ANCC IQ Domain 1-5
Study online at https://quizlet.com/_cmhmg7
1. 1. You see a patient for a routine medication visit. At the end of the session,
the patient asks questions and the session ends up 50 minutes in length. You
normally charge for the 30-minute appointment, but instead you charge for the
1-hour appointment. The 1-hour appointment includes a full body assessment
that you did not perform. This violation is known as:
- Over-coding
- Super-coding
- Down-coding
- Up-coding: - Up-coding
Rationale: Up-coding is a fraudulent practice in which the provider services are
billed at higher procedure codes than were actually performed, resulting in a higher
payment by Medicare or other third-party payers.
2. 1. During a session, your patient asks to be able to contact you via your
Facebook page on the internet. You reply:
- I cannot do that because I have a concealed Facebook identity; and I cannot
reveal that to my patients
- I would be happy to communicate with you. It makes it easier for me to reach
you this way.
- I would be happy to use Facebook but you will have to use a private message
so that you can be anonymous
- I cannot do that because Facebook does not protect your Private Health
Information: - I cannot do that because Facebook does not protect your Private
Health Information
Rationale: Using Facebook breaks patient-provider confidentiality, in addition to blur-
ring ethical boundaries of the therapeutic relationship. Facebook does not protect
private health information. Information on the site is available for anyone to see or
hack into even if private messaged.
3. 1. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
insures which of the following?
- Small employers who insure 50 or fewer covered lives are exempt from the
provisions of this MHPAEA law.
- Annual or lifetime dollar limits on mental health and substance use disorder
benefits are no lower than any such dollar limits for medical and surgical
benefits offered by a group health plan.
- Mental health and substance use disorder benefits must be available through
both in-network providers and out-of-network providers by a group health
plan.
- Group health plans may obtain an exemption if they can demonstrate ex-
pected cost increase resulting from implementation of the parity provisions
, ANCC IQ Domain 1-5
Study online at https://quizlet.com/_cmhmg7
greater than a 5% increase in the cost under existing plan.: - Annual or lifetime
dollar limits on mental health and substance use disorder benefits are no lower than
any such dollar limits for medical and surgical benefits offered by a group health
plan.
Rationale: The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
provides federal legislation that requires any annual or lifetime limits on medical
and surgical benefits be the same for mental health and substance use disorder
benefits. Small employers who insure 2 to 50 employees can apply for an "opt-out"
waiver, but they are not automatically exempt from the MHPAEA requirements. The
group health plan will be required to provide in-network and out-of-network mental
health and substance use disorder benefits only if it provides both in-network and
out-of-network medical and surgical benefits. The group health plan my obtain an
exemption or waiver if the first year of implementation results in 2% increase in group
health plan costs over prior year that covers the following year, and if implementation
results in 1% increase in group health plan costs in subsequent years. A section on
actuarial determination of these increased costs is included in the law.
4. 1. A 68-year-old, retired African-American widower who served for 30 years
as an Army officer was recently diagnosed with terminal lung cancer. He made
plans to die at home with hospice care. He was hospitalized for a broken hip
and succumbed to complications in the hospital. Despite his request to be
addressed as "Mr. Baxter" the hospital staff persisted in calling him by his first
name, "John." Which principle of culturally competent care does this violate?
- Autonomy
- Advocacy
- Collaboration
- Respect: - Respect
Rationale: Respect of cultural values and beliefs is violated in this scenario.
5. 1. PMHNPs seeking admitting privileges at a community hospital with in-
patient psychiatric services need to influence policymakers at which of the
following levels?
- State board of nursing
- State legislature
- County board of health
- Local hospital: - Local hospital
Rationale: Local PMHNPs who want admitting privileges will want to persuade the
appropriate hospital decision maker, through facts, figures, and a presentation of
projected benefits to the hospital, of the need to change policy and allow PMHNPs
to admit patients.
, ANCC IQ Domain 1-5
Study online at https://quizlet.com/_cmhmg7
6. 1. To demonstrate her support for social justice, within her role as a PMHNP
caring for the person who is homeless with mental illness, the PMHNP:
- Volunteers to serve food at the local Home for Girls.
- Teaches Sunday School.
- Volunteers to walk at the March of Dimes walk each year.
- Volunteers her clinical services at the psychiatric clinic, run by a local
mission project.: - Volunteers her clinical services at the psychiatric clinic, run by
a local mission project.
Rationale: Social justice is bringing things to those who have the least means of
getting them but need them the most. In this case, the homeless mentally ill need
the PMHNP's skills more.
7. 1. You have students from local psychiatric nurse practitioner programs
follow you in your clinical practice to show them what you do as a PMHNP.
This is called being a:
- Preceptor
- Mentor
- Teacher
- Professor: - Preceptor
Rationale: The preceptor is a 1;1 relationship sustained over a short time where
each person brings something to the relationship. It is a contracted, defined role
with goals. The preceptor is in a teaching role. Teaching is completed through the
observed performance, examples, and role modeling.
8. 1. As an individual advanced practitioner, you cannot afford to have a
standalone Electronic Health Record (EHR) system to keep all of your pa-
tients' health information on a computer-based system. How could you prob-
lem-solve this dilemma?
- Process your patient records manually, in your current fashion. You are
keeping a full record according to HIPAA.
- Process your notes manually and keep them in a locked file. The records are
available for copy and distribution at any time.
- Process your notes and patient records on a laptop that you are able to
transport between your office and home office. You always have the records
available if needed.
- Process your notes and patient records in a secure electronic system with
a template for patient information and interactions, supporting quick access
within your network.: - Process your notes and patient records in a secure elec-
tronic system with a template for patient information and interactions, supporting
quick access within your network.
Rationale: Having an EHR system is the ideal situation according to the US Health
, ANCC IQ Domain 1-5
Study online at https://quizlet.com/_cmhmg7
and Human Services and The Office of Clinical Quality and Safety. Not all offices
have the ability to afford installation and maintenance of such systems. The US
government has established financial help for EHRs in rural hospitals. For single
practitioner offices, doing the best possible to keep information ready for quick
access is the best possible solution. Without an EHR, incentives for having an EHR
will not be available to you.
9. 1. You are in a meeting of your state nurse practitioner legislative group. The
group's director has asked you to present information on a law bill (LB) that
is being presented for public hearing in the state legislature. The information
covers how best to approach securing support from the state's Health and
Human Services Committee (state senators and congressmen). As you begin
to present the information, two of your colleagues on the committee begin to
talk over you about their ideas and will now quiet down. The group director
does not intervene to settle the meeting. You decide to:
- Talk over colleagues. Ask them to allow you to finish before they make
comments. Take questions at the end of the presentation.
- Clear your voice and ask for attention. When that does not work, stop
speaking until the situation resolves. If it does not resolve, sit down quietly
until the behavior stops.
- Confront the speakers for their ill behavior and ask them to be quiet until you
have finished your presentation.
- Ignore the speakers and ask the group director to settle the room so that you
can finish your presentation.: - Clear your voice and ask for attention. When that
does not work, stop speaking until the situation resolves. If it does not resolve, sit
down quietly until the behavior stops.
Rationale: She should wait quietly for them to stop their behavior. This is a situation
of indirect bullying where the two colleagues were directly subverting the information
that the presenter was attempting to present to the group. The definition of social
bullying, which is defined as persistent, demeaning, downgrading activities incorpo-
rating vicious word and cruel acts that undermine self-esteem. Bullying is malicious
and psychologically damaging. The speaker could choose to make a spectacle and
shout over the persons interfering and cause chaos, throwing bad publicity on the
nursing group as a whole. She could lose her own power by asking the group director
to manage the rowdy persons.
10. 1. Your mother calls you at the office and asks you to call in a prescription
for her. The medication is for her sleeping pills, Eszopiclone (Lunesta) 3 mg 1
PO QHS #30. You:
- Tell her to call the provider who normally prescribes that medication for her.
- Call your mother's provider and ask the provider to call your mother's script
Study online at https://quizlet.com/_cmhmg7
1. 1. You see a patient for a routine medication visit. At the end of the session,
the patient asks questions and the session ends up 50 minutes in length. You
normally charge for the 30-minute appointment, but instead you charge for the
1-hour appointment. The 1-hour appointment includes a full body assessment
that you did not perform. This violation is known as:
- Over-coding
- Super-coding
- Down-coding
- Up-coding: - Up-coding
Rationale: Up-coding is a fraudulent practice in which the provider services are
billed at higher procedure codes than were actually performed, resulting in a higher
payment by Medicare or other third-party payers.
2. 1. During a session, your patient asks to be able to contact you via your
Facebook page on the internet. You reply:
- I cannot do that because I have a concealed Facebook identity; and I cannot
reveal that to my patients
- I would be happy to communicate with you. It makes it easier for me to reach
you this way.
- I would be happy to use Facebook but you will have to use a private message
so that you can be anonymous
- I cannot do that because Facebook does not protect your Private Health
Information: - I cannot do that because Facebook does not protect your Private
Health Information
Rationale: Using Facebook breaks patient-provider confidentiality, in addition to blur-
ring ethical boundaries of the therapeutic relationship. Facebook does not protect
private health information. Information on the site is available for anyone to see or
hack into even if private messaged.
3. 1. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
insures which of the following?
- Small employers who insure 50 or fewer covered lives are exempt from the
provisions of this MHPAEA law.
- Annual or lifetime dollar limits on mental health and substance use disorder
benefits are no lower than any such dollar limits for medical and surgical
benefits offered by a group health plan.
- Mental health and substance use disorder benefits must be available through
both in-network providers and out-of-network providers by a group health
plan.
- Group health plans may obtain an exemption if they can demonstrate ex-
pected cost increase resulting from implementation of the parity provisions
, ANCC IQ Domain 1-5
Study online at https://quizlet.com/_cmhmg7
greater than a 5% increase in the cost under existing plan.: - Annual or lifetime
dollar limits on mental health and substance use disorder benefits are no lower than
any such dollar limits for medical and surgical benefits offered by a group health
plan.
Rationale: The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
provides federal legislation that requires any annual or lifetime limits on medical
and surgical benefits be the same for mental health and substance use disorder
benefits. Small employers who insure 2 to 50 employees can apply for an "opt-out"
waiver, but they are not automatically exempt from the MHPAEA requirements. The
group health plan will be required to provide in-network and out-of-network mental
health and substance use disorder benefits only if it provides both in-network and
out-of-network medical and surgical benefits. The group health plan my obtain an
exemption or waiver if the first year of implementation results in 2% increase in group
health plan costs over prior year that covers the following year, and if implementation
results in 1% increase in group health plan costs in subsequent years. A section on
actuarial determination of these increased costs is included in the law.
4. 1. A 68-year-old, retired African-American widower who served for 30 years
as an Army officer was recently diagnosed with terminal lung cancer. He made
plans to die at home with hospice care. He was hospitalized for a broken hip
and succumbed to complications in the hospital. Despite his request to be
addressed as "Mr. Baxter" the hospital staff persisted in calling him by his first
name, "John." Which principle of culturally competent care does this violate?
- Autonomy
- Advocacy
- Collaboration
- Respect: - Respect
Rationale: Respect of cultural values and beliefs is violated in this scenario.
5. 1. PMHNPs seeking admitting privileges at a community hospital with in-
patient psychiatric services need to influence policymakers at which of the
following levels?
- State board of nursing
- State legislature
- County board of health
- Local hospital: - Local hospital
Rationale: Local PMHNPs who want admitting privileges will want to persuade the
appropriate hospital decision maker, through facts, figures, and a presentation of
projected benefits to the hospital, of the need to change policy and allow PMHNPs
to admit patients.
, ANCC IQ Domain 1-5
Study online at https://quizlet.com/_cmhmg7
6. 1. To demonstrate her support for social justice, within her role as a PMHNP
caring for the person who is homeless with mental illness, the PMHNP:
- Volunteers to serve food at the local Home for Girls.
- Teaches Sunday School.
- Volunteers to walk at the March of Dimes walk each year.
- Volunteers her clinical services at the psychiatric clinic, run by a local
mission project.: - Volunteers her clinical services at the psychiatric clinic, run by
a local mission project.
Rationale: Social justice is bringing things to those who have the least means of
getting them but need them the most. In this case, the homeless mentally ill need
the PMHNP's skills more.
7. 1. You have students from local psychiatric nurse practitioner programs
follow you in your clinical practice to show them what you do as a PMHNP.
This is called being a:
- Preceptor
- Mentor
- Teacher
- Professor: - Preceptor
Rationale: The preceptor is a 1;1 relationship sustained over a short time where
each person brings something to the relationship. It is a contracted, defined role
with goals. The preceptor is in a teaching role. Teaching is completed through the
observed performance, examples, and role modeling.
8. 1. As an individual advanced practitioner, you cannot afford to have a
standalone Electronic Health Record (EHR) system to keep all of your pa-
tients' health information on a computer-based system. How could you prob-
lem-solve this dilemma?
- Process your patient records manually, in your current fashion. You are
keeping a full record according to HIPAA.
- Process your notes manually and keep them in a locked file. The records are
available for copy and distribution at any time.
- Process your notes and patient records on a laptop that you are able to
transport between your office and home office. You always have the records
available if needed.
- Process your notes and patient records in a secure electronic system with
a template for patient information and interactions, supporting quick access
within your network.: - Process your notes and patient records in a secure elec-
tronic system with a template for patient information and interactions, supporting
quick access within your network.
Rationale: Having an EHR system is the ideal situation according to the US Health
, ANCC IQ Domain 1-5
Study online at https://quizlet.com/_cmhmg7
and Human Services and The Office of Clinical Quality and Safety. Not all offices
have the ability to afford installation and maintenance of such systems. The US
government has established financial help for EHRs in rural hospitals. For single
practitioner offices, doing the best possible to keep information ready for quick
access is the best possible solution. Without an EHR, incentives for having an EHR
will not be available to you.
9. 1. You are in a meeting of your state nurse practitioner legislative group. The
group's director has asked you to present information on a law bill (LB) that
is being presented for public hearing in the state legislature. The information
covers how best to approach securing support from the state's Health and
Human Services Committee (state senators and congressmen). As you begin
to present the information, two of your colleagues on the committee begin to
talk over you about their ideas and will now quiet down. The group director
does not intervene to settle the meeting. You decide to:
- Talk over colleagues. Ask them to allow you to finish before they make
comments. Take questions at the end of the presentation.
- Clear your voice and ask for attention. When that does not work, stop
speaking until the situation resolves. If it does not resolve, sit down quietly
until the behavior stops.
- Confront the speakers for their ill behavior and ask them to be quiet until you
have finished your presentation.
- Ignore the speakers and ask the group director to settle the room so that you
can finish your presentation.: - Clear your voice and ask for attention. When that
does not work, stop speaking until the situation resolves. If it does not resolve, sit
down quietly until the behavior stops.
Rationale: She should wait quietly for them to stop their behavior. This is a situation
of indirect bullying where the two colleagues were directly subverting the information
that the presenter was attempting to present to the group. The definition of social
bullying, which is defined as persistent, demeaning, downgrading activities incorpo-
rating vicious word and cruel acts that undermine self-esteem. Bullying is malicious
and psychologically damaging. The speaker could choose to make a spectacle and
shout over the persons interfering and cause chaos, throwing bad publicity on the
nursing group as a whole. She could lose her own power by asking the group director
to manage the rowdy persons.
10. 1. Your mother calls you at the office and asks you to call in a prescription
for her. The medication is for her sleeping pills, Eszopiclone (Lunesta) 3 mg 1
PO QHS #30. You:
- Tell her to call the provider who normally prescribes that medication for her.
- Call your mother's provider and ask the provider to call your mother's script
