1.
I pledge to demonstrate the core values of the American Nurses Association Code of Ethics by upholding the standards of honesty and integrity. By answering "Yes", I certify that I am the person taking this test.
Correct Answer
A. Yes
Explanation
The given correct answer is "Yes" because by choosing this option, the person is affirming their commitment to uphold the standards of honesty and integrity as outlined in the American Nurses Association Code of Ethics. Additionally, by selecting "Yes", they are certifying that they are the person taking the test, indicating their understanding of the importance of personal accountability in their professional role.
2.
Who is the organ procurement agency for RHJ VAMC?
Correct Answer
B. LifePoint
Explanation
CPM 00-14-16; T:drive>All CPMs> type "Organ" in the search box
3.
Who is responsible for contacting Veterans who meet inclusion criteria and delivering the MOVE program at the medical center and CBOCs?
Correct Answer
B. MOVE Dieticians along with other ancillary staff and the MOVE Coordinator
Explanation
T drive---CPM (all services)---Primary Care---MOVE! Weight Management Program for Veterans (MOVE) 11C-14-12
4.
Chest Pain: When a patient complains of chest pain, what are the first interventions an RN should perform before calling the MD?
Correct Answer
D. All of the above
Explanation
T-drive--Guidelines and Protocols---Protocols Chest Pain or Chest Tightness Protocol
5.
The following are nurses’ actions in the event of a blood transfusion reaction except:
Correct Answer
A. Collect 2 seven ml lavender tubes of blood from distant site from the transfusion.
Explanation
CPM 113-13-01. T drive- All CPMs—type “blood transfusion ” in the search box
6.
What are the signs and symptoms of blood transfusion reaction? (Select all that apply).
Correct Answer(s)
A. Dizziness
B. Chills
C. Fever
D. Flushing of skin
Explanation
CPM 113-13-01. T drive---All CPMs, type "blood transfusion" in search box
7.
What would you do if your SCI patient was showing symptoms of Autonomic Dysreflexia?
Correct Answer
E. All of the Above
Explanation
CPG 12-2013 Spinal Cord Injury Treatment Guidelines for Physicians and Nurses. Located on the T drive--Clinical Guidelines and Protocols---Clinical Practice and Guidelines. Type "spinal" in the search box.
8.
When a patient in the CBOC shows signs and symptoms of a stroke, nursing staff will call 911 for transport to the nearest Acute Ischemic Stroke center (facility).
Correct Answer
A. True
Explanation
T:\Clinical Guidelines & Protocols\Protocols\Nursing Protocol Signs and Symptoms of Acute Ischemic Stroke (04-24-15)
9.
Nursing staff are responsible for documenting reported falls in CPRS. Falls will be tracked and reported quarterly.
Correct Answer
A. True
Explanation
T:drive---All CPMs---type "falls" in the search box.
10.
A patient is being seen in the clinic for a routine visit. Upon check in, he appears pale and sweaty. The patient complains of feeling shaky and dizzy, stating his appointment was early so he did not have time to eat this morning. He is found to have a fingerstick blood glucose (FSBG) <70mg/dL. Using the Hypoglycemia Outpatient Clinic Protocol, all of the following actions are taken EXCEPT:
Correct Answer
C. Administer Dextrose 50% by rapid intravenous push (IVP) according to scale for patient who is UNABLE to eat and swallow safely.
Explanation
T:drive>Clinical Guidelines & Protocols>Protocols>Hypoglycemia - Outpatient Clinic Protocol (06-03-15)
11.
It is the policy for RHJVAMC and CBOCs where Primary Care, Women's Health and/or Mental Health services are provided, that access to clinically appropriate services extending beyond normal business hours are available at least once on weekdays (Wednesday) and once every weekend (Saturday), at times and venues that match Veteran demand and expectation.
Correct Answer
A. True
Explanation
Extended Hours Access for Veterans at Medical Centers and Selected Community Based Outpatient Clinics (CBOCs) CPM No. 11-14-51
12.
The Women Veterans Program Manager (WVPM) will coordinate with Primary Care Providers to ensure that all female veterans ages 50-64 and female veterans who present with a higher risk of breast cancer will receive mammograms consistent with the U.S. Preventive Medicine Task Force breast cancer screening recommendations.
Correct Answer
A. True
Explanation
CPM 114-14-04 Requests for Mammography Procedures located on the T-drive
13.
The following Service Lines are responsible for delivering care to at-risk patients identified by the PAVE program (select all that apply):
Correct Answer(s)
A. Podiatry---Podiatrist sees and treats all patients who are moderate and high risk for amputation per the Foot Risk Screening tool.
B. Primary Care LPN administers the V7 Diabetic Foot Exam Clinical Reminder which contains the Foot Risk Assessment Score and includes a treatment referral algorithm. Patients identified as being at risk are assessed by a Primary Care Provider
C. Surgical Service---Vascular Surgery evaluates patients in need of possible amputation, performs amputation as indicated and refers to Amputee Clinic as indicated after amputation.
D. Diabetic Nurse Educators and the wound care nurse are PAVE members
Explanation
CPM 117-13-03 Prevention of Amputation in Veterans Everywhere (PAVE) Program located on the T-drive
14.
Breathalyzer testing may be used by clinical staff without the patient’s informed consent, to aid in determining whether a patient is intoxicated.
Correct Answer
B. False
Explanation
Breathalization Procedure CPM 116-16-09 located on the T-drive
15.
Prostate cancer screening should occur with the following populations (Select all that apply)
Correct Answer(s)
B. Men who choose to be tested age 40 years or higher with highest risk factors (several first-degree relatives diagnosed with prostate cancer at an early age (younger than age 65))
C. Men who choose to be tested age 45 or older at high risk for developing prostate cancer (African American men and men who have a first-degree relative diagnosed with prostate cancer at younger than 65 years of age)
Explanation
Prostate Cancer Screening CPM NO.11C-14-10 Located on the T-Drive
16.
The Primary Care LPN/RN must use the Hypoglycemia Protocol Note to document all FSBG results, treatments, and patient responses to treatment when hypoglycemia is identified in a patient.
Correct Answer
A. True
Explanation
Hypoglycemia - Outpatient Clinic Protocol; This policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "hypoglycemia" and this will bring up the policy.
17.
Protocols for Patient Aligned Care Team (PACT) Nursing Staff in Primary Care Service Line establishes guidelines for RNs/LPNs to initiate specific diagnostic tests and consultations based on patient's presenting history and/or symptoms.
Correct Answer
A. True
Explanation
Protocol for Patient Aligned Care Team (PACT) Nursing Staff in Primary Care Service Line; This protocol is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "PACT" and this will bring up the policy.
18.
Primary Care nursing staff will document a foot screening for patients at risk of lower limb loss or history of amputation that includes: (select all which apply)
Correct Answer(s)
A. Visual inspection of skin surfaces
B. Circulation to include palpation of pedal pulses
C. Sensory testing for loss of protective sensation
D. Provide patient education and patient level of understanding on foot care
Explanation
Management of Diabetic Patients for the Preservation and Treatment of Lower Limbs Primary Care Program Memorandum 11C-12-05 located on the T-Drive
19.
It is VHA policy that any Veteran receiving care at more than one VHA facility must have that care coordinated by the preferred facility, and that non-preferred facilities must expedite care provided to traveling veterans with unexpected medical needs.
Correct Answer
A. True
Explanation
CPM 11-C-11-11 Coordinated Care Policy for traveling Veterans located on the T-drive
20.
Your Clinic Emergency Plan can be found on the T-Drive under Service Policies by selecting Primary Care 11-C, Primary Care Supplemental (Select specific CBOC location).
Correct Answer
A. True
Explanation
T:drive> Search "Primary Care Supplemental" and select your clinic
21.
When a veteran/ caller is reporting suicidal or homicidal thoughts or other crises to the Ralph H. Johnson Department of Veterans Affairs Medical Center telephone operator or to other staff they should: (select all which apply)
Correct Answer(s)
A. When a Nurse, pHysician, Social Worker, pHysician Assistant or Psychologist receives a call, they will triage the call, determine the appropriate clinical intervention and initiate a rescue if needed.
B. When possible make a warm transfer (allows for all three parties to be on the line at the same time)
C. Veterans who call the Medical Center with expressed suicidal or homicidal thoughts during duty hours (8:00 a.m. – 4:30 p.m.) will be referred to the Psychiatry Access Center Team (PAC) pager 17359 (MUSC Simon).
D. NEVER PLACE A CALL ON HOLD
Explanation
ICPM116-11-06 NTERVENTION FOR SUICIDAL/HOMICIDALPATIENTS VIA TELEPHONE Located on the T-drive
22.
According to The Missing Patient policy, an at-risk patient includes one who is (select all which apply):
Correct Answer(s)
A. Legally committed.
B. pHysically or mentally impaired with increased risk of harm to self or others
C. Assigned a court appointed legal guardian.
D. Lacking cognitive ability (either permanently or temporarily) to make relevant decisions
Explanation
CPM 07B-13-01 Missing Patient Policy located on the T-drive
23.
According to Medication Reconciliation policy (select all that apply)...
Correct Answer
A. The updated medication list will be given to the patient/surrogate at the conclusion of the visit. If the patient is receiving a portion of his medical care outside of the VA system, the patient will be encouraged to share the updated medication list with any outside health care providers
Explanation
According to the Medication Reconciliation policy, the updated medication list will be provided to the patient or their surrogate at the end of the visit. Additionally, if the patient is receiving medical care outside of the VA system, they will be encouraged to share the updated medication list with their outside healthcare providers. This ensures that all healthcare providers involved in the patient's care have access to an accurate and up-to-date medication list, promoting patient safety and continuity of care.
24.
Proper identification of a patient prior to check-in or initiation of care is important in ensuring that care and information are given to the right patient. It is the policy at RHJ VAMC to use 2 unique patient identifiers such as:
Correct Answer
D. Having the patient state their FULL Name and FULL Social Security Number
Explanation
CPM 118-14-23; Patient Identification
25.
Labels should be prepared and applied at the time medications/solutions are prepared. Pre-labeling medication/solution containers in advance of the procedure is not acceptable.
Correct Answer
A. True
Explanation
CPM 11-15-19 Labeling Medications and Solutions On and Off the Sterile Field