Fy16 Primary care RN Annual Policy Review

25 Questions | Total Attempts: 251

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Fy16 Primary care RN Annual Policy Review

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

  • 2. 
    Who is the organ procurement agency for RHJ VAMC?
    • A. 

      LifeCare

    • B. 

      LifePoint

    • C. 

      LifeChoice

    • D. 

      LifeLine

  • 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)

  • 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

  • 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

  • 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

  • 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

  • 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

  • 9. 
    Nursing staff are responsible for documenting reported falls in CPRS. Falls will be tracked and reported quarterly. 
    • A. 

      True

    • B. 

      False

  • 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.

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

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