Deck 18: Telenursing and Remote Access Telehealth

Question 1

Will the increased use of telehealth technology tools be viewed as dehumanizing patient care, or will it be viewed as a means to promote more contact with healthcare providers and as new ways for people to stay connected (as in online disease support groups), thereby creating better long-term disease management and patient satisfaction?

Answer 1

No Answer

Question 2

Which types of resistance to new technologies might be evident among patients, caregivers, and nurses? Which evidence and strategies might help to diminish these resistances?

Answer 2

No Answer

Question 3

As telehealth technology advances toward seamless data access regardless of distance or health system, how can patient privacy rights and the confidentiality of personal medical data be protected?

Answer 3

No Answer

Question 4

Consider a recent patient care scenario and describe how it could have been managed at a distance.
Which training would be needed?
Which equipment would be used?
How would the patient and his or her family respond to home telemonitoring?

Question 5

Telehealth used in the medical field is known as:

A) telemedicine.
B) teleradiology.
C) telepathology.
D) telenursing.

Question 6

The term for transmitted radiologic images to specialists is:

A) telemedicine.
B) teleradiology.
C) telepathology.
D) telenursing.

Question 7

The term for transmitted pathologic images to specialists is:

A) telemedicine.
B) teleradiology.
C) telepathology.
D) telenursing.

Question 8

Telehealth used in the nursing practice is known as:

A) telemedicine.
B) teleradiology.
C) telepathology.
D) telenursing.

Question 9

Which of the following factors are drivers of the growing trend toward telehealth and technology use and will influence nursing practice significantly in the next decades?

A) Overabundance of nursing and healthcare workers
B) Chronic diseases and conditions
C) Uneducated consumers
D) All of these are correct.

Question 10

Which of the following is an example of real-time clinical telehealth applications?

A) Telemental health
B) Telerehabilitation
C) Telehome care
D) All of these are correct.

Question 11

Which of the following is an example of telemonitoring?

A) Monitoring patient parameters during home-based nocturnal dialysis
B) Cardiac and multiparameter monitoring of remote intensive care units
C) Daily home telemonitoring of vital signs by patients
D) All of these are correct.

Question 12

Which of the following is the most basic type of telehealth?

A) Telephony
B) mHealth
C) Video transmission
D) All of these are correct.

Question 13

In home telehealth care, which of the following would not be considered a home location?

A) Nursing home
B) Assisted living facility
C) Hotel room
D) Hospice facility

Question 14

Patients who have which of the following characteristics can use telenursing services?

A) Are immobilized
B) Have a chronic disease
C) Live in remote places
D) All of these are correct.

Question 15

The use of teletechnology allows the telenurse to:

A) evaluate the patient's status.
B) use data to make decisions to better manage patient's health conditions.
C) monitor the patient's vital signs.
D) All of these are correct.

Question 16

The American Telemedicine Association released a clinical care guideline for TeleICU. In this guideline, they identified three practice models. Which practice model refers to monitoring the patient without interruption for a designated period of time?

A) Continuous care model
B) Scheduled care model
C) Responsive (reactive) care model
D) Reimbursement for care episode model

Question 17

The American Telemedicine Association released a clinical care guideline for TeleICU. In this guideline, they identified three practice models. Which practice model refers to periodic consultation within a predetermined time frame?

A) Continuous care model
B) Scheduled care model
C) Responsive (reactive) care model
D) Reimbursement for care episode model

Question 18

The American Telemedicine Association released a clinical care guideline for TeleICU. In this guideline, they identified three practice models. Which practice model refers to virtual visits prompted by an alert that are unscheduled?

A) Continuous care model
B) Scheduled care model
C) Responsive (reactive) care model
D) Reimbursement for care episode model

Question 19

Nurses using telehealth have much greater access to their patients' conditions and needs and are able to respond in a more timely way than is possible using only face-to-face visits.

Question 20

The ability to provide better healthcare access is the number one benefit of using telehealth.

Question 21

Telehealth can refer to clinical and nonclinical uses of health-related contacts.

Question 22

A clinical use for telehealth technologies includes providing disease prevention and promotion of good health. One example is telephonic or smartphone app case management and patient education provided through asthma and weight management programs conducted in public schools.

Question 23

Nurses must become familiar with the many and varied clinical and nonclinical transmission formats and applications of telehealth technologies so that they can make informed choices about the tools that are available for their use, as needed.

Question 24

In a store-and-forward telehealth transmission, digital images, video, audio, and clinical data are immediately transmitted securely to a specialist or clinician at another location, where they are studied by the relevant specialist or clinician and then are captured and stored on the client's computer or device.

Question 25

Teleconsultations use a variety of technologies to enable collaborative exchanges or consultations between individuals or among groups that are involved with a case. These teleconsults may be transmitted live using videoconferencing technology.

Question 26

Telehospice or telepalliative care can use real-time or remote monitoring to provide psychological support to patients and caregivers. Telehealth devices can also play a role in symptom management, in effect helping end-of-life patients achieve an optimal quality of life.

Question 27

The use of mobile phones, tablets and personal digital assistants for managing health is a rapidly advancing form of telehealth. There are numerous apps that target specific health behaviors and illnesses and provide a platform for management at a distance.

Question 28

As a clinical field, telenursing is part of telehealth and has many points of contact with other medical and nonmedical applications, such as telediagnosis, teleconsultation, and telemonitoring.

Question 29

Over the last decade, the efficiencies of telenursing have been well documented, as have the resulting improved patient care outcomes that can be expected by frequent telecontact.

Question 30

Telephony-based call centers may be operated by managed care organizations, hospitals, and other health organizations. Some call centers also include telemonitoring services, which allow the patient to stay at home and use different telehealthcare devices to transmit biometric and other medical information back to the call center. Monitoring can be intermittent or continuous.

Question 31

Some home-based telecardiology programs involve the patient, the family, the physician, and a specialized cardiac monitoring center. A multidisciplinary approach is used along with best practice-defined protocols to manage the patient, improve the patient's quality of life, and reduce healthcare costs, especially hospitalization costs. Nurses play a key role in this network of care.

Question 32

TeleICU nurses provide remote monitoring, oversight, and expert consultation for patients in rural intensive care units by examining real-time data collected at the bedside.

Question 33

Telehealth can positively impact the healthcare outcomes for patients with chronic diseases, particularly those with higher acuity levels who are at significant risk of having a medical crisis that might necessitate emergency or unplanned acute interventions. Many other patients with chronic diseases are less susceptible to a health crisis but would greatly benefit from home telemonitoring to improve care and reduce costs.

Question 34

Patients who have a predisposition to disease are at increased risk of medical problems associated with employment, lifestyle, or location, and those patients who have displayed early signs of potentially serious health problems could be placed on preventive monitoring. In such cases, telehealth could benefit these patients since monitoring is used to ensure that interventions are timely and acute incidents avoided.

Question 35

One of the key advantages of home telemonitoring is the creation of a digital health record that allows information to be recorded over time. If a patient takes his or her weight and blood pressure daily, most software will graphically display these data over time so that subtle trends can be observed. This type of trend data is much more useful in identifying emerging or developing conditions than snapshot data that are collected every 6 to 8 weeks at a physician's office.

Question 36

Telehealth is affected by certain legal, ethical, and regulatory issues of which nurses should be aware. In the United States, interstate practice of telenursing, for example, requires attending nurses to be licensed to practice in all of the states in which they provide telehealth services by directly interacting with patients.

Question 37

A telenurse reviews patient data that are transmitted via a remote server. The nurse recognizes a mild elevation in the blood pressure. Which of the following is the telenurse's priority action?

A) Call and ask the patient about signs or symptoms of hypertension
B) Immediately call the physician for notification of the change in blood pressure
C) Travel to the patient's home for an in-person blood pressure assessment
D) Call the patient's family members to inquire about recent interactions with the patient

Question 38

A telenurse reviews a patient's blood sugar level and phones the patient to instruct the patient on a change in the dose of insulin. This process is known as which of the following?

A) Knowledge dissemination
B) Knowledge generation
C) Knowledge processing
D) Knowledge gathering

Question 39

A telenurse is teaching a nursing student on telehealth. Which statement by the nurse is correct?

A) "Telehealth uses the same best practice standards as inpatient and acute care settings."
B) "Telenursing requires less nursing care so we can take additional patients on our caseloads."
C) "Telenursing has its own set of best practice guidelines that provide recommendations for home care."
D) "Telehealth involves a great deal of non-care-oriented tasks."

Question 40

A patient asks a telenurse about the efficiency of telenursing. Which of the following is the appropriate response by the nurse?

A) "Telenursing reduces the need to have face-to-face interactions, which improves efficiency of care."
B) "Telenursing reduces the amount of care required, which enables better use of nursing time."
C) "Telenursing increases non-care-related tasks, so telenursing care must then be efficient."
D) "Telenursing is not very efficient because telenurses have more documentation to complete."

Question 41

A patient is diagnosed with a new health condition and needs education. Which of the following telehealth tools will the telenurse suggest for provision of this information?

A) Video conferencing patient education
B) Transmitting still images and paper handouts
C) Watching embedded videos on social media
D) Calling the patient on the phone to review the condition

Question 42

A telenurse is teaching a nursing student on the skills and attributes every new telenurse must have, which include which of the following?

A) Excellent listening skills
B) Advanced computer skills
C) Experience with telehealth applications
D) Interest in data collection

Question 43

A patient with congestive heart failure is homebound. Why would the nurse recommend telenursing for this patient?

A) Ongoing monitoring reduces the occurrence of acute exacerbations of disease.
B) Telehealth reduces inpatient length of stays.
C) Telehealth uses healthcare resources more appropriately than inpatient centers do.
D) The use of standards and guidelines in telehealth occurs more often than in inpatient centers.

Question 44

A nurse is reviewing telehealth policies and protocols to see if a patient qualifies for telenursing. Which of the following will the nurse consider?

A) Equipment that will be required for home use
B) Patient's income level
C) Patient's proximity to a healthcare facility
D) Patient's family agreement

Question 45

An elderly patient with dementia lives in a home with six family members. What question should the nurse consider prior to initiating telenursing?

A) How will telenursing affect home life and family dynamics?
B) To what extent will the in-home technology usage change the patient's normal behaviors?
C) Is the technology provider-centric or patient-centric?
D) Will this telenursing experience contribute data to nursing research?

Question 46

A nurse researcher is reviewing the results of a telehealth study. Which of the following is considered a clinical outcome of the study?

A) Patient and family satisfaction
B) Demographics of the patient sample
C) Raw data results
D) Enrollment criteria

Question 47

A telenurse is concerned about the status of a patient who is at home. To make a complete and accurate decision about next steps for the patient, which question(s) should the nurse consider?

A) Do I need to call the patient?
B) Do I need additional information?
C) Do I need to call the patient's family member?
D) Do I need to go to the patient's home?

Question 48

A physician is reviewing chest radiograph images of a patient who is located 30 miles away at another healthcare facility. This type of care delivery is known as:

A) teleradiology.
B) telepathology.
C) telereview.
D) telemanagement.

Question 49

Expansion of telehealth can impact the impending shortage of nurses in which of the following ways?

A) Improving job retention and job satisfaction
B) Improving patient satisfaction
C) Improving access to healthcare services for patients
D) Increasing interdisciplinary collaboration

Question 50

A patient with obesity needs nutrition education. Which of the following is an example of the facilitation of patient education through telenursing?

A) A video conference on menu planning
B) Use of a phone application to track exercise
C) An interdisciplinary face-to-face conference on diabetes
D) Use of email to request medication refills

Question 51

A patient with the comorbidities of diabetes, hypertension, and fibromyalgia lives in a home in a rural area. The telenurse remotely monitors the patient's objective data, which would include:

A) vital signs and blood glucose results.
B) complaints of shortness of breath, lightheadedness, shakiness.
C) a 24-hour nutritional log.
D) pain scores.

Question 52

An advanced practice nurse is providing telehealth care for patients who are incarcerated. The nurse understands which of the following?

A) Telehealth provides cost-effective care and supports public safety when this method of care is provided.
B) Telehealth is used for this patient population because public safety outweighs quality of patient care.
C) Patients have increased options of appointment times when telehealth is delivered in this manner.
D) Patients prefer telehealth when they are incarcerated because they do not have to leave the facility.

Question 53

An elderly patient who lives alone is homebound and receives telehealth services. The telenurse has discovered that the patient often forgets to turn off appliances after use. Which of the following telehealth tools would the nurse recommend?

A) A sensor and activity-monitoring system
B) A personal emergency response system
C) A medication management device
D) A central station

Question 54

A telenurse will be providing care to patients in two bordering states. Which of the following does the nurse need to review before caring for these patients?

A) State licensure requirements
B) State tax exemptions
C) National recommendations for nursing practice
D) National nursing certification guidelines

Question 55

A patient has undergone a knee replacement and lives in a rural location. Which of the following will the nurse recommend for a home exercise program?

A) Teletherapy with motion-tracking webcam technology
B) Inpatient physical therapy
C) Outpatient physical therapy at the closest healthcare facility
D) Use of written patient handouts on exercise after a joint replacement

Question 56

A nursing administrator at an acute care facility is meeting with a telehealth nursing administrator on the expansion of telehealth for mutual patients. Which of the following is a collaborative opportunity for both organizations to reduce cost and expenditures?

A) Provide initiatives for reducing hospital readmissions in patients with chronic disease
B) Improve beneficiary access under fee-for-service payments
C) Promote telehealth networks to improve care quality and accessibility
D) Mandate telehealth for every patient with two or more chronic diseases