NR 511 Week 1 practice questions Answers Available

NR 511 Week 1 practice questions Answers Available 1. Which of the following initiatives does not fall under the National Prevention Strategy? • Diabetes Management. Reference Page 29 • Tobacco Free Living • Healthy Eating • Mental and Emotional Wellbeing 2. All of the following statements about the US Preventive Services Task Force (USPSTF) are true except? • All of the recommendations made by the USPSTF are strong recommendations. (The recommendations made by this organization are based on a grading scale. Some of the guidelines state that they don’t have enough scientific data to support an informed recommendation.) Reference Page 31-32 • This is a private sector group without government ties. • This group makes recommendations about preventive medicine. • All of the USPSTF recommendations are considered mandatory in primary care. 3. What type of reaction following an immunization is considered serious and requires reevaluation? • Temperature greater than 103˚F. (High fever is a reason to reevaluate a patient following a vaccine. Reference Page 33 • Fatigue • Temperature of 100.2˚F. • Erythema and soreness at the injection site. 4. Herbert, a 69-year-old man, comes to your office complaining of nocturia. On questioning Herbert, you find that for the past 3 months he has been getting up at least 5 times a night to void. He came in to seek help today because of his wife’s insistence that he be checked out. When you perform the digital rectal exam, you find that his prostate protrudes 3 to 4 cm into the rectum. What grade would you assign to Herbert’s prostate enlargement? • Grade 1 (Grade 1 enlargement is a protrusion of 1 to 2 cm.) • Grade 2 (Grade 2 enlargement is a protrusion of 2 to 3 cm) • Grade 3 (The degree of prostate enlargement is based on the amount of projection of the prostate into the rectum. The normal prostate protrudes less than 1 cm into the rectum. A grade 3 enlargement is 3 to 4 cm. into the rectum) Reference Page 748 • Grade 4 (Grade 4 enlargement is a protrusion of greater than 4 cm) 5. Which of the following individuals should get the shingles (herpes zoster) vaccine? • Jerry, who has a mild upper respiratory tract infection and is allergic to neomycin (Allergy to neomycin is a contraindication to receiving the shingles vaccine) • Tim, who has been on prolonged use of high-dose steroids for his chronic obstructive pulmonary disease (COPD). (Prolonged use of high-dose steroids is a contraindication to receiving the shingles vaccine) • Joan, whose husband recently had shingles and who is trying to get pregnant (Women should not get pregnant until 4 weeks after receiving the vaccination) • Joe, who has a stressful job (Joe, who has a stressful job, is a candidate for the shingles (herpes zoster) vaccine) Reference page 134 6. As a primary care provider, which of the following topics is not typically important for adults aged 20 to 40? • Focusing on increasing lifespan. (This is typically important to patients greater than 65 years old) • Career development. • Self-image. • Family relationships. 7. Which of the following statements defines health literacy? • The level to which a patient can understand, gain access to, and make proper medical decisions. • The ability of a patient to read health pamphlets. • The extent to which a patient can travel to see a medical provider. • The ability of a patient to write in the language of the health practitioner. 8. Between ages 7 and 18, both boys and girls are immunized against the following diseases: • Tetanus, diphtheria, pertussis, meningitis, and human papillomavirus. • Tetanus, diphtheria, pertussis, and rotavirus. (The rotavirus vaccine is given prior to age 7) • Tetanus, diphtheria, pertussis, meningitis, human papillomavirus, and hepatitis A. (The hepatitis A vaccine is given prior to age 7) • Tetanus, diphtheria, pertussis, meningitis, human papillomavirus, and hepatitis C. (There is no known vaccine for Hep C yet) 9. The OLD CARTS (onset, location, duration, character, aggravating/alleviating factors, radiation, timing, severity) mnemonic is best used in which part of your chart note? • History of present illness (The OLD CARTS mnemonic is best used to describe the patient’s symptoms in the history of present illness) • Plan. • Diagnosis. • Physical exam. 10. Eileen, a 42-year-old woman, comes to your office with a chief complaint of fatigue, weight loss, and blurred vision. Eileen has a past medical history that is negative for any chronic medical problems. You obtain a fasting chemistry panel, lipid profile, complete blood count (CBC), and hemoglobin A1c (HbA1c). The results of the blood work show Eileen’s blood sugar elevated at 356 mg/dL, total cholesterol elevated at 255, high-density lipoprotein (HDL) cholesterol low at 28, low-density lipoprotein (LDL) cholesterol elevated at 167, triglycerides 333, and HbA1c 12. On questioning Eileen further, you discover that both her grandmothers had adult- onset diabetes mellitus. You diagnose type 2 diabetes mellitus. Your treatment plan should include a cholesterol-lowering agent, an agent that lowers blood sugar, and which other class of medication? • Angiotensin-converting enzyme (ACE) inhibitor ( Studies have shown the use of ACE inhibitors in clients with diabetes, with or without hypertension, has slowed the progression of nephropathy. You must monitor the client’s creatinine and potassium levels routinely. If the client’s renal function does decrease, elevated potassium levels may occur. Some clinicians disagree on this approach and recommend waiting until microalbuminuria is present before initiating an ACE inhibitor. Other clinicians feel that her A1C indicates that she has been a diabetic for probably 10 years and would benefit from this approach) • Diuretic. • Weight loss medication (Diet and weight loss are fundamental components of diabetes management) • Beta blocker. 11. Margaret, age 29, is of medium build and 5 ft 4 in tall. You estimate that she should weigh about: • 105 lb. • 110 lb. • 120 lb (To estimate a client’s ideal weight, use the following formula: For women older than age 25, allow 100 lb for the first 5 ft, then add 5 lb for each inch thereafter. For men, allow 106 lb for the first 5 ft, then add 6 lb for each inch thereafter. Multiply the number by 110% for a client with a large frame and 90% for a client with a small frame) • 130 lb. 12. Susie, age 5, comes to the clinic for a well-child visit. She has not been in since she was 2. Her immunizations are up to date. What immunizations would you give her today? • None; wait until she is 6 years old to give her her booster shots (Susie is due for diphtheria, tetanus, and pertussis (DTaP); inactivated polio vaccine (IPV); and measles, mumps, and rubella (MMR) between the ages of 4 and 6. There is no need to wait until she is 6 years old) • Diphtheria, tetanus, and pertussis (DTaP); Haemophilus influenzae type B (Hib); and measles, mumps, and rubella (MMR) ( Susie is due for inactivated polio vaccine (IPV), in addition to DTaP and MMR. She is not due for Hib) • Diphtheria, tetanus, and pertussis (DTaP) and inactivated polio vaccine (IPV) (Susie is due for measles, mumps, and rubella (MMR), in addition to DTaP and IPV) • Diphtheria, tetanus, and pertussis (DTaP); inactivated polio vaccine (IPV); and measles, mumps, and rubella (MMR) (Because Susie has not been in for several years, one cannot assume she will come in next year to get the immunizations that are due between the ages of 4 and 6; therefore, this opportunity to give her needed immunizations cannot be missed. Between the ages of 4 and 6, a child is due for DTaP, IPV, and MMR, if all other immunizations are up to date) 13. Mimi, age 52, asks why she should perform a monthly breast self-examination (BSE) when she has her mammograms on schedule. You respond: • “If you are faithful about your annual exams and mammograms, that is enough.” (All women older than age 20 should examine their breasts monthly) • “More breast abnormalities are picked up by mammograms than by clinical exams or BSE.” ( More than 90% of all breast abnormalities are first detected by self-examination_ • “More than 90% of all breast abnormalities are first detected by self-examination.” (More than 90% of all breast abnormalities are first detected by self-examination. All women older than age 20 should examine their breasts monthly, a week after their period. After menopause, women should examine their breasts at the same time each month. There is some controversy. Most women perform BSE incorrectly, thus making the significance of a positive finding questionable. B recommends a BSE be performed as a mammogram may miss a tumor) • “Self-examinations need to be performed only every other month.” ( All women older than age 20 should examine their breasts monthly) 14. Marian’s husband, Stu, age 72, has temporal arteritis. She tells you that his physician wants to perform a biopsy of the temporal artery. She asks if there is a less invasive diagnostic test. What test do you tell her is less invasive? • Computed tomography (CT) scan (A CT scan and magnetic resonance imaging (MRI) are done to detect neurological damage from hemorrhage, tumor, cyst, edema, or myocardial infarction. These tests may also identify displacement of the brain structures by expanding lesions. However, not all lesions can be detected by CT scan or MRI) • Magnetic resonance imaging (MRI) (A computed tomography (CT) scan and MRI are done to detect neurological damage from hemorrhage, tumor, cyst, edema, or myocardial infarction. These tests may also identify displacement of the brain structures by expanding lesions. However, not all lesions can be detected by CT scan or MRI) • Electroencephalogram (EEG) (An EEG is used to evaluate the electrical activity of the brain. It can identify seizure activity as well as certain infectious and metabolic conditions) • Color duplex ultrasonography (A biopsy of the temporal artery is usually required to confirm the diagnosis of temporal arteritis. However, color duplex ultrasonography (a combination of ultrasonography and the flow velocity determinations of a Doppler system) has been shown to examine even small vessels, such as the superficial temporal artery, and show a halo around the inflamed arteries when temporal arteritis is present. Therefore, it is a much less invasive procedure than biopsy) 15. Which of the following refers to an aspect of a patient’s health that can be changed or affected by a health intervention? • Modifiable risk factor (A modifiable risk factor is an aspect of a patient’s health that can be changed or affected by a health intervention) • Nonmodifiable risk factor (A nonmodifiable risk factor is something in a patient’s health profile that cannot be changed) • Adjustable risk factor (This term does not exist in medicine) • Changeable risk factor (This term does not exist in medicine) 16. An 81-year-old patient presents for a physical. She recently had a fall and now has problems walking up her stairs. The only restroom in the house is on the second floor. She also has a flight of stairs outside her house she has to navigate in order to reach street level, and this is difficult for her. Where does this information belong in your chart note? • Functional health patterns (The patient is having trouble with her normal routine and daily life due to her recent fall, so this information belongs here) • Review of systems (This section is for patient symptoms, not functional home circumstances) • Plan (While you can address these problems in the plan, this is not the place to make note of them) • Assessment (You can list her immobility as a diagnosis, but this area of the note would not be the place to note these findings) 17. Telehealth has shown a drastic increase in utilization by patients in which of the following fields of medicine? • Psychology and psychiatry. • Pediatrics. • Primary care. • Dermatology. 18. Mark, a 56-year-old man, comes to your practice seeking help quitting smoking. You prescribe varenicline (Chantix), a prescription medication, to aid with his attempt. What instructions do you give Mark regarding how to stop smoking with Chantix? • Start the Chantix today according to the dosing schedule and then quit smoking after the 12-week medication schedule (Following the 12-week medication schedule after quitting minimizes the effect of nicotine withdrawal because Chantix works on the same receptors as nicotine) • Start the Chantix today according to the dosing schedule and then pick a date to stop smoking about 7 days after starting Chantix (Chantix has been shown to be more effective in helping smokers quit than Zyban, another nonnicotine prescription medicine for smoking cessation. While Chantix contains no nicotine, it works on the same receptors as nicotine. It’s the addiction to the nicotine inhaled from smoking that makes quitting so hard. The recommended dosing schedule for Chantix is as follows: day 1 to day 3, one 0.5-mg tablet per day; day 4 to day 7, one 0.5-mg tablet twice a day (once in the morning and once in the evening); day 8 to the end of treatment, one 1-mg tablet twice per day (once in the morning and once in the evening). Chantix should be taken with a full glass of water after eating. The client should choose a quit date to stop smoking. Chantix should be taken for 7 days before the quit date. This lets Chantix build up in the body. Smoking should cease on the quit day, and Chantix should be continued for up to 12 weeks. If the client has not completely quit smoking by 12 weeks, another 12 weeks may help the client stay cigarette-free. The most common side effect is nausea (30%), but this is usually not severe enough to make the client discontinue the medication) • Pick a date to stop smoking and start Chantix that day according to the dosing schedule (Taking Chantix for 7 days before the quit date allows it to build up in the body) • Start Chantix today, take it twice a day for 2 weeks, and then stop smoking (Chantix should be initiated with one tab once a day. It should be taken for 7 days prior to the quit date) 19. Joseph, a 55-year-old man with diabetes, is at your office for his diabetes follow-up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Joseph receive today regarding the care of his feet? • “Wash your feet with cold water only.” (Joseph should wash his feet with warm, soapy water) • “See a podiatrist every two years, inspect your own feet monthly, and apply lotion to your feet daily.” (Diabetic clients should see a podiatrist yearly) • “Go to a spa and have a pedicure monthly.” (Joseph should rely on licensed health professionals for the care of his feet) • “See a podiatrist yearly; wash your feet daily with warm, soapy water and towel dry between the toes; inspect your feet daily for any lesions; and apply lotion to any dry areas.” (The American Diabetes Association recommends careful inspection of a diabetic client’s feet for corns, calluses, and open lesions to prevent further deterioration into diabetic foot ulcers. Joseph should wash his feet daily with warm, soapy water and then towel dry them, especially between the toes, to prevent fungal infections. Diabetic clients should see a podiatrist yearly. Encourage patients to use a mirror to inspect the bottom of their feet) 20. Marvin is a gay man who is ready to “come out.” What is the last step in the process of coming out? • Testing and exploration (Testing and exploration is the second of 4 steps) • Identity acceptance (Identity acceptance is the third of 4 steps) • Identity integration and self-disclosure (The last step in the process of a gay man or lesbian coming out is that of identity integration and self-disclosure. The process of discovering and revealing one’s sexual orientation can occur at any age and is known as “coming out.” Stage theories for coming out have been summarized as a 4-step process: (1) awareness of homosexual feelings, (2) testing and exploration, (3) identity acceptance, and (4) identity integration and self-disclosure. If the ultimate costs of self-disclosure are felt to be too high, an individual may become socially isolated or deny gay or lesbian identity) • Awareness of homosexual feelings (Awareness is the first of 4 steps) 21. A lab value that is commonly decreased in older adults is: • Creatinine clearance (The creatinine clearance value is commonly decreased in older adults because of impaired renal function) • Serum cholesterol (this is typically increased in older adults) • Serum triglycerides (This is typically increased in older adults) • Blood urea nitrogen (This is typically increased in older adults) 22. Martha, age 82, has an asymptomatic carotid bruit on the left side. What do you recommend? • Acetylsalicylic acid, or aspirin (ASA), therapy (Starting an asymptomatic older woman on ASA therapy may produce more problems, such as skin bruising or gastrointestinal bleeding) • Coumadin therapy (There is insufficient data to support Coumadin therapy for clients with asymptomatic carotid bruits) • Surgery (There is insufficient data to support surgery for clients with asymptomatic carotid bruits) • No treatment at this time (Clients with asymptomatic carotid bruits have a 2% incidence of cerebrovascular accident (CVA), also known as stroke or brain attack, per year. Although acetylsalicylic acid, or aspirin (ASA), anticoagulants, and surgery are frequently ordered, there are not sufficient data to prove that these treatments reduce the risk of CVA in clients with asymptomatic carotid bruits. A carotid ultrasound would show the percentage of any blockage, but at age 82 with no symptoms, this is not necessary) 23. Which of the following is not a modifiable risk factor? • Weight. • Stress level. • Race. • Physical activity level. 24. Which of the following is not one of the generalized patterns of nursing care included in the Circle of Caring model? • Intelligence. • Patience. • Advocacy. • Courage. 25. Which of the following statements does not belong in the past medical history portion of your chart note? • Your patient had lab work at their last appointment that was negative (This belongs in the history of present illness or diagnostic tests portion of your note) • Your patient had a cholecystectomy 3 years prior • Your patient’s father passed away from lung cancer. • Your patient has an allergy to penicillin. 26. You have a patient who presents with ankle pain. Which of the following facts or observations does not belong in the physical exam portion of your note? • The patient’s pain started after a fall off his skateboard (This belongs in the history of present illness) • The patient has a normal pulse and normal sensation of the foot. • The patient has edema in his ankle. • The patient has limited motion of his ankle. 27. Harry is taking his entire family to Central America and is wondering about protection against bites from malaria-causing mosquitoes. What advice do you give him? • Use an insect repellent with diethyltoluamide (DEET) for the entire family, applying it sparingly to small children (DEET is not recommended for application to the hands or faces of young children) • Make sure the family is in well-screened or indoor areas from dusk to dawn ( This preventive measure is recommended in combination with an insect repellent) • Use an insect repellent with diethyltoluamide (DEET) for adults and permethrin for children, and stay inside from dusk to dawn (Insect repellents with high concentrations (greater than 35%) of DEET are effective in preventing mosquito bites; however, DEET is not recommended for application to the hands or faces of young children. Permethrin is effective as a scabicide (at 5%) and as a pediculicide (at 1%). It is very effective at a low concentration against malaria-carrying mosquitoes and is safe for all ages. Other preventive measures include remaining in well-screened or indoor areas from dusk to dawn, using mosquito nets, and wearing clothing that covers most of the body) • Stay inside from dusk to dawn, and use an insect repellent with permethrin (Permethrin is recommended for young children. DEET is most effective for preventing mosquito bites) 28. Mary, a 70-year-old woman with diabetes, is at your office for her 3-month diabetic checkup. Mary’s list of medications includes metformin (Glucophage XR) 1000 mg daily, an angiotensin-converting enzyme (ACE) inhibitor daily, and 1 baby aspirin (ASA) daily. Mary’s blood work showed a fasting blood sugar (FBS) of 112 and glycosylated hemoglobin (HbA1c) of 6.5. You tell Mary that her blood work shows: • That her diabetes is under good control and she should remain on the same medications (For optimal control, a person with type 2 diabetes mellitus should have an HbA1c of 6.5 or less and an FBS less than 130. Because the client’s lab results fall in those categories, she is under good control and her medications should stay the same) • That her diabetes is controlled and she needs to have her medications decreased. • That her diabetes is not controlled and her medications need to be increased. • That her diabetes has resolved and she no longer needs any medication. 29. Sandy, a 68-year-old woman, presents to your office for screening for osteoporosis. She states that her grandmother and mother both lost inches in their old age. She has been postmenopausal for the past 15 years and never took any hormone replacement medications. She is Caucasian, weighs 108 lb, and is 5 ft 1 in tall on today’s measurement. When do women lose the greatest amount of bone density? • During adolescence (Bone density increases during adolescence until peak bone density occurs (about age 20). • The first year of menopause (Women lose the greatest amount of bone density in the first decade after menopause) • The first 10 years after menopause (Bone loss begins at a rate of 0.5% a year in a woman’s middle to late 40s. The rate then increases up to 7% a year for the first decade after menopause. This increase in the rate of bone loss is directly related to a decrease in a woman’s estrogen. Bone loss then decreases to 0.5% to 1% a year until death. This patient should be encouraged to do weight-bearing exercises and have an adequate calcium intake of 1000 to 1500 mg/d, with sufficient amounts of vitamin D) • Bone loss occurs continuously at the same rate from menopause to death (Bone loss occurs at different rates from menopause until death) 30. If a screening test used on 100 individuals known to be free of breast cancer identified 80 individuals who did not have breast cancer while missing 20 of the individuals, the specificity would be: • 80% (Specificity measures a screening test’s ability to recognize individuals who are nondiseased or those with negative reactions (true negatives). It can be represented by a ratio of tested negatives to the total number of known, or true, negatives. In this case, the number of negatives that the test recognized was 80, with the total number of known, or true, negatives being 100. Therefore, 80 out of 100 (80/100) equals a specificity of 80%) • 60%. • 40%. • 20%. 31. Julia, age 18, asks you how many calories of fat she is eating when 1 serving has 3 g of fat. You tell her: • 12 cal. • 18 cal. • 27 cal (A gram of fat contains 9 cal, whereas a gram of either carbohydrates or proteins contains 4 cal. In this case, Julia was eating 3 g, or 27 cal, of fat (9 cal per gram of fat times 3 g of fat equals 27 cal). • 30 cal. 32. In relation to writing a patient encounter note, the acronym SOAP stands for which of the following words? • Subjective, objective, assessment, plan. • Symptoms, objective, assessment, pills. • Subjective, outward findings, assessment, plan. • Symptoms, objective, assessment, plan. 33. Which of the following demonstrates a subjective finding? • Pain level. • Pulse rate. • Eye color. • Extremity edema. 34. Which of the following statements about health promotion is false? • Health promotion is a benefit to add to your practice if you have time (Health promotion is an important aspect of clinical practice and not used solely if it is convenient for the practitioner) • Health promotion helps to prevent diseases (This is included in the scope of health promotion) • Health promotion includes early screening to detect diseases (This is included in the scope of health promotion) • Health promotion includes helping to restore health after a patient has had an illness (This is included in the scope of health promotion) 35. What intervention would not be included in the definition of secondary prevention? • Sexually transmitted infection (STI) testing • Preventive mammography. • Testicular self-examination. • Routine immunizations (This is primary) 34. As a nurse practitioner, which of the following would not be an example of primary health promotion? • Posting health articles on your social media account. • Speaking to patients at each visit about strategies for maintaining/attaining a healthy life. • Lecturing at local community centers about diabetes. • Organizing a 5K running event for the patients in your practice. 35. Which of the following patients is health literate? • A 62-year-old female who speaks the language of her provider, has Medicare for insurance, and can drive (This patient has access to transportation and health insurance and has the ability to communicate with her provider) • A 70-year-old patient with dementia (This patient cannot make his or her own medical decisions) • A 22-year-old migrant worker who only speaks Spanish (This patient may have difficulty understanding a provider in the United States and therefore may not be able to heed medical advice) • A 45-year-old college graduate with no health insurance (This person can be seen only at an emergency department or if they have the ability to pay; their ability to obtain medical care is not guaranteed) 36. The study of the way diseases are spread through groups and what causes and helps spread these diseases is called? • Epidemiology (Epidemiology is the study of the way diseases are spread through groups and what causes and helps spread these diseases) • Pathology (Pathology is the study of diseased tissues and cells) • Physiology (Physiology is the study of the physiological processes of the body) • Kinesiology (Kinesiology is the study of body movement) 37. Documentation in your patient’s chart is important for all the following reasons except? • Documentation is only important for recording your side of the visit so you can reduce your liability in the event of a lawsuit (While an accurate record will help to document your office visit and could serve as a legal document in a lawsuit, it is not the only reason documentation is important) • Documentation allows you to communicate your findings to another provider. • Documentation allows you to remember the office visit so you can best treat the patient in the future. • Documentation allows you to create a record of the visit and record your patient’s findings and treatment plans. 38. How often should you receive a Tdap booster when no injury history is present? • Every 10 years (You need this vaccine every 10 years. If you suffer an injury between 5 and 10 years after receiving your last vaccine, some providers will go ahead and give you a booster) • After 18 you don’t need a booster unless you have a laceration. • Every 20 years. • Every 5 years. 39. How do you respond when Jill, age 42, asks you how long she should work out each week? • Exercise for at least 30 minutes every day. • Exercise a total of 2 hours per week. • Exercise for at least 20 minutes 3 or more days per week. • Exercise for at least 30 minutes 5 days per week ( The American College of Sports Medicine (ACSM) recommends 3 to 5 days per week for most cardiovascular exercise programs. For cardiovascular benefits, aim for 20 to 60 minutes in your target heart rate zone, apart from the warm-up and cool-down periods. ACSM’s overall recommendation is for most adults to engage in at least 150 minutes of moderate- intensity exercise each week. If you encourage patients to exercise most days of the week, they might make this goal) 40. Sandra, a 27-year-old nurse, states that she does not want to get the hepatitis B virus vaccine because of its adverse effects. You tell her that the most common adverse effect is: • Fatigue (This mild, transient systemic adverse effect occurs in 11% to 17% of adults and 8% to 18% of children) • Headache (This mild, transient systemic adverse effect occurs in 11% to 17% of adults and 8% to 18% of children) • Pain at the injection site (The most common adverse reaction to the hepatitis B virus vaccine is pain at the injection site (13%–20% in adults, 3%–9% in children). • Elevated temperature (This mild, transient systemic adverse effect occurs in 1% to 6% of all injections) 41. You are sharing with your client the idea that he needs to get some counseling to deal with his severe stress because it is affecting his physiological condition. Which of the following hormonal changes occurs during severe stress? • A decrease in catecholamines (During severe stress, as glucagon release increases, catecholamine levels increase. The insulin to glucagon ratio decreases, glycogen breakdown increases, and glucose production from amino acids increases) • An increase in cortisol (During severe stress, the cortisol level increases, allowing mobilization of free fatty acids. This triggers a series of reactions. With the increased cortisol, glucose production from amino acids increases) • A decrease in antidiuretic hormone (The release of antidiuretic hormone also increases during stressful periods, increasing the retention of water) • A decrease in aldosterone (The level of aldosterone increases, leading to the increased retention of sodium) 42. Emily, a healthy 26-year-old woman, asks you how she can prevent bone loss as she ages. She is concerned because both her maternal grandmother and now her mother have severe osteoporosis. What guidance would you give to Emily? • Drink all the soda you like—it has no effect on your bone density (Soda drinking has been shown to decrease bone mass) • It has not been proved that smoking affects bone loss (Smoking has been shown to decrease bone mass) • Replace estrogen when you reach menopause (Estrogen replacement therapy is no longer recommended for bone health; it is recommended only for short-term use to alleviate vasomotor symptoms of menopause) • Perform aerobic exercise at least 3 times a week (Emily is only 26 years old and has not reached her peak bone mass yet. It has been proven that aerobic exercise increases bone mass) 43. Harvey, age 55, comes to the office with a blood pressure (BP) of 144/96 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the examination, it remains 144/96. What should your next action be? • Start him on an angiotensin-converting enzyme (ACE) inhibitor (If Harvey’s diastolic pressure is still 96 mm Hg after 2 weeks, a diuretic or an ACE inhibitor would be indicated) • Start him on a diuretic • Have him monitor his blood pressure at home (Harvey should try nonpharmacological methods to lower his blood pressure and should monitor his blood pressure at home) • Try nonpharmacological methods and have him monitor his blood pressure at home (Before drug therapy for hypertension is instituted (unless the BP is extremely elevated), nonpharmacological methods (Lifestyle changes), such as salt restriction, weight reduction, biofeedback, and exercise, should be considered. Aggressive treatment of all clients aged 18 to 59 with a systolic pressure greater than 140 mm Hg and/or a diastolic pressure greater than 90 mm Hg is essential. The client should monitor his or her blood pressure at home and call the health care provider if it exceeds the parameters discussed. In this case, Harvey should try nonpharmacological methods and monitor his blood pressure at home and then return in 1 to 2 weeks for follow-up. If his diastolic pressure is still 96 mm Hg after 2 weeks, a diuretic or an ACE inhibitor would be indicated) 44. For which patient would you administer the human papillomavirus (HPV) vaccination? • Susie, age 7 (The HPV vaccination is not recommended for females under the age of 9) • Janice, age 17, who had a baby 6 months ago and is breastfeeding (Women who are lactating or immunocompromised are eligible to receive the vaccine. It is also recommended for females aged 9 to 25 years, regardless of whether they have had sex yet and even if the women already have a history of genital warts, a positive HPV test, or an abnormal Pap test) • Alice, age 18, who is allergic to yeast (A contraindication to the HPV vaccine is a history of immediate hypersensitivity to yeast) • Jill, age 25, who is pregnant (HPV vaccination is not recommended for use in women who are pregnant) 45. Which of the following is not a subjective finding? • Headache. • Respiratory rate (This is an objective physical exam finding that can be measured) • Shortness of breath. • Ankle pain. 46. Which of the following doesn’t fall under the umbrella of health promotion as a nurse practitioner? • Information about online dating (This doesn’t promote the health of your patient, although he or she may consider it extremely important) • Exercise programs. • Immunizations. • Nutrition support. 47. Which of the following refers to an aspect of a patient’s health that cannot be changed or affected by a health intervention? • Modifiable risk factor. • Nonmodifiable risk factor (A nonmodifiable risk factor is an aspect of a patient’s health that cannot be changed or affected by a health intervention) • Adjustable risk factor. • Changeable risk factor. 48. A nurse practitioner is practicing based on the rule-based actions he was taught in school and doesn’t understand when/where those rules may be inappropriate. Which following statement best describes this skill level? • Novice. • Advanced beginner. • Proficient. • Expert. 49. Mildred, an independent 92-year-old woman, is moving into her daughter’s home. Her daughter comes to see you seeking information to help keep her mother from falling. Which of the following interventions would you suggest she do to help prevent Mildred from falling? • Install an intercom system in Mildred’s bedroom. • Limit the time Mildred is home alone. • Hire an aide to assist Mildred 24 hours a day. • Remove all loose rugs from floors and install hand grasps in bathtubs and near toilets (The correct answer is to allow Mildred her independence but provide a safe environment by removing loose rugs that she could easily trip over and installing handrails by the toilet and in the bathtub. The rails will provide support for her as she goes from a sitting to a standing position) 50. Dennis, age 62, has benign prostatic hyperplasia (BPH). He tells you that he voids at least 4 times per night and that he has read about a preventive drug called terazosin hydrochloride (Hytrin) that might help him. What do you tell him? • “It’s not a preventive drug, but it relaxes smooth muscle in the prostate and bladder neck (Terazosin (Hytrin) is an alpha-1 adrenergic blocker. It is not a preventive drug, but it does relax smooth muscle in the prostate and bladder neck and allows complete emptying of the bladder, relieving frequent nocturnal urination. Terazosin is begun at 1 mg at bedtime initially and then titrated upward to 10 mg once a day.) • “It changes the pH of the urine and prevents infections caused by urinary stasis.” (Alpha-1 adrenergic blockers do not affect the pH of the urine. They relax smooth muscle in the prostate and bladder neck) • “It relaxes the urethra.” (The urethra is not directly involved in BPH) • “It shrinks the prostate tissue.” (Finasteride (Proscar), a 5-alpha-reductase inhibitor, decreases the volume of the prostate within about 3 months. At 12 months, it reaches its peak effectiveness. Finasteride is given at 5 mg daily for at least 6 months; then the client is reevaluated) 51. Jan’s mother has Alzheimer disease (AD). Jan tells you that her mother’s recent memory is poor and that she is easily disoriented, incorrectly identifies people, and is lethargic. Jan asks you, “Is this as bad as it gets?” You tell her that her mother is in which stage of the disease? • Stage 1 (Stage 1 of AD is the onset, which is insidious. Spontaneity, energy, and initiative are decreased; slowness is increased; word finding is difficult; the person angers more easily; and familiarity is sought and preferred) • Stage 2 (In stage 2, supervision with detailed activities, such as banking, is needed; speech and understanding are much slower; and the train of thought is lost) • Stage 3 (Families of persons with AD need to know that AD is a progressive disorder of the brain, affecting memory, thought, and language. Although the progression of the stages is individual, and changes may occur rapidly or slowly over the course of several years, knowing what stage a family member is in helps family members in planning and knowing what to expect. In stage 3, personality change is marked and depression may occur. Directions must be specific and repeated for safety, recent memory is poor, disorientation occurs easily, people are incorrectly identified, and the person may be lethargic) • Stage 4 (In stage 4, apathy is noticeable, memory is poor or absent, urinary incontinence is present, individuals are not recognized, and the person should not be alone) 52. When performing a sports physical exam on Kevin, a healthy 16-year-old boy, which question in the history is important to ask Kevin or his guardian? • Did anyone in your family ever have sudden cardiac death? (The risk of sudden death during sports activities from hypertrophic cardiomyopathy may be greatly reduced with a thorough cardiac history and examination. If a child has a relative who died of sudden cardiac disease before age 55, that child could possibly have hypertrophic cardiomyopathy) • Does anyone in your family have elevated cholesterol levels? • Did you ever have any injury requiring stitches? • Does anyone in your family have a history of asthma? 53. The Agency for Healthcare Research and Quality (AHRQ) was established to: • Mandate treatment protocols • Dictate health care policy based on voluminous research. • Promote evidence-based practice (The AHRQ was established to promote evidence-based practice and develop databases for research and clinical guidelines. The AHRQ routinely publishes reviews of studies on clinical problems with summaries of treatment protocols and effectiveness) • Develop cost-effective interventions. 54. You have seen a client who has tested positive for syphilis. You have treated the client; tested the client for other potential sexually transmitted diseases, including human immunodeficiency virus (HIV); counseled the client about safe sexual practices; and scheduled the client to return at 3 and 6 months for repeat serologic testing. The tests at those times demonstrated that no further syphilis was present. Should you have taken any other action? • No, you have treated the client appropriately (You must report the case to the local health authorities) • Yes, you must report the case to the local health authorities (The practitioner is also responsible for reporting the case of syphilis to the local health authorities. Syphilis is easily treated and controllable if its presence is reported) • Yes, you need to notify all sexual contacts (All sexual partners of the client should be contacted; however, it is the health department that has the trained staff who will investigate contacts and follow up) • Yes, you must follow up on the client’s HIV status (It is not necessary to retest the client’s HIV status unless there is a new clinical reason on subsequent visits) 55. Which of the following is the best method for evaluating the efficacy of a new clinical intervention? • A case report. • A descriptive study. • A randomized controlled trial (The best method for evaluating the efficacy of a new clinical intervention is a randomized controlled trial (RCT). Case reports, descriptive studies, and correlational studies are methodological approaches that are less reliable in establishing causal relationships, and thus the attribution of an effect to the new clinical intervention would be less clear. The effect might be attributable to other confounding variables) • A correlational study. 56. Negligence is the predominant legal theory of malpractice liability. Negligence includes: • Failure to give necessary care (Failure to give necessary care, failure to follow up, failure to refer when necessary, and failure to disclose necessary information to patients are all examples of negligence) • Failure to discharge. • Failure to share information with family. • Failure to provide shelter and food. 57. While counseling Mr. Brown, a patient newly diagnosed with diabetes, the advanced practice registered nurse (APRN) hands him a pamphlet on foot care. She notices that he puts it away, saying he will read it later. What might this behavior indicate? • Being overly dependent on others. • Having a low literacy level (The National Assessment of Adult Literacy reported that 1 out of every 3 Americans lacks the literacy needed to understand health care providers and is embarrassed to admit it. One sign of lack of literacy is putting aside written information) • Having a high level of motivation. • Memorization of the information that is being taught. 58. If conflict arises during a job negotiation, you should consider: • Separating the issue from the person (Always separate the issue from the person. It is about achieving a mutually satisfying outcome—a win-win situation. Clarifying misconceptions and focusing on what has been achieved thus far can be an effective strategy. You want to leave the process with positive feelings even if a work agreement is not achieved) • Always standing your ground. • Getting a legal opinion. • Basing your actions on the contract a friend of yours has secured in a local practice. 59. There are advantages to owning your own practice. However, there are also barriers to the ability to do this. These barriers include which of the following? • Getting and keeping a collaborating physician, if required by law; getting on managed care panels; and getting privileges at hospitals ( Barriers to independent practice include getting on managed care panels; getting and keeping a collaborating physician, if mandated in the state where one is practicing; getting referrals from hospital emergency rooms; getting privileges at hospitals; and lacking legal authority in the state of practice to admit to nursing homes, to order home care services, and/or to direct hospice services) • Getting privileges at hospitals, getting referrals from hospital emergency departments, and lack of knowledge. • Inability to find a collaborating physician, inability to find clients, and lack of empathy. • Lack of legal authority to admit clients to nursing homes, to order home care, and/or to direct hospice services, and lack of ability to manage client care without clear medical oversight and supervision. 60. Which of the following statements related to statistical techniques and their usage in research is true? • Statistical significance and clinical significance are the same. • If a journal article you are writing is required to be limited in length, you should delete the descriptive statistics and keep the inferential statistics (If a journal article you are writing is required to be limited in length, you should not delete the descriptive statistics and keep the inferential statistics. You must describe your sample and possibly a number of other things before explaining your inferences) • Correlational coefficients imply causality (Correlational coefficients measure the strength of the relationship between variables; correlation does not imply causality, nor can you make firm predictions based on these data) • To determine the appropriate statistical test to use, consider sample size, level of measurement, and data type (This is true; to determine the appropriate statistical test to use, consider sample size, level of measurement, and data type, as well as other factors) 61. Prescriptive authority for advanced practice registered nurses (APRNs): • Is permitted only under protocol. • Is mandated by law in more than 40 states. • Varies by state (Prescriptive authority for APRNs varies by state) • Includes the ability to prescribe controlled substances. 62. Mr. Griffin, age 85, has been given a diagnosis of bowel cancer, and surgery is indicated. He is mentally alert; however, he is refusing to give consent for the procedure. You respond by: • Ordering a psychiatric consultation. • Having your collaborating physician talk with the client. • Respecting his wishes (Respecting the client’s wishes is the most correct response to this situation. You may want to consider a psychological overlay, such as depression, and be sure this is not a driving component of the client’s behavior. However, if the client appears to be of sound mind, his wishes should be respected) • Talking with his family. 63. When caring for a client who speaks a language different from yours, the ideal strategy is to: • Use gestures to convey the meaning of words and use a foreign language dictionary of medical terms. • Rely on family members to interpret ( may be necessary to rely on family members to translate, but it is not the best strategy. For example, it is often the school-age child who has the best grasp of English; however, relying on the child to interpret reverses parent-child roles and places an unnecessary and sometimes inappropriate burden on the child. It also lessens the client’s sense of authority and privacy) • Review the case first with an interpreter before beginning the clinical visit (If you are in a setting where an interpreter is available, reviewing the case with them before seeing the client is the ideal strategy for enhancing cross-cultural communication. Information about the reason for the visit and the purpose of the health care encounter can be exchanged beforehand, potentially enhancing communication) • Use a pad and pencil to pass information back and forth with an interpreter. 64. The term collaboration is best defined as: • Interdisciplinary teamwork (Collaboration is essential in interdisciplinary teamwork, but the term interdisciplinary teamwork is not the definition of collaboration) • A protocol arrangement with a physician ( Collaboration may include a protocol arrangement with a physician, but it is not solely defined that way) • Case management (The term case management is defined as managing an entire episode of illness from the standpoint of coordination of resources and services. This will involve collaboration but is a different concept) • Cooperation with another to achieve mutual goals while not losing sight of one’s own interests. (The term collaboration is best defined as cooperation with another to achieve mutual goals while not losing sight of one’s own interests. True collaboration combines the activities of cooperation or concern for another’s interests with assertiveness. The interest considered most important in nurse-physician collaboration is the professionals’ concern for the care of the client rather than the providers’ personal agendas) 65. You are interviewing a client who becomes tearful. An appropriate response is to: • Ask if the client has a support person with them. • Sit quietly with the client and offer a tissue (The most important thing a practitioner can do for a crying client is accept his or her feelings. If the client is on the verge of tears during the interview, pausing, gently probing, or responding with empathy gives him or her permission to cry. Offering a tissue and waiting for the client to recover is an appropriate—and your best— initial response) • Offer to get a glass of water to help the client compose himself or herself • Let the client have privacy and spend the time reviewing the chart and background of the client. 66. The best way you, as an individual advanced practice registered nurse (APRN), can make a difference or real impact is by: • Reading about issues in the newspaper. • Writing letters to the editor supporting APRNs (As an individual APRN, you can make a difference in advancing the role of all APRNs by writing letters to the editor on health care issues that outline the positive impact of APRNs) • Thinking positively about the work you do. • Supporting a Democratic candidate. 67. You are seeing your client for the first time, and he says, “I like that you are a physician assistant.” You tell him you are a nurse practitioner, and he asks you how the two are different. Your best answer is: • A nurse practitioner has much more training than a physician assistant (PA). • Nurse practitioners cannot practice independently. • Physician assistants do not have the breadth of knowledge nurse practitioners have. • Physician assistants are health care professionals who are authorized by the state to practice medicine under the license of a physician, whereas nurse practitioners have an independent base of knowledge—ie, advanced nursing knowledge—and independent licensure to practice (According to the website of the National Commission on Certification of Physician Assistants, physician assistants are health care professionals who are authorized by the state to practice medicine as part of a team with, and under the direction of, a physician. As licensed independent practitioners, advanced practice registered nurses (APRNs) practice autonomously and in collaboration with health care professionals and other individuals to assess, diagnose, treat, and manage a client’s health problems and needs) 68. It is important to prepare for your interview as an advanced practice registered nurse (APRN). You should be prepared to answer which of the following? • How old you are and how many children you have because your childcare responsibilities might affect how you are able to do your job. • Whether you are prepared to advertise the practice using your own funds as well as other things you can bring to the practice. • What you can bring to the practice and whether you will be able to see clients in a 10- to 15-minute block of time to make yourself revenue-producing. • Why you should be hired, how many clients per day you will see, what you can bring to the practice, your willingness to work evenings and/or weekends and to take calls, and how independent you are in your practice (You must be prepared to answer what you will bring to the practice, although it does not have to be put in writing. You must be prepared to answer whether you will be on call weekends or evenings. You may not be willing to do this, but you must have an answer for this question. You must be able to share how many clients you may be able to see in 1 day as well as how independently you are willing to practice. You must also be willing to positively promote the practice in the community) 69. When caring for clients from a different culture, which of the following is an important piece of assessment data? • Determining the ultimate decision maker (When caring for clients from a different culture, important pieces of assessment data include determining the ultimate decision maker (it may be someone other than the client; eg, it may be the patriarch of the family), determining the client’s perception of the cause of his or her problem (eg, some clients may view it as fate or a curse), and ascertaining the client’s, not the family’s, expectations of the provider. Each clinical visit needs to be evaluated in light of the general cultural background of the client as well as the specific reasons for the visit) • Making decisions based on your general knowledge about the cultural background of the client. • Determining the family’s perception of the cause of the client’s problem. • Understanding that clients from other cultures expect their health care provider to be an authority figure. 70. Mr. Jones, age 44, is admitted to the emergency department complaining of chest pain. Which of the following actions would be the best way to establish a therapeutic relationship with Mr. Jones? • Asking several quick and specific questions in rapid succession to establish the exact nature of this emergent clinical situation. • Asking open-ended questions to elicit pertinent clinical data (Asking open-ended questions is essential for establishing a therapeutic relationship, even in an emergency situation, and it is a good interviewing technique) • Reassuring the client that he is in good hands, in a well-equipped emergency department, and that everything will be okay. • Asking the client about his anxiety level. 71. Certain characteristics differentiate research from quality improvement. Which of the following is an example of research? • Client satisfaction being evaluated relative to existing practice. • An intervention—well supported in the literature—being implemented and evaluated. • A standardized assessment tool (eg, risk assessment for falls) being implemented and evaluated. • A new intervention being implemented and compared with current practice to determine which is better (One characteristic that differentiates research from quality improvement is its comparison of new interventions with current practices to determine which is better. Research asks new questions that generate new knowledge when answered with a degree of generalizability. Additionally, there may be an implied risk to a human subject—ie, clients receiving the new and untested interventions may be at risk) 72. Which of the following statements about Medicaid is true? • Medicaid is a federal plan created to provide care for indigent persons. • Medicaid pays for family planning services, dental care, and eyeglasses. • Eligibility requirements for Medicaid are mandated by the Health Care Financing Administration. • Medicaid is a program for the indigent financed jointly by the federal and state governments (Financed jointly by the federal and state governments, Medicaid is a program created to pay for health care services for the indigent. Minimally, Medicaid must provide inpatient, skilled nursing facility, and home care; physician services; outpatient care; family planning services; and periodic screening, detection, and treatment of children under age 12) 73. Advanced practice registered nurses (APRNs) are affected by laws and rules, although these vary by state. Which of the following is affected by state laws and regulations? • Delegation of authority by physicians (APRNs must abide by laws and regulations, such as those related to scope of practice, reimbursement for health care services, delegation of authority by physicians, quality of care, and requirements for collaboration) • How many clients you must see every hour. • Universal health care law. • Making no more than 5 referrals for 1 client. 74. What must you do as an advanced practice registered nurse (APRN) before billing for visits? • Establish a collaborative agreement with a physician. • Obtain a provider number and familiarize yourself with the rules and policies of the third-party payer (To bill your clients for services, you must obtain a provider number or panel membership (as needed) and familiarize yourself with the rules and policies of each payer) • Provide evidence of continuing medical education. • Obtain a Drug Enforcement Administration (DEA) number. 75. Because of the potential for exploitation of older adults, the geriatric population is designated a vulnerable one when it comes to obtaining informed consent for serving as a research subject. Safeguards you should adhere to when conducting research on a geriatric population include which of the following? • Assessing the competence of the individual before obtaining consent (Safeguards to follow when conducting research on a geriatric population include assessing the competence of the individual before obtaining consent, making sure the consent form is in understandable language, and obtaining verbal consent (in some situations, verbal consent is all that is required) • Obtaining permission from the family or staff • Stressing how important the research is and why their participation and perspective, as older adults, are important. • Determining if the research is exempt, in which case you do not need to obtain consent to participate. 76. Relapse is a common phenomenon seen during behavioral changes. Useful strategies for the health care provider to institute to aid the client in a relapse situation include: • Using fear to reinforce the need to change. • Telling the client that the relapse is a learning opportunity in preparation for the next action stage (Useful strategies for the health care provider to institute to aid the client in a relapse situation include telling the client that the relapse is a learning opportunity in preparation for the next action stage (ie, positive reframing). • Stressing the need to stay “straight.” • Involving the family in stressing the need to stay “straight.” 77. Mrs. Smith, age 85, lost her husband 6 months ago. Since that time, she has been overwhelmed and has had difficulty coping. Today, she is in your office, tearful, weak, and discouraged. Her mobility is also becoming increasingly limited because of her need for a hip replacement. She is indecisive, expresses fear about the surgery, and tells you she does not want the surgery. Your best action is to: • Treat the client’s psychological problems and provide support (Your best action is to treat the client’s psychological problems and provide support. With Mrs. Smith, there are enough symptoms to warrant evaluation and possible intervention for psychological problems—most likely depression) • Respect the client’s wishes. • Consider placing the client in an assisted living facility. • Explain to the client that she is depressed and will feel better after the surgery. 78. An emancipated minor is a client who is younger than age 18 but who is considered a competent adult with the authority to accept or refuse medical treatment. How do you determine if the 16-year-old you are seeing is an “emancipated minor”? • No 16-year-old would be considered an emancipated minor. • Although definitions vary among states, the term usually implies that the minor has entered into a valid marriage, is a member of the military, or has been granted this status by a court (To treat this client as an emancipated minor, you need some proof of marriage, active military status, or papers from a court attesting to the minor’s status as emancipated. To petition a court for emancipation, a minor must be a certain age (ie, 14-16, depending on the state law), not live with his or her parents or guardian, be capable of managing financial affairs, and have the ability to provide for his or her well-being) • The client claims that he is free from all parental control. • The client is accompanied by an older friend who states that he or she is the client’s guardian and will accept legal responsibility. 79. An effective method for assessing a client’s retention and understanding of educational materials is: • Asking the client to restate what you have reviewed (Methods used to assess your client’s retention and understanding of educational materials include asking your client to restate or do a return demonstration of what you have reviewed, having your client keep a diary or record of his or her behaviors, and reviewing written materials with your client) • Providing a pathophysiology book for your client to take home and read. • Repeating your explanations of disease pathophysiology. • Objective testing. 80. When counseling on health behavior change, the advanced practice registered nurse (APRN) would say which of the following? • “Stop smoking. Here is a pamphlet.” • “Why are you still smoking?” • “What are your thoughts about quitting smoking at this time?” (To explore what might motivate behavioral change, use open- ended, nonjudgmental questions that ask about the person’s desires or hopes) • “You should quit smoking; it isn’t good for your health.” 81. The purpose of a block grant is to: • Provide more comprehensive services for Medicaid recipients. • Encourage individuals to obtain their own health insurance so they will not need government assistance. • Allow states to have greater flexibility in providing services to the poor (The purpose of a block grant is to allow states to have greater flexibility in providing services to the poor. Accelerating costs of the Medicaid program have prompted state- based initiatives for reform. These state-based initiatives may—or may not—provide more comprehensive care. That is determined by each respective state’s use of the block grants) • Decrease the proportion of state taxes allocated to pay for Medicaid. 82. Mr. Brill, age 50, is a house painter who has smoked 2 to 3 packs of cigarettes per day since he was 20 years old. He comes in to the clinic complaining of a chronic cough. When you discuss his smoking behavior, he states, “I know I need to stop smoking, but I’m under too much stress right now.” Mr. Brill is at which stage of change? • The precontemplative stage (If Mr. Brill were in the precontemplative stage of change, he would deny having a problem, and you would focus your teaching on increasing his awareness of his condition) • The contemplative stage (Mr. Brill’s response indicates that he is in the contemplative stage of change. He is considering change but has not taken any action. You would focus your teaching on reinforcing his understanding of the need to change, teaching him the skills needed to make the change, pointing out the positive aspects of making the change, and stressing his ability to do so) • The action stage (If the client had already begun to change his behavior, he would be in the action stage. You would focus your teaching on reinforcing his behavior with modeling and reward. This is a crucial stage because you do not want the client to stop the behavioral change. You must support his actions in every way possible) • The maintenance stage (A client in the maintenance stage is practicing the behavior regularly. Your intervention would be to continue to reinforce the new behavior and the need to maintain the change) 83. Which of the following describes a situation in which medical information may be passed on without client consent? • When the client has a gunshot wound (One situation in which medical information may be passed on without client consent is when the client has a gunshot wound. Other situations include when the client has a sexually transmitted or communicable disease) • When a potential employer asks for it. • When certifying absence from work. • When talking to another health care provider. 84. The term credentialing means that: • An individual is permitted to practice advanced practice nursing. • The practitioner has met certain criteria through licensure, certification, and education (The term credentialing means that the practitioner has met certain criteria through licensure, education, and certification. The criteria for credentialing vary depending on the credentialing body. Hospitals may use credentialing to grant hospital privileges) • An individual has completed a program of study. • An individual has prescriptive authority. 85. The research function of the advanced practice registered nurse (APRN) may be operationalized as both a consumer of research findings and a researcher. Being a consumer of researc