CEA NURS 580 EXAM AND PRACTICE EXAM
NEWEST 2026 TEST BANK| NURS 580 CEA
EXAM PREP
1. A DNP leader is implementing a new telehealth policy. Which federal
regulation primarily governs reimbursement parity for telehealth services in
rural areas?
A) Stark Law
B) HIPAA Privacy Rule
C) SUPPORT Act
D) Social Security Act (Section 1834)
Answer: D
Rationale: Section 1834 of the Social Security Act authorizes Medicare
reimbursement for telehealth services, specifically addressing geographic
eligibility and originating sites. The SUPPORT Act (C) addresses opioid treatment,
Stark Law (A) covers physician self-referral, and HIPAA (B) covers privacy, not
reimbursement.
2. A nurse executive notes that the emergency department (ED) has a 4-hour
average wait time. Applying Lean methodology, the first step should be to:
A) Hire more ED physicians immediately.
B) Create a value stream map to identify waste.
C) Implement a mandatory overtime policy.
D) Benchmark against the national average.
Answer: B
Rationale: Lean methodology begins with defining value from the patient's
perspective and mapping the value stream to visualize waste, delays, and non-
value-added steps. Hiring (A) or overtime (C) are interventions done after analysis;
benchmarking (D) is useful but not the first Lean step.
,3. A nurse practitioner (NP) prescribes a controlled substance via telemedicine
to a new patient in a different state. Which of the following is the most critical
legal requirement?
A) A valid DEA registration in the patient's state.
B) A signed patient consent for telemedicine.
C) A face-to-face evaluation within the past 12 months (Ryan Haight Act
exception).
D) A synchronous audio-visual encounter prior to prescribing.
Answer: D
Rationale: The Ryan Haight Act requires a real-time, interactive (synchronous)
audio-visual visit before prescribing controlled substances, with specific COVID-19-
era flexibilities now requiring reinstatement of this standard. DEA registration (A)
is federal, not state-specific. Consent (B) is required but secondary.
4. A hospital is switching to a Value-Based Purchasing (VBP) model. Which
metric will most directly impact the hospital's reimbursement?
A) Total number of inpatient surgeries performed.
B) Patient satisfaction (HCAHPS) scores and clinical process outcomes.
C) The hospital's total assets and capital reserves.
D) The number of medical students rotating through the facility.
Answer: B
Rationale: VBP ties reimbursement to quality performance, including HCAHPS
(patient experience) and clinical outcomes (mortality, readmissions). Volume (A) is
fee-for-service; assets (C) and students (D) do not affect VBP payments.
5. A DNP student performs a systematic review. The student finds five RCTs,
three cohort studies, and one case series. According to the GRADE system, the
highest initial quality rating is assigned to which type of evidence?
A) Case series
B) Cohort studies
C) Randomized Controlled Trials (RCTs)
,D) Systematic reviews of RCTs
Answer: D
Rationale: In the GRADE system, systematic reviews of RCTs start as high-quality
evidence. Individual RCTs (C) start as high but are lower than a synthesized review;
cohort studies (B) start as moderate; case series (A) start as very low.
6. A nurse manager is faced with a budget cut. To maintain safe staffing, which
cost-center strategy is most aligned with transformational leadership?
A) Eliminating all travel nurse contracts immediately.
B) Reducing supply waste through staff education and shared governance.
C) Freezing all merit-based salary increases for the year.
D) Delaying all routine equipment maintenance.
Answer: B
Rationale: Transformational leadership empowers staff, fosters ownership, and
seeks sustainable solutions. Reducing waste via education (B) engages the team.
Options A, C, and D are top-down, reactive cuts that damage morale and safety.
7. A patient with decision-making capacity refuses a life-saving blood
transfusion based on religious beliefs. The NP respects this decision. This is an
application of which ethical principle?
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Answer: C
Rationale: Autonomy respects the patient's right to self-determination, even if the
choice conflicts with beneficence (doing good). Non-maleficence (B) is "do no
harm," and justice (D) is fairness in resource allocation.
, 8. In a quality improvement project, the team implements a new sepsis bundle.
After 1 month, the compliance rate is 85%. To determine if this improvement is
statistically significant, the team should use:
A) A paired t-test.
B) A run chart or Shewhart control chart.
C) A Chi-square test of independence.
D) A Pearson correlation coefficient.
Answer: B
Rationale: In QI, statistical process control (run charts/Shewhart charts) is used to
distinguish common cause from special cause variation over time. T-tests (A) and
Chi-square (C) are for research comparing groups, not time-series QI data.
9. An APRN identifies that a specific population has higher rates of diabetes due
to lack of grocery stores and safe walking areas. This assessment focuses on:
A) Genetic predisposition.
B) Health literacy deficits.
C) Social Determinants of Health (SDOH).
D) Medication non-adherence.
Answer: C
Rationale: Food deserts and unsafe neighborhoods are classic SDOH (economic
stability and physical environment). Genetics (A), literacy (B), and adherence (D)
are individual-level factors, not community-level environmental barriers.
10. The Institute for Healthcare Improvement (IHI) Triple Aim includes improving
the patient experience, reducing costs, and:
A) Enhancing provider satisfaction.
B) Improving population health.
C) Expanding hospital bed capacity.
D) Increasing specialty referrals.
Answer: B
Rationale: The IHI Triple Aim is: (1) improve patient experience, (2) improve
NEWEST 2026 TEST BANK| NURS 580 CEA
EXAM PREP
1. A DNP leader is implementing a new telehealth policy. Which federal
regulation primarily governs reimbursement parity for telehealth services in
rural areas?
A) Stark Law
B) HIPAA Privacy Rule
C) SUPPORT Act
D) Social Security Act (Section 1834)
Answer: D
Rationale: Section 1834 of the Social Security Act authorizes Medicare
reimbursement for telehealth services, specifically addressing geographic
eligibility and originating sites. The SUPPORT Act (C) addresses opioid treatment,
Stark Law (A) covers physician self-referral, and HIPAA (B) covers privacy, not
reimbursement.
2. A nurse executive notes that the emergency department (ED) has a 4-hour
average wait time. Applying Lean methodology, the first step should be to:
A) Hire more ED physicians immediately.
B) Create a value stream map to identify waste.
C) Implement a mandatory overtime policy.
D) Benchmark against the national average.
Answer: B
Rationale: Lean methodology begins with defining value from the patient's
perspective and mapping the value stream to visualize waste, delays, and non-
value-added steps. Hiring (A) or overtime (C) are interventions done after analysis;
benchmarking (D) is useful but not the first Lean step.
,3. A nurse practitioner (NP) prescribes a controlled substance via telemedicine
to a new patient in a different state. Which of the following is the most critical
legal requirement?
A) A valid DEA registration in the patient's state.
B) A signed patient consent for telemedicine.
C) A face-to-face evaluation within the past 12 months (Ryan Haight Act
exception).
D) A synchronous audio-visual encounter prior to prescribing.
Answer: D
Rationale: The Ryan Haight Act requires a real-time, interactive (synchronous)
audio-visual visit before prescribing controlled substances, with specific COVID-19-
era flexibilities now requiring reinstatement of this standard. DEA registration (A)
is federal, not state-specific. Consent (B) is required but secondary.
4. A hospital is switching to a Value-Based Purchasing (VBP) model. Which
metric will most directly impact the hospital's reimbursement?
A) Total number of inpatient surgeries performed.
B) Patient satisfaction (HCAHPS) scores and clinical process outcomes.
C) The hospital's total assets and capital reserves.
D) The number of medical students rotating through the facility.
Answer: B
Rationale: VBP ties reimbursement to quality performance, including HCAHPS
(patient experience) and clinical outcomes (mortality, readmissions). Volume (A) is
fee-for-service; assets (C) and students (D) do not affect VBP payments.
5. A DNP student performs a systematic review. The student finds five RCTs,
three cohort studies, and one case series. According to the GRADE system, the
highest initial quality rating is assigned to which type of evidence?
A) Case series
B) Cohort studies
C) Randomized Controlled Trials (RCTs)
,D) Systematic reviews of RCTs
Answer: D
Rationale: In the GRADE system, systematic reviews of RCTs start as high-quality
evidence. Individual RCTs (C) start as high but are lower than a synthesized review;
cohort studies (B) start as moderate; case series (A) start as very low.
6. A nurse manager is faced with a budget cut. To maintain safe staffing, which
cost-center strategy is most aligned with transformational leadership?
A) Eliminating all travel nurse contracts immediately.
B) Reducing supply waste through staff education and shared governance.
C) Freezing all merit-based salary increases for the year.
D) Delaying all routine equipment maintenance.
Answer: B
Rationale: Transformational leadership empowers staff, fosters ownership, and
seeks sustainable solutions. Reducing waste via education (B) engages the team.
Options A, C, and D are top-down, reactive cuts that damage morale and safety.
7. A patient with decision-making capacity refuses a life-saving blood
transfusion based on religious beliefs. The NP respects this decision. This is an
application of which ethical principle?
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Answer: C
Rationale: Autonomy respects the patient's right to self-determination, even if the
choice conflicts with beneficence (doing good). Non-maleficence (B) is "do no
harm," and justice (D) is fairness in resource allocation.
, 8. In a quality improvement project, the team implements a new sepsis bundle.
After 1 month, the compliance rate is 85%. To determine if this improvement is
statistically significant, the team should use:
A) A paired t-test.
B) A run chart or Shewhart control chart.
C) A Chi-square test of independence.
D) A Pearson correlation coefficient.
Answer: B
Rationale: In QI, statistical process control (run charts/Shewhart charts) is used to
distinguish common cause from special cause variation over time. T-tests (A) and
Chi-square (C) are for research comparing groups, not time-series QI data.
9. An APRN identifies that a specific population has higher rates of diabetes due
to lack of grocery stores and safe walking areas. This assessment focuses on:
A) Genetic predisposition.
B) Health literacy deficits.
C) Social Determinants of Health (SDOH).
D) Medication non-adherence.
Answer: C
Rationale: Food deserts and unsafe neighborhoods are classic SDOH (economic
stability and physical environment). Genetics (A), literacy (B), and adherence (D)
are individual-level factors, not community-level environmental barriers.
10. The Institute for Healthcare Improvement (IHI) Triple Aim includes improving
the patient experience, reducing costs, and:
A) Enhancing provider satisfaction.
B) Improving population health.
C) Expanding hospital bed capacity.
D) Increasing specialty referrals.
Answer: B
Rationale: The IHI Triple Aim is: (1) improve patient experience, (2) improve
