Ambulatory 400 Questions and Answers 2022-23

The question "Is the patient pregnant?" should appear for any imaging orderables. What type of question record needs to be built? - Correct answer-Build an order specific question. Describe the most efficient way to have the same question appear for all the diagnostic imaging procedures. - Correct answer-Link the procedure category for those imaging tests to the question. Dr. Mica orders a procedure called Amb Referral to Dermatology. Would this be an orderable, performable, chargeable, or combination? - Correct answer-The referral would be an orderable because it's like saying, "somebody please do this" and isn't actually being performed or charged now. I created a SmartText with functional type MR Orders. Why am I unable to use it for a process instruction in a procedure? - Correct answer-You cannot use it because MR Orders is the functional type for SmartText used as Comments. True or False Procedures that are chargeables should be marked as active in billing. - Correct answer-True In a procedure, what is the purpose of the Override Procedure Category Questions item? - Correct answer-It allows the administrator the option of having questions from both levels appear (or not) when the procedure is ordered. True or False Lab related SmartLinks look to the procedure that was ordered. - Correct answer-False If you list Glucose as a result component in a Glucose Accucheck procedure record, how does that affect the end user who results this test? - Correct answer-In the Enter/Edit Results activity, the end user sees the component by default, thus saving time. In the procedure category for Lab Sent Outs, two buttons were set up for the Class field. However whenever Dr. Mica orders an iron assay (which is a procedure linked to the Lab Send Outs procedure category), she sees four buttons for the Class field. Explain why. - Correct answer-The system searches for details using the procedure procedure category hierarchy, so it found the four buttons defined in the procedure record and displayed them. Dr. Quartz complains that whenever he orders any diagnostic imaging test for any patient, the question, "is the patient pregnant?" appears. What setup is wrong? - Correct answer-The linked question record should have been limited to females of a certain age. You set up item buttons to display for the Class field. What must you do to make sure the Class field appears in the Order Composer? - Correct answer-Define Class among the desired display items at the appropriate level's OCC record. If you choose a display item that has "Collapsed" in its name (like Comment Collapsed), how does that appear in the Order Composer? - Correct answer-It appears as a hyperlink. Dr. Quartz complains that whenever he orders any outpatient referral, a default department specialty of Obstetrics and Gynecology appears. What did an administrator do incorrectly, and what should have been done? - Correct answer-The administrator defined that department specialty in the referral procedure category. She should have defined it only in appropriate referral procedure records. True or False Additional order detail display items can only be set up in a system level OCC record. - Correct answer-False What is the purpose of the Dispensable Product field in a medication record? - Correct answer-The system automatically substitutes the dispensable product in place of this medication when this medication is ordered. Name one type of SmartText to which a mediation record can link. - Correct answerAdministration instructions To what type of questions can you link a medication? - Correct answer-Order specific In a medication record for Ranitidine 150 mg tabs, the Administration Unit and Rounding Factor are set up as the "nearest 0.5 Tab". What is the purpose of this? - Correct answer-Administration unit is the amount that must be given, or administered. If the system calculates that the patient should take 1.435 tabs, for example, it will round to 1.5 tabs. For Amoxicillin 250 mg/5mL Suspension, what quantities and units would you specify in an equivalency table? - Correct answer-250 mg = 5 mL The providers are complaining that 25 particular medications offer inappropriate choices when they click the Selection button in the Frequency field. Describe how you would fix that. - Correct answer-In each of the 25 medication records, set the list of allowed frequencies to those that are desired. True or False Dose buttons (for example, 50 mg or 100 mg) are set up on the same screen on which you set up item buttons. - Correct answer-False I need to set up administration instructions stating "Refrigerate and shake well before administering" for 75 medications. What is the most efficient way to set this up AND how do I make sure those instructions are seen? - Correct answer-Create a SmartText for administration instructions. Link the 75 medications to that SmartText. For each medication, make sure to specify display items that include the instructions. True or False If you set up a Use Free Text button for dose, then administration instructions automatically appear as a display item. - Correct answer-False True or False If you set up items buttons to display for the Route field, then the Route field automatically becomes a display item in the Order Composer. - Correct answerFalse, it also needs to be listed as a Display item. Five display items are defined in the system level OCC record. For a particular medication, you want those five display items and one more. In your medication level OCC record, do you list the six display items in total, or just the extra one you want? Explain. - Correct answer-List all six. Reason: The system searches in a hierarchy, so if you just listed the one item in the medication level OCC record, only that one would show as a display item. True or False To set up the display items that appear when the Additional Order Details hyperlink is clicked in the Order Composer, choose a context of Ambulatory. - Correct answer-False, you have to choose say 11 for outpatient Additional Order Details Explain where the system looks when you order an immunization in Order Entry versus when you document a patient reported immunization in the Immunizations activity. - Correct answer-When a provider places an order in Order Entry, the system looks for a record in the Procedure master file. When a provider documents a historical immunization, the system looks for a record in the immunizations master file. What is one type of question record to which you can link an immunization? - Correct answer-Type = Immunization Question or Order Specific Questions Dr. Mica places an order in Order Entry for a Tetanus Vaccine. In the Tetanus Vaccine procedure record, there is a default dose. In the linked Tetanus immunization record, there is also a default dose. When Nurse Denver goes to Immunizations activity to document the administration, which default dose will he see? - Correct answer-The default dose from the procedure record. True or False In a preference list record, you must create at least one section. - Correct answer-True Nurse Memphis is unable to add anything to her user preference lists, but all the other nurses in her group can add to theirs. Why is that? - Correct answer-Nurse Memphis' user record is set to OFF for all the user preference lists An administrator makes a preference list for the Allergy departments. The end users in the Allergy departments do not see the preference list. What is wrong? - Correct answer-The administrator did not link the department profile(s) to this preference list. What two types of preference lists can you make in the Preference List Composer? - Correct answer-Medications and procedure based preference lists. List two places in Hyperspace where end users see preference lists. - Correct answerOne possible answer: Order Entry, Problem List Lead poisoning affects virtually every system in the body, and often occurs with no distinctive symptoms. Some states require toddlers to be tested once at the age of 1 year and again at the age of 2 years. What type of Health Maintenance topic would you make? - Correct answer-You would make a sequential type of topic. Name each type of Health Maintenance topic and give an example of how you would use each. - Correct answer-Normal: annual Pap smear Seasonal: flu shot Sequential: DTaP vaccination series Finish this statement: HM modifiers can be used to... - Correct answer-include or exclude patients from Health Maintenance plans. You need to add a new modifier called "Asbestos Exposure" to the list of modifiers. How do you do that? - Correct answer-Go to Category List Maintenance and add this value to the list (EPT-18675) Scenario: You created a Flu Shot topic, and you created a Flu Shot Seniors plan for patients over the age of 65. You have now been tasked with making sure that asthmatic patients of all ages are also informed that they should receive a flu shot. Should you create a topic or plan? What should be involved in the setup of this record? How can you accommodate that, while the seniors get notified two weeks in advance, you want the asthmatics to get notified one month in advance? - Correct answer-Create a new plan for this population. The plan will include an "asthma" modifier, and it will be for any age and sex. In the plan, you can override the topic setup, so you could set the Prior Time to one month for the asthmatics. Joni is overdue for a vision exam. She received a vision exam at Eyemart. How can Dr. Coal satisfy this Health Maintenance without ordering a vision exam? - Correct answerIn the Health Maintenance activity, override the Vision Health Maintenance. When patients report getting shots elsewhere, you document that in the Immunization activity as a historical immunization. You want that process to also satisfy related Health Maintenance topics. How would you set this up? - Correct answer-Make immunization related Health Maintenance topics and plans. Then, in the Immunization master file, link the appropriate Immunization records to the appropriate Health Maintenance topic records. Scenario: Rita is a 43 year old female with a family history of cancer. Rita has also had a double mastectomy. Rita's patient record has both the "family hx ca" and "double mastectomy" modifiers. In the system, the mammogram topic is linked to a plan that includes the "family hx ca" modifier but excludes those with the "double mastectomy" modifier. Will Rita be part of this plan? Why or why not? - Correct answer-Rita will be excluded. EpicCare looks at the plan like this: This plan is for patients who are female and within the ages of 40-59 and who have the "family hx ca" modifier, but not if they have the "breast absent" modifier. Rita is part of the subset of patients who are female, age 40-59, and have the family hx ca. But, she is removed from that subset because she has the "breast absent" modifier. True or False Specific destinations for order transmittal are set up in destination map records. - Correct answer-True. The Specific destination (workstation record) is mapped to a generic destination (destination descriptor) in a destination map record. If Dr. Mica places five orders for a patient during one visit, how many order records are created? - Correct answer-Five order records are created. List the three types of directives described in this chapter and give an example of how each would be used in a rule. - Correct answer-SET - change the values of properties in an order such as order class, charge status, priority DO - perform an action such as put a color flag on the schedule or a patient on a patient list SEND - send to a destination such as send to a printer or a nurse pool True or False Medication orders can only be reprinted by administrators in the Printer Status activity. - Correct answer-False. Medications can also be reprinted in Order Entry in the encounter in which they were ordered. In addition, they can be reprinted in Clinical Administration. True or False In Basket classes are set up in the In Basket Class master file. - Correct answer-False. They are values on a category list. Describe what you need to do to create a new In Basket class and to have Dr. Mica, Dr. Seeger and Dr. Iron be members of that class. - Correct answer-Create a new value in the category list for classes. In each of these user's user records, point to that value. I created a pool with the name South Scheduler but don't see it on the list when I type "P?" in the To field of my message from. What is one reason I am not seeing it? - Correct answer-The registry record is marked Inactive. I created a class called "Pediatric Nurse-South" and a Registry record called "South Pediatric Nurses". When I want to sent a pool message to this group, what do I type in the To field? - Correct answer-You type "P South Pediatric Nurses" which is the name of the registry record. Ideally, if a class and pool cover the same group they should have the same name. This is an example of setup that isn't ideal. You've been asked to create a pool for East Urgent Care Nurses, for which a class already exists. In which master file do you set this up? And, what master file will be searched? - Correct answer-The pool is created in the Registry master file. Search the User master file for members of that class. Why is is important that the most specific criteria be listed first in a results routing scheme record? - Correct answer-When a result matches all the criteria in a row, it will be routed accordingly and result routing does not evaluate any other rows in that scheme. How is a result routed if none of the criteria of the scheme are True? - Correct answer-it goes to the default recipients specified in the scheme record. One of the providers in my department is conducting a research study in which a certain procedure is to be routed to a special Research Study Pool. This procedure is not part of any criteria for the results routing scheme we are using at the department level. Describe all of the setup required so that she will receive results when that procedure is ordered. - Correct answer-Create a new results routing scheme for her that is the same as the department scheme, but with an additional criterion that includes the particular procedure and lists the Research Study Pool as a recipient. Make sure this is the first line on the Scheme. Attach this scheme to her provider record. For this question, explain how the hierarchy was leveraged. One of the providers in my department is conducting a research study in which a certain procedure is to be routed to a special Research Study Pool. This procedure is not part of any criteria for the results routing scheme we are using at the department level. Describe all of the setup required so that she will receive results when that procedure is ordered. - Correct answer-Results Routing always checks the provider record of the Authorizing Provider first. In this case, a results routing scheme was plugged in at that level, so it was used. True or False The system looks to the Procedure master file for any order that is not a medication. - Correct answer-True... that means that referrals to specialties, supplies, xrays, lab tests, and injection orders all have records in the Procedure master file Procedures can have process instructions, scheduling instructions and comments. All are SmartText records. Each has a special function type: Scheduling instructions: Process Instructions: Comments: - Correct answer-Scheduling Instructions: MR Procedure Scheduling Instructions Process Instructions: MR Procedure Process Information Comments: MR Orders True or False You must enter a procedure type of Charge to activate the procedure. - Correct answer-True...regardless of the billing status. When set to Charge end users can look up the procedure in Order Entry. Orderable purpose: - Correct answer-Someone please do this. Performed or done for a patient...nursing procedure, external referral, referral orders Performable purpose: - Correct answer-This has been done. Thing that need to be documented but not charged, foot exam. Chargeable purpose: - Correct answer-Let's get paid for it. Things to charge immediately Historical purpose: - Correct answer-Document historical procedure. Things documented as performed in the patient's past. What are the primary display item? - Correct answer-Status Class Scheduling instructions Comments True or False OCC record can set the display items and the summary items. - Correct answer-True What is evaluated by the system to determine where to transmit a signed order? - Correct answer-Order type and order class. This is done in the Procedure Category. You can override the order type in the Procedure Record. True or False You link your Procedure Category to the OCC Record. - Correct answerTrue And then link the Procedure to the Procedure Category. Any setup in a procedure record is specific to only that what?? - Correct answerProcedure Any setup in a procedure category record applies to... - Correct answer-All procedures belonging to that category (unless overridden at the procedure level)