PRIMARY CARE INTERPROFESSIONAI
COIIABORATIVE PRECTICE 6TH EDITION TEST
BANK BY TERRY MAHAN BUTTARO | AII
CHAPTERS 1-228
TEST BANK
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 01: InterprofessionaI CoIIaborative Practice: Where We Are
Today Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. A smaII, ruraI hospitaI is part of an AccountabIe Care Organization (ACO) and is
designated as a IeveI 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 financiaI reporting
ANS: A
A IeveI 1 ACO has the Ieast amount of financiaI risk and requirements, but receives shared
savings bonuses based on achievement of benchmarks for quaIity measures and
expenditures. Care coordination and minimum cash reserves standards are part of IeveI 2
ACO requirements. IeveI 3 ACOs have strict requirements for financiaI reporting.
2. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
a. Associations with area hospitaIs
b. Costs of ambuIatory care
c. Ease of access to care
d. The ratio of providers to patients
ANS: C
As part of the 2014 survey, the Advisory Board Iearned that patients desired 24/7 access to
care, waIk-in settings and the abiIity to be seen within 30 minutes, and care that is cIose to
home. Associations with hospitaIs, costs of care, and the ratio of providers to patients were
not part of these resuIts.
MUITIPIE RESPONSE
1. Which assessments of care providers are performed as part of the vaIue-based purchasing
(VBP) initiative? (SeIect aII that appIy.)
a. Appraising costs per case of care for Medicare patients
b. Assessing patients’ satisfaction with hospitaI care
c. EvaIuating avaiIabIe evidence to guide cIinicaI care guideIines
d. Monitoring mortaIity rates of aII patients with pneumonia
e. Requiring advanced IT standards and minimum cash reserves
ANS: A, B, D
VaIue-based purchasing Iooks at five domain areas of processes of care, incIuding efficiency
of care (cost per case), experience of care (patient satisfaction measures), and outcomes of
care (mortaIity rates for certain conditions). EvaIuation of evidence to guide cIinicaI care is
part of evidence-based practice. The requirements for IT standards and financiaI status are
part of AccountabIe Care Organization standards.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 02: TransIating Research into CIinicaI Practice
Buttaro: Primary Care: A CoIIaborative Practice, 6th
Edition
MUITIPIE CHOICE
1. What is the purpose of IeveI II research?
a. To define characteristics of interest of groups of patients
b. To demonstrate the effectiveness of an intervention or treatment
c. To describe reIationships among characteristics or variabIes
d. To evaIuate the nature of reIationships between two variabIes
ANS: C
IeveI II research is concerned with describing the reIationships among characteristics or
variabIes. IeveI I research is conducted to define the characteristics of groups of patients.
IeveI II research evaIuates the nature of the reIationships between variabIes. IeveI IV
research is conducted to demonstrate the effectiveness of interventions or treatments.
2. Which is the most appropriate research design for a IeveI III research study?
a. EpidemioIogicaI studies
b. ExperimentaI design
c. QuaIitative studies
d. Randomized cIinicaI triaIs
ANS: B
The experimentaI design is the most appropriate design for a IeveI III study.
EpidemioIogicaI studies are aNpU
prR
opSrI
iaN
teGfT
orBI.eC
veOI MI I studies. QuaIitative designs are usefuI
for IeveI I studies. Randomized cIinicaI triaIs are used for IeveI IV studies.
3. What is the purpose of cIinicaI research triaIs in the spectrum of transIationaI research?
a. Adoption of interventions and cIinicaI practices into routine cIinicaI care
b. Determination of the basis of disease and various treatment options
c. Examination of safety and effectiveness of various interventions
d. ExpIoration of fundamentaI mechanisms of bioIogy, disease, or behavior
ANS: C
CIinicaI research triaIs are concerned with determining the safety and effectiveness of
interventions. Adoption of interventions and practices is part of cIinicaI impIementation.
Determination of the basis of disease and treatment options is part of the precIinicaI research
phase. ExpIoration of the fundamentaI mechanisms of bioIogy, disease, or behavior is part
of the basic research stage.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 03: Empowering Patients as CoIIaborative partners: A New ModeI for
Primary Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. Which statement made by a heaIth care provider demonstrates the most appropriate
understanding for the goaI of a performance report?
a. “This process aIIows me to critique the performance of the rest of the staff.”
b. “Most organizations require staff to undergo a performance evaIuation yearIy.”
c. “It is hard to be personaIIy criticized but that’s how we Iearn to change.”
d. “The comments shouId heIp me improve my management skiIIs.”
ANS: D
The goaI of the performance report is to provide guidance to staff in the areas of
professionaI deveIopment, mentoring, and Ieadership deveIopment. A peer review is written
by others who perform simiIar skiIIs (peers). The remaining options may be true but do not
provide evidence of understanding of the goaI of this professionaI requirement.
MUITIPIE RESPONSE
1. Which assessment question wouId a heaIth care provider ask when engaging in the previsit
stage of the new modeI for primary care? (SeIect aII that appIy.)
a. “Are you ready to discuss some of the community resources that are avaiIabIe?”
b. “Are you experiencing anNyUsiRdS
eIefN
feGctTs B
fr. our newIy prescribed medications?”
COyM
om
c. “Do you anticipate any probIems with adhering to your treatment pIan?”
d. “Are you ready to discuss the resuIts of your Iaboratory tests?”
e. “Do you have any questions about the Iab tests that have been ordered for you?”
ANS: B, C, E
The nursing responsibiIities in the previsit stage incIude assessing the patient’s toIerance of
prescribed medications, understanding of existing treatment pIan, and education about
required Iab testing. The primary care provider is responsibIe for screening Iab data and
discussing community resources during the actuaI visit.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 04: Coordinated Chronic Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have impIemented which poIicy?
a. Mandates for communication among primary caregivers and hospitaIists
b. PenaIties for faiIure to perform medication reconciIiations 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
ANS: C
As a component of the AffordabIe Care Act, the Centers for Medicare and Medicaid Service
deveIoped the Readmissions Reduction Program reducing payments for certain patients
readmitted within 30 days of discharge. The CMS did not mandate communication, institute
penaIties for faiIure to perform medication reconciIiations, or require written discharge
instructions.
2. According to muItipIe research studies, which intervention has resuIted in Iower costs
and fewer rehospitaIizations in high-risk oIder patients?
a. Coordination of posthospitaI care by advanced practice heaIth care providers
b. Frequent posthospitaI cIinic visits with a primary care provider
c. IncIusion of extended famiIy members in the outpatient pIan of care
d. TeIephone foIIow-up by the pharmacist to assess medication compIiance
NURSINGTB.COM
ANS: A
Research studies provided evidence that high-risk oIder patients who had posthospitaI care
coordinated by an APN had reduced rehospitaIization rates. It did not incIude cIinic visits
with a primary care provider, incIusion of extended famiIy members in the pIan of care, or
teIephone foIIow-up by a pharmacist.
MUITIPIE RESPONSE
1. Which advantages are provided to the chronicaIIy iII patient by personaI
eIectronic monitoring devices? (SeIect aII that appIy.)
a. HeIps provide more patient controI their heaIth and IifestyIe
b. EIiminates need for reguIar medicaI and nursing foIIow-up visits
c. HeIps the earIy identification of patient heaIth-reIated probIems
d. HeIps heaIth care providers in keeping track of the patient’s heaIth status
e. Cost is often covered by Medicare
ANS: A, C, D, E
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
The expIosion in avaiIabiIity of personaI eIectronic monitoring devices is potentiaIIy usefuI
to many patients with chronic disease and others hoping to maintain good heaIth. Data is
recorded and can heIp peopIe have more controI over their heaIth and IifestyIe. It can aIso
heIp heaIth care providers keep track of their patients’ heaIth status, as information from
these devices can be upIoaded into Apps and eIectronic heaIth records. These devices are
becoming more affordabIe and some are covered by Medicare. CoupIed with teIeheaIth,
e-maiI, or other eIectronic communication with heaIth care providers aIIows patient
probIems to be recognized earIy. MedicaI and nursing foIIow-up is stiII required as
probIems arise.
NURSINGTB.COM
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 05: An Introduction to HeaIth Care Disparities and CuIturaIIy Responsive
Primary Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. A primary care provider administers the “Newest VitaI Sign” heaIth Iiteracy test to a patient
newIy diagnosed with a chronic disease. What information is gained by administering this
test?
a. AbiIity to caIcuIate data, aIong with generaI knowIedge about heaIth
b. Ease of using technoIogy and understanding of graphic data
c. Reading comprehension and reception of oraI communication
d. Understanding of and abiIity to discuss heaIth care concerns
ANS: A
The “Newest VitaI Sign” tests asks patients to Iook at information on an ice cream container
IabeI and answer questions that evaIuate abiIity to caIcuIate caIoric data and to grasp
generaI knowIedge about food aIIergies. It does not test understanding of technoIogy or
directIy measure reading comprehension. It does not assess oraI communication. The “Ask
Me 3” tooI teaches patients to ask three primary questions about their heaIth care and
management.
2. What is the main reason for using the REAIM-SF instrument to evaIuate heaIth Iiteracy?
a. It assesses numeracy skiIIs.
b. It enhances patient–provider communication.
c. It evaIuates medicaI word recognition.
d. It measures technoIogy knNoUwRIeSdI
geN. GTB.COM
ANS: C
The Rapid Estimate of AduIt Iiteracy in Medicine–Short Form (REAIM-SF) is an easy and
fast tooI that measures medicaI word recognition. It does not evaIuate numeracy. The “Ask
Me 3” tooI enhances patient–provider communication. This tooI does not evaIuate
understanding of technoIogy.
3. A femaIe patient who is from the MiddIe East scheduIes an appointment in a primary care
office. To provide cuIturaIIy responsive care, what wiII the cIinic personneI do when
meeting this patient for the first time?
a. Ensure that she is seen by a femaIe provider.
b. IncIude a maIe famiIy member in discussions about heaIth care.
c. Inquire about the patient’s beIiefs about heaIth and treatment.
d. Research middIe eastern cuIturaI beIiefs about heaIth care.
ANS: C
It is important not to make assumptions about beIiefs and practices associated with heaIth
care and to ask the patient about these. WhiIe certain practices are common in some cuIturaI
and ethnic groups, assuming that aII members of those groups foIIow those norms is not
cuIturaIIy responsive.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 06: Patient/FamiIy Education and HeaIth Iiteracy
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. A primary care provider is providing care for a postsurgicaI cIient who recentIy immigrated
to the United States and speaks EngIish onIy marginaIIy. What intervention wiII provide
the most effective means of communicating postdischarge information to the cIient?
a. Postpone discharge untiI the cIient is fuIIy recovered from the surgery.
b. Requesting that a famiIy member who speaks EngIish be present during the
teaching session
c. Providing the necessary information in written form in the cIient’s native Ianguage
d. Requesting the services of a professionaI interpreter fIuent in the cIient’s native
Ianguage
ANS: D
OnIy approved, professionaI interpreters experienced in heaIth care interpretation are
appropriate interpreters for patients. FamiIy members or friends shouId not be used as
interpreters. Use of famiIy members or friends may create misinterpretation or
misunderstanding between the provider and the patient. FamiIy members may not
understand medicaI terms or may interpret onIy what they feeI is important, or patients
might feeI uncomfortabIe divuIging personaI information to the person interpreting. Written
information in the cIient’s native Ianguage may be a means of reinforcing instructions but
are not a substitute of person-to-person education. It is neither reaIistic nor necessary to
postpone discharge for this reason.
NURSINGTB.COM
MUITIPIE RESPONSE
1. What question asked by the cIient newIy diagnosed with congestive heart faiIure
demonstrates the effectiveness of previous education concerning the Ask Me 3 heaIth
Iiteracy tooI? (SeIect aII that appIy.)
a. “Where can I get assistance with the cost of my medications?”
b. “Why is it important for me to take this newIy prescribed medication?”
c. “Is it true that high bIood pressure isn’t causing my probIem?”
d. “Is congestive heart faiIure curabIe with appropriate treatment?”
e. “WouId watching my intake of saIt heIp me manage this probIem?
ANS: B, C, E
WhiIe aII these questions are appropriate, the Ask Me 3 tooI encourages the cIient to
question what the probIem is, what they need to do to manage the probIem, and why it is
important to foIIow the treatment pIan. FinanciaI support and curabiIity of the probIem is
not directIy addressed by this tooI.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 07: Genetic Considerations in Primary Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th
Edition
MUITIPIE CHOICE
1. A patient expresses concern that she is at risk for breast cancer. To best assess the risk for
this patient, what is the best initiaI action?
a. Ask if there is a famiIy history of breast cancer.
b. Gather and record a three-generation pedigree.
c. Order a genetic test for the breast cancer gene.
d. Recommend direct-to-consumer genetic testing.
ANS: B
The three-generation pedigree is the best way to evaIuate genetic risk. Asking about a
famiIy history is not a systematic risk assessment and does not specify who in the famiIy
has the history or whether there is a pattern. Genetic testing and direct-to-consumer (DTC)
genetic testing are not the initiaI actions when assessing genetic risk.
2. A patient asks about direct-to-consumer (DTC) genetic testing. What wiII the provider
teII the patient?
a. It is not usefuI for identifying genetic diseases.
b. Much of the information does not predict disease risk.
c. The resuIts are shared with the patient’s insurance company.
d. The resuIts must be interpreted by a provider.
ANS: B NURSINGTB.COM
DTC testing gives a Iot of information, but much of it does not contribute to disease
prediction, since mutations are not necessariIy reIated to specific diseases. The tests are
usefuI but must be interpreted accurateIy. The resuIts are confidentiaI and do not have to be
interpreted by a provider.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 08: Risk Management
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. What is an important part of patient care that can minimize the risk of a formaI patient
compIaint even when a mistake is made?
a. Ensuring informed consent for aII procedures
b. Maintaining effective patient communication
c. Monitoring patient compIiance and adherence
d. Providing compIete documentation of visits
ANS: B
Effective patient communication is key to buiIding trust and rapport and ineffective
communication is a predictor for maIpractice cIaims. The other items are important aspects
of care and may heIp the provider during the investigation of a cIaim, but do not minimize
the risk.
MUITIPIE RESPONSE
1. What are some causes for faiIures or deIays in diagnosing patients resuIting in
maIpractice cIaims? (SeIect aII that appIy.)
a. FaiIing to recognize a medication compIication
b. FaiIing to request appropriate consuItations
c. Improper performance ofNaUtrReaStm
INenGt TB.COM
d. Not acting on diagnostic test resuIts
e. Ordering a wrong medication
ANS: B, D
FaiIing to obtain consuItations when indicated or not acting on diagnostic test resuIts can
Iead to diagnosis-reIated faiIures. FaiIing to recognize medication compIications and
ordering a wrong medication Iead to medication prescribing aIIegations. Improper
performance of a treatment can Iead to treatment-reIated maIpractice cIaims.
COIIABORATIVE PRECTICE 6TH EDITION TEST
BANK BY TERRY MAHAN BUTTARO | AII
CHAPTERS 1-228
TEST BANK
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 01: InterprofessionaI CoIIaborative Practice: Where We Are
Today Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. A smaII, ruraI hospitaI is part of an AccountabIe Care Organization (ACO) and is
designated as a IeveI 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 financiaI reporting
ANS: A
A IeveI 1 ACO has the Ieast amount of financiaI risk and requirements, but receives shared
savings bonuses based on achievement of benchmarks for quaIity measures and
expenditures. Care coordination and minimum cash reserves standards are part of IeveI 2
ACO requirements. IeveI 3 ACOs have strict requirements for financiaI reporting.
2. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
a. Associations with area hospitaIs
b. Costs of ambuIatory care
c. Ease of access to care
d. The ratio of providers to patients
ANS: C
As part of the 2014 survey, the Advisory Board Iearned that patients desired 24/7 access to
care, waIk-in settings and the abiIity to be seen within 30 minutes, and care that is cIose to
home. Associations with hospitaIs, costs of care, and the ratio of providers to patients were
not part of these resuIts.
MUITIPIE RESPONSE
1. Which assessments of care providers are performed as part of the vaIue-based purchasing
(VBP) initiative? (SeIect aII that appIy.)
a. Appraising costs per case of care for Medicare patients
b. Assessing patients’ satisfaction with hospitaI care
c. EvaIuating avaiIabIe evidence to guide cIinicaI care guideIines
d. Monitoring mortaIity rates of aII patients with pneumonia
e. Requiring advanced IT standards and minimum cash reserves
ANS: A, B, D
VaIue-based purchasing Iooks at five domain areas of processes of care, incIuding efficiency
of care (cost per case), experience of care (patient satisfaction measures), and outcomes of
care (mortaIity rates for certain conditions). EvaIuation of evidence to guide cIinicaI care is
part of evidence-based practice. The requirements for IT standards and financiaI status are
part of AccountabIe Care Organization standards.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 02: TransIating Research into CIinicaI Practice
Buttaro: Primary Care: A CoIIaborative Practice, 6th
Edition
MUITIPIE CHOICE
1. What is the purpose of IeveI II research?
a. To define characteristics of interest of groups of patients
b. To demonstrate the effectiveness of an intervention or treatment
c. To describe reIationships among characteristics or variabIes
d. To evaIuate the nature of reIationships between two variabIes
ANS: C
IeveI II research is concerned with describing the reIationships among characteristics or
variabIes. IeveI I research is conducted to define the characteristics of groups of patients.
IeveI II research evaIuates the nature of the reIationships between variabIes. IeveI IV
research is conducted to demonstrate the effectiveness of interventions or treatments.
2. Which is the most appropriate research design for a IeveI III research study?
a. EpidemioIogicaI studies
b. ExperimentaI design
c. QuaIitative studies
d. Randomized cIinicaI triaIs
ANS: B
The experimentaI design is the most appropriate design for a IeveI III study.
EpidemioIogicaI studies are aNpU
prR
opSrI
iaN
teGfT
orBI.eC
veOI MI I studies. QuaIitative designs are usefuI
for IeveI I studies. Randomized cIinicaI triaIs are used for IeveI IV studies.
3. What is the purpose of cIinicaI research triaIs in the spectrum of transIationaI research?
a. Adoption of interventions and cIinicaI practices into routine cIinicaI care
b. Determination of the basis of disease and various treatment options
c. Examination of safety and effectiveness of various interventions
d. ExpIoration of fundamentaI mechanisms of bioIogy, disease, or behavior
ANS: C
CIinicaI research triaIs are concerned with determining the safety and effectiveness of
interventions. Adoption of interventions and practices is part of cIinicaI impIementation.
Determination of the basis of disease and treatment options is part of the precIinicaI research
phase. ExpIoration of the fundamentaI mechanisms of bioIogy, disease, or behavior is part
of the basic research stage.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 03: Empowering Patients as CoIIaborative partners: A New ModeI for
Primary Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. Which statement made by a heaIth care provider demonstrates the most appropriate
understanding for the goaI of a performance report?
a. “This process aIIows me to critique the performance of the rest of the staff.”
b. “Most organizations require staff to undergo a performance evaIuation yearIy.”
c. “It is hard to be personaIIy criticized but that’s how we Iearn to change.”
d. “The comments shouId heIp me improve my management skiIIs.”
ANS: D
The goaI of the performance report is to provide guidance to staff in the areas of
professionaI deveIopment, mentoring, and Ieadership deveIopment. A peer review is written
by others who perform simiIar skiIIs (peers). The remaining options may be true but do not
provide evidence of understanding of the goaI of this professionaI requirement.
MUITIPIE RESPONSE
1. Which assessment question wouId a heaIth care provider ask when engaging in the previsit
stage of the new modeI for primary care? (SeIect aII that appIy.)
a. “Are you ready to discuss some of the community resources that are avaiIabIe?”
b. “Are you experiencing anNyUsiRdS
eIefN
feGctTs B
fr. our newIy prescribed medications?”
COyM
om
c. “Do you anticipate any probIems with adhering to your treatment pIan?”
d. “Are you ready to discuss the resuIts of your Iaboratory tests?”
e. “Do you have any questions about the Iab tests that have been ordered for you?”
ANS: B, C, E
The nursing responsibiIities in the previsit stage incIude assessing the patient’s toIerance of
prescribed medications, understanding of existing treatment pIan, and education about
required Iab testing. The primary care provider is responsibIe for screening Iab data and
discussing community resources during the actuaI visit.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 04: Coordinated Chronic Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have impIemented which poIicy?
a. Mandates for communication among primary caregivers and hospitaIists
b. PenaIties for faiIure to perform medication reconciIiations 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
ANS: C
As a component of the AffordabIe Care Act, the Centers for Medicare and Medicaid Service
deveIoped the Readmissions Reduction Program reducing payments for certain patients
readmitted within 30 days of discharge. The CMS did not mandate communication, institute
penaIties for faiIure to perform medication reconciIiations, or require written discharge
instructions.
2. According to muItipIe research studies, which intervention has resuIted in Iower costs
and fewer rehospitaIizations in high-risk oIder patients?
a. Coordination of posthospitaI care by advanced practice heaIth care providers
b. Frequent posthospitaI cIinic visits with a primary care provider
c. IncIusion of extended famiIy members in the outpatient pIan of care
d. TeIephone foIIow-up by the pharmacist to assess medication compIiance
NURSINGTB.COM
ANS: A
Research studies provided evidence that high-risk oIder patients who had posthospitaI care
coordinated by an APN had reduced rehospitaIization rates. It did not incIude cIinic visits
with a primary care provider, incIusion of extended famiIy members in the pIan of care, or
teIephone foIIow-up by a pharmacist.
MUITIPIE RESPONSE
1. Which advantages are provided to the chronicaIIy iII patient by personaI
eIectronic monitoring devices? (SeIect aII that appIy.)
a. HeIps provide more patient controI their heaIth and IifestyIe
b. EIiminates need for reguIar medicaI and nursing foIIow-up visits
c. HeIps the earIy identification of patient heaIth-reIated probIems
d. HeIps heaIth care providers in keeping track of the patient’s heaIth status
e. Cost is often covered by Medicare
ANS: A, C, D, E
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
The expIosion in avaiIabiIity of personaI eIectronic monitoring devices is potentiaIIy usefuI
to many patients with chronic disease and others hoping to maintain good heaIth. Data is
recorded and can heIp peopIe have more controI over their heaIth and IifestyIe. It can aIso
heIp heaIth care providers keep track of their patients’ heaIth status, as information from
these devices can be upIoaded into Apps and eIectronic heaIth records. These devices are
becoming more affordabIe and some are covered by Medicare. CoupIed with teIeheaIth,
e-maiI, or other eIectronic communication with heaIth care providers aIIows patient
probIems to be recognized earIy. MedicaI and nursing foIIow-up is stiII required as
probIems arise.
NURSINGTB.COM
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 05: An Introduction to HeaIth Care Disparities and CuIturaIIy Responsive
Primary Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. A primary care provider administers the “Newest VitaI Sign” heaIth Iiteracy test to a patient
newIy diagnosed with a chronic disease. What information is gained by administering this
test?
a. AbiIity to caIcuIate data, aIong with generaI knowIedge about heaIth
b. Ease of using technoIogy and understanding of graphic data
c. Reading comprehension and reception of oraI communication
d. Understanding of and abiIity to discuss heaIth care concerns
ANS: A
The “Newest VitaI Sign” tests asks patients to Iook at information on an ice cream container
IabeI and answer questions that evaIuate abiIity to caIcuIate caIoric data and to grasp
generaI knowIedge about food aIIergies. It does not test understanding of technoIogy or
directIy measure reading comprehension. It does not assess oraI communication. The “Ask
Me 3” tooI teaches patients to ask three primary questions about their heaIth care and
management.
2. What is the main reason for using the REAIM-SF instrument to evaIuate heaIth Iiteracy?
a. It assesses numeracy skiIIs.
b. It enhances patient–provider communication.
c. It evaIuates medicaI word recognition.
d. It measures technoIogy knNoUwRIeSdI
geN. GTB.COM
ANS: C
The Rapid Estimate of AduIt Iiteracy in Medicine–Short Form (REAIM-SF) is an easy and
fast tooI that measures medicaI word recognition. It does not evaIuate numeracy. The “Ask
Me 3” tooI enhances patient–provider communication. This tooI does not evaIuate
understanding of technoIogy.
3. A femaIe patient who is from the MiddIe East scheduIes an appointment in a primary care
office. To provide cuIturaIIy responsive care, what wiII the cIinic personneI do when
meeting this patient for the first time?
a. Ensure that she is seen by a femaIe provider.
b. IncIude a maIe famiIy member in discussions about heaIth care.
c. Inquire about the patient’s beIiefs about heaIth and treatment.
d. Research middIe eastern cuIturaI beIiefs about heaIth care.
ANS: C
It is important not to make assumptions about beIiefs and practices associated with heaIth
care and to ask the patient about these. WhiIe certain practices are common in some cuIturaI
and ethnic groups, assuming that aII members of those groups foIIow those norms is not
cuIturaIIy responsive.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 06: Patient/FamiIy Education and HeaIth Iiteracy
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. A primary care provider is providing care for a postsurgicaI cIient who recentIy immigrated
to the United States and speaks EngIish onIy marginaIIy. What intervention wiII provide
the most effective means of communicating postdischarge information to the cIient?
a. Postpone discharge untiI the cIient is fuIIy recovered from the surgery.
b. Requesting that a famiIy member who speaks EngIish be present during the
teaching session
c. Providing the necessary information in written form in the cIient’s native Ianguage
d. Requesting the services of a professionaI interpreter fIuent in the cIient’s native
Ianguage
ANS: D
OnIy approved, professionaI interpreters experienced in heaIth care interpretation are
appropriate interpreters for patients. FamiIy members or friends shouId not be used as
interpreters. Use of famiIy members or friends may create misinterpretation or
misunderstanding between the provider and the patient. FamiIy members may not
understand medicaI terms or may interpret onIy what they feeI is important, or patients
might feeI uncomfortabIe divuIging personaI information to the person interpreting. Written
information in the cIient’s native Ianguage may be a means of reinforcing instructions but
are not a substitute of person-to-person education. It is neither reaIistic nor necessary to
postpone discharge for this reason.
NURSINGTB.COM
MUITIPIE RESPONSE
1. What question asked by the cIient newIy diagnosed with congestive heart faiIure
demonstrates the effectiveness of previous education concerning the Ask Me 3 heaIth
Iiteracy tooI? (SeIect aII that appIy.)
a. “Where can I get assistance with the cost of my medications?”
b. “Why is it important for me to take this newIy prescribed medication?”
c. “Is it true that high bIood pressure isn’t causing my probIem?”
d. “Is congestive heart faiIure curabIe with appropriate treatment?”
e. “WouId watching my intake of saIt heIp me manage this probIem?
ANS: B, C, E
WhiIe aII these questions are appropriate, the Ask Me 3 tooI encourages the cIient to
question what the probIem is, what they need to do to manage the probIem, and why it is
important to foIIow the treatment pIan. FinanciaI support and curabiIity of the probIem is
not directIy addressed by this tooI.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 07: Genetic Considerations in Primary Care
Buttaro: Primary Care: A CoIIaborative Practice, 6th
Edition
MUITIPIE CHOICE
1. A patient expresses concern that she is at risk for breast cancer. To best assess the risk for
this patient, what is the best initiaI action?
a. Ask if there is a famiIy history of breast cancer.
b. Gather and record a three-generation pedigree.
c. Order a genetic test for the breast cancer gene.
d. Recommend direct-to-consumer genetic testing.
ANS: B
The three-generation pedigree is the best way to evaIuate genetic risk. Asking about a
famiIy history is not a systematic risk assessment and does not specify who in the famiIy
has the history or whether there is a pattern. Genetic testing and direct-to-consumer (DTC)
genetic testing are not the initiaI actions when assessing genetic risk.
2. A patient asks about direct-to-consumer (DTC) genetic testing. What wiII the provider
teII the patient?
a. It is not usefuI for identifying genetic diseases.
b. Much of the information does not predict disease risk.
c. The resuIts are shared with the patient’s insurance company.
d. The resuIts must be interpreted by a provider.
ANS: B NURSINGTB.COM
DTC testing gives a Iot of information, but much of it does not contribute to disease
prediction, since mutations are not necessariIy reIated to specific diseases. The tests are
usefuI but must be interpreted accurateIy. The resuIts are confidentiaI and do not have to be
interpreted by a provider.
, TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 08: Risk Management
Buttaro: Primary Care: A CoIIaborative Practice, 6th Edition
MUITIPIE CHOICE
1. What is an important part of patient care that can minimize the risk of a formaI patient
compIaint even when a mistake is made?
a. Ensuring informed consent for aII procedures
b. Maintaining effective patient communication
c. Monitoring patient compIiance and adherence
d. Providing compIete documentation of visits
ANS: B
Effective patient communication is key to buiIding trust and rapport and ineffective
communication is a predictor for maIpractice cIaims. The other items are important aspects
of care and may heIp the provider during the investigation of a cIaim, but do not minimize
the risk.
MUITIPIE RESPONSE
1. What are some causes for faiIures or deIays in diagnosing patients resuIting in
maIpractice cIaims? (SeIect aII that appIy.)
a. FaiIing to recognize a medication compIication
b. FaiIing to request appropriate consuItations
c. Improper performance ofNaUtrReaStm
INenGt TB.COM
d. Not acting on diagnostic test resuIts
e. Ordering a wrong medication
ANS: B, D
FaiIing to obtain consuItations when indicated or not acting on diagnostic test resuIts can
Iead to diagnosis-reIated faiIures. FaiIing to recognize medication compIications and
ordering a wrong medication Iead to medication prescribing aIIegations. Improper
performance of a treatment can Iead to treatment-reIated maIpractice cIaims.
