This is Part 1 of the Ambulatory Care Nursing
(RN-BC) Exam 5th Edition Comprehensive
Test Bank by AAACN.
TABLE OF CONTENTS — PART 1 of 5
Domain I: Assess and Evaluate — Questions 1-30
Domain II: Plan and Implement — Questions 31-40
Domain III: Professional Role — Questions 41-50
Q1. Which statement best defines the scope of ambulatory care nursing practice?
A. Nursing care provided exclusively during overnight hospital stays
B. Nursing care of individuals, families, and populations across the wellness-illness continuum in
outpatient and community settings
C. Nursing care limited to telephone triage and appointment scheduling
D. Nursing care focused only on acute episodic illness visits
Correct Answer: Nursing care of individuals, families, and populations across the wellness-illness
continuum in outpatient and community settings ✅
Rationale: Ambulatory care nursing is defined by the AAACN and ANA as care of individuals,
families, and populations across the wellness-illness continuum in settings where encounters are
typically episodic and patients manage care at home between visits. Option A is incorrect because
overnight hospital stays describe inpatient care, not ambulatory care. Option C is incorrect because
telephone triage is one component of the specialty, not its entire scope. Option D is incorrect
because ambulatory care extends beyond acute visits to include prevention, chronic disease
management, and care coordination. The key concept is that ambulatory care nursing is a specialty
spanning the full continuum of health and illness in outpatient settings.
Q2. A nurse completes a pre-visit review of a new patient's history, medications, allergies, and
screening gaps before the provider arrives. Which ANA standard of practice is the nurse
demonstrating?
A. Assessment
B. Diagnosis
,C. Planning
D. Evaluation
Correct Answer: Assessment ✅
Rationale: Assessment is the ANA standard that involves systematic collection of
comprehensive data pertinent to the patient's health and situation, and the pre-visit chart review is a
classic ambulatory example of this activity. Option B is incorrect because diagnosis involves analyzing
assessment data to identify problems, which is not the described activity. Option C is incorrect
because planning involves developing a strategy to attain expected outcomes, not collecting baseline
data. Option D is incorrect because evaluation measures progress toward outcomes after
interventions have been implemented. The key concept is that assessment is the foundational
standard of practice that precedes all other nursing process steps.
Q3. A nurse in a busy primary care clinic must delegate a task to unlicensed assistive personnel.
Which task may be safely delegated?
A. Performing telephone triage for a patient reporting chest discomfort
B. Obtaining vital signs and weight on a stable patient and reporting results to the RN
C. Providing diabetes self-management education to a newly diagnosed patient
D. Interpreting a 12-lead electrocardiogram for the provider
Correct Answer: Obtaining vital signs and weight on a stable patient and reporting results to the RN ✅
Rationale: Obtaining vital signs and anthropometric measurements on a stable patient is a
routine, non-judgment task within the UAP scope when delegated with clear directions and
supervision. Option A is incorrect because telephone triage requires nursing assessment and clinical
judgment and may never be delegated to unlicensed personnel. Option C is incorrect because
diabetes self-management education requires the knowledge base and licensure of an RN or
qualified diabetes educator. Option D is incorrect because rhythm and 12-lead interpretation require
licensed clinical judgment. The key concept is that delegation must match the task to the delegatee's
scope and the RN retains accountability.
Q4. A patient calls the clinic reporting chest pressure, shortness of breath, and diaphoresis that
started 20 minutes ago while at rest. Which telephone triage action is the nurse's priority?
A. Schedule a same-day clinic appointment in 2 hours
B. Advise the patient to take aspirin and rest while monitoring symptoms
C. Instruct the patient to call 911 immediately for emergency transport
D. Recommend the patient drive to the nearest urgent care center
,Correct Answer: Instruct the patient to call 911 immediately for emergency transport ✅
Rationale: Chest pressure with autonomic symptoms and respiratory distress indicates
potential acute coronary syndrome, and immediate EMS activation ensures rapid transport, ECG
monitoring, and access to definitive cardiac care. Option A is incorrect because a 2-hour delay could
allow myocardial damage to progress. Option B is incorrect because advising aspirin and rest without
emergency activation delays definitive treatment. Option D is incorrect because driving oneself to
urgent care delays care and risks collapse en route. The key concept is that red-flag symptoms during
telephone triage require immediate emergency activation rather than clinic-based evaluation.
Q5. A 28-year-old patient calls with sore throat, fever of 101.5 degrees Fahrenheit, and swollen
anterior cervical lymph nodes for 2 days. There is no difficulty breathing or swallowing. Which
disposition is most appropriate?
A. Direct to emergency department immediately
B. Schedule a same-day clinic visit for rapid strep testing
C. Advise home care with follow-up in 1 week if not improved
D. Prescribe antibiotics over the phone without examination
Correct Answer: Schedule a same-day clinic visit for rapid strep testing ✅
Rationale: Fever, sore throat, and cervical lymphadenopathy are classic for streptococcal
pharyngitis, and same-day evaluation allows rapid strep testing to guide appropriate antibiotic
therapy. Option A is incorrect because there are no red-flag symptoms requiring emergency
evaluation. Option C is incorrect because a 1-week delay risks complications such as rheumatic fever
if strep is present. Option D is incorrect because prescribing without examination violates standards
of practice. The key concept is that telephone triage must match disposition to acuity while ensuring
appropriate diagnostic evaluation.
Q6. A 62-year-old patient with type 2 diabetes calls reporting blood glucose readings of 280-320
mg/dL for 3 days, increased thirst, and frequent urination. Which action should the nurse take first?
A. Advise the patient to increase oral hypoglycemic medication dosage
B. Instruct the patient to check urine ketones and come to the clinic today
C. Tell the patient this is normal during antibiotic treatment
D. Recommend the patient skip meals to lower blood glucose
Correct Answer: Instruct the patient to check urine ketones and come to the clinic today ✅
, Rationale: Persistent hyperglycemia above 250 mg/dL with polyuria and polydipsia requires
ketone assessment to rule out diabetic ketoacidosis, and same-day evaluation allows for medication
adjustment. Option A is incorrect because the nurse cannot advise medication changes without
provider order. Option C is incorrect because hyperglycemia of this magnitude is not a normal
finding. Option D is incorrect because skipping meals can worsen glycemic instability and does not
address the underlying cause. The key concept is that persistent hyperglycemia with symptoms
requires prompt evaluation for acute complications.
Q7. A 35-year-old patient presents with a 3 cm clean-edged forearm laceration that stopped bleeding
2 hours ago. Which intervention is the nurse's priority?
A. Apply topical antibiotic and send home without closure
B. Irrigate the wound, assess for foreign bodies, and prepare for primary closure
C. Delay closure for 48 hours to allow natural debridement
D. Administer oral antibiotics prophylactically without wound care
Correct Answer: Irrigate the wound, assess for foreign bodies, and prepare for primary closure ✅
Rationale: Clean lacerations can be closed primarily within 6-8 hours, and proper irrigation
with foreign body assessment reduces infection risk and promotes healing. Option A is incorrect
because clean lacerations benefit from closure. Option C is incorrect because delay increases
infection risk without benefit for clean wounds. Option D is incorrect because antibiotics alone do
not address wound closure. The key concept is that timely wound care with irrigation and closure is
the standard for clean lacerations.
Q8. A 55-year-old patient with COPD calls reporting increased shortness of breath, productive cough
with green sputum, and rescue inhaler use every 2 hours for the past day. Which disposition is most
appropriate?
A. Advise increasing home oxygen flow rate
B. Direct the patient to the emergency department
C. Recommend doubling the daily corticosteroid dose
D. Schedule a routine clinic appointment in 3 days
Correct Answer: Direct the patient to the emergency department ✅
Rationale: COPD exacerbation with increased rescue inhaler dependence and purulent sputum
indicates possible bacterial infection requiring urgent assessment and potentially emergency-level
care. Option A is incorrect because adjusting oxygen without assessment can cause hypercapnia.
Option C is incorrect because the nurse cannot recommend medication changes without provider
(RN-BC) Exam 5th Edition Comprehensive
Test Bank by AAACN.
TABLE OF CONTENTS — PART 1 of 5
Domain I: Assess and Evaluate — Questions 1-30
Domain II: Plan and Implement — Questions 31-40
Domain III: Professional Role — Questions 41-50
Q1. Which statement best defines the scope of ambulatory care nursing practice?
A. Nursing care provided exclusively during overnight hospital stays
B. Nursing care of individuals, families, and populations across the wellness-illness continuum in
outpatient and community settings
C. Nursing care limited to telephone triage and appointment scheduling
D. Nursing care focused only on acute episodic illness visits
Correct Answer: Nursing care of individuals, families, and populations across the wellness-illness
continuum in outpatient and community settings ✅
Rationale: Ambulatory care nursing is defined by the AAACN and ANA as care of individuals,
families, and populations across the wellness-illness continuum in settings where encounters are
typically episodic and patients manage care at home between visits. Option A is incorrect because
overnight hospital stays describe inpatient care, not ambulatory care. Option C is incorrect because
telephone triage is one component of the specialty, not its entire scope. Option D is incorrect
because ambulatory care extends beyond acute visits to include prevention, chronic disease
management, and care coordination. The key concept is that ambulatory care nursing is a specialty
spanning the full continuum of health and illness in outpatient settings.
Q2. A nurse completes a pre-visit review of a new patient's history, medications, allergies, and
screening gaps before the provider arrives. Which ANA standard of practice is the nurse
demonstrating?
A. Assessment
B. Diagnosis
,C. Planning
D. Evaluation
Correct Answer: Assessment ✅
Rationale: Assessment is the ANA standard that involves systematic collection of
comprehensive data pertinent to the patient's health and situation, and the pre-visit chart review is a
classic ambulatory example of this activity. Option B is incorrect because diagnosis involves analyzing
assessment data to identify problems, which is not the described activity. Option C is incorrect
because planning involves developing a strategy to attain expected outcomes, not collecting baseline
data. Option D is incorrect because evaluation measures progress toward outcomes after
interventions have been implemented. The key concept is that assessment is the foundational
standard of practice that precedes all other nursing process steps.
Q3. A nurse in a busy primary care clinic must delegate a task to unlicensed assistive personnel.
Which task may be safely delegated?
A. Performing telephone triage for a patient reporting chest discomfort
B. Obtaining vital signs and weight on a stable patient and reporting results to the RN
C. Providing diabetes self-management education to a newly diagnosed patient
D. Interpreting a 12-lead electrocardiogram for the provider
Correct Answer: Obtaining vital signs and weight on a stable patient and reporting results to the RN ✅
Rationale: Obtaining vital signs and anthropometric measurements on a stable patient is a
routine, non-judgment task within the UAP scope when delegated with clear directions and
supervision. Option A is incorrect because telephone triage requires nursing assessment and clinical
judgment and may never be delegated to unlicensed personnel. Option C is incorrect because
diabetes self-management education requires the knowledge base and licensure of an RN or
qualified diabetes educator. Option D is incorrect because rhythm and 12-lead interpretation require
licensed clinical judgment. The key concept is that delegation must match the task to the delegatee's
scope and the RN retains accountability.
Q4. A patient calls the clinic reporting chest pressure, shortness of breath, and diaphoresis that
started 20 minutes ago while at rest. Which telephone triage action is the nurse's priority?
A. Schedule a same-day clinic appointment in 2 hours
B. Advise the patient to take aspirin and rest while monitoring symptoms
C. Instruct the patient to call 911 immediately for emergency transport
D. Recommend the patient drive to the nearest urgent care center
,Correct Answer: Instruct the patient to call 911 immediately for emergency transport ✅
Rationale: Chest pressure with autonomic symptoms and respiratory distress indicates
potential acute coronary syndrome, and immediate EMS activation ensures rapid transport, ECG
monitoring, and access to definitive cardiac care. Option A is incorrect because a 2-hour delay could
allow myocardial damage to progress. Option B is incorrect because advising aspirin and rest without
emergency activation delays definitive treatment. Option D is incorrect because driving oneself to
urgent care delays care and risks collapse en route. The key concept is that red-flag symptoms during
telephone triage require immediate emergency activation rather than clinic-based evaluation.
Q5. A 28-year-old patient calls with sore throat, fever of 101.5 degrees Fahrenheit, and swollen
anterior cervical lymph nodes for 2 days. There is no difficulty breathing or swallowing. Which
disposition is most appropriate?
A. Direct to emergency department immediately
B. Schedule a same-day clinic visit for rapid strep testing
C. Advise home care with follow-up in 1 week if not improved
D. Prescribe antibiotics over the phone without examination
Correct Answer: Schedule a same-day clinic visit for rapid strep testing ✅
Rationale: Fever, sore throat, and cervical lymphadenopathy are classic for streptococcal
pharyngitis, and same-day evaluation allows rapid strep testing to guide appropriate antibiotic
therapy. Option A is incorrect because there are no red-flag symptoms requiring emergency
evaluation. Option C is incorrect because a 1-week delay risks complications such as rheumatic fever
if strep is present. Option D is incorrect because prescribing without examination violates standards
of practice. The key concept is that telephone triage must match disposition to acuity while ensuring
appropriate diagnostic evaluation.
Q6. A 62-year-old patient with type 2 diabetes calls reporting blood glucose readings of 280-320
mg/dL for 3 days, increased thirst, and frequent urination. Which action should the nurse take first?
A. Advise the patient to increase oral hypoglycemic medication dosage
B. Instruct the patient to check urine ketones and come to the clinic today
C. Tell the patient this is normal during antibiotic treatment
D. Recommend the patient skip meals to lower blood glucose
Correct Answer: Instruct the patient to check urine ketones and come to the clinic today ✅
, Rationale: Persistent hyperglycemia above 250 mg/dL with polyuria and polydipsia requires
ketone assessment to rule out diabetic ketoacidosis, and same-day evaluation allows for medication
adjustment. Option A is incorrect because the nurse cannot advise medication changes without
provider order. Option C is incorrect because hyperglycemia of this magnitude is not a normal
finding. Option D is incorrect because skipping meals can worsen glycemic instability and does not
address the underlying cause. The key concept is that persistent hyperglycemia with symptoms
requires prompt evaluation for acute complications.
Q7. A 35-year-old patient presents with a 3 cm clean-edged forearm laceration that stopped bleeding
2 hours ago. Which intervention is the nurse's priority?
A. Apply topical antibiotic and send home without closure
B. Irrigate the wound, assess for foreign bodies, and prepare for primary closure
C. Delay closure for 48 hours to allow natural debridement
D. Administer oral antibiotics prophylactically without wound care
Correct Answer: Irrigate the wound, assess for foreign bodies, and prepare for primary closure ✅
Rationale: Clean lacerations can be closed primarily within 6-8 hours, and proper irrigation
with foreign body assessment reduces infection risk and promotes healing. Option A is incorrect
because clean lacerations benefit from closure. Option C is incorrect because delay increases
infection risk without benefit for clean wounds. Option D is incorrect because antibiotics alone do
not address wound closure. The key concept is that timely wound care with irrigation and closure is
the standard for clean lacerations.
Q8. A 55-year-old patient with COPD calls reporting increased shortness of breath, productive cough
with green sputum, and rescue inhaler use every 2 hours for the past day. Which disposition is most
appropriate?
A. Advise increasing home oxygen flow rate
B. Direct the patient to the emergency department
C. Recommend doubling the daily corticosteroid dose
D. Schedule a routine clinic appointment in 3 days
Correct Answer: Direct the patient to the emergency department ✅
Rationale: COPD exacerbation with increased rescue inhaler dependence and purulent sputum
indicates possible bacterial infection requiring urgent assessment and potentially emergency-level
care. Option A is incorrect because adjusting oxygen without assessment can cause hypercapnia.
Option C is incorrect because the nurse cannot recommend medication changes without provider
