NSG 555 QUIZ 1 LATEST EXAM ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
|ALREADY GRADED A+
1. Areas of risk - specialties with highest claims: Neonatal and pediatric
2. Areas of risk for NP: Underserved areas
Aging services facility
NP oflce practice
Behavioral/psych facility ER
3. Practices to reduce risk: 1-practice within requirements of NP act
2- comply with organizational policies and procedures and within standards of care
3- document pt care assessment, observations, communications, actions in an objective, timely and complete manner
4- Use a chain of command or risk management ream regarding pt care of practice concerns 5-
appropriate communication
6-thorough documentation
7-ettective adverse event management 8-
detailed pt assessment
9-well-documented informed consent 10-
explained tx and referral processes
4. Disclosure of errors and adverse medical events: 1-report to clinical supervisor or risk manager per
policy
2- complete an incident report
5. General principals of geriatric care: 1-many disorders are multifactorial in origin and are best managed by
multifactorial interventions
2- disesases often present atypically or with nonspecific sx (eg confusion or functional decline)
3- not all abnormalities require evaluation and tx
4- multiple chronic conditions and geriatric syndromes often coexist and should be managed in concert with one another
6. Geriatrics - address the 5 Ms: 1-Mind (dementia, delirium, and depression) 2-Mobility
(immobility, falls, and gait disorders)
3- Medications (polypharmacy)
1|Page
, 4- Multicomplexity (comprehensive geriatric assessment guides tx decisions) 5-what
Matters most (assess pt values and goals)
7. Multicomplexity: 1-expands upon the conventional assessment of sx, dz, and meds 2-considers
the biopsychosocial situation
3-includes an analysis of prognosis, values and preferences, and ability to function independently
8. Assessment of prognosis: If less than 10 years (especially if much less), choices of tests and tx should be made based on
their ability to attect a clinicl outcome that is valued by the patient in the context of their life expectancy
9. Assessment of values and preferences: many frail older adults may prioritize maintaining their independence
over prolonging survival
-may change over time
10. Conduct a functional screening of older pts: -assessment of ADLS
-questions to detect weight loss, falls, incontinence, depressed mood, self-neglect, fear for personal safety, common serious impairments
(vision, cognition, mobility)
-ask if they have discontinued favorite activities like bowling or gardening
11. Elements of frailty: 3 of the following:
-weakness (diminished grip strength)
-slow gait speed
-decreased physical activity
-weight loss
-exhaustion or low energy
12. Beers Criteria purpose: 1-reduce older adults' exposure to potentially inappropriate meds (PIMs) by improving
med selection
2- educate clinicians and pts
3- serve as a tool for evaluating the quality of care, cost, and patterns of drug use in older adults
13. Palliative care: medical care focused on improving quality of life for people living with serious illness (carries a high risk of
mortality, negatively impacts QOL and daily function, and/or is burdensome in sx, tx, or caregiver stress.
14. Palliative care can be provided: alongside life-prolonging tx
-near the end of life - may become the sole focus of care
15. Palliative care basics: 1-routinely identify and take initial steps to manage sx 2-communicate
about prognosis and elicit pt preferences for care
3-help identify and address sources of distress
16. Discussing prognostics: -ask for permission before discussing prognosis
2|Page
, -ask how they want to receive information: direct, through others, or not all information
17. Communication about serious illness: 1-obtain consent
2- assess what pt and family already knows
3- provide clinical information, be brief and direct and avoid jargon
4- allow time for processing and emotions 5-
collabarative decision-making
6-briefly summarize conversation and next steps
18. Advanced care planning: a process that supports adults at any age or stage of health in understanding and sharing their
personal values, life goals, and preferences regarding future medical care.
19. Advanced care planning goal: help ensure that people receive medical care that is consistent with their values,
goals, and preferences during serious and chronic illness
20. Advanced care planning considerations: -appoint a surrogate decision-maker
-talk to that person about their preferences for future care
-document their wishes
21. Advanced directives: written or oral statements made by pts when they are competent which are intended to guide care
should they lose the capacity to make and communicate their decisions
22. When discussing CPR with someone with short prognosis, help them under- stand: it is
not about whether they will live, but about how they will die
23. Advanced directives: also focus on which interventions will be continued and started to promote comfort, rather than
focusing only on which interventions will be stopped or withheld
24. Durable Power of Attorney for Health Care: a surrogate decision-maker who is to use "substituted
judgment" to decide what the patient would have wanted when the patient has become unable to make and communicate their own
decisions
25. Physician Orders for Life-Sustaining Treatment (POLST): active orders, including for resuscitation,
that complement advance directives and can guide care for pts especially in the setting of an emergency
26. Chronic cough: lasts 8 or more weeks
27. Causes of chronic cough: Upper airway cough syndrome
Asthma
GERD
Nonasthmatic eosinophilic bronchitis
28. Chronic cough symptoms: Persistent
Usually dry
3|Page
QUESTIONS AND CORRECT DETAILED ANSWERS
|ALREADY GRADED A+
1. Areas of risk - specialties with highest claims: Neonatal and pediatric
2. Areas of risk for NP: Underserved areas
Aging services facility
NP oflce practice
Behavioral/psych facility ER
3. Practices to reduce risk: 1-practice within requirements of NP act
2- comply with organizational policies and procedures and within standards of care
3- document pt care assessment, observations, communications, actions in an objective, timely and complete manner
4- Use a chain of command or risk management ream regarding pt care of practice concerns 5-
appropriate communication
6-thorough documentation
7-ettective adverse event management 8-
detailed pt assessment
9-well-documented informed consent 10-
explained tx and referral processes
4. Disclosure of errors and adverse medical events: 1-report to clinical supervisor or risk manager per
policy
2- complete an incident report
5. General principals of geriatric care: 1-many disorders are multifactorial in origin and are best managed by
multifactorial interventions
2- disesases often present atypically or with nonspecific sx (eg confusion or functional decline)
3- not all abnormalities require evaluation and tx
4- multiple chronic conditions and geriatric syndromes often coexist and should be managed in concert with one another
6. Geriatrics - address the 5 Ms: 1-Mind (dementia, delirium, and depression) 2-Mobility
(immobility, falls, and gait disorders)
3- Medications (polypharmacy)
1|Page
, 4- Multicomplexity (comprehensive geriatric assessment guides tx decisions) 5-what
Matters most (assess pt values and goals)
7. Multicomplexity: 1-expands upon the conventional assessment of sx, dz, and meds 2-considers
the biopsychosocial situation
3-includes an analysis of prognosis, values and preferences, and ability to function independently
8. Assessment of prognosis: If less than 10 years (especially if much less), choices of tests and tx should be made based on
their ability to attect a clinicl outcome that is valued by the patient in the context of their life expectancy
9. Assessment of values and preferences: many frail older adults may prioritize maintaining their independence
over prolonging survival
-may change over time
10. Conduct a functional screening of older pts: -assessment of ADLS
-questions to detect weight loss, falls, incontinence, depressed mood, self-neglect, fear for personal safety, common serious impairments
(vision, cognition, mobility)
-ask if they have discontinued favorite activities like bowling or gardening
11. Elements of frailty: 3 of the following:
-weakness (diminished grip strength)
-slow gait speed
-decreased physical activity
-weight loss
-exhaustion or low energy
12. Beers Criteria purpose: 1-reduce older adults' exposure to potentially inappropriate meds (PIMs) by improving
med selection
2- educate clinicians and pts
3- serve as a tool for evaluating the quality of care, cost, and patterns of drug use in older adults
13. Palliative care: medical care focused on improving quality of life for people living with serious illness (carries a high risk of
mortality, negatively impacts QOL and daily function, and/or is burdensome in sx, tx, or caregiver stress.
14. Palliative care can be provided: alongside life-prolonging tx
-near the end of life - may become the sole focus of care
15. Palliative care basics: 1-routinely identify and take initial steps to manage sx 2-communicate
about prognosis and elicit pt preferences for care
3-help identify and address sources of distress
16. Discussing prognostics: -ask for permission before discussing prognosis
2|Page
, -ask how they want to receive information: direct, through others, or not all information
17. Communication about serious illness: 1-obtain consent
2- assess what pt and family already knows
3- provide clinical information, be brief and direct and avoid jargon
4- allow time for processing and emotions 5-
collabarative decision-making
6-briefly summarize conversation and next steps
18. Advanced care planning: a process that supports adults at any age or stage of health in understanding and sharing their
personal values, life goals, and preferences regarding future medical care.
19. Advanced care planning goal: help ensure that people receive medical care that is consistent with their values,
goals, and preferences during serious and chronic illness
20. Advanced care planning considerations: -appoint a surrogate decision-maker
-talk to that person about their preferences for future care
-document their wishes
21. Advanced directives: written or oral statements made by pts when they are competent which are intended to guide care
should they lose the capacity to make and communicate their decisions
22. When discussing CPR with someone with short prognosis, help them under- stand: it is
not about whether they will live, but about how they will die
23. Advanced directives: also focus on which interventions will be continued and started to promote comfort, rather than
focusing only on which interventions will be stopped or withheld
24. Durable Power of Attorney for Health Care: a surrogate decision-maker who is to use "substituted
judgment" to decide what the patient would have wanted when the patient has become unable to make and communicate their own
decisions
25. Physician Orders for Life-Sustaining Treatment (POLST): active orders, including for resuscitation,
that complement advance directives and can guide care for pts especially in the setting of an emergency
26. Chronic cough: lasts 8 or more weeks
27. Causes of chronic cough: Upper airway cough syndrome
Asthma
GERD
Nonasthmatic eosinophilic bronchitis
28. Chronic cough symptoms: Persistent
Usually dry
3|Page
