1.
What values on the glucometer warrant immediate intervention?
Correct Answer
B. 400
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.
2.
RHJ VAMC and the CBOCs are latex free facilities.
Correct Answer
B. False
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.
3.
What is the proper procedure to verify a patient’s identification?
Correct Answer
C. Ask the patient to state his/her full name and full social security number
Explanation
Nursing Assessment Documentation and Accountability. Located on the T drive--All CPMs, type "documentation" in the search box.
4.
How many staff members are required with all emergent assists for patients with limited mobility?
Correct Answer
B. A minimum of 2 people
Explanation
CPM 13-13 Safe Patient Handling and Movement Policy. Located on T drive--CPMs-type "safe patient" in the search box.
5.
What assessment tool does one use to document skin breakdown risk?
Correct Answer
B. Braden Scale
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.
6.
How often do the narcotics in the PYXIS/OmniCell get inventoried by narcotic inspectors?
Correct Answer
C. Weekly
Explanation
CPM 00-13-27 Inspection of Controlled Substances and CPM 119-13-20 Pyxis medstation (is currently being updated to Omnicell)
7.
A SCI patient is at risk for Autonomic Dysreflexia if he/she has an injury at level ________ or higher?
Correct Answer
C. T6
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.
8.
What would you do if your SCI patient was showing symptoms of autonomic dysreflexia?
Correct Answer
D. A, B, & C
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.
9.
Which of the following are considered to be "High Alert Medications"? Select all that apply?
Correct Answer(s)
A. TPN
B. Heparin
C. Chemotherapy IV drugs
D. Insulin
Explanation
CPM 110-21 High Alert Medications and Standardized Fusions. Located on the T drive--All CPMs--pharmacy. Type "medications" in the search box.
10.
According to the CPM 136-02, who does one call to obtain assistance for a hard of hearing patient or a language interpreter?
Correct Answer
D. Both A & B
Explanation
Communication with Hearning Imparied/non-English Speaking Individua. located on the T drive--Health Administration Officel
11.
Where does one find a list that will inform you of which MD has privileges for RHJ VAMC?
Correct Answer
C. T drive
Explanation
Located on the T drive under Priviledges-- Scopes of Practices
12.
Which of the following medications are associated with risk for falls (select all that apply):
Correct Answer(s)
A. Diuretics
B. Opioids
C. Antidiabetic
D. Antihistamines
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.
13.
When patients have missed multiple appointments the clinical scheduler is responsible for: (select all that apply)
Correct Answer(s)
A. Making a minimum of 2 attempts to reach patients via phone to reschedule if PCP determines there is an immediate need for an appointment.
B. Making no-show post card or patient cancellation letter when applicable
Explanation
MANAGEMENT OF PATIENTS WITH MULTIPLE MISSED APPOINTMENTS
CENTER POLICY MEMORANDUM NO. 11-14-12 Located on the T-drive
14.
Assigned primary care staff who are trained in the use of digital imaging cameras are responsible for Dermatology Consult photographs.
Correct Answer
A. True
Explanation
Wound Documentation Through Photography
CENTER POLICY MEMORANDUM NO. 11-12-36 Located on the T-drive
15.
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
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
16.
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
17.
Written consent is required for patients utilizing the Clinical Telehealth Program and must be documented in the patient’s medical record
Correct Answer
B. False
Explanation
Verbal consent. CPM 116-12-18 Clinical Telehealth Program located on the T-drive
18.
The following services 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
19.
Breathalyzer test may be used by clinical staff without the patient’s informed consent to aid in making the determination of intoxication
Correct Answer
B. False
Explanation
Breathalization Procedure CPM 116-13-09 located on the T-drive
20.
Prostate cancer screening should occur with the following populations (Select all that apply)
Correct Answer(s)
A. 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
21.
Reusable medical equipment (RME) has established policy for
Correct Answer
A. All of the above
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
22.
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.
Correct Answer
A. True
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.
23.
In order to help prevent and identify patients at risk for falling Primary Care staff will (select all which apply)
Correct Answer(s)
A. Complete an annual fall screen and provide pamphlet explaining fall prevention in the home to patients at risk.
B. Implement interventions to create and maintain a safe patient environment
C. Implement universal fall precautions for all veterans
D. Provide education to veteran and family members on potential for falls, fall complications, and provide information on interventions to eliminate and/or decreased fall potential.
Explanation
Assessment and Care of Patients/Residents at risk of Falling CPM NO. 118-13-13 Located on the T-drive
24.
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.
Correct Answer
A. True
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.
25.
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.
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.
26.
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.
Correct Answer
A. 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.
27.
Communication of patient diagnostic test results to patients should be:
Correct Answer(s)
A. A phone call from the clinician to the patient if test results indicate a need for timely intervention.
B. A registered letter if the patient can not be reached by clinician over the phone for test result requiring timely intervention.
Explanation
Follow up for diagnostic porcedures Primary Care Service Line Memorandum 11C-10-01 Located on the T-drive
28.
Close patient supervision may be ordered if:
Correct Answer(s)
A. During the initial triage the nurse feels patients is a danger to himself or others
C. During course of examination Primary Care clinician feels patient may be a danger to himself or others
Explanation
Primary Care Service Line Memorandum 11C-12-03 Close Patient Supervision Located on the T-drive
29.
All eligible veterans will be afforded the opportunity to enroll in the medical center's Primary Care Service Line.
Correct Answer
A. True
Explanation
Establishing Access to Primary Care. Primary Care service line memorandum 11C-12-04
30.
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
31.
Primary care staff is responsible for completing the clinical reminders for MOVE program for Veterans as indicated.
Correct Answer
A. True
Explanation
MOVE!weight management program for Veterans (MOVE) CPM NO.11C-14-12 located on the T -drive
32.
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.
Correct Answer
A. True
Explanation
CPM 11-C-11-11 Coordinated Care Policy for traveling Veterans located on the T-drive
33.
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.
Correct Answer
A. True
Explanation
CPM NO 118-14-09 Nursing assessments Documentation and Accountability Located on the T-drive
34.
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.
Correct Answer
A. True
Explanation
CPM NO. 112A-13-03 Pain Management Located on the T-drive
35.
According to The Missing Patient Policy an at risk patient includes (select all which apply)
Correct Answer(s)
A. Are legally committed.
B. Have a court appointed legal guardian.
C. Lack cognitive ability (either permanently or temporarily) to make relevant decisions
D. Have physical or mental impairments that increase their risk of harm to self or others
Explanation
CPM 07B-13-01 Missing Patient Policy located on the T-drive
36.
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.
Correct Answer
A. True
Explanation
SPM. 118-14-502 Annual Education and Competency located on the T-drive
37.
According to Medication Reconciliation policy (select all that apply)...
Correct Answer(s)
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
C. Prior to each primary care visit, a medication list will be printed for each scheduled clinic visit and given to the patient at the time of check in. The patient will be asked to review and make notations/changes/corrections on this document for discussion with the provider during the visit.
Explanation
CPM 11-12-23, Medication Reconcilliation
38.
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.
Correct Answer
A. True
Explanation
CPM 00-14-16 Organ and Tissue Donor Program located on the T-drive
39.
When a patient is experiencing symptoms of a stroke the Primary Care nurse should: (Select all that apply)
Correct Answer(s)
A. Record the time of stroke systems onset
B. Make the patient NPO
C. Monitor Vital signs
D. Notify physcian to complete acute asessment
Explanation
Neurology Acute Stroke Protocol locate on the T-drive
40.
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.
Correct Answer
A. True
Explanation
MEDICAL STAFF MEMBER HEALTH POLICY 11-14-04 Located on the T-drive
41.
Informed consent includes informing patient of : (select alll which apply)
Correct Answer(s)
A. Known side effects or consequences: predictable outcomes of a particular treatment or procedure; e.g., pain after surgery
B. Possible side effects or consequences: outcomes that are not certain to happen as a result of a particular treatment or procedure, but that commonly occur; e.g., drowsiness in response to medication.
C. Complications or adverse events: undesirable outcomes that result from a particular treatment or procedure but were not intended or expected: e.g., infection of a surgical wound.
D. Risks in a language understandable to the patient
Explanation
11-12-09 Informed Consent Located on the T-drive
42.
Medication labels should be prepared and applied at the time the medication or solution is prepared.
Correct Answer
A. True
Explanation
CPM 11-12-19 LABELING MEDICATIONS AND SOLUTIONS ON AND OFF THE STERILE FIELD Located on the T-drive
43.
Any outpatient expressing a desire to complete an Advance Directive will be referred to their respective Social Worker.
Correct Answer
A. True
Explanation
CPM 11-13-26 Advanced Health Care Planning and Resuscitation Instructions Located on the T-drive
44.
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.
Correct Answer
A. True
Explanation
11-14-40 ADULT VICTIMS OF ALLEGED ACUTE SEXUAL ASSAULT
45.
Alerts not processed within 14 days will be automatically sent to the Service Chief or appropriate designee for timely processing
Correct Answer
A. True
Explanation
VIEW ALERT MANAGEMENT CPM 11-14-52 located on the T-drive
46.
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.
Correct Answer
A. True
Explanation
CPM 112-11-07 MANAGEMENT OF PATIENTS WITH SWALLOWING (DYSPHAGIA) OR FEEDING DISORDERS
47.
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. NEVER PLACE A CALL ON HOLD
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. 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.
Explanation
ICPM116-11-06 NTERVENTION FOR SUICIDAL/HOMICIDALPATIENTS VIA TELEPHONE Located on the T-drive
48.
A large percentage of patient suicides occur within 3 months of discharge from acute inpatient care from previous suicide attempt.
Correct Answer
A. True
Explanation
CPM 116-13-05 SUICIDE ATTEMPTS: ASSESSMENT AND INTERVENTION PROTOCOL Located on the T-drive
49.
In the CBOCs MANAGEMENT OF COMMITTABLE PSYCHIATRIC PATIENTS includes: (Select all that apply)
Correct Answer(s)
A. The nurse manager will take the lead role in coordinating the continuous observation of the patient until the patient is picked up for transport.
B. If the patient has not been picked up for transport by the close of business, two staff will stay after hours to continue the observation of the patient. One of the two staff must be a Mental Health provider.
C. 911 will be called if the patient exhibits violent or threatening behavior.
D. All State policies will be followed regarding the commitment process and required paperwork
Explanation
CPM 116-14-13 MANAGEMENT OF COMMITTABLE PSYCHIATRIC PATIENTS located on the T-drive
50.
All professionals have a responsibility to act on all suspected abuse.
Correct Answer
A. True
Explanation
CPM 122-13-02 ADULT/CHILD VICTIMS OF ALLEGED ABUSE located on the T-drive