ANCC IQ Domains 1-5 Qbank: 241 Questions & Answers for Nursing Exams, Exams of Nursing

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ANCC IQ Domain 1-5 ANCC IQ Domains 1- 5

Qbank 241Questions & Answers all correctly

answered, Exams of Nursing

1. 1. You see a patient for a routine medication visit. At the end of the session, the patient asks questions and the session ends up 50 minutes in length. You normally charge for the 30-minute appointment, but instead you charge for the 1-hour appointment. The 1-hour appointment includes a full body assessment that you did not perform. This violation is known as:

• Over-coding
• Super-coding
• Down-coding
• Up-coding: - Up-coding Rationale: Up-coding is a fraudulent practice in which the provider services are billed at higher procedure codes than were actually performed, resulting in a higher payment by Medicare or other third-party payers.

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2. 1. During a session, your patient asks to be able to contact you via your Facebook page on the internet. You reply:

• I cannot do that because I have a concealed Facebook identity; and I cannot reveal that to my patients
• I would be happy to communicate with you. It makes it easier for me to reach you this way.
• I would be happy to use Facebook but you will have to use a private message so that you can be anonymous
• I cannot do that because Facebook does not protect your Private Health Information: - I cannot do that because Facebook does not protect your Private Health Information Rationale: Using Facebook breaks patient-provider confidentiality, in addition to blurring ethical boundaries of the therapeutic relationship. Facebook does not protect private health information. Information on the site is available for anyone to see or hack into even if private messaged.

pected cost increase resulting from implementation of the parity provisions greater than a 5% increase in the cost under existing plan.: - Annual or lifetime dollar limits on mental health and substance use disorder benefits are no lower than any such dollar limits for medical and surgical benefits offered by a group health plan. Rationale: The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) provides federal legislation that requires any annual or lifetime limits on medical and surgical benefits be the same for mental health and substance use disorder benefits. Small employers who insure 2 to 50 employees can apply for an "opt- out" waiver, but they are not automatically exempt from the MHPAEA requirements. The group health plan will be required to provide in-network and out-of-network mental health and substance use disorder benefits only if it provides both in-network and out-of-network medical and surgical benefits. The group health plan my obtain

an exemption or waiver if the first year of implementation results in 2% increase in group health plan costs over prior year that covers the following year, and if implementation results in 1% increase in group health plan costs in subsequent years. A section on actuarial determination of these increased costs is included in the law.

4. 1. A 68-year-old, retired African-American widower who served for 30 years as an Army officer was recently diagnosed with terminal lung cancer. He made plans to die at home with hospice care. He was hospitalized for a broken hip and succumbed to complications in the hospital. Despite his request to be addressed as "Mr. Baxter" the hospital staff persisted in calling him by his first name, "John." Which principle of culturally competent care does this violate?

• Autonomy
• Advocacy
• Collaboration

projected benefits to the hospital, of the need to change policy and allow PMHNPs to admit patients.

6. 1. To demonstrate her support for social justice, within her role as a PMH- NP caring for the person who is homeless with mental illness, the PMHNP:

• Volunteers to serve food at the local Home for Girls.
• Teaches Sunday School.
• Volunteers to walk at the March of Dimes walk each year.
• Volunteers her clinical services at the psychiatric clinic, run by a local mission project.: - Volunteers her clinical services at the psychiatric clinic, run by a local mission project. Rationale: Social justice is bringing things to those who have the least means of getting them but need them the most. In this case, the homeless mentally ill need the PMHNP's skills more.

7. 1. You have students from local psychiatric nurse practitioner programs follow you in your clinical practice to show them what you do as a PMHNP. This is called being a:

• Preceptor
• Mentor
• Teacher
• Professor: - Preceptor Rationale: The preceptor is a 1;1 relationship sustained over a short time where each person brings something to the relationship. It is a contracted, defined role with goals. The preceptor is in a teaching role. Teaching is completed through the observed performance, examples, and role modeling.

8. 1. As an individual advanced practitioner, you cannot afford to have a standalone Electronic Health Record (EHR) system to keep all of your

secure electronic system with a template for patient information and interactions, supporting quick access within your network. Rationale: Having an EHR system is the ideal situation according to the US Health and Human Services and The Office of Clinical Quality and Safety. Not all offices have the ability to afford installation and maintenance of such systems. The US government has established financial help for EHRs in rural hospitals. For single practitioner offices, doing the best possible to keep information ready for quick access is the best possible solution. Without an EHR, incentives for having an EHR will not be available to you.

9. 1. You are in a meeting of your state nurse practitioner legislative group. The group's director has asked you to present information on a law bill (LB) that is being presented for public hearing in the state legislature. The information covers how best to approach securing support from the state's Health and Human Services Committee (state senators and congressmen). As you begin to present the information, two of your colleagues on the

committee begin to talk over you about their ideas and will now quiet down. The group director does not intervene to settle the meeting. You decide to:

• Talk over colleagues. Ask them to allow you to finish before they make comments. Take questions at the end of the presentation.
• Clear your voice and ask for attention. When that does not work, stop speaking until the situation resolves. If it does not resolve, sit down quietly until the behavior stops.
• Confront the speakers for their ill behavior and ask them to be quiet until you have finished your presentation.
• Ignore the speakers and ask the group director to settle the room so that you can finish your presentation.: - Clear your voice and ask for attention. When that does not work, stop speaking until the situation resolves. If it does not resolve, sit down quietly until the behavior stops. Rationale: She should wait quietly for them to stop their behavior. This is a situation of indirect bullying where the two colleagues were directly subverting

1 PO QHS #30. You:

• Tell her to call the provider who normally prescribes that medication for her.
• Call your mother's provider and ask the provider to call your mother's script in for her.
• Tell her that you will only do it "just this once" for her and then call the script into her pharmacy.
• Call the script into her pharmacy with three additional refills, just like any other patient.: - Tell her to call the provider who normally prescribes that medication for her. Rationale: It is not illegal to call a family member's prescription in but it is not recommended to prescribe for someone with whom you have a close relationship. You do not have the proper distance and perspective to make the medical decisions that a disinterested third party can make. Prescribing scheduled medication for yourself or your family members can get you and your

license in trouble. Do not call your mother's prescriber unless your mother is too ill to do it herself.

11. 1. As a PMHNP, you evaluate your patients for health concerns and beyond, in a holistic manner. Your current patient has a blood sugar of 186 and a hemoglobin A1C of 6.7. You refer this patient to an internal medicine practitioner with whom you frequently share patients. You have just violated:

• The Stark law.
• The DATA Act.
• No statute.
• The Adams Act.: - No statute. Rationale: You are permitted to refer your patient to an appropriate provider of care as long as you have no financial gain for the referral and are doing this in the best interest of the patient.

• Calls the Internal Medicine office and verbally requests that they fax over the laboratory results.: - Gets a signed release of information from the patient for the Internal Medicine Physician for the laboratory results. Rationale: Private healthcare information is private and cannot be released without a signed release of information pe the Health Insurance Portability and Account- ability Act (HIPAA). As long as patients do not object, the health care provider is allowed to share or discuss health information with the family, friends, or others involved in their care of payment for their care. The provider may ask your per- mission, may tell you he or she plans to discuss the information and provide an opportunity to object, or may decide, using his or her professional judgment, that you do not object. In any of these cases, the health care provider may discuss only the information that the person involved needs to know about the care or payment for the care. Healthcare providers must have a signed consent.

13. 1. Which study design is appropriate in determining the difference in effectiveness of one medication compared to another medication in the treatment of bipolar disorder?

• Cross-sectional design
• Case-controlled trial
• Randomized controlled trial
• Cohort design: - Randomized controlled trial Rationale: When the research question is treatment-based, you would likely choose a randomized controlled trial where patients are randomly allocated to control or treatment groups.

14. 1. A newly graduated NP wants to open a private psychiatric practice in her hometown. She wants to find out about the laws that cover her responsibility and the legal liability that this practice will encounter for her as an independent PMHNP. Her best source of information is:

• Local Psychiatric Nurse Practitioners in practice.

15. 1. The core values that underlie advanced practice nursing and culturally competent care include:

• Care, respect, collaboration
• Autonomy, respect, collaboration
• Respect, advocacy, partnership
• Care, advocacy, respect: - Respect, advocacy, partnership Rationale: The culturally competent PMHNP is knowledgeable and respectful of diverse cultural beliefs and practices, partners with the patient to develop a care regimen that produces the desired health outcomes within the context of the pa- tient's cultural values, and advocates for the development of culturally appropriate patient care services.

16. 1. As an NP, you teach your patients that mental illness is no different from any other physical illness that a person suffers. In classes for the community, you emphasize that everybody ahs a brain and it is another

organ in the body. You remind your audience that illness in the brain is no different from illness in the heart, lungs, or liver. This is an example of:

• Integrated health
• Cross education
• Holistic dynamism
• Reducing stigma: - Reducing stigma Rationale: Stigma is one of the worst offenders separating persons suffering with mental illness from the mainstream. There is a spoken and unspoken prej- udice against anyone who suffers with a mental illness. Persons suffering with schizophrenia are not treated the same way that other persons are treated in medical practitioner's offices, stores, postal offices, or other public and some private venues. It is the duty of every PMHNP to change this and reduce and/or eliminate this stigma.

17. 1. To advocate for the skills and value of the NP, you: