-compliance bias; D-admission bias - Correct Answers: B-selection bias The National Patient Safety Goals communication requirements related to telephone orders or reporting include: A-the receiver reading back the orders or report; B-the receiver repeating each part of an order or report as it's given; C-the individual giving orders or reports asks information is understood; D-the individual giving orders or reports repeats each item twice - Correct Answers: A-the receiver reading back the orders or report A necessary component of informed consent prior to a procedure is: A-names of assisting staff members; B-beginning and ending times; C-risks and benefits of procedure; D-facility statistics regarding procedure - Correct Answers: C-risks and benefits or procedure When instituting a plan for risk management, the primary concern in the statement of purpose should be: A-reduction in financial risk; B-client safety; C-decreased liability; D-scope of program - Correct Answers: B-client safety The Mini-Cog test to assess for dementia includes: A-counting backward from 100 by 7s; B-copying a picture of interlocking shapes; C-following simple 3 part directions; D-drawing the face of a clock with the hands indicating a specific time - Correct Answers: D-drawing the face of a clock with the hands indicating a specific time Outcome are derived from: A-client, nurse and system; B-client only; C-clients, physician and nurses; D-nurse ony - Correct Answers: A-client, nurse and system A community resource that can provide nursing and personal care in the home is: A-public health department; B-home health agency; C-social services; D-senior citizens organzations - Correct Answers: B-home health agency The primary focus of a risk mitigation program is: A-to decrease adverse patient outcomes and reduce liability; B-to improve processes of care; C-to improve patient outcomes; D-to adhere to professional standards - Correct Answers: A-to decrease adverse patient outcomes and reduce liability The governmental agency responsible for blood-borne pathogens standards in medical institutions is: A-CDC; B-OSHA; C-EPA; D-FDA - Correct Answers: B-OSHA With continuous quality improvement (CQI) model, the focus of improvement is on: A-processes; B-staff; C-administrative personnel; D-clients - Correct Answers: A-processes When developing guidelines for evidence-based practice, the weakest justification for establishing a procedure is: A-evidence review; B-staff preference; C-policy considerations; D-expert judgement - Correct Answers: B-staff preference Viatical settlements primarily benefit: A-beneficiaries; B-healthcare providers; C-insurance companies; D-policy holders - Correct Answers: D-policy holders The model for managed care that provides services at discounted rates to those enrolled is: A-Health Maintenance Organization (HMO); B-Point of Service Plan (POS); C-Preferred Provider Organization (PPO); D-Exclusive Provider Organization (EPO) - Correct Answers: D-Exclusive Provider Organization (EPO) The model for health maintenance organizations in which the HMO hires physicians to work in clinic-type settings is: A-group model; B-network model; C-staff model; D-direct contact model - Correct Answers: C-staff model Medicare B benefits include: A-hospitalization (acute care); B-skilled nursing facility care; C-clinical laboratory services; D-hospice care - Correct Answers: C-clinical laboratory services The healthcare insurance reimbursement system that involves an advanced fixed monthly payment to a provider is: A-per-diem reimbursement; B-fee for service; C-pay for performance; D-capitation - Correct Answers: C-capitation The Agency for Healthcare Research and Quality (AHRQ) quality indicators (QI) that measure the quality of care for disorders sensitive to outpatient care (with good care reducing the need for hospitalization are: A- Prevention QIs; B-Inpatient QWIs; C-Patient Safety indicatiors (PSIs); D-Pediatric QIs - Correct Answers: A- Prevention QIs Core measures for Centers for Medicare and Medicaid (CMS) include measures related to: A-cancer; B-brain injuries; C-asthma care for children; D- Alzheimer's disease - Correct Answers: C-asthma care for children URAC case management accreditation standards require healthcare organizations, such as managed care program, to establish processes to: A-assess, plan and implement case management interventions; B-evaluated outcomes of case management interventions; C-conduce peer reviews of case management interventions; D-cut costs of case management interventions - Correct Answers: A-assess, plan and implement case management interventions The healthcare accreditation agency that assists purchasers of health plan and consumers to evaluate performance of the health plan is: A-Centers for Medicare & Medicaid (CMS); B-TJC-formerly the Joint Commission; C-URAC; D-National Committee for Quality Assurance - Correct Answers: D-National Committee for Quality Assurance The government agency that regulates protection of human subjects involved in research projects for experimental treatments is: A-FDA; B-OSHA; C-CMS; C-CDC - Correct Answers: A-FDA Eligibility criteria for Supplemental Security Income (SSI) for those with low income and few resources include: A-deafness; B-age 55 or older; C-chronic pain; D- blindness - Correct Answers: D-blindness Guidelines for eligibility and reimbursement in Medicaid programs are established by: A- SSA; B-individual counties; C-state consortia; D-individual states - Correct Answers: D-individual states Under the chronic care model, the primary purpose of utilizing community resource is to: A-identify client needs; B-improve client's self management skills; C-reduce the need for rehospitalization; D-reduce costs - Correct Answers: B-improve client's self management skills If a client has only Medicare and no supplementary insurance and her physician accepts Medicare, the client's out of pocket cost for care will be: A-nothing; B-10%; C-20%; D-80% - Correct Answers: C-20% A client with both Tricare and Medicare may avoid hospitalization in a Veterans' Affairs facility because: A-Tricare and Medicare combines reimburse for only 80% of the costs; B-The VA can bill neither Tricare or Medicare; C-the VA cannot bill Tricare; D-the VA cannot bill Medicare - Correct Answers: D-The VA cannot bill Medicare Criteria for Social Security Disability Insurance (SSDI) include a physical/mental disability as well as: A-restriction in employment ability; B-age greater than 65; C-limited income; D-expectation of permanent disability - Correct Answers: A-restriction in employment ability A specified dollar amount that a client must pay at the time of receiving healthcare services is A-premium; B-copayment; C-deductible; D-coinsurance - Correct Answers: B-copayment If a child has been hospitalized 3 times in 12 months with acute asthma because of noncompliance with the treatment regimen, the best initial action of the CCM is: A-make referral to child protective services (CPS); B-reprimand the parents; C-suggest a change in treatment regimen; D-question the reasons for noncompliance - Correct Answers: D-question the reasons for noncompliance An affidavit of merit is usually filed to: A-support a lawsuit for malpractice; B-refute a lawsuit for malpractice; C-reward excellence in service; D-confer accreditations - Correct Answers: A-support a lawsuit for malpractice The most appropriate rehabilitation placement for a 72 year old woman who lives alone and had a hip replacement 5 days earlier is: A-rehabilitation in an acute hospital; B-rehabilitation in the provider's office; C-rehabilitation in her home; D-rehabilitation in a skilled nursing/rehabilitation facility - Correct Answers: D-rehabilitation in a skilled nursing/rehabilitation facility For a client with peripheral arterial disease, an ankle-brachial index (ABI) score of 0.4 indicates: A-limb threatening condition with pain at rest; B-borderline perfusion; C-critical limb threatening condition; D-narrowing of one or more blood vessels - Correct Answers: A-limb threatening condition with pain at rest For a client with a chronic mental health disorder, recovery means: A-absence of symptoms; B-discontinuation of mental health service; C-coping with symptoms and problems; D-independence in meeting individual needs - Correct Answers: C-coping with symptoms and problems Client empowerment primarily requires: A-options, authority and action; B-time and effort; C-intellectual capacity; D-institutional support - Correct Answers: A-options, authority and action Threatening to injure and withhold food and clothes from a person who is uncooperative is an example of: A-physical abuse; B-psychological abuse; C-neglect; D-financial abuse - Correct Answers: B-psychological abuse Medication reconciliation should be completed: A-prior to admission; B-during admission assessment; C-on discharge; D-during all phases of care - Correct Answers: D-during all phases of care If the CCM observes an elderly patient in an assisted living facility is unkempt, dehydrated and fearful and has a number of unexplained bruises, the CCM's most appropriate response is to: A-notify the owner of the facility; B-reprimand the caregivers; C-notify appropriate state authorities, such as adult protective services; D-arrange for transfer to another facility - Correct Answers: C-notify appropriate state authorities such as adult protective services According to InterQual ISD discharge reviews, the appropriate discharge documentation of a client admitted with a WBC of 15,000 and temperature of 39.8C is: A-client stable; B-infection cleared; C-clients lab finding and temperature are within normal limits; D-WBC 7,000 and temperature 37 C - Correct Answers: D-WBC 7,000 and temperature 37 C An important purpose of a critical pathway is to: A-allow flexibility; B-focus on one discipline; C-establish accountability; D-reduce/prevent variations in care - Correct Answers: D-reduce/prevent variations in care The first step in negotiation for a CCM should be: A-statement of problem; B-discussion; C-research; D-statement of financial limits - Correct Answers: C-research A CCM who is contracted by an individual or family to manage healthcare needs and services is a/an: A-private case manager; B-independent case manager; C-community-base case manager; D-internal case manager - Correct Answers: A-private case manager The Milliman care guidelines that can be used for clients with very complex medical situations that to not easily fit into other guidelines are: A-general recovery guidelines; B-inpatient and surgical care guidelines; C-chronic care guidelines; D-ambulatory care guidelines - Correct Answers: A-general recovery guidelines According to Tuckman's group developmental stages, the stage in which members express positive feelings toward each other is: A-forming; B-Storming; C-norming; D-performing - Correct Answers: C-norming Using the average cost of a problem and the cost of intervention to demonstrate saving is: A-cost benefit analysis; B-an efficacy study; C-a product evaluation; D-a cost effective analysis - Correct Answers: A-a cost benefit analysis In Erikson's psychosocial model of development, which state is typical of those entering young adulthood: A-identify vs role confusion; B-initiative vs. guilt; C-ego integrity vs despair; D-intimacy vs isolation - Correct Answers: D-intimacy vs isolation Measuring the effectiveness of an intervention rather than the monetary savings is: A-cost benefit analysis; B-an efficacy study; C-a product evaluation; D-a cost effective analysis - Correct Answers: D-a cost effective analysis A Hispanic patient is admitted to a hospital unit where a nurse is to obtain the patient's admission history, but the patient speaks very little English. What should te nurse do? A-as the patient's 12 year old son, who is fluent in English to interpret; B-use sign language and pictures to supplement questions; C-arrange for an interpreter; D-ask the patient's wife, who speaks fair English, to answer the questions for the patient - Correct Answers: C-arrange for an interpreter The Health Insurance Portability and Accountability Act (HIPPA) regulates: A-the transfer of patients from one facility to another; B-the rights of the individual related to privacy of health information; C-medical trials; D-workplace safety - Correct Answers: A-the transfer of patients from one facility to another The nurse is teaching a 45 year old woman with a colostomy to perform a colostomy irrigation. The nurse has prepared written directions and a video, but the patient ignores them. Instead, the patient picks up the equipment and looks at each part, trying to figure it out. The patient's learning style is probably: A-auditory; B-visual; C-kinesthetic; D-mixed - Correct Answers: C-kinesthetic A retrospective attempt to determine the cause of an event is: A-root cause analysis; B-external benchmarking; C-internal trending; D-tracer methodology - Correct Answers: B-external benchmarking All departments in a healthcare institution should strive toward: A-autonomy; B-a common vision of care; C-increased budget allocation; D-spirit of competition - Correct Answers: B-a common vision of care An Alzheimer patient walked away from the hospital and was found hiding in the parking lot. The most appropriate nursing diagnosis to account for his behavior is: A-acute confusion; B-risk prone health behavior; C-impaired memory;n D- wandering - Correct Answers: D-wandering Clinical pathways should be based on: A-a survey of current practices in the area; B-committed recommendations; C-evidence based research; D-staff preferences - Correct Answers: C-evidence based research An 80 year old patient is dying of cancer and has been in and out of consciousness. The family should be encouraged to: A-go home, as the patient does not know they are present; B-talk to the patient, as hearing is usually the last sense to fail; C-offer the patient frequent sips of water to avoid dehydration; D-raise the head of the patient's bed if respirations become rattling to help the patient clear secretions - Correct Answers: B-talk to the patient, as hearing is usually the last sense to fail A cost saving study showed that a free medical clinic ordered 17 different types of dressing supplies because of varying staff preferences. Because of this large number, the clinic was not able to buy in sufficient bulk to receive a large quantity discount. The best solution to this problem is: A-continue to order the same types of supplies to keep the staff happy; B-create an ad hoc team to survey staff preferences and agree on a reduced number of dressing supplies; C-reduce number of dressing supplies ordered to administrative preference; D-complete a 6 month survey of the use of dressing supplies - Correct Answers: B-create an ad hoc team to survey staff preferences and agree on a reduced number of dressing supplies A 76 year old female with lung cancer was placed in hospice care by her physician 6 months earlier (two 90 day periods), but she is still alive. Her family asks the nurse if the patient will be removed from hospice care. The best response is: A-She will be removed from hospice care until her condition worsens because she had exceeded the 6 month period; B-she has exhausted all of her hospice benefits and will be removed from hospice care; C-she can continue with hospice care as long as the physician continues to authorize care every 60 days; D-she can continue with hospice care as long as the physician continues to authorize care every 90 days; - Correct Answers: C-she can continue with hospice care as long as the physician continues to authorize care every 60 days; The best question to elicit information about a patient's pain is: A-are you having pain; B-will you describe your pain for me; C-what kind of pain are you having; C-what is your pain on a scale from 1 to 10 - Correct Answers: B-will you describe your pain for me Failure mode and effects analysis (FEMA) is done: A-retrospectively; B-upon utilization of a new process; C-during the trail of a new process; D-prior to utilization of a new process - Correct Answers: D-prior to utilization of a new process How do team members usually deal with issues of power? A-by observing the leader; B-by arguing; C-by following strict rules; D-by rotating leadership roles - Correct Answers: A-by observing the leader Which assessment tool for dementia involves remembering and repeating the names of 3 common objects and the face of a clock with all 12 numbers and hands indicating the time specified by the examiner: A-Mini mental status exam; B-mini cog; C-digit repetition test; confusion assessment method - Correct Answers: B-mini cog A 66 year old male on Medicare is being discharged home. He has an open, draining abdominal wound that he is unable to care for independently because of poor vision. His 14 year old grandson lives with him. The best solution is: A-transferring the patient to an extended care facility; B-keeping the patient in the hospital until the wound has healed; C-teaching the man's 14 year old grandson to provide wound care; D-making a referral to a home health agency to provide in home care. - Correct Answers: D-making a referral to a home health agency to provide in home care When preparing material to teach a 28 year old auto mechanic about wound care; the first thing the nurse should do is: A-prepare an audiotape; B-prepare visual material, such as pictures and diagram;s C-assess a patient's learning style; D-prepare manipulatives, assuming a male mechanic will be a kinesthetic learner - Correct Answers: C-assess a patient's learning style A patient with end stage bone cancer has elected hospice and palliative care. The patient is experiencing severe bone pain from a tumor, and the physician orders radiotherapy to reduce the tumor's size and to reduce pain. Is this treatment acceptable under hospice care criteria? A-No, the patient has elected to forego curative treatment, so Medicare will not pay for the radiotherapy; B-No the patient needs to be removed from hospice care first; C-Yes, the hospice recommends only palliative care but curative treatment is acceptable; D-yes, if the purpose of the treatment is to relieve pain, it is essentially palliative - Correct Answers: D-yes, if the purpose of the treatment is to relieve pain, it is essentially palliative Which scale is used to assess and predict the risk of a patient developing pressure sores based upon sensory perception, moisture, activity, mobility, nutrition pattern and friction and sheer: A-Norton scale; B-Pressure Ulcer Scale for Healing (PUSH); C-The Braden scale; D-Diabetic Foot Ulcer Scale (DFS) - Correct Answers: C-the Braden scale A primary purpose of interdisciplinary teams is: A-sharing ideas and perspectives to solve problems; B-cost savings; C-improved patient satisfaction; D-time saving - Correct Answers: A-sharing ideas and perspectives to solve problems A 60 year old make is being treated for myocardial infarction. While he is progressing well physically, he becomes upset when asked to make independence decisions and he rings the call bell constantly asking for reassurance that he will get well. This psychological response to stress is an example of: A-dependence; B-passivity; C-depression; D-confusion - Correct Answers: A-dependence Which members of the healthcare institution are responsible for identifying performance improvement projects: A-administrative staff; B-nursing team leaders; C-physicians; D-all staff - Correct Answers: D-all staff The American Geriatrics Society's Guideline for the Prevention of Falls in Older Persons recommends (among other things): A-remediation of visual deficits where possible (e.g., glasses); B-home health care aide; C-stretching exercises; D-dietary modifications - Correct Answers: A-remediation of visual deficits where possible (e.g., glasses) Which of the following is on of the 12 leading health indicators (determinants of health) outlined in Healthy People 2020: A-mental health; B-chronic disease; C-immunization; D-family support - Correct Answers: A-mental health Which of the following provides research and funding for the development of evidence based practice guidelines: A-Occupational Health and Safety Association (OSHA); B-Food and Drug Administration (FDA); C-Health Insurance Portability and Accountability Act (HIPPA); D-Agency for Healthcare Research and Quality (AHRQ) - Correct Answers: D-Agency for Healthcare Research and Quality (AHRQ) A 32 year old single mother of a 4 year old child is being discharged after a hysterectomy for cervical cancer. She states she is very depressed because she has lost her job, cannot feed her family, and will soon be homeless. Which referral is most appropriate: A-food bank; B-homeless shelter; C-social worker; D-mental health clinic - Correct Answers: C-social worker According to principles of adult learning, adult learners tend to be: A-unmotivated; B-lacking in self direction; C-practical and goal oriented; D-insecure - Correct Answers: C-practical and goal oriented The Instrumental Activities of Daily Living (IADL) tool includes assessment of: A-bathing; B-toileting; C-ascending or descending stairs; D-financial responsibility - Correct Answers: D-financial responsibility Which nurses should be covered by malpractice insurance: A-advance practice nurses only; B-nurse practitioners only; C-all licensed nursing personnel; D-all unlicensed nursing assistants - Correct Answers: C-all licensed nursing personnel The best time to initiate conflict resolution is: A-when those in conflict have had time to resolve their differences; B-when conflict first emerges; B-when conflict interferes with function; D-when those involved ask for conflict resolution - Correct Answers: N-when conflict first emerges The psychological theory that characterized a hierarchy of needs culminating in self actualization was developed by: A-Jung; B-Havighurst; C-Maslow; D-Freud - Correct Answers: C-Maslow The nurse's scope of practice is defined by: A-Medicare; B-The American Nurses Association; C-The Health Insurance Portability and Accountability Act; D-the state Nurse Practice Act - Correct Answers: D-the state Nurse Practice Act Bloom's taxonomy outline behaviors necessary for learning. Which 3 kinds of learning does the theory describe: A-cognitive, affective and psychomotor; B-auditory, visual and kinesthetic; C-formal and informal; D-attitudes, subjective norms and behavioral intention - Correct Answers: B-auditory, visual and kinesthetic The 5 Rights of delegation include: A-right time, right place, right person, right direction, right evaluation; B-right person, right place, right time, right assignment; right supervision; C-right task, right time, right circumstance; right place, right supervision; D-right task, right circumstance, right person, right direction, right supervision - Correct Answers: B-right person, right place, right time, right assignment; right supervision Failing to provide reasonable care based upon appropriate standards and expertise is an example of: A-laziness; B-poor judgment; C-negligent conduct; D-inadequate supervision - Correct Answers: C-negligent conduct The Disaster Preparedness Committee is responsible for: A-instituting infection control procedures; B-establishing guidelines for the use of patient restraints; C-posting exit routes from each area of the hospital; D-ensuring compliance with air ventilation guidelines - Correct Answers: C-posting exit routes form each area of the hospital During an interview with a patient, what type of patient response provides the most useful information about the patient: A-verbal responses; B-non verbal responses; C-silence; C- both verbal and non verbals responses - Correct Answers: D-both verbal and non verbal responses Providing professional guidance and being someone to whom other staff can bring questions or concerns may be described as: A-mentoring; B-role modeling; C-supervising; D-coaching - Correct Answers: A-mentoring The best determinant of the effectiveness of patient education is: A-patient's satisfaction; B-a patient's ability to demonstrate a behavior; C-a patient's ability to explain a procedure and demonstrate understanding; D- a patient's behavior modification and compliance rates - Correct Answers: D-a patient's behavior modification and compliance rates Which right is included in the Patient's Bill of Rights: A-affordable healthcare; B-pain control; C-right to sue; D-access to latest medical technology - Correct Answers: B-pain control A patient with liver disease and a history of depression commits suicide after repeatedly ringing the call bell and telling a nurse that he wanted to die. Which of the following is an act of negligent omission: A-giving the patient the wrong dosage of antidepressant; B-failing to notify the crisis management team or appropriate authorities of the patient's suicidal statements; C-documenting that the patient was attention seeking; C-moving the call bell out of the patient's reach - Correct Answers: B-failing to notify the crisis management team or appropriate authorities of the patient's suicidal statements Which of the following complies with the American Medical Association's guidelines for informed consent: A-a patient with meningioma is provided a list of treatment options, wait and observe, radiosurgery or craniotomy; B-a patient with possible breast cancer is told that her only option for diagnosis is a fine needle aspirations; C-a preoperative patient is advised that she has nothing to worry about because gall bladder surgery poses almost no risks; D-a patient with 4th stage pancreatic cancer is advised that he must have chemotherapy or he will die - Correct Answers: A-a patient with meningioma is provided a list of treatment options, wait and observe, radiosurgery or craniotomy A legal document that specifically designates someone to make decisions regarding medical and end of life care if a patient is mentally incompetent is a/an: A-advance directive; B-do not resuscitate order; C-durable power of attorney for health care; D-general power of attorney - Correct Answers: C-durable power of attorney for health care A surgical patient develops a wound infection and informs the nurse that she plans to sue the hospital. Which department would handle this issue: A-the adminstration; B-risk management; C-human resources; D-infection control - Correct Answers: B-risk management Jung's theory about the development of the personality over the lifespan is referred to as: A-hierarchy of needs; B-theory of individualism; C-age stratification; D-life course - Correct Answers: B-theory of individuation Which of the following is most likely to lead to medical errors: A-hand block printing of all orders; B-the use of bar coding and scanners; C-the use of medical abbreviations; D-computer generated orders - Correct Answers: C-the use of medical abbreviations One advantage of group instruction over one on one instruction is: A-it is more cost effective; B-it requires less planning; C-it allows more time for questions; D-it is more flexible - Correct Answers: A-it is more cost effective One of the most common causes of the person to person spread of infection in hospitals is: A-crowded conditions; B-poor hand washing technique; C-inadequate housekeeping; D-antibiotic resistance - Correct Answers: B-poor hand washing technique Pain Assessment in Advanced Demential (PAINAD) utilizes: A-a face scale with pictures of smiling or crying faces; B-a 0 to 10 severity scale (0 no pain and 10 the worst); C-monitoring of blood pressure changes; D-observations of non-verbal behavior - Correct Answers: D-observations of non verbal behavior The Confusion Assessment Method is a tool that covers 9 factors related to mental status. This tool is used to assess for: A-delirium; B-Alzheimer's disease; C-substance abuse; D-brain injury - Correct Answers: B-Alzheimer's disease A wealthy patient who has been on the unit for two weeks gives a nurse an expensive watch out of gratitude. What is the nurse's best response: A-you don't need to pay for nursing care; B-thank you so much, I will treasure this; C-this is much too expensive for me to accept; D- I'm sorry. This is so kind of you, but nurses are not allowed to accept gifts from patients. - Correct Answers: D- I'm sorry. This is so kind of you, but nurses are not allowed to accept gifts from patients. A problem list focuses on: A-a prioritized list of patient problems based on assessment, history and interview; B-all identifies patient problems based on assessment, history and interview; C-the patient's self reported problems; D-a standardized list of problems related to a specific diagnosis - Correct Answers: A-a prioritized list of patient problems based on assessment, history and interview; Working for the best interests of the patient despite conflicting personal values and assisting patients to have access to appropriate resources may be defined as: A-moral agency; B-advocacy; C-agency; C-collaboration - Correct Answers: B-advocacy Which therapy involves the use of monitoring devices to allow people to control their own physiological responses: A-imagery; B-acupuncture; C-meditation; D-biofeedback - Correct Answers: D-biofeedback A nurse documents a treatment on the wrong chart. Which is the correct action: A-drawing a line through the entry and writing "error"; B-leaving the initial entry but indicating below that it was documented on the wrong chart; C-whiting out the entry so it's not legible; C-recopying the entire page omitting the entry - Correct Answers: A-drawing a line through the entry and writing "error" A 23 year old Hmong male has acute appendicitis but refuses to sign the consent form until his grandfather arrives. The probable reason is: A-the patient has no insurance; B-the patient lives with his grandfather and is dependent upon him for support; C-the patient is afraid to have surgery without family present; D-the grandfather is the eldest make in the family and makes the decisions for the family - Correct Answers: D-the grandfather is the eldest make in the family and makes the decisions for the family The best approach to solving a problems that involves 3 different departments in the hospital is: A-forming an interdisciplinary team that works together to find a solution; B-the administration resolves the problem independently; C-each department proposes a solution to administration; D-all three departmetns have a joint meeting to brainstorm possible solutions - Correct Answers: A-forming an interdisciplinary team that works together to find a solution A home health nurse visits an older adult and observes that the patient has little food in the house. The patient states he has run out of money and cannot buy groceries, but he does not want his family and friends to know. Which nurse response is appropriate: A-going to the store and buying a small bag of groceries for the patient; B-referring the patient to the appropriate social service agencies; C-calling the patient's daughter anyway and telling her that the patient needs assistance; D-asking the next door neighbor who has expressed a willingness to help to provide meals. - Correct Answers: B-referring the patient to the appropriate social service agencies When preparing written material for patients, what readability level would be appropriate for a homogenos adult patient group in an affluent area: A-grade 6 level; B-ugrade 9 level; C-grade 3 level; D-grade 12 level - Correct Answers: A-grade 6 level Which of Piaget's states of cognitive development is characterized by the ability to think logically, use abstraction and test hypotheses: A-sensorimotor; B-preoperational, preconceptual and intuitive; C-concrete operational; D-formal operational - Correct Answers: C-concrete operational A team leader makes decisions independently and strictly enforces all rules. This type of leadership is: A-bureaucratic; B-laissez faire; C-autocratic; D-democratic - Correct Answers: C-autocratic The manner of making eye contact, the tone of voice, along with touch, gestures, and posture are examples of: A-non verbal communication; B-therapeutic communication; C-proxemics; D-non therapeutic communication - Correct Answers: A-non verbal communication A 50 year old man dying from liver disease is Catholic and asks to take final communion even though it is 2 am. The nurse should: A-contact the patient's priest or a priest on call for the institution and ask him to come right away; B-tell the patient that no priest is available; C-ask the patient if he would be willing to see the Protestant chaplain who is on call; D-tell the patient the priest will be called at 7 am - Correct Answers: A-contact the patient's priest or a priest on call for the institution and ask him to come right away Which of the following most closely characterized Selye's biological theory of stress and aging: A-the body is a machine that wears out over time; B-the body's response to stress is characterized by a generalized adaptation syndrome; C-all cells and organisms have a programmed life span; D-over time, mutations occur that interfere with body functioning and cause aging - Correct Answers: B-the body's response to stress is characterized by a generalized adaptation syndrome What type of precaution is appropriate under CDC isolation guidelines for a patient with tuberculosis: A-Tier I standard precautions; B-Tier II airborne precautions; C-Tier II droplet precautions; D-Tier II contact precautions - Correct Answers: B-Tier II airborne precautions Which of the following theories is characterized by the contention that life is an unending process of changes and transitions: A-life course/life span; B-modernization; C-geo transcendence; D-exchanges - Correct Answers: A-l