Fy 15 Primary care Annual Education Policy/Procedure/Protocol Review

1. The Telehealth Clinical Technicians (TCT) are responsible for daily operations of all Telehealth clinics

True

False

CPM NO.116-12-18 Clinical Telehealth Program Located on the T-drive

Explanation

CPM NO.116-12-18 Clinical Telehealth Program Located on the T-drive

2. Medication labels should be prepared and applied at the time the medication or solution is prepared.

True

False

CPM 11-12-19 LABELING MEDICATIONS AND SOLUTIONS ON AND OFF THE STERILE FIELD Located on the T-drive

Explanation

CPM 11-12-19 LABELING MEDICATIONS AND SOLUTIONS ON AND OFF THE STERILE FIELD Located on the T-drive

3. The primary care LPN/RN must use Hypoglycemia Protocol Note to document all BG results, treatments, and patient responses to treatment when hypoglycemia is identified in a patient.

True

False

Hypoglycemia-Hyperglycemia 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.

Explanation

Hypoglycemia-Hyperglycemia 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.

4. Policy 00-14-16 Organ and Tissue Donor Program ensures that families of potential donors are presented with the option of organ and tissue donation in a manner which promotes informed consent in compliance with applicable laws and regulations while addressing the emotional/ spiritual needs of the family.

True

False

CPM 00-14-16 Organ and Tissue Donor Program located on the T-drive

Explanation

CPM 00-14-16 Organ and Tissue Donor Program located on the T-drive

5. Primary care staff is responsible for completing the clinical reminders for MOVE program for Veterans as indicated.

True

False

MOVE!weight management program for Veterans (MOVE) CPM NO.11C-14-12 located on the T -drive

Explanation

MOVE!weight management program for Veterans (MOVE) CPM NO.11C-14-12 located on the T -drive

6. 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)

Visual inspection of skin surfaces

Circulation to include palpation of pedal pulses

Sensory testing for loss of protective sensation

Provide patient education and patient level of understanding on foot care

Management of Diabetic Patients for the Preservation and Treatment of Lower Limbs Primary Care Program Memorandum 11C-12-05 located on the T-Drive

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

Submit

7. All professionals have a responsibility to act on all suspected abuse.

True

False

CPM 122-13-02 ADULT/CHILD VICTIMS OF ALLEGED ABUSE located on the T-drive

Explanation

CPM 122-13-02 ADULT/CHILD VICTIMS OF ALLEGED ABUSE located on the T-drive

8. 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)

NEVER PLACE A CALL ON HOLD

When possible make a warm transfer (allows for all three parties to be on the line at the same time)

ICPM116-11-06 NTERVENTION FOR SUICIDAL/HOMICIDALPATIENTS VIA TELEPHONE Located on the T-drive

Explanation

ICPM116-11-06 NTERVENTION FOR SUICIDAL/HOMICIDALPATIENTS VIA TELEPHONE Located on the T-drive

Submit

9. Reusable medical equipment (RME) has established policy for

All of the above

Use

Decontamination

Cleaning, reprocessing,disinfection, or sterilization

Non-Critical Reusable Medical Equipment (RME) Reprocessing CPM No. 002SPS-14-03, Use and Reprocessessing of reusable medical equipment (RME) CPM NO.002SPS-14-02 Located on the T-Drive

Explanation

Non-Critical Reusable Medical Equipment (RME) Reprocessing CPM No. 002SPS-14-03, Use and Reprocessessing of reusable medical equipment (RME) CPM NO.002SPS-14-02 Located on the T-Drive

10. All levels of staff providing nursing care at the Community Based Outpatient Clinics are responsible for timely, accurate, and relevant documentation of assessments and reassessments in the patients medical record.

True

False

CPM NO 118-14-09 Nursing assessments Documentation and Accountability Located on the T-drive

Explanation

CPM NO 118-14-09 Nursing assessments Documentation and Accountability Located on the T-drive

11. When an adult victim expresses an allegation of an acute sexual assault the CBOCs will refer to their local Rape Crisis Center to determine the appropriate facility for follow up.

True

False

11-14-40 ADULT VICTIMS OF ALLEGED ACUTE SEXUAL ASSAULT

Explanation

11-14-40 ADULT VICTIMS OF ALLEGED ACUTE SEXUAL ASSAULT

12. What values on the glucometer warrant immediate intervention?

200

400

300

400

Hypoglycemia-Hyperglycemia 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.

Explanation

Hypoglycemia-Hyperglycemia 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.

13. RHJ VAMC and the CBOCs are latex free facilities.

True

False

CPM 118-12-08 Laxtex Allergy/Sensitivity. This policy is located on the T drive--All CPMs---Nursing. Type "laxtex" in the search box.

Explanation

CPM 118-12-08 Laxtex Allergy/Sensitivity. This policy is located on the T drive--All CPMs---Nursing. Type "laxtex" in the search box.

14. What is the proper procedure to verify a patient's identification?

Ask the patient to state his/her full name and last four of social security number

Ask the patient to state his/her last name and last four of social security number

Ask the patient to state his/her full name and full social security number

Ask the patient to state his/her last name and full social security number

Nursing Assessment Documentation and Accountability. Located on the T drive--All CPMs, type "documentation" in the search box.

Explanation

Nursing Assessment Documentation and Accountability. Located on the T drive--All CPMs, type "documentation" in the search box.

15. How many staff members are required with all emergent assists for patients with limited mobility?

One person

A minimum of 2 people

At least 3 people

CPM 13-13 Safe Patient Handling and Movement Policy. Located on T drive--CPMs-type "safe patient" in the search box.

Explanation

CPM 13-13 Safe Patient Handling and Movement Policy. Located on T drive--CPMs-type "safe patient" in the search box.

16. How often do the narcotics in the PYXIS/OmniCell get inventoried by narcotic inspectors?

Daily

Bi-weekly

Weekly

Monthly

CPM 00-13-27 Inspection of Controlled Substances and CPM 119-13-20 Pyxis medstation (is currently being updated to Omnicell)

Explanation

CPM 00-13-27 Inspection of Controlled Substances and CPM 119-13-20 Pyxis medstation (is currently being updated to Omnicell)

17. What would you do if your SCI patient was showing symptoms of autonomic dysreflexia?

A. Sit patient upright

B. Take patient's B/P

C. Seek to eliminate the cause

A, B, & C

Only A & C

CPG 12-2013 Spinal Cord Injury Treatment Guidelines for Physicians and Nurses. Located on the T drive--Clinical Guidelines and Protocols---Clinical Practice and Guidlelines. Type "spinal" in the search box.

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 Guidlelines. Type "spinal" in the search box.

18. Where does one find a list that will inform you of which MD has privileges for RHJ VAMC?

S drive

U drive

T drive

V drive

Located on the T drive under Priviledges-- Scopes of Practices

Explanation

Located on the T drive under Priviledges-- Scopes of Practices

19. Any outpatient expressing a desire to complete an Advance Directive will be referred to their respective Social Worker.

True

False

CPM 11-13-26 Advanced Health Care Planning and Resuscitation Instructions Located on the T-drive

Explanation

CPM 11-13-26 Advanced Health Care Planning and Resuscitation Instructions Located on the T-drive

20. 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 presenting history and /or symptoms.

True

False

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.

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.

21. Assigned primary care staff who are trained in the use of digital imaging cameras are responsible for Dermatology Consult photographs.

True

False

Wound Documentation Through Photography
CENTER POLICY MEMORANDUM NO. 11-12-36 Located on the T-drive

Explanation

Wound Documentation Through Photography
CENTER POLICY MEMORANDUM NO. 11-12-36 Located on the T-drive

22. It is a policy at the medical center and selected CBOCs where Primary Care, Women's Health and/or Mental Health services are provided, access to clinically appropriate services that extend beyond regular business at least once on weekdays (Wednesday) and once every weekend (Saturday), at times and venues that match Veteran demand and expectation

True

False

Extended Hours Access for Veterans at Medical Centers and Selected Community Based Outpatient Clinics (CBOCs) CPM NO. 11-14-51

Explanation

Extended Hours Access for Veterans at Medical Centers and Selected Community Based Outpatient Clinics (CBOCs) CPM NO. 11-14-51

23. Links to Material Safety Data Sheets (MSDS) for approved Non-critical reusable medical equipment cleaning agents can be found at the end of the policy on the T-drive.

True

False

The given statement is true. The Material Safety Data Sheets (MSDS) for approved Non-critical reusable medical equipment cleaning agents can be found at the end of the policy on the T-drive. This means that individuals can access information about the safety and proper use of these cleaning agents by referring to the MSDS.

Explanation

The given statement is true. The Material Safety Data Sheets (MSDS) for approved Non-critical reusable medical equipment cleaning agents can be found at the end of the policy on the T-drive. This means that individuals can access information about the safety and proper use of these cleaning agents by referring to the MSDS.

24. The term "impaired professional" is used to describe the practitioner who is prevented by reason of illness, disorder, or other health/behavioral problems from performing professional duties at the expected level of skill and/or competence.

True

False

MEDICAL STAFF MEMBER HEALTH POLICY 11-14-04 Located on the T-drive

Explanation

MEDICAL STAFF MEMBER HEALTH POLICY 11-14-04 Located on the T-drive

25. According to The Missing Patient Policy an at risk patient includes (select all which apply)

Are legally committed.

Have a court appointed legal guardian.

Lack cognitive ability (either permanently or temporarily) to make relevant decisions

Have physical or mental impairments that increase their risk of harm to self or others

CPM 07B-13-01 Missing Patient Policy located on the T-drive

Explanation

CPM 07B-13-01 Missing Patient Policy located on the T-drive

Submit

26. It is VHA policy that all patients with potential for swallowing or feeding disorders must be appropriately assessed, referred for diagnostic evaluation (as necessary), treated, managed, monitored, and followed throughout the continuum of care.

True

False

CPM 112-11-07 MANAGEMENT OF PATIENTS WITH SWALLOWING (DYSPHAGIA) OR FEEDING DISORDERS

Explanation

CPM 112-11-07 MANAGEMENT OF PATIENTS WITH SWALLOWING (DYSPHAGIA) OR FEEDING DISORDERS

27. It is VHA policy that all veterans 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.

True

False

CPM 11-C-11-11 Coordinated Care Policy for traveling Veterans located on the T-drive

Explanation

CPM 11-C-11-11 Coordinated Care Policy for traveling Veterans located on the T-drive

28. A large percentage of patient suicides occur within 3 months of discharge from acute inpatient care from previous suicide attempt.

True

False

CPM 116-13-05 SUICIDE ATTEMPTS: ASSESSMENT AND INTERVENTION PROTOCOL Located on the T-drive

Explanation

CPM 116-13-05 SUICIDE ATTEMPTS: ASSESSMENT AND INTERVENTION PROTOCOL Located on the T-drive

29. 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.

True

False

CPM 114-14-04 Requests for Mammography Procedures located on the T-drive

Explanation

CPM 114-14-04 Requests for Mammography Procedures located on the T-drive

30. Staff that does not complete all components of their annual competency at the time of their annual performance appraisal will be placed on a Leave Without Pay (LWOP) status until successful completion/verification occurs. Staff unable to complete their requirements due to medical, physical or other extenuating circumstances may submit a waiver.

True

False

SPM. 118-14-502 Annual Education and Competency located on the T-drive

Explanation

SPM. 118-14-502 Annual Education and Competency located on the T-drive

31. Written consent is required for patients utilizing the Clinical Telehealth Program and must be documented in the patient's medical record

True

False

Verbal consent. CPM 116-12-18 Clinical Telehealth Program located on the T-drive

Explanation

Verbal consent. CPM 116-12-18 Clinical Telehealth Program located on the T-drive

32. To improve the quality of life for Veterans RHJVAMC has establishing policies and procedures to effectively manage acute and chronic pain by using a stepped care model.

True

False

CPM NO. 112A-13-03 Pain Management Located on the T-drive

Explanation

CPM NO. 112A-13-03 Pain Management Located on the T-drive

33. You can located your clinics emergency plan on the T-Drive under Service Policies then select Primary Care 11-C then select Primary Care Supplementals and select CBOC location.

True

False

The explanation for the given correct answer is that the clinics emergency plan can be found on the T-Drive under Service Policies, specifically in the Primary Care 11-C folder. From there, one should select the Primary Care Supplementals folder and then choose the CBOC location. Therefore, the statement is true.

Explanation

The explanation for the given correct answer is that the clinics emergency plan can be found on the T-Drive under Service Policies, specifically in the Primary Care 11-C folder. From there, one should select the Primary Care Supplementals folder and then choose the CBOC location. Therefore, the statement is true.

34. All eligible veterans will be afforded the opportunity to enroll in the medical center's Primary Care Service Line.

True

False

Establishing Access to Primary Care. Primary Care service line memorandum 11C-12-04

Explanation

Establishing Access to Primary Care. Primary Care service line memorandum 11C-12-04

35. Alerts not processed within 14 days will be automatically sent to the Service Chief or appropriate designee for timely processing

True

False

VIEW ALERT MANAGEMENT CPM 11-14-52 located on the T-drive

Explanation

VIEW ALERT MANAGEMENT CPM 11-14-52 located on the T-drive

36. Breathalyzer test may be used by clinical staff without the patient's informed consent to aid in making the determination of intoxication

True

False

Breathalization Procedure CPM 116-13-09 located on the T-drive

Explanation

Breathalization Procedure CPM 116-13-09 located on the T-drive

37. When a patient is experiencing symptoms of a stroke the Primary Care nurse should: (Select all that apply)

Record the time of stroke systems onset

Make the patient NPO

Monitor Vital signs

Notify physcian to complete acute asessment

Wait until completed lab work and ECG are completed to notify provider

Neurology Acute Stroke Protocol locate on the T-drive

Explanation

Neurology Acute Stroke Protocol locate on the T-drive

Submit

38. The following services are responsible for delivering care to at risk patients identified by the PAVE program select all that apply:

Podiatry---Podiatrist sees and treats all patients who are moderate and high risk for amputation per the Foot Risk Screening tool.

Diabetic Nurse Educators and the wound care nurse are PAVE members

CPM 117-13-03 Prevention of Amputation in Veterans Everywhere (PAVE) Program located on the T-drive

Explanation

CPM 117-13-03 Prevention of Amputation in Veterans Everywhere (PAVE) Program located on the T-drive

Submit

39. What assessment tool does one use to document skin breakdown risk?

Glasgow Scale

Braden Scale

PIP Scale

Pressure Ulcer Scale

CPM 118-14-2 Assessment and Preventin of Pressure Ulcers. Located on the T drive--All CPMs. Type ulcer prevention in the search box.

Explanation

CPM 118-14-2 Assessment and Preventin of Pressure Ulcers. Located on the T drive--All CPMs. Type ulcer prevention in the search box.

40. A SCI patient is at risk for Autonomic Dysreflexia if he/she has an injury at level ________ or higher?

T4

T5

T6

T7

CPG 12-2013 Spinal Cord Injury Treatment Guidelines for Physicians and Nurses. Located on the T drive--Clinical Guidelines and Protocols---Clinical Practice and Guidlelines. Type "spinal" in the search box.

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 Guidlelines. Type "spinal" in the search box.

41. According to the CPM 136-02, who does one call to obtain assistance for a hard of hearing patient or a language interpreter?

AT&T Relay Service

TTY Phone

Bellsouth Relay Service

Both A & B

Communication with Hearning Imparied/non-English Speaking Individua. located on the T drive--Health Administration Officel

Explanation

Communication with Hearning Imparied/non-English Speaking Individua. located on the T drive--Health Administration Officel

42. Which of the following medications are associated with risk for falls (select all that apply):

Diuretics

Opioids

Antidiabetic

Antihistamines

CPM 118-13-18 Assessment and Care of Patients-Residents at Risk for Falls. Locsatedon the T drive--All CPMs--type "falls" in the search box.

Explanation

CPM 118-13-18 Assessment and Care of Patients-Residents at Risk for Falls. Locsatedon the T drive--All CPMs--type "falls" in the search box.

Submit

43. Informed consent includes informing patient of : (select alll which apply)

Known side effects or consequences: predictable outcomes of a particular treatment or procedure; e.g., pain after surgery

Risks in a language understandable to the patient

11-12-09 Informed Consent Located on the T-drive

Explanation

11-12-09 Informed Consent Located on the T-drive

Submit

44. In the CBOCs MANAGEMENT OF COMMITTABLE PSYCHIATRIC PATIENTS includes: (Select all that apply)

911 will be called if the patient exhibits violent or threatening behavior.

All State policies will be followed regarding the commitment process and required paperwork

CPM 116-14-13 MANAGEMENT OF COMMITTABLE PSYCHIATRIC PATIENTS located on the T-drive

Explanation

CPM 116-14-13 MANAGEMENT OF COMMITTABLE PSYCHIATRIC PATIENTS located on the T-drive

Submit

45. Which of the following are considered to be "High Alert Medications"? Select all that apply?

TPN

Heparin

Chemotherapy IV drugs

Insulin

Hypertensive drugs

CPM 110-21 High Alert Medications and Standardized Fusions. Located on the T drive--All CPMs--pharmacy. Type "medications" in the search box.

Explanation

CPM 110-21 High Alert Medications and Standardized Fusions. Located on the T drive--All CPMs--pharmacy. Type "medications" in the search box.

Submit

46. In order to help prevent and identify patients at risk for falling Primary Care staff will (select all which apply)

Complete an annual fall screen and provide pamphlet explaining fall prevention in the home to patients at risk.

Implement interventions to create and maintain a safe patient environment

Implement universal fall precautions for all veterans

Assessment and Care of Patients/Residents at risk of Falling CPM NO. 118-13-13 Located on the T-drive

Explanation

Assessment and Care of Patients/Residents at risk of Falling CPM NO. 118-13-13 Located on the T-drive

Submit

47. Close patient supervision may be ordered if:

During the initial triage the nurse feels patients is a danger to himself or others

Has a history of mental illness

During course of examination Primary Care clinician feels patient may be a danger to himself or others

Patient is not happy with current treatment

Primary Care Service Line Memorandum 11C-12-03 Close Patient Supervision Located on the T-drive

Explanation

Primary Care Service Line Memorandum 11C-12-03 Close Patient Supervision Located on the T-drive

Submit

48. Communication of patient diagnostic test results to patients should be:

A phone call from the clinician to the patient if test results indicate a need for timely intervention.

From any staff member available

From any member of PACT nursing team

Follow up for diagnostic porcedures Primary Care Service Line Memorandum 11C-10-01 Located on the T-drive

Explanation

Follow up for diagnostic porcedures Primary Care Service Line Memorandum 11C-10-01 Located on the T-drive

Submit

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

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

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

CPM 11-12-23, Medication Reconcilliation

Explanation

CPM 11-12-23, Medication Reconcilliation

Submit

50. When patients have missed multiple appointments the clinical scheduler is responsible for: (select all that apply)

Making no-show post card or patient cancellation letter when applicable

Calling the veteran to make an appointment without an identified immediate need.

Making sure providers adhere to policy

MANAGEMENT OF PATIENTS WITH MULTIPLE MISSED APPOINTMENTS
CENTER POLICY MEMORANDUM NO. 11-14-12 Located on the T-drive

Explanation

MANAGEMENT OF PATIENTS WITH MULTIPLE MISSED APPOINTMENTS
CENTER POLICY MEMORANDUM NO. 11-14-12 Located on the T-drive

Submit

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

Men older than 75 years of age

All men

Prostate Cancer Screening CPM NO.11C-14-10 Located on the T-Drive

Explanation

Prostate Cancer Screening CPM NO.11C-14-10 Located on the T-Drive

Submit