Care I (FNP) - Wilkes University 2026/2027 Academic Year -
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1. A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as
a Level 1 ACO. What is part of this designation?
a. Bonuses based on achievement of benchmarks
b. Care coordination for chronic diseases
c. Standards for minimum cash reserves
d. Strict requirements for financial reporting
ACCURATE ANSWER: A
A Level 1 ACO has the least amount of financial risk and requirements, but receives shared
savings bonuses based on achievement of benchmarks for quality measures and
expenditures. Care coordination and minimum cash reserves standards are part of Level 2 ACO
requirements. Level 3 ACOs require financial reporting
2. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
,c. Ease of access to care
d. The ratio of providers to patients
ACCURATE ANSWER: C
As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access to
care, walk-in settings and the ability to be seen within 30 minutes, and care that is close to
home. Associations with hospitals, costs of care, and the ratio of providers to patients were not
part of these results.
3. Which statement made by a health care provider demonstrates the most appropriate
understanding for the goal of a performance report?
a. "This process allows me to critique the performance of the rest of the staff." b. "Most
organizations require staff to undergo a performance evaluation yearly."
c. "It is hard to be personally criticized but that's how we learn to change."
d. "The comments should help me improve my management skills."
ACCURATE ANSWER: D
The goal of the performance report is to provide guidance to staff in the areas of professional
development, mentoring, and leadership development. A peer review is written by others who
perform similar skills (peers). The remaining options may be true but do not provide evidence of
understanding of the goal of this professional requirement.
4. Which assessment question would a health care provider ask when engaging in the previsit
stage of the new model for primary care? (Select all that apply.)
a. "Are you ready to discuss some of the community resources that are available?"
,b. "Are you experiencing any side effects from your newly prescribed medications?"
c. "Do you anticipate any problems with adhering to your treatment plan?"
d. "Are you ready to discuss the results of your laboratory tests?"
e. "Do you have any questions about the lab tests that have been ordered for you?"
ACCURATE ANSWER: B, C, E
The nursing responsibilities in the previsit stage include assessing the patient's tolerance of
prescribed medications, understanding of existing treatment plan, and education about
required lab testing. The primary care provider is responsible for screening lab data and
discussing community resources during the actual visit.
5. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
a. Mandates for communication among primary caregivers and hospitalists
b. Penalties for failure to perform medication reconciliations at time of discharge
c. Reduction of payments for patients readmitted within 30 days after discharge
d. Requirements for written discharge instructions for patients and caregivers
ACCURATE ANSWER: C
As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service
developed the Readmissions Reduction Program reducing payments for certain patients
readmitted within 30 days of discharge. The CMS did not mandate communication, institute
penalties for failure to perform medication reconciliations, or require written discharge
instructions.
, 6. According to multiple research studies, which intervention has resulted in lower costs and
fewer rehospitalizations in high-risk older patients?
a. Coordination of posthospital care by advanced practice health care providers
b. Frequent posthospital clinic visits with a primary care provider
c. Inclusion of extended family members in the outpatient plan of care
d. Telephone follow-up by the pharmacist to assess medication compliance
ACCURATE ANSWER: A
Research studies provided evidence that high-risk older patients who had posthospital care
coordinated by an APN had reduced rehospitalization rates. It did not include clinic visits with a
primary care provider, inclusion of extended family members in the plan of care, or telephone
follow-up by a pharmacist.
7. A primary care provider administers the "Newest Vital Sign" health literacy test to a patient
newly diagnosed with a chronic disease. What information is gained by administering this test?
a. Ability to calculate data, along with general knowledge about health
b. Ease of using technology and understanding of graphic data
c. Reading comprehension and reception of oral communication
d. Understanding of and ability to discuss health care concerns
ACCURATE ANSWER: A
The "Newest Vital Sign" tests asks patients to look at information on an ice cream container
label and answer questions that evaluate ability to calculate caloric data and to grasp general
knowledge about food allergies. It does not test understanding of technology or directly
measure reading comprehension. It does not assess oral communication. The "Ask Me 3" tool
teaches patients to ask three primary questions about their health care and management.