Fy16 Primary care RN Annual Policy Review

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Fy16 Primary care RN Annual Policy Review - Quiz

Annual Nursing Education review of policies, procedures, and protocols for Primary Care RN Care Coordinator. Must be completed by March 31, 2016 with a minimum score of 90.


Questions and Answers
  • 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.

    • A.

      Yes

    • B.

      No

    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.

    Rate this question:

  • 2. 

    Who is the organ procurement agency for RHJ VAMC?

    • A.

      LifeCare

    • B.

      LifePoint

    • C.

      LifeChoice

    • D.

      LifeLine

    Correct Answer
    B. LifePoint
    Explanation
    CPM 00-14-16; T:drive>All CPMs> type "Organ" in the search box

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  • 3. 

    Who is responsible for contacting Veterans who meet inclusion criteria and delivering the MOVE program at the medical center and CBOCs?

    • A.

      Care Coordinator RN assigned to the Veteran's Primary Care PACT

    • B.

      MOVE Dieticians along with other ancillary staff and the MOVE Coordinator

    • C.

      Physician Champion in collaboration with the MOVE Coordinator

    • D.

      Bariatric Program Coordinator (Surgery Service)

    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

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  • 4. 

    Chest Pain: When a patient complains of chest pain, what are the first interventions an RN should perform before calling the MD? 

    • A.

      Assessment of pain

    • B.

      Stat EKG

    • C.

      Initiate oxygen at 4L/min

    • D.

      All of the above

    • E.

      B & C only

    Correct Answer
    D. All of the above
    Explanation
    T-drive--Guidelines and Protocols---Protocols Chest Pain or Chest Tightness Protocol

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  • 5. 

    The following are nurses’ actions in the event of a blood transfusion reaction except: 

    • A.

      Collect 2 seven ml lavender tubes of blood from distant site from the transfusion.

    • B.

      Notify blood bank

    • C.

      Notify physician.

    • D.

      Label the tubes as immediate post-transfusion reaction

    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

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  • 6. 

    What are the signs and symptoms of blood transfusion reaction? (Select all that apply)

    • A.

      Dizziness

    • B.

      Chills

    • C.

      Fever

    • D.

      Flushing of skin

    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

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  • 7. 

    What would you do if your SCI patient was showing symptoms of Autonomic Dysreflexia? 

    • A.

      Sit patient upright

    • B.

      Loosen any restrictive clothing

    • C.

      Palpate patient's bladder for distention

    • D.

      Do a general survey to seek and eliminate the cause of symptoms

    • E.

      All of the Above

    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.

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  • 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). 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    T:\Clinical Guidelines & Protocols\Protocols\Nursing Protocol Signs and Symptoms of Acute Ischemic Stroke (04-24-15)

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  • 9. 

    Nursing staff are responsible for documenting reported falls in CPRS. Falls will be tracked and reported quarterly. 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    T:drive---All CPMs---type "falls" in the search box.

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  • 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:

    • A.

      Repeat FSBG to confirm results, if there is a 50-point variance between the first and second FSBG check, complete a third FSBG check on the same meter to determine what is most accurate.

    • B.

      Contact provider after treatment has been administered for blood glucose

    • C.

      Administer Dextrose 50% by rapid intravenous push (IVP) according to scale for patient who is UNABLE to eat and swallow safely.

    • D.

      Administer glucagon 1mg intramuscularly (IM); may repeat x1 if necessary, for patient who is UNABLE to swallow safely or is unconscious.

    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)

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  • 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.

    • A.

      True

    • B.

      False

    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

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  • 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. 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    CPM 114-14-04 Requests for Mammography Procedures located on the T-drive

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  • 13. 

    The following Service Lines are responsible for delivering care to at-risk patients identified by the PAVE program (select all that apply):

    • 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

    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

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  • 14. 

    Breathalyzer testing may be used by clinical staff without the patient’s informed consent, to aid in determining whether a patient is intoxicated. 

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Breathalization Procedure CPM 116-16-09 located on the T-drive

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  • 15. 

    Prostate cancer screening should occur with the following populations (Select all that apply) 

    • A.

      Men older than 75 years of age

    • 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)

    • D.

      All men

    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

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  • 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. 

    • A.

      True

    • B.

      False

    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.

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  • 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. 

    • A.

      True

    • B.

      False

    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.

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  • 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) 

    • 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

    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

    Rate this question:

  • 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. 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    CPM 11-C-11-11 Coordinated Care Policy for traveling Veterans located on the T-drive

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  • 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). 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    T:drive> Search "Primary Care Supplemental" and select your clinic

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  • 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) 

    • 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

    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

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  • 22. 

    According to The Missing Patient policy, an at-risk patient includes one who is (select all which apply): 

    • 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

    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

    Rate this question:

  • 23. 

    According to Medication Reconciliation policy (select all that apply)... 

    • 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

    • B.

      It is the primary responsibility of the nurse to update all medications

    • C.

      Patients are not allowed to receive medications from both VA and an outside source. If they receive medications from an outside source then their VA benefits will be canceled

    • D.

      Over the counter medications do not need to be in the patients record

    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.

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  • 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:

    • A.

      Having the patient state their FULL Name and Room Number

    • B.

      Having the patient state their LAST Name and LAST 4 of their Social Security Number

    • C.

      Having the patient state their FULL Home Address

    • D.

      Having the patient state their FULL Name and FULL Social Security Number

    Correct Answer
    D. Having the patient state their FULL Name and FULL Social Security Number
    Explanation
    CPM 118-14-23; Patient Identification

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  • 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.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    CPM 11-15-19 Labeling Medications and Solutions On and Off the Sterile Field

    Rate this question:

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  • Mar 21, 2023
    Quiz Edited by
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