Question 1

A nurse is reading a journal article on population health that describes healthcare policy. Which agency would the nurse identify as being involved with providing evidence to ensure safe, high-quality, accessible healthcare?

A)Agency for Healthcare Research and Quality (AHRQ)
B)Health Effectiveness Data and Information Set (HEDIS)
C)Centers for Medicare and Medicaid Services (CMS)
D)Occupational Safety and Health Administration (OSHA)

Agency for Healthcare Research and Quality (AHRQ)

Accepted Answer

The Agency for Healthcare Research and Quality (AHRQ) houses the National Quality Measures Clearinghouse (NQMC), an agency that provides population-based structured, standardized summaries for use by practitioners, providers, health plans, and other health professionals. The mission of the AHRQ is to produce evidence that can be used to make healthcare safer, higher quality, more accessible, equitable, and affordable. Healthcare Effectiveness Data and Information Set (HEDIS) is a healthcare quality tool made up of 94 performance measures across seven domains of care developed and maintained by the National Committee for Quality Assurance. The Centers for Medicare and Medicaid Services (CMS) (2018) provides the minimum health and safety and Clinical Laboratory Improvement Amendments (CLIA) standards. The Occupational Safety and Health Administration (OSHA) is a branch of the US Department of Labor. The mission of OSHA is based on the General Duty Clause of the OSH Act of 1970. The Act requires employers to provide a safe workplace, that is, an environment free of any known hazards that cause or have the potential to cause death or severe injury.

Question 2

An ambulatory care nurse working in a population-focused clinic is implementing programs to coach individuals on increasing their physical activity level, eating a heart-healthy diet, and reducing stress. The nurse is engaged in which role(s)? Select all that apply.

A)Care coordination
B)Transition management
C)Health promotion
D)Disease prevention
E)Risk stratification

Health promotion
Disease prevention

Accepted Answer

Healthy lifestyle coaching is focused on promoting health and preventing disease from occurring. Care coordination involves organizing care activities between two or more participants to facilitate the appropriate delivery of healthcare services. Transition management involves assisting in providing coordinated services between healthcare settings. Risk stratification, as represented by a risk score, demonstrates the likelihood of experiencing a particular outcome. It is used proactively to identify and institute outreach to at-risk individuals to initiate individual-centered care planning.

Question 3

A nurse working in a women's healthcare practice is conducting a presentation to a local women's group about the services the practice provides. The nurse determines that additional discussion is needed based on which statement by the group?

A)"This would be a good place to get my Pap test."
B)"I can use this setting to get birth control."
C)"You have to be pregnant to use this practice."
D)"I could get treatment for my fibroids here."

"You have to be pregnant to use this practice."

Accepted Answer

The focus of women's healthcare has evolved in the past century from one based primarily on reproductive healthcare to one encompassing the totality of healthcare concerns for women as a distinct population. The nurse should reiterate to the group that the aim of women's healthcare is to promote well-being and optimal health for women at all stages of the life cycle beginning with puberty. Focus areas include birth control, screenings for cancer, benign conditions affecting the function of the female reproductive organs, as well as pregnancy care.

Question 4

Which activit(ies) would reflect the care coordination role for a nurse working in elementary school-based healthcare? Select all that apply.&#10;A)Sharing observations about a child's behavior&#10;B)Facilitating a referral for a community service&#10;C)Administering immunizations&#10;D)Teaching about healthy food choices&#10;E)Treating common childhood illness

Accepted Answer

Care coordination in the school setting would include activities such as sharing observations about a child's behavior and facilitating a referral for a community service. Administering immunizations and teaching about healthy food choices would reflect the role of health promotion and disease prevention. Treating common childhood illnesses falls under the category of chronic disease management.

Question 5

A nurse who works in a specialty care clinic is hosting a booth at a local community health fair. While talking with a group of primary care nurses, one member of the group asks the specialty care nurse, "What types of things do you do?" Which response(s) by the specialty care nurse would be appropriate? Select all that apply.

A)"We assess the individuals' needs based on the specialty we work in."
B)"We often initiate referrals to other specialists when we see the need."
C)"We teach individuals and families about the episode that brought them in."
D)"We make sure to coordinate any referrals for individuals from other providers."
E)"We focus on the typical chronic conditions that affect most individuals."

Accepted Answer

Specialty care nurses provide a consistent point of contact for individuals and families, educating them on episodic disease processes or acute injury (not chronic disease processes) and assessing the individuals' focused health needs related to the specialty. They also coordinate referrals from primary care, whereas primary care nurses make referrals to specialists.

Question 6

A nurse working in a specialty care clinic focuses care on which area as a priority?&#10;A)Individual preferences&#10;B)Individual satisfaction&#10;C)Management of individual transitions&#10;D)Individual empowerment

Accepted Answer

Although individual satisfaction, preferences, and managing individual transitions are important to the role of a specialty care nurse, the ambulatory care nurse in specialty care practice has a key role in empowering, encouraging, motivating, educating, and partnering with individuals to be engaged in all aspects of their care to achieve their healthcare goals. The nurse supports the individuals' autonomy in prioritizing needs, preferences, and values while assisting them to examine the cognitive, emotional, and social aspects of their lives and the impact of their decisions. The end result is improved outcomes and individual satisfaction.

Question 7

A specialty care nurse works to ensure that an individual's needs are addressed across all levels of care as the individual transitions from one specialist to another and to primary care. Which area(s) would be essential for the nurse to focus on? Select all that apply.

A)Collaboration
B)Communication
C)Education
D)Advocacy
E)Ethics

Accepted Answer

To ensure appropriate referrals and safe transitions of care across many specialists, the specialty care RN collaborates with the interprofessional team, serving as the primary contact to coordinate the transitions and communicating with the primary care setting when the individual experiences a care transition. Although education, advocacy, and ethics are important in any nursing situation, collaboration and communication between the high-level primary care or PCMH, specialty practices, and other key services such as social work and community health workers are important to stay abreast of the individuals' plan of care and well-being.

Question 8

A nurse who has worked in a respiratory specialty clinic is transitioning to working in a specialty clinic that provides care to individuals with human immunodeficiency virus (HIV). When assessing individuals and teaching them about their disease, which topic would be critical for the nurse to address?

A)Medications
B)Smoking cessation
C)Lifestyle
D)Activity

Accepted Answer

The nurse previously worked in a specialty clinic that provided care to individuals with noncommunicable chronic diseases. Now the nurse is working in a specialty clinic that provides care for a chronic infectious disease, for which transmission is a key topic. Chronic infectious diseases such as HIV and hepatitis B and C are spread directly or indirectly from one person to another, which distinguishes them from noninfectious chronic diseases that are not spread from individual to individual. This distinction can have an impact on individual education, which may need to include difficult topics such as sexual or lifestyle implications related to transmission. Medications, activity, and smoking cessation may be appropriate topics to address, but the key difference here is addressing topics related to transmission.

Deck 9: Medical Specialty Clinics, and Population Health: Ambulatory Focus on Selected Populations