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New ACNS Exam Prep | Exam ACNS Actual Tests

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Nursing ANCC Adult Health Clinical Nurse Specialist Certification (ACNS) Sample Questions (Q145-Q150):

NEW QUESTION # 145
The information contained with the National Practitioner Data Bank includes all of the following except:

A. malpractice payment history
B. record of clinical privileges
C. the practitioner's home address
D. practitioner's licensure

Answer: C

Explanation:
The National Practitioner Data Bank (NPDB) is a U.S. repository of information about the credentials and professional conduct of healthcare practitioners. It was established with the goal of improving healthcare quality and reducing fraud and abuse in healthcare programs. The NPDB collects and releases information related to medical malpractice payments, sanctions for professional misconduct, and other relevant performance and conduct indicators. This data serves as a resource for healthcare entities to make informed decisions regarding the credentialing and hiring of healthcare providers.
The types of information maintained in the NPDB include: 1. **Practitioner's Licensure**: Information regarding the licensure status of healthcare providers, including any disciplinary actions taken against their licenses by a state licensing board. 2. **Malpractice Payment History**: Details of payments made on behalf of practitioners in settlement of, or as a judgment in, medical malpractice actions. 3. **Record of Clinical Privileges**: Information about changes to, or voluntary or involuntary limitation of, a practitioner's right to admit and treat patients in a healthcare institution. 4. **Professional Society Memberships and Actions**: Information concerning membership in professional societies and any disciplinary actions taken by such bodies.
However, it is important to note that the NPDB does not contain every type of personal information about practitioners. **The Practitioner's Home Address** is specifically excluded from the data bank. This exclusion helps protect the privacy and security of healthcare practitioners by not disclosing their personal residence information. The focus of the NPDB is primarily on professional qualifications and conduct, rather than personal data that does not relate to a practitioner's professional life.
The exclusion of personal addresses from the NPDB reflects a balance between transparency in healthcare and the protection of individual privacy rights. By maintaining this boundary, the NPDB ensures that its data serves the intended purpose of aiding in the credentialing process and enhancing trust in healthcare professionals, without unnecessarily exposing personal details. This approach helps healthcare entities access critical information while respecting the privacy of individual practitioners.

NEW QUESTION # 146
What does a nurse consider when applying research utilization?

A. Safety, effectiveness, cost, and impact.
B. Cost, effectiveness, and safety.
C. Safety and effectiveness.
D. Safety and cost.

Answer: A

Explanation:
When a nurse is considering the application of research utilization, there are several critical factors to evaluate to ensure the research is not only applicable but also beneficial in a clinical setting. These include safety, effectiveness, cost, and impact. Let's delve deeper into each of these considerations:
Safety: This is the foremost concern. When a nurse is applying research findings to patient care, the safety of the patient must be the top priority. The research used must have demonstrated that the interventions or procedures considered do not pose undue risk to patients. This involves assessing the methodology of the research to ensure it adheres to ethical standards, and that the findings have been replicated in multiple studies or under various conditions to confirm safety outcomes.
Effectiveness: The nurse must consider whether the research provides clear evidence that the interventions or practices in question actually work and achieve the desired outcomes. This involves looking at the strength and consistency of the evidence. For instance, were the study results statistically significant? Were they clinically significant as well? Effectiveness also involves evaluating whether the research is relevant to the specific patient populations the nurse is working with, as results can vary widely among different groups.
Cost: Healthcare costs are a significant concern for both providers and patients. When applying research, it is important for nurses to consider the financial implications. This includes the direct costs involved in implementing new practices or interventions, such as the need for new equipment or additional training, as well as the potential for cost savings. For example, a more expensive intervention might be justified if it leads to shorter hospital stays or fewer readmissions.
Impact: Lastly, the broader impact of applying the research should be considered. This includes the potential effects on patient satisfaction, quality of life, and overall healthcare outcomes. It also involves considering the impact on the healthcare system itself, such as changes in workflow or the need for additional staffing. Furthermore, nurses should think about the long-term impacts, which might include setting new standards of care or influencing future research directions.
In summary, when a nurse is looking at research utilization, they must critically assess all these factors - safety, effectiveness, cost, and impact - to ensure that the research is not only applicable but will also enhance patient care and optimize healthcare resources. This comprehensive evaluation helps in making informed decisions that align with both clinical goals and ethical standards.

NEW QUESTION # 147
The CNS understands that she will be treating patients with Title XIX Medicaid of the Social Security Act. The following are accurate statements regarding Medicaid with the exception of:

A. Providers are allowed to collect from these patients if Medicaid denies the claim.
B. Medical assistance is provided to low income persons under this.
C. This is a federal and state matching program.
D. Medicaid pays for health care and prescription drugs.

Answer: A

Explanation:
The question pertains to understanding the rules and regulations regarding Medicaid, which is covered under Title XIX of the Social Security Act. This federal program is designed to assist with medical costs for people with limited income and resources, and it offers benefits not typically covered by Medicare, such as nursing home care and personal care services.
One of the statements provided in the question is that "Providers are allowed to collect from these patients if Medicaid denies the claim." This statement is incorrect and serves as the correct answer to the question. In the Medicaid program, providers who accept Medicaid patients must agree to accept Medicaid's payment as the full payment for their services. If Medicaid denies the claim, the provider generally cannot bill the patient for the denied charges. This rule is in place to protect low-income patients from incurring medical bills they cannot afford, which they might face if Medicaid denies payment and providers are allowed to charge them directly.
Medicaid operates as a joint federal and state program. The federal government provides part of the funding, while states must match a percentage of that funding. Each state administers its own Medicaid program but must follow federal guidelines. The state's flexibility allows it to determine aspects such as the type, amount, duration, and scope of services, which can vary widely between states.
The intention behind Medicaid rules, including the prohibition against billing patients for covered services when claims are denied, is to ensure that financial barriers do not prevent vulnerable populations-such as low-income individuals, the elderly, disabled, blind, and families with dependent children-from accessing necessary medical care. Providers who participate in Medicaid accept these terms, which includes accepting the Medicaid reimbursement as payment in full, thereby agreeing not to pursue additional payment from the patient for any services that Medicaid is supposed to cover.
In summary, the correct answer to the question, "Providers are allowed to collect from these patients if Medicaid denies the claim," is a misstatement about Medicaid's regulations. Providers are indeed not allowed to bill Medicaid patients directly if Medicaid denies the claim, provided the services are ones that Medicaid is expected to cover and the provider has accepted the terms of Medicaid payments. This is fundamental to ensuring that Medicaid fulfills its role in helping those who are financially disadvantaged to receive necessary healthcare.

NEW QUESTION # 148
Your 30-year-old female patient suffers from asthm
a. You understand that all of the following are considered maintenance medications except:

A. leukotriene inhibitors
B. mast cell stabilizers
C. steroids
D. short-acting B2 agonists

Answer: D

Explanation:
In managing asthma, it is crucial to distinguish between maintenance medications and rescue medications, as each serves a different purpose in the treatment plan. Maintenance medications are used regularly to prevent asthma attacks and to manage chronic symptoms. These typically include inhaled corticosteroids, long-acting beta-agonists (LABAs), leukotriene modifiers, mast cell stabilizers, and theophylline.
Inhaled corticosteroids, for example, help reduce inflammation in the airways, making them less sensitive and less likely to react to asthma triggers. Leukotriene modifiers, another type of maintenance medication, work by blocking chemicals in the immune system that contribute to inflammation, airway constriction, and mucus production. Mast cell stabilizers prevent the release of histamine and other chemicals that cause inflammation and bronchoconstriction.
On the other hand, short-acting beta2-agonists (SABAs), such as albuterol, are classified as rescue medications. These are used to relieve acute asthma symptoms or an asthma attack by quickly relaxing tightened muscles around the airways. This action opens the airways and makes breathing easier. SABAs are not intended for regular use as a preventive measure but are essential in providing rapid relief from acute symptoms.
Therefore, when considering the correct answer to the question about which of the listed options is not a maintenance medication, the answer is "short-acting B2 agonists." Unlike the other listed medications which are used regularly to reduce the frequency and severity of asthma symptoms, short-acting B2 agonists are used on an as-needed basis for quick relief of breathing difficulties. This distinction is critical in the effective management of asthma, ensuring that patients use the appropriate medications in the right context to maintain control over their condition and to handle acute exacerbations safely and effectively.

NEW QUESTION # 149
Which of the following is most consistent with the diagnosis of anxiety?

A. difficulty initiating sleep
B. consistent early morning wakening
C. diminished cognitive ability
D. nausea

Answer: A

Explanation:
To understand why "difficulty initiating sleep" is most consistent with the diagnosis of anxiety, it's important to delve into the relationship between anxiety and sleep disturbances. Anxiety disorders involve excessive and persistent worry, fear, or nervousness. These intense feelings of anxiety can activate the body's stress response, often termed as the 'fight or flight' response, which prepares the body to either confront or flee from perceived threats. This response is associated with a variety of physiological changes including increased heart rate, heightened senses, and a surge in adrenaline.
These physiological changes can significantly impact an individual's ability to initiate sleep. When the brain is in a heightened state of alertness due to anxiety, it becomes difficult for it to transition into the calm and relaxed state necessary for sleep onset. This is why difficulty initiating sleep is commonly reported among individuals with anxiety disorders. The mind continues to race with thoughts, often worrying or ruminating about past events or anticipating future problems, which can prevent the relaxation needed for sleep.
While other symptoms such as nausea or consistent early morning awakening may also occur in individuals with anxiety, they are not as directly linked to the disorder as difficulty initiating sleep. Nausea can be a symptom of many conditions including anxiety, but it is also commonly associated with gastrointestinal disorders, medications, or other illnesses. Consistent early morning awakening could suggest other sleep-related disorders like insomnia or could be influenced by depression, another condition often comorbid with anxiety but distinct in its sleep disturbance patterns.
In summary, while anxiety can manifest in various physical and psychological symptoms, difficulty initiating sleep is particularly illustrative of the disorder due to the direct interference of anxiety's physiological and cognitive effects with the mechanisms of sleep initiation. This makes it a key symptom for clinicians to consider when diagnosing anxiety. The heightened state of alertness and the inability to relax, both characteristic of anxiety, are what primarily contribute to this sleep initiation difficulty.

NEW QUESTION # 150
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