Test Bank Primary Care Interprofessional Collaborative Practice 6th Edition ButtaroChapter 01: Interprofessional Collaborative Practice: Where We Are Today MULTIPLE CHOICE 1. A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1 ACO. What is part o...
Chapter 01: Interprofessional Collaborative Practice: Where We Are Today
MULTIPLE CHOICE
1. A small, rural hospital is part of an Accountable Care Organization (ACO) and is
designatedas a Level 1 ACO. What is part of this designation?
a. Bonuses based on achievement of benchmarks
b. Care coordination for chronic diseases
c. Standards for minimum cash reserves
d. Strict requirements for financial reporting
ANS: A
A Level 1 ACO has the least amount of financial risk and requirements, but receives
sharedsavings bonuses based on achievement of benchmarks for quality measures and
expenditures. Care coordination and minimum cash reserves standards are part of Level
2 ACO requirements. Level 3 ACOs have strict requirements for financial reporting.
2. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
c. Ease of access to care
d. The ratio of providers to
patientsANS: C
As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access
tocare, walk-in settings and the ability to be seen within 30 minutes, and care that is close
to home. Associations with hospitals, costs of care, and the ratio of providers to patients
werenot part of these results.
MULTIPLE RESPONSE
1. Which assessments of care providers are performed as part of the value-based
purchasing(VBP) initiative? (Select all that apply.)
a. Appraising costs per case of care for Medicare patients
b. Assessing patients’ satisfaction with hospital care
c. Evaluating available evidence to guide clinical care guidelines
d. Monitoring mortality rates of all patients with pneumonia
e. Requiring advanced IT standards and minimum cash
reservesANS: A, B, D
Value-based purchasing looks at five domain areas of processes of care, including
efficiencyof care (cost per case), experience of care (patient satisfaction measures), and
outcomes of care (mortality rates for certain conditions). Evaluation of evidence to guide
clinical care is part of evidence-based practice. The requirements for IT standards and
financial status are part of Accountable Care Organization standards.
Chapter 02: Translating Research into Clinical Practice
MULTIPLE CHOICE
1. What is the purpose of Level II research?
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,a. To define characteristics of interest of groups of patients
b. To demonstrate the effectiveness of an intervention or treatment
c. To describe relationships among characteristics or variables
d. To evaluate the nature of relationships between two
variablesANS: C
Level II research is concerned with describing the relationships among characteristics or
variables. Level I research is conducted to define the characteristics of groups of
patients.Level II research evaluates the nature of the relationships between variables.
Level IV research is conducted to demonstrate the effectiveness of interventions or
treatments.
2. Which is the most appropriate research design for a Level III research study?
a. Epidemiological studies
b. Experimental design
c. Qualitative studies
d. Randomized clinical trials
ANS: B
The experimental design is the most appropriate design for a Level III study.
Epidemiological studies are appropriate for Level II studies. Qualitative designs are useful
for Level I studies. Randomized clinical trials are used for Level IV studies.
3. What is the purpose of clinical research trials in the spectrum of translational research?
a. Adoption of interventions and clinical practices into routine clinical care
b. Determination of the basis of disease and various treatment options
c. Examination of safety and effectiveness of various interventions
d. Exploration of fundamental mechanisms of biology, disease, or
behaviorANS: C
Clinical research trials are concerned with determining the safety and effectiveness of
interventions. Adoption of interventions and practices is part of clinical implementation.
Determination of the basis of disease and treatment options is part of the preclinical
researchphase. Exploration of the fundamental mechanisms of biology, disease, or
behavior is part of the basic research stage.
Chapter 03: Empowering Patients as Collaborative partners: A New Model forPrimary Care
MULTIPLE CHOICE
1. Which statement made by a health care provider demonstrates the most
appropriateunderstanding for the goal of a performance report?
a. “This process allows me to critique the performance of the rest of the staff.”
b. “Most organizations require staff to undergo a performance evaluation yearly.”
c. “It is hard to be personally criticized but that’s how we learn to change.”
d. “The comments should help me improve my management skills.”
ANS: D
The goal of the performance report is to provide guidance to staff in the areas of
professional development, mentoring, and leadership development. A peer review is
writtenby others who perform similar skills (peers). The remaining options may be true but
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, do not provide evidence of understanding of the goal of this professional requirement.
MULTIPLE RESPONSE
1. Which assessment question would a health care provider ask when engaging in the
previsitstage of the new model for primary care? (Select all that apply.)
a. “Are you ready to discuss some of the community resources that are available?”
b. “Are you experiencing any side effects from your newly prescribed medications?”
c. “Do you anticipate any problems with adhering to your treatment plan?”
d. “Are you ready to discuss the results of your laboratory tests?”
e. “Do you have any questions about the lab tests that have been ordered for
you?”ANS: B, C, E
The nursing responsibilities in the previsit stage include assessing the patient’s tolerance
ofprescribed medications, understanding of existing treatment plan, and education about
required lab testing. The primary care provider is responsible for screening lab data and
discussing community resources during the actual visit.
Chapter 04: Coordinated Chronic Care
MULTIPLE CHOICE
1. To reduce adverse events associated with care transitions, the Centers for Medicare
andMedicaid Service have implemented which policy?
a. Mandates for communication among primary caregivers and hospitalists
b. Penalties for failure to perform medication reconciliations at time of discharge
c. Reduction of payments for patients readmitted within 30 days after discharge
d. Requirements for written discharge instructions for patients and
caregiversANS: C
As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service
developed the Readmissions Reduction Program reducing payments for certain patients
readmitted within 30 days of discharge. The CMS did not mandate communication, institute
penalties for failure to perform medication reconciliations, or require written discharge
instructions.
2. According to multiple research studies, which intervention has resulted in lower costs
andfewer rehospitalizations in high-risk older patients?
a. Coordination of posthospital care by advanced practice health care providers
b. Frequent posthospital clinic visits with a primary care provider
c. Inclusion of extended family members in the outpatient plan of care
d. Telephone follow-up by the pharmacist to assess medication
complianceANS: A
Research studies provided evidence that high-risk older patients who had posthospital
carecoordinated by an APN had reduced rehospitalization rates. It did not include clinic
visits with a primary care provider, inclusion of extended family members in the plan of
care, ortelephone follow-up by a pharmacist.
MULTIPLE RESPONSE
1. Which advantages are provided to the chronically ill patient by personal
electronicmonitoring devices? (Select all that apply.)
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, a. Helps provide more patient control their health and lifestyle
b. Eliminates need for regular medical and nursing follow-up visits
c. Helps the early identification of patient health-related problems
d. Helps health care providers in keeping track of the patient’s health status
e. Cost is often covered by
MedicareANS: A, C, D, E
The explosion in availability of personal electronic monitoring devices is potentially useful
to many patients with chronic disease and others hoping to maintain good health. Data is
recorded and can help people have more control over their health and lifestyle. It can also
help health care providers keep track of their patients’ health status, as information from
these devices can be uploaded into Apps and electronic health records. These devices
are becoming more affordable and some are covered by Medicare. Coupled with
telehealth,
e-mail, or other electronic communication with health care providers allows patient
problems to be recognized early. Medical and nursing follow-up is still required as problems
arise.
Chapter 05: An Introduction to Health Care Disparities and Culturally ResponsivePrimary
Care
MULTIPLE CHOICE
1. A primary care provider administers the “Newest Vital Sign” health literacy test to a patient
newly diagnosed with a chronic disease. What information is gained by administering this
test?
a. Ability to calculate data, along with general knowledge about health
b. Ease of using technology and understanding of graphic data
c. Reading comprehension and reception of oral communication
d. Understanding of and ability to discuss health care
concernsANS: A
The “Newest Vital Sign” tests asks patients to look at information on an ice cream container
label and answer questions that evaluate ability to calculate caloric data and to grasp
generalknowledge about food allergies. It does not test understanding of technology or
directly measure reading comprehension. It does not assess oral communication. The “Ask
Me 3” tool teaches patients to ask three primary questions about their health care and
management.
2. What is the main reason for using the REALM-SF instrument to evaluate health literacy?
a. It assesses numeracy skills.
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