NSG 554 EXAM 1 | COMPREHENSIVE NURSING STUDY GUIDE,
PRACTICE QUESTIONS & ANSWERS 2026/2027
ANS: A
A Level 1 ACO has the least amount of financial risk and requirements, but receives shared
savings bonuses based on achievement of benchmarks for quality measures and
expenditures. Care coordination and minimum cash reserves standards are part of Level 2 ACO
requirements. Level 3 ACOs require financial reporting - correct answer ✔✔1. A small, rural hospital is
part of an Accountable Care Organization (ACO) and is designated as a Level 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 financial reporting
ANS: C
As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access to care, walk-in
settings and the ability to be seen within 30 minutes, and care that is close to home. Associations with
hospitals, costs of care, and the ratio of providers to patients were not part of these results. - correct
answer ✔✔2. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
c. Ease of access to care
d. The ratio of providers to patients
ANS: D
The goal of the performance report is to provide guidance to staff in the areas of professional
development, mentoring, and leadership development. A peer review is written by others who perform
similar skills (peers). The remaining options may be true but do not provide evidence of understanding of
the goal of this professional requirement. - correct answer ✔✔3. Which statement made by a health
care provider demonstrates the most appropriate understanding for the goal of a performance report?
a. "This process allows me to critique the performance of the rest of the staff." b. "Most organizations
require staff to undergo a performance evaluation yearly."
c. "It is hard to be personally criticized but that's how we learn to change."
d. "The comments should help me improve my management skills."
ANS: B, C, E
,The nursing responsibilities in the previsit stage include assessing the patient's tolerance of prescribed
medications, understanding of existing treatment plan, and education about required lab testing. The
primary care provider is responsible for screening lab data and discussing community resources during
the actual visit. - correct answer ✔✔4. Which assessment question would a health care provider ask
when engaging in the previsit stage of the new model for primary care? (Select all that apply.)
a. "Are you ready to discuss some of the community resources that are available?"
b. "Are you experiencing any side effects from your newly prescribed medications?"
c. "Do you anticipate any problems with adhering to your treatment plan?"
d. "Are you ready to discuss the results of your laboratory tests?"
e. "Do you have any questions about the lab tests that have been ordered for you?"
ANS: C
As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service developed
the Readmissions Reduction Program reducing payments for certain patients
readmitted within 30 days of discharge. The CMS did not mandate communication, institute penalties for
failure to perform medication reconciliations, or require written discharge instructions. - correct answer
✔✔5. To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid
Service have implemented which policy?
a. Mandates for communication among primary caregivers and hospitalists
b. Penalties for failure to perform medication reconciliations 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: A
Research studies provided evidence that high-risk older patients who had posthospital care coordinated
by an APN had reduced rehospitalization rates. It did not include clinic visits with a primary care provider,
inclusion of extended family members in the plan of care, or telephone follow-up by a pharmacist. -
correct answer ✔✔6. According to multiple research studies, which intervention has resulted in lower
costs and fewer rehospitalizations in high-risk older patients?
a. Coordination of posthospital care by advanced practice health care providers
b. Frequent posthospital clinic visits with a primary care provider
c. Inclusion of extended family members in the outpatient plan of care
d. Telephone follow-up by the pharmacist to assess medication compliance
ANS: A
The "Newest Vital Sign" tests asks patients to look at information on an ice cream container label and
answer questions that evaluate ability to calculate caloric data and to grasp general knowledge about
food allergies. It does not test understanding of technology or directly measure reading comprehension.
It does not assess oral communication. The "Ask Me 3" tool teaches patients to ask three primary
questions about their health care and management. - correct answer ✔✔7. A primary care provider
administers the "Newest Vital Sign" health literacy test to a patient newly diagnosed with a chronic
disease. What information is gained by administering this test?
, a. Ability to calculate data, along with general knowledge about health
b. Ease of using technology and understanding of graphic data
c. Reading comprehension and reception of oral communication
d. Understanding of and ability to discuss health care concerns
ANS: C
The Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) is an easy and fast tool that
measures medical word recognition. It does not evaluate numeracy. The "Ask Me 3" tool enhances
patient-provider communication. This tool does not evaluate understanding of technology. - correct
answer ✔✔8. What is the main reason for using the REALM-SF instrument to evaluate health literacy?
a. It assesses numeracy skills.
b. It enhances patient-provider communication.
c. It evaluates medical word recognition.
d. It measures technology knowledge.
ANS: C
It is important not to make assumptions about beliefs and practices associated with health care and to
ask the patient about these. While certain practices are common in some cultural and ethnic groups,
assuming that all members of those groups follow those norms is not culturally responsive. - correct
answer ✔✔9. A female patient who is from the Middle East schedules an appointment in a primary care
office. To provide culturally responsive care, what will the clinic personnel do when meeting this patient
for the first time?
a. Ensure that she is seen by a female provider.
b. Include a male family member in discussions about health care.
c. Inquire about the patient's beliefs about health and treatment.
d. Research middle eastern cultural beliefs about health care.
ANS: A
Early adolescents challenge authority, experience wide mood swings, reject the ideation of childhood,
and can be argumentative and disobedient. Middle adolescents experience fatigue and begin
experimenting with sex and risky behaviors. Late adolescents begin to assimilate adult roles. - correct
answer ✔✔10. Which behavior is most characteristic of early adolescence?
a. Arguing with parents and teachers
b. Assimilating adult roles and thinking
c. Exhibiting fatigue more frequently
d. Experimenting with sex and risky behaviors
ANS: D
PRACTICE QUESTIONS & ANSWERS 2026/2027
ANS: A
A Level 1 ACO has the least amount of financial risk and requirements, but receives shared
savings bonuses based on achievement of benchmarks for quality measures and
expenditures. Care coordination and minimum cash reserves standards are part of Level 2 ACO
requirements. Level 3 ACOs require financial reporting - correct answer ✔✔1. A small, rural hospital is
part of an Accountable Care Organization (ACO) and is designated as a Level 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 financial reporting
ANS: C
As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access to care, walk-in
settings and the ability to be seen within 30 minutes, and care that is close to home. Associations with
hospitals, costs of care, and the ratio of providers to patients were not part of these results. - correct
answer ✔✔2. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
c. Ease of access to care
d. The ratio of providers to patients
ANS: D
The goal of the performance report is to provide guidance to staff in the areas of professional
development, mentoring, and leadership development. A peer review is written by others who perform
similar skills (peers). The remaining options may be true but do not provide evidence of understanding of
the goal of this professional requirement. - correct answer ✔✔3. Which statement made by a health
care provider demonstrates the most appropriate understanding for the goal of a performance report?
a. "This process allows me to critique the performance of the rest of the staff." b. "Most organizations
require staff to undergo a performance evaluation yearly."
c. "It is hard to be personally criticized but that's how we learn to change."
d. "The comments should help me improve my management skills."
ANS: B, C, E
,The nursing responsibilities in the previsit stage include assessing the patient's tolerance of prescribed
medications, understanding of existing treatment plan, and education about required lab testing. The
primary care provider is responsible for screening lab data and discussing community resources during
the actual visit. - correct answer ✔✔4. Which assessment question would a health care provider ask
when engaging in the previsit stage of the new model for primary care? (Select all that apply.)
a. "Are you ready to discuss some of the community resources that are available?"
b. "Are you experiencing any side effects from your newly prescribed medications?"
c. "Do you anticipate any problems with adhering to your treatment plan?"
d. "Are you ready to discuss the results of your laboratory tests?"
e. "Do you have any questions about the lab tests that have been ordered for you?"
ANS: C
As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service developed
the Readmissions Reduction Program reducing payments for certain patients
readmitted within 30 days of discharge. The CMS did not mandate communication, institute penalties for
failure to perform medication reconciliations, or require written discharge instructions. - correct answer
✔✔5. To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid
Service have implemented which policy?
a. Mandates for communication among primary caregivers and hospitalists
b. Penalties for failure to perform medication reconciliations 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: A
Research studies provided evidence that high-risk older patients who had posthospital care coordinated
by an APN had reduced rehospitalization rates. It did not include clinic visits with a primary care provider,
inclusion of extended family members in the plan of care, or telephone follow-up by a pharmacist. -
correct answer ✔✔6. According to multiple research studies, which intervention has resulted in lower
costs and fewer rehospitalizations in high-risk older patients?
a. Coordination of posthospital care by advanced practice health care providers
b. Frequent posthospital clinic visits with a primary care provider
c. Inclusion of extended family members in the outpatient plan of care
d. Telephone follow-up by the pharmacist to assess medication compliance
ANS: A
The "Newest Vital Sign" tests asks patients to look at information on an ice cream container label and
answer questions that evaluate ability to calculate caloric data and to grasp general knowledge about
food allergies. It does not test understanding of technology or directly measure reading comprehension.
It does not assess oral communication. The "Ask Me 3" tool teaches patients to ask three primary
questions about their health care and management. - correct answer ✔✔7. A primary care provider
administers the "Newest Vital Sign" health literacy test to a patient newly diagnosed with a chronic
disease. What information is gained by administering this test?
, a. Ability to calculate data, along with general knowledge about health
b. Ease of using technology and understanding of graphic data
c. Reading comprehension and reception of oral communication
d. Understanding of and ability to discuss health care concerns
ANS: C
The Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) is an easy and fast tool that
measures medical word recognition. It does not evaluate numeracy. The "Ask Me 3" tool enhances
patient-provider communication. This tool does not evaluate understanding of technology. - correct
answer ✔✔8. What is the main reason for using the REALM-SF instrument to evaluate health literacy?
a. It assesses numeracy skills.
b. It enhances patient-provider communication.
c. It evaluates medical word recognition.
d. It measures technology knowledge.
ANS: C
It is important not to make assumptions about beliefs and practices associated with health care and to
ask the patient about these. While certain practices are common in some cultural and ethnic groups,
assuming that all members of those groups follow those norms is not culturally responsive. - correct
answer ✔✔9. A female patient who is from the Middle East schedules an appointment in a primary care
office. To provide culturally responsive care, what will the clinic personnel do when meeting this patient
for the first time?
a. Ensure that she is seen by a female provider.
b. Include a male family member in discussions about health care.
c. Inquire about the patient's beliefs about health and treatment.
d. Research middle eastern cultural beliefs about health care.
ANS: A
Early adolescents challenge authority, experience wide mood swings, reject the ideation of childhood,
and can be argumentative and disobedient. Middle adolescents experience fatigue and begin
experimenting with sex and risky behaviors. Late adolescents begin to assimilate adult roles. - correct
answer ✔✔10. Which behavior is most characteristic of early adolescence?
a. Arguing with parents and teachers
b. Assimilating adult roles and thinking
c. Exhibiting fatigue more frequently
d. Experimenting with sex and risky behaviors
ANS: D
