NUR 555 Quiz 1| QUESTIONS AND ANSWERS |
2026 UPDATE | WITH COMPLETE SOLUTIONS
Areas of risk - specialties with highest claims
Neonatal and pediatric
Areas of risk for NP
Underserved areas
Aging services facility
NP office practice
Behavioral/psych facility
ER
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-effective adverse event management
8-detailed pt assessment
9-well-documented informed consent
10-explained tx and referral processes
,Disclosure of errors and adverse medical events
1-report to clinical supervisor or risk manager per policy
2-complete an incident report
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
Geriatrics - address the 5 Ms
1-Mind (dementia, delirium, and depression)
2-Mobility (immobility, falls, and gait disorders)
3-Medications (polypharmacy)
4-Multicomplexity (comprehensive geriatric assessment guides tx decisions)
5-what Matters most (assess pt values and goals)
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
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 affect a clinicl outcome that is valued by the patient in the context of their life
expectancy
Assessment of values and preferences
many frail older adults may prioritize maintaining their independence over prolonging survival
-may change over time
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
Elements of frailty
3 of the following:
-weakness (diminished grip strength)
-slow gait speed
-decreased physical activity
-weight loss
-exhaustion or low energy
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
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.
Palliative care can be provided
alongside life-prolonging tx
-near the end of life - may become the sole focus of care
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
Discussing prognostics
-ask for permission before discussing prognosis
-ask how they want to receive information: direct, through others, or not all information
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
2026 UPDATE | WITH COMPLETE SOLUTIONS
Areas of risk - specialties with highest claims
Neonatal and pediatric
Areas of risk for NP
Underserved areas
Aging services facility
NP office practice
Behavioral/psych facility
ER
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-effective adverse event management
8-detailed pt assessment
9-well-documented informed consent
10-explained tx and referral processes
,Disclosure of errors and adverse medical events
1-report to clinical supervisor or risk manager per policy
2-complete an incident report
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
Geriatrics - address the 5 Ms
1-Mind (dementia, delirium, and depression)
2-Mobility (immobility, falls, and gait disorders)
3-Medications (polypharmacy)
4-Multicomplexity (comprehensive geriatric assessment guides tx decisions)
5-what Matters most (assess pt values and goals)
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
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 affect a clinicl outcome that is valued by the patient in the context of their life
expectancy
Assessment of values and preferences
many frail older adults may prioritize maintaining their independence over prolonging survival
-may change over time
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
Elements of frailty
3 of the following:
-weakness (diminished grip strength)
-slow gait speed
-decreased physical activity
-weight loss
-exhaustion or low energy
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
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.
Palliative care can be provided
alongside life-prolonging tx
-near the end of life - may become the sole focus of care
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
Discussing prognostics
-ask for permission before discussing prognosis
-ask how they want to receive information: direct, through others, or not all information
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
