AMB-BC – Ambulatory Care Nursing Board
Certification Comprehensive Ambulatory
Nursing Study Guide, Outpatient Care, Patient
Education, Clinical Practice, and Certification
Preparation
1. The ambulatory care nurse is triaging a patient who reports chest pain
described as "pressure" that started 20 minutes ago and is radiating to
the left arm. The patient has a history of hypertension and is
diaphoretic. Which of the following is the priority action?
a. Instruct the patient to call 911 immediately
b. Schedule an appointment for later today
c. Advise the patient to take an antacid
d. Instruct the patient to rest and call back if pain worsens
ANSWER: A
Rationale: This patient is showing signs of an acute myocardial infarction
(chest pressure, diaphoresis, radiation to the left arm). The priority is to
instruct the patient to call 911 immediately for emergency medical services.
Scheduling an appointment (B) would delay care. Antacids (C) are not
appropriate for cardiac symptoms. Resting and calling back (D) could delay
lifesaving treatment.
DIF: Cognitive Level: Analyze
TOP: Triage/Emergency Assessment
2. The ambulatory care nurse is performing a physical assessment on a
patient with suspected diabetic neuropathy. Which of the following
assessment findings is most consistent with this diagnosis?
a. Decreased sensation to monofilament testing on the feet
b. Increased deep tendon reflexes
c. Hyperesthesia of the lower extremities
d. Muscle hypertrophy in the calves
,ANSWER: A
Rationale: Diabetic neuropathy commonly presents with decreased sensation
to monofilament testing, particularly on the feet. Deep tendon reflexes are
typically decreased (B), not increased. Hyperesthesia (C) is less common than
decreased sensation. Muscle hypertrophy (D) is not associated with diabetic
neuropathy.
DIF: Cognitive Level: Apply
TOP: Physical Assessment
3. The ambulatory care nurse is providing education to a patient with
newly diagnosed hypertension. Which of the following blood pressure
readings is consistent with the diagnosis of hypertension according to
current guidelines?
a. 140/90 mmHg
b. 120/80 mmHg
c. 130/85 mmHg
d. 118/78 mmHg
ANSWER: A
Rationale: According to the ACC/AHA guidelines, hypertension is defined as a
blood pressure of ≥130/80 mmHg. However, the traditional threshold for
diagnosis in many clinical settings remains ≥140/90 mmHg (option A) for
patients without other risk factors. Option B is normal. Option C (130/85)
would be considered elevated or Stage 1 hypertension depending on the
guideline. Option D is normal.
DIF: Cognitive Level: Understand
TOP: Chronic Disease Management
4. The ambulatory care nurse is assessing a patient with asthma who
reports using their rescue inhaler 4 times per week. Which of the
following is the most appropriate nursing action?
a. Assess the patient's asthma control and consider stepping up therapy
b. Reassure the patient that this is acceptable use
,c. Advise the patient to increase the dose of their controller medication
d. Instruct the patient to stop using the rescue inhaler
ANSWER: A
Rationale: Using a rescue inhaler more than 2 times per week indicates poor
asthma control and requires assessment and consideration of stepping up
therapy. Accepting the use (B) is inappropriate as it indicates poor control.
Increasing the controller dose (C) should be done under provider guidance.
Stopping the rescue inhaler (D) is unsafe.
DIF: Cognitive Level: Analyze
TOP: Respiratory Assessment
5. The ambulatory care nurse is educating a patient on proper insulin
injection technique. Which of the following statements by the patient
indicates a need for further teaching?
a. "I should rotate my injection sites."
b. "I can use the same needle for multiple injections."
c. "I should check my blood sugar before injecting."
d. "I need to store unopened insulin in the refrigerator."
ANSWER: B
Rationale: Needles should never be reused due to the risk of infection and
tissue damage. Rotating sites (A), checking blood sugar before injection (C),
and refrigerating unopened insulin (D) are all correct practices.
DIF: Cognitive Level: Evaluate
TOP: Diabetes Education
6. The ambulatory care nurse is caring for a patient with heart failure
who reports a weight gain of 3 pounds in 2 days. Which of the following
is the priority nursing action?
a. Instruct the patient to contact the healthcare provider
b. Advise the patient to increase diuretic dose
c. Instruct the patient to restrict fluid intake
d. Reassure the patient that this is normal
, ANSWER: A
Rationale: A weight gain of 2-3 pounds in 1-2 days indicates fluid retention
and possible worsening of heart failure. The patient should contact the
provider. Increasing the diuretic dose (B) should not be done without
provider guidance. Fluid restriction (C) may be needed but the provider
should be notified first. Reassuring (D) is inappropriate as this is a concerning
finding.
DIF: Cognitive Level: Analyze
TOP: Heart Failure Management
7. The ambulatory care nurse is teaching a patient with chronic kidney
disease about dietary modifications. Which of the following foods should
the patient be advised to limit?
a. Apples
b. Bananas
c. Rice
d. Lettuce
ANSWER: B
Rationale: Patients with chronic kidney disease should limit foods high in
potassium, such as bananas, oranges, and potatoes. Apples (A), rice (C), and
lettuce (D) are lower in potassium and generally safer.
DIF: Cognitive Level: Apply
TOP: Renal Disease Management
8. The ambulatory care nurse is performing a medication reconciliation
for a patient with multiple chronic conditions. Which of the following is
the primary purpose of this process?
a. To identify discrepancies and prevent adverse drug events
b. To reduce the cost of medications
c. To improve patient satisfaction
d. To reduce the number of medications
ANSWER: A
Certification Comprehensive Ambulatory
Nursing Study Guide, Outpatient Care, Patient
Education, Clinical Practice, and Certification
Preparation
1. The ambulatory care nurse is triaging a patient who reports chest pain
described as "pressure" that started 20 minutes ago and is radiating to
the left arm. The patient has a history of hypertension and is
diaphoretic. Which of the following is the priority action?
a. Instruct the patient to call 911 immediately
b. Schedule an appointment for later today
c. Advise the patient to take an antacid
d. Instruct the patient to rest and call back if pain worsens
ANSWER: A
Rationale: This patient is showing signs of an acute myocardial infarction
(chest pressure, diaphoresis, radiation to the left arm). The priority is to
instruct the patient to call 911 immediately for emergency medical services.
Scheduling an appointment (B) would delay care. Antacids (C) are not
appropriate for cardiac symptoms. Resting and calling back (D) could delay
lifesaving treatment.
DIF: Cognitive Level: Analyze
TOP: Triage/Emergency Assessment
2. The ambulatory care nurse is performing a physical assessment on a
patient with suspected diabetic neuropathy. Which of the following
assessment findings is most consistent with this diagnosis?
a. Decreased sensation to monofilament testing on the feet
b. Increased deep tendon reflexes
c. Hyperesthesia of the lower extremities
d. Muscle hypertrophy in the calves
,ANSWER: A
Rationale: Diabetic neuropathy commonly presents with decreased sensation
to monofilament testing, particularly on the feet. Deep tendon reflexes are
typically decreased (B), not increased. Hyperesthesia (C) is less common than
decreased sensation. Muscle hypertrophy (D) is not associated with diabetic
neuropathy.
DIF: Cognitive Level: Apply
TOP: Physical Assessment
3. The ambulatory care nurse is providing education to a patient with
newly diagnosed hypertension. Which of the following blood pressure
readings is consistent with the diagnosis of hypertension according to
current guidelines?
a. 140/90 mmHg
b. 120/80 mmHg
c. 130/85 mmHg
d. 118/78 mmHg
ANSWER: A
Rationale: According to the ACC/AHA guidelines, hypertension is defined as a
blood pressure of ≥130/80 mmHg. However, the traditional threshold for
diagnosis in many clinical settings remains ≥140/90 mmHg (option A) for
patients without other risk factors. Option B is normal. Option C (130/85)
would be considered elevated or Stage 1 hypertension depending on the
guideline. Option D is normal.
DIF: Cognitive Level: Understand
TOP: Chronic Disease Management
4. The ambulatory care nurse is assessing a patient with asthma who
reports using their rescue inhaler 4 times per week. Which of the
following is the most appropriate nursing action?
a. Assess the patient's asthma control and consider stepping up therapy
b. Reassure the patient that this is acceptable use
,c. Advise the patient to increase the dose of their controller medication
d. Instruct the patient to stop using the rescue inhaler
ANSWER: A
Rationale: Using a rescue inhaler more than 2 times per week indicates poor
asthma control and requires assessment and consideration of stepping up
therapy. Accepting the use (B) is inappropriate as it indicates poor control.
Increasing the controller dose (C) should be done under provider guidance.
Stopping the rescue inhaler (D) is unsafe.
DIF: Cognitive Level: Analyze
TOP: Respiratory Assessment
5. The ambulatory care nurse is educating a patient on proper insulin
injection technique. Which of the following statements by the patient
indicates a need for further teaching?
a. "I should rotate my injection sites."
b. "I can use the same needle for multiple injections."
c. "I should check my blood sugar before injecting."
d. "I need to store unopened insulin in the refrigerator."
ANSWER: B
Rationale: Needles should never be reused due to the risk of infection and
tissue damage. Rotating sites (A), checking blood sugar before injection (C),
and refrigerating unopened insulin (D) are all correct practices.
DIF: Cognitive Level: Evaluate
TOP: Diabetes Education
6. The ambulatory care nurse is caring for a patient with heart failure
who reports a weight gain of 3 pounds in 2 days. Which of the following
is the priority nursing action?
a. Instruct the patient to contact the healthcare provider
b. Advise the patient to increase diuretic dose
c. Instruct the patient to restrict fluid intake
d. Reassure the patient that this is normal
, ANSWER: A
Rationale: A weight gain of 2-3 pounds in 1-2 days indicates fluid retention
and possible worsening of heart failure. The patient should contact the
provider. Increasing the diuretic dose (B) should not be done without
provider guidance. Fluid restriction (C) may be needed but the provider
should be notified first. Reassuring (D) is inappropriate as this is a concerning
finding.
DIF: Cognitive Level: Analyze
TOP: Heart Failure Management
7. The ambulatory care nurse is teaching a patient with chronic kidney
disease about dietary modifications. Which of the following foods should
the patient be advised to limit?
a. Apples
b. Bananas
c. Rice
d. Lettuce
ANSWER: B
Rationale: Patients with chronic kidney disease should limit foods high in
potassium, such as bananas, oranges, and potatoes. Apples (A), rice (C), and
lettuce (D) are lower in potassium and generally safer.
DIF: Cognitive Level: Apply
TOP: Renal Disease Management
8. The ambulatory care nurse is performing a medication reconciliation
for a patient with multiple chronic conditions. Which of the following is
the primary purpose of this process?
a. To identify discrepancies and prevent adverse drug events
b. To reduce the cost of medications
c. To improve patient satisfaction
d. To reduce the number of medications
ANSWER: A
