Question 1

An ambulatory care nurse provides care for a variety of individuals in a metropolitan area. Which factors are constant concerns for the local individuals that the nurse can assist with? Select all that apply.

A)Adequate supply of nutritious food
B)Lack of employment opportunities
C)Improve housing options.
D)Ensure all individuals are safe.
E)Provide routine health screenings.

Adequate supply of nutritious food
Lack of employment opportunities
Improve housing options.
Provide routine health screenings.

Accepted Answer

Individuals living in a metropolitan area face various challenges, especially those living in one of the poorer sections of the town. Such challenges can include inadequate food supplies, lack of employment options, inadequate housing, or poor housing structures, as well as lack of opportunities for quality education. The ambulatory care nurse can help advocate for these changes and encourage others to help contribute to the situation and help improve the living conditions in these areas. The nurse will also be involved in providing basic nursing care. This can include providing routine health screenings and education on how to improve one's life and care for any health conditions. Ensuring that all individuals are safe will, unfortunately, be outside the capability of the nurse; however, the nurse can advocate for safer conditions for the community.

Question 2

An ambulatory care nurse helps provide care at a housing center for women and children who are victims of domestic violence. Which action should the nurse prioritize when providing care?&#10;A)Encourage communication.&#10;B)Assess educational level of mother.&#10;C)Ensure children are enrolled in school.&#10;D)Assess for injuries.

Accepted Answer

The initial step is to encourage the woman and/or children to share their story and communicate their needs, frustrations, fears, and desires with the nurse. From there, the nurse will be better able to determine a care plan for this family, which could include the other choices. All nursing care starts with communication.

Question 3

An ambulatory nurse is concerned that a recent forest fire will increase health challenges among the local population. Which action could best improve the future health of the individuals in this population?

A)Advocate for policy change to address the continuing environmental damage.
B)Educate the local residents about best ways to prevent health challenges during these times.
C)Provide individuals with high risks with the appropriate preventive treatments.
D)Suggest individuals with high risks to leave the area as soon as a fire is reported.

Advocate for policy change to address the continuing environmental damage.

Accepted Answer

Policy changes can have a great effect on the health of the local population. Nurses should advocate for environmental and social policies that influence better health outcomes for all populations. Prevention is always better than trying to repair the damage done. The other choices would be additional measures the nurse could utilize until the situation improves.

Question 4

A newly registered nurse has chosen to specialize in ambulatory nursing following the example of an older relative who has worked as a nurse since the 1980s. Which opportunit(ies) will the new nurse have that were not yet in place when the older nurse began working? Select all that apply.

A)Telehealth involvement
B)Increased advocacy roles
C)Ability to work independently
D)Improved home environments
E)Involvement in disease prevention

Accepted Answer

In the 21st century, the role of the ambulatory care nurse has expanded to include providing care and education, advocacy, and care coordination in a variety of settings to include telehealth, being an advocate for the local population, and working independently in various settings such as home health and hospice. In the 1930s, Florence Nightingale first advocated for improving home environments to help improve health, and nurses began to encourage the prevention of diseases by educating individuals about immunizations. Such changes to the nursing role were already established when the older nurse began working in the 1980s.

Question 5

When seeking a position with a local primary care physician, the nurse learns this office is part of a large network involving the local hospital, pharmacy, and other specialties. Which type of care model is this office most likely a part of?

A)Accountable Care Organizations (ACOs)
B)Patient-Centered Medical Homes (PCMHs)
C)Bundled Payments for Care Improvement (BPCIs)
D)Quality Payment Program (QPP)

Accepted Answer

This primary care office in this example is part of an ACO, an entity of physicians, hospitals, pharmacies, and other healthcare providers who join together to provide high-quality, coordinated care to a defined population of those on Medicare. The organization and structure can be multifaceted and intricate depending upon the variety of providers joining the entity. The PCMHs are an enhancement of the current primary care office. This can include many different professional team members but does not usually include the hospital. The QPP option is a payment model that offers incentive payments for performance in areas such as quality, costs, and use of electronic health records to physicians. The BPCI provides a single payment for the entire episode of care for all the different providers in an individual's healthcare episode. This forces hospitals, physicians, and post-acute care settings to collaborate, coordinating care and eliminating wasteful services and tests that have no impact on individual health outcomes.

Question 6

An ambulatory care nurse is preparing a poster on the future of ambulatory care nursing for the local high school career fair. Which should the nurse feature as the way(s) RNs can influence the future of ambulatory care nursing? Select all that apply.

A)Advocating for the inclusion of ambulatory nursing in local, state, and federal legislation
B)Conducting research to expand the knowledge of evidence-based practice in the field of ambulatory nursing
C)Sharing the progress of the positive impact of ambulatory nursing on public health
D)Encouraging improvement in electronic health record technology to allow better tools for documentation
E)Writing textbooks to promote ambulatory nursing among nursing students

Accepted Answer

The American Academy of Ambulatory Care Nursing's Position Statement (2017) highlights current and future roles for all ambulatory care practice settings. The statement contains a call to action for registered nurses to participate in activities that influence the future of ambulatory care. This includes developing an agenda that informs healthcare and political stakeholders of the value and cost-effectiveness of professional ambulatory care nurses; expanding the body of knowledge for ambulatory care clinical and telehealth nursing practice by conducting and/or applying the findings of scientific studies that build evidence-based nursing practice; communicating the powerful story of professional progress made by ambulatory care nurses and articulating their ability to positively impact patient care and outcomes; and ensuring electronic health records include robust documentation tools that support professional ambulatory and telehealth nursing practice. While ambulatory nurses write textbooks, doing so is not the best way to promote ambulatory care. Instead, the nurse may work to form strategic alliances between health systems and academic institutions to develop curriculums that prepare students for practice in ambulatory care settings.

Question 7

The pathway to ambulatory care nursing has experienced tremendous growth. Which factor will best continue to assist in expanding the role and need for ambulatory nurses?&#10;A)Documentation of improved healthcare costs&#10;B)Increased educational opportunities&#10;C)More legislative measures to increase acceptance&#10;D)Increased employment opportunities

Accepted Answer

Future care delivery models will be driven by healthcare payment models such as value-based purchasing and shared savings programs. Many of the quality indicator metrics associated with these financing programs can be achieved by registered nurses. Additional quality indicator metrics supported by registered nurses include longitudinal care planning, access to 24-hour care, advanced directives and care planning, activation measures, health information exchange portals, and clinical data registries. While the other choices may contribute some, they will see an increase as the call for more ambulatory care nurses goes out.

Question 8

The role of the ambulatory nurse will continue to evolve. Which goal should inform all changes and improvements to the role?&#10;A)Improve care to each individual.&#10;B)Continue to improve healthcare cost.&#10;C)Improve technology to monitor and coordinate care.&#10;D)Manage the entire healthcare team's involvement.

Accepted Answer

The ultimate goal of any nursing care should be about the individual who is seeking care. Each one should receive the best care possible, no matter what the situation is. The other choices all contribute to making this goal possible.

Deck 2: Healthcare Delivery, Political, Social, and Economic Influences on Health Outcomes