Question 1

The nurse has recently made a career change from an acute care hospital to a local urgent care center. Which factor will the nurse be able to point out as the most important difference between the two healthcare environments?

A)The individual is in charge of the treatment regimen.
B)Ambulatory care is less demanding.
C)Acute care requires round-the-clock coverage.
D)The individual's needs are less demanding.

The individual is in charge of the treatment regimen.

Accepted Answer

One of the defining elements of ambulatory care is locus of control. In ambulatory care, the individual is in charge of their treatment regimen, and the RN role is one of consultant and collaborator. In ambulatory care, any treatments, medications, or lifestyle changes are essentially completely under the control of the individual, not the MD, NP, PA, RN, or any other member of the staff. The recent changes in ambulatory nursing have increased the demands on the nurse, and this factor may not necessarily be true depending on the location and type of service. Some ambulatory care facilities are open 24 hours, depending on the services they provide. Many of the individuals who come into an ambulatory care facility do not have a primary care physician and are receiving no care for their medical needs. An acute care nurse concentrates on just the main problem during the admission. An ambulatory nurse will need to include all medical concerns in the care.

Question 2

A hospital has started sending a mobile unit out into the local rural communities with no healthcare facilities to offer basic care on a routine basis. Which factor might the public health nurses find to be common among the walk-up individuals?

A)Many have no primary care physician.
B)The need for more staff to handle the crowds
C)Individuals asking for an urgent care facility in these communities
D)High school students inquiring about starting a career in the medical field

Many have no primary care physician.

Accepted Answer

The ambulatory nurse may function outside the traditional clinic setting for a population that may include either individuals or groups. The individuals often include those who have no primary care physician and do not seek medical care due to various reasons. The RN role in this situation may be one of direct care or may primarily consist of educational and screening activities. Needing more staff to assist, asking for a local urgent care unit, and counseling high school students about a nursing career are also possible events; however, the more common will be individuals without a primary care provider and of greater concern.

Question 3

The nurse has witnessed many changes in the continuum of care offered at the healthcare provider's office over the years. Which factor has most likely contributed to an increased and more satisfying level of involvement of the nurse in individual care over the past 10 years?

A)Changes in Medicare reimbursement
B)Increased certification opportunities
C)Increased population in the area needing care
D)Opportunity to specialize in ambulatory care

Changes in Medicare reimbursement

Accepted Answer

The financial shift of emphasis by the CMS on preventive care has provided support to providers in primary care settings and created an opportunity for ambulatory care nurses. In 2015, the U.S. Health and Human Services announced plans that future Medicare payments would be linked to value. CMS introduced fee-for-service add-on payments that RNs can provide, such as annual wellness visits and chronic care management services. This has greatly increased the value of the ambulatory nurse. There are also increased opportunities to now earn certification, the population in many areas is rising, and the field of ambulatory care is becoming more specialized; however, the financial incentive is the top reason.

Question 4

The student nurse is surprised to learn that the RN office manager at the ambulatory clinic is in the process of introducing some new evidence-based practice (EBP) to the staff. Which factor is the RN reinforcing for this student with this action?

A)The need for professional excellence
B)The use of EBP improves reimbursement.
C)It is an expected action of the office manager's job description.
D)The utilization of EBP is not just for acute care.

Accepted Answer

One of the responsibilities of the RN is professional excellence. This includes the use of EBP to improve or continue proper care for all individuals. The other choices are possible results or reasons, but are not the main focus. The field of ambulatory care has advanced much in recent years and tries to accomplish the same goals as acute care-provide the best possible care for all individuals.

Question 5

A new individual has arrived at the urgent care with complaints of ongoing midabdominal pain and occasional nausea and vomiting. Which action should the nurse prioritize during this visit?&#10;A)Evaluate the individual's total healthcare status.&#10;B)Concentrate care on the individual's GI complaints.&#10;C)Reschedule a follow-up appointment after laboratory testing is complete.&#10;D)Request permission from the individual to gather records from previous healthcare providers.

Accepted Answer

Treatment management perspectives differ between acute care and ambulatory care. Whereas acute care is focused solely on the issue that brought the individual to the acute care facility in the first place, ambulatory care is viewed in the context of a total healthcare picture. The nurse prioritizes the evaluation of the individual's total healthcare status, considering all aspects to create a complete picture of the condition so it can be properly addressed. The other choices are those aspects the nurse might consider when managing treatment for this individual, but none are priorities on their own.

Deck 1: Ambulatory Nursing: An Overview