100 terms

CRRN Practice Exam 12/2012

STUDY
PLAY
What represents that the rehab nurse grasps the significance of capitated fee system for services?
I need to put the answers in ... sorry
A pt who has had a stroke and has residual left sided neglect is about to be discharged. What should the rehab nurse educate the family about regarding the unilateral neglect, which may jeopardize the patient?
tbd
Which member of the rehab team has as his or her main goal to provide activities that keep the young patient occupied in a constructive manner that is developmentally appropriate?
tbd
Which of the following is a characteristic of case management?
A It is practiced only by social workers
B It was originally practiced by occupational therapists
C It is a functional area of practice in nursing
D It is only practiced in hospitals and insurance companies
tbd
A patient recently discharged after having a total hip replacement calls and reports acute groin pain and shortening of the involved extremity in external rotation. What should the case manager advise the patient to do?
A Increase the exercises prescribed by the physical therapist
B Take pain medication on a regular basis rather than as needed
C Decrease activities until the symptoms subside
D Contact the physician immediately or go to an emergency room
tbd
Which of the following is one of the MOST crucial factors influencing short-term and long-term functional outcomes in pediatric rehabilitation?
A Severity, extent and location of injury
B Health status
C Development, maturation, and growth
D Family influences
tbd
Mr. V. has had damage to his right parietal lobe as a result of a brain injury. Mr. V. will probably have difficulty with which of the following activities?
A Hearing and responding to communications
B Standing and walking
C Finding his room
D Seeing items on a food plate
tbd
School age children with disabilities need to develop social skills to overcome the fear and prejudices they may face. This can be accomplished by which of the following?
A Incorporating therapies as part of the school program.
B Promoting reliance on one important non-family member to provide the support needed.
C Insisting upon self-reliance as the most important aspect of development.
D Providing health related activities at a time that does not interfere with critical academic subjects or peer relationships.
tbd
Which of the following BEST defines cross-subsidization?
A The amount by which the price exceeds the variable cost
B Discounts from normal charges given to large payers for health care services
C The practice of assigning some patients more costs than they incur and others less
D The revenue based on the organization receiving payment for costs incurred
tbd
A young woman has had a stroke as a result of cocaine usage. She has poor eye contact with staff, often is impatient with her abilities, has been seen by staff to injure affected limbs, and frequently refers to herself as a cripple. This client may be experiencing which of the following alterations of self perception as a result of her stroke?
A Sensory schema
B Self-image
C Body-image
D Self-evaluation
tbd
Metered dose inhalers (MDIs) deliver medicine to patients with lung disease. Which of the following is an ADVANTAGE of this delivery method?
A Less likelihood for systemic side effects
B Less potential for interaction with liquids
C Less likelihood for carbon dioxide retention
D Less potential for hypoxia
tbd
Which of the following actions should the nurse consider INITIALLY when providing spiritual care?
A Offer to administer communion
B Guide clients through prayers
C Contact a spiritual advisor for the client
D Listen to and support the client
tbd
The cost of health care has been positively impacted by which of the following actions?
A Payment for home care services with federal funds
B Expanding public insurance plans
C Creation of new lifesaving technologies
D Conversion to a managed care process
tbd
What type of living environment provides supervised living for persons with similar disabilities and staff who are available at all times of the day and night?
A Group home
B Independent living center
C Skilled nursing facility
D Integrated housing facility
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The bulbocavernosus reflex is a test that is used frequently in which patient population to determine if there is the potential for training the bowel to empty in response to a suppository or digital stimulation?
A Spinal cord injury
B Diabetes mellitus
C Spina bifida
D Guillain-Barre' Syndrome
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What is ONE of the overall purposes of spirituality?
A To guide adherence to a particular religion such as Catholicism
B To assist individuals in times of great stress, and help them adjust to change
C To provide a framework to determine moral action and consistent values
D To help people develop a cohesive view of the meaning of their lives
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For who were early intervention programs (EIP's) INITIALLY designed?
A Brain injured patients during the acute rehabilitation phase of treatment
B Frail elderly about to be discharged to home
C Any disabled patient during the acute hospitalization phase of treatment
D Children with developmental or physical disabilities
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What should the rehabilitation nurse do prior to discharging the elderly patient with urge incontinence to the home environment?
A Advise the patient to reduce fluid intake to between 1200ml and 1500ml.
B Perform a home evaluation to assure that obstacles are removed from the path to the bathroom
C Encourage the patient to replace water with grapefruit juice for hydration
D Insert a Foley catheter
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What should the rehabilitation nurse do prior to discharging the elderly patient with urge incontinence to the home environment?
A Advise the patient to reduce fluid intake to between 1200ml and 1500ml.
B Perform a home evaluation to assure that obstacles are removed from the path to the bathroom
C Encourage the patient to replace water with grapefruit juice for hydration
D Insert a Foley catheter
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Mrs. A. is convinced that prayer is an important aspect in her recovery. The nurse is skeptical about the power of prayer. Today Mrs. A. has asked the nurse to join her in a prayer session. Which of the following is the BEST way for the nurse to answer this request?
A I know this is important to you, but I'm not comfortable joining you. Would you like me to find someone else to do so?
B I'd be glad to join you.
C I don't believe prayer helps and would feel uncomfortable joining you.
D I'm sorry, but the hospital does not allow us to become involved in such activities.
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Which of the following theorist developed a model for data collection system comprised of 10 functional health patterns necessary for the assessment of a patient's health status?
A Betty Neuman
B Jacqueline Fawcett
C Marjory Gordon
D Dorothea Orem
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The reflex arc associated with micturition is located at which level of the spinal cord?
A Sacral
B Thoracic
C Cervical
D Peripheral
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Facilitating and educating children with congenital and acquired disability is an ongoing process to help them move from dependence to a balance of independence and interdependence. Three of the four concepts listed below are appropriate to teach children from eight to eleven years of age, and one concept is appropriate for youth in their teens. Which statement below reflects content that should be covered with teenagers?
A Ways of expressing sexuality, including communication, dating, love, intercourse and reproduction
B Signs of puberty e.g. female menses and male nocturnal emission
C Family communication about sexuality, values, and decision making
D Self pleasuring (masturbation), reproduction, pregnancy, and sexual abuse issues
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A patient with diabetes has been admitted to a skilled care unit for recovery and wound healing after several revisions of an above the knee amputation that had begun as an ingrown toenail. The patient says to the nurse, " I don't know what else to do. Nothing I try seems to make a difference with respect to healing this wound. " This statement might be an example of which of the following?
A Hopelessness
B Self-perception
C Self reflection
D Lack of knowledge
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Cost-control efforts in the United States are characterized by a combination of government regulation and market-based competition. Which of the following is an example of a regulation-based cost-containment strategy?
A Managed care
B Restrictions on supply of physicians
C Cost sharing
D Antitrust regulation
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Which organization has taken the lead in developing case management standards?
A The American Accreditation HealthCare Commission/URAC
B The Association of Rehabilitation Nurses
C The National Coalition of Associations for Advancement of Case Management
D The Commission on Accreditation of Rehabilitation Facilities (CARF)
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What MUST an internal case manager do when arranging for equipment in the home environment?
A Negotiate rates with the vendor
B Utilize the vendor with the least expensive rates
C Identify if the payer source has contracts with any vendors
D Select the vendor for the patient
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During periods of stress or trauma, which nutrients are used by the body as energy sources?
A Fats
B Proteins
C Vitamins
D Minerals
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Which term BEST describes the discounts from full charges available to governments and some other third party payers?
A Contribution margin
B Contractual allowance
C Cross-subsidization
D Cost reimbursement
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Which cranial nerves are MOST affected in persons with multiple sclerosis?
A II and III
B IV and X
C V and VII
D VIII and XI
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The case manager for the brain injured child start the process of re-entry into the school system?
A Upon the parents request
B Prior to discharge from the rehabilitation facility
C At the time of discharge to home
D During the acute hospitalization
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Each method of paying health care providers has incentives or imposes financial risks to affect choices and decisions. Which method places all the risk on the payer of health care?
A Fee-for-service payment
B Prospective payment
C Capitation payment
D Cost sharing
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Which of the following theorist developed the health care systems model utilizing an open system in interaction with the environment?
A Betty Neuman
B Jacqueline Fawcett
C Marjory Gordon
D Dorothea Orem
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Parasomnias such as sleepwalking and enuresis occur during which phase of sleep?
A Stage 1
B Stage 2
C Stage 4
D REM
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Nursing theorists draw from existing knowledge in nursing as well as from other disciplines. Which theorist used learning and motivational theories?
A Lydia Hall
B Imogene King
C Sister Calista Roy
D Martha Rogers
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Ms. H. has recently had a right hemisphere stroke. It is likely that Ms. H's extremities will tend to be positioned in which of the following patterns?
A Upper extremity flexion and abduction with lower extremity flexion
B Upper extremity flexion and adduction with lower extremity extension
C Lower extremity flexion and upper extremity flexion and abduction
D Both upper and lower extremity extension and adduction
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What MUST be present for a patient to qualify for home health care under the Medicare program?
A A need of assistance with bathing
B A need of assistance with dressing
C Homebound
D Physical disability
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How can the case manager positively INCREASE the value of an Independent Medical Examination (IME)?
A By using a physician whose expertise matches the issue
B By asking open ended questions in the referral letter
C By offering to pay in advance for the evaluation
D By allowing the physician plenty of time to generate the report
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Identify which of the candidate's jobs below would be protected under the Americans with Disabilities Act (ADA)?
A A woman who has carpal tunnel syndrome and cannot type 30 words per minute (an essential function of the job) with or without reasonable accommodation
B A man who has AIDS and will raise the employer's health insurance premiums
C A woman who is applying for a job as a forklift operator who has poorly controlled epilepsy
D A man with unstable angina who is applying for a job as a warehouse worker
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When assisting the patient with multiple sclerosis, the case manager should strongly recommend the payer/insurance company authorize funding for which of the following?
A Vigorous exercises
B A heated jacuzzi or spa
C A home evaluation by an occupational or physical therapist
D Bedrest
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Which statement is consistent with the principle of social justice?
A Distribution of health care is based on market demand
B Acquisition of health care services is an individual responsibility
C Equitable distribution of health care is a societal responsibility
D Health care services are based on ability to pay
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Common debilitating effects of chronic obstructive pulmonary disease (COPD) that interfere with activities of daily living include which of the following?
A Depression and sleep apnea
B Loss of libido and weight gain
C Orthopnea and syncope
D Dyspnea and fatigue
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Which of the following acts allows children with disabilities appropriate education, transition services, assistive technology, and rehabilitation counseling?
A Rehabilitation Act of 1973
B Education for All Handicapped Children's Act
C Early Intervention Amendments to the Education for All Handicapped Children's Act
D Individuals with Disabilities Education Act
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What is a function of the rehabilitation nurse case manager?
A Transport the patient to physician appointments
B Coordinate attendant care and/or assistance with behavioral management
C Administer medications to the cognitively impaired patient
D Perform the bowel program for the spinal cord injured patient
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What is a SMALL number of people with complementary skills who are equally committed to a common purpose, goals, and working approach known as?
A Working group
B Pseudo team
C Potential team
D Real team
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Participants in health care have combined widely shared human beliefs about health and illness into four major ethical principles. What obligation requires health care providers to help people in need?
A Beneficence
B Nonmaleficence
C Autonomy
D Justice
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Following spinal cord injury, patients who express a positive spiritual well-being are MOST likely to exhibit what disposition?
A More depressed but less fatigued
B Less involved in the community
C More likely to volunteer
D Less depressed with a better quality of life
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What is the process of aligning and developing the capacity of a team to create the results its members desire?
A Shared accountability
B Team building
C Teamwork
D Team learning
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Which of the following is a barrier to independent living for the C4 spinal cord injured patient?
A Lack of new clinical research
B Availability of affordable, accessible housing
C Motor impairment below the level of injury
D Changing payment systems
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Which method of paying health care providers shifts part of the financial risk to hospitals by paying a fixed amount based on admission diagnosis?
A Fee-for-service payment
B Prospective payment
C Capitation payment
D Cost sharing
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What should the case manager do if a needed service is NOT included in the patient's insurance policy?
A Explain to the patient why the services cannot be provided
B Insist the payer go out of policy to provide the service
C Explore alternative funding sources for the service
D Provide the service at no charge
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A patient on the rehabilitation unit refuses to go to therapy on Saturday. The patient tells the nurse that in his religion Saturday is a holy day and he does not work on the Sabbath. The nurse is perplexed because she knows that the client is not Jewish. Which Christian sect maintains Saturday as the holy day?
A Methodist
B Christian Scientist
C Jehovah's Witness
D Seventh Day Adventist
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Mutual goal setting is important for successful rehabilitation and may influence the effectiveness of coping strategies. Which of the following statements regarding the process of mutual goal setting is TRUE?
A Goals should be relevant to the patient and within the expertise of the rehabilitation team to achieve
B Goals should be easy to achieve
C The process of mutual goal setting is relatively unproblematic
D Goals should be established by the rehabilitation team and communicated in the process to the client
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How often should wheelchair bound patients be taught to perform weight shifts?
A Every 15 minutes
B Every hour
C Four times per day
D When they become uncomfortable
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Which of the following statements BEST depicts the relationship between physical and spiritual pain?
A There is no relationship between physical and spiritual pain.
B Physical pain can be felt by almost everyone but spiritual pain is only felt by the religious.
C Physical pain often provokes spiritual pain.
D Lack of physical pain generally means a lack of spiritual pain.
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Which of the following would be the BEST approach for the rehabilitation nurse with a new interest in political activism?
A Identify one issue of interest and act on it
B Serve on a local disability commission
C Work on the campaign of an elected official
D Subscribe to newsletters that inform nurses about legislation
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Mr. T. is quiet and withdrawn and is not interacting with others. Which of the following should the nurse do FIRST?
A Recognize this as a call for help and seek a psychological consult
B Understand that these behaviors are signs of hostility and be on guard when providing care
C Identify these behaviors as signs of denial and seek opportunities to interact in a low key manner to build rapport
D Interpret these behaviors as a request to be alone and provide care while not engaging
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Which of the following is included in the Americans with Disabilities Act of 1990?
A Prohibits discrimination against the disabled when they rent or purchase federally subsidized property
B Mandates relay services by telephone companies for patients who have telecommunication devices for the deaf
C Mandates the provision of funding for mortgage loans to developers to build housing for the elderly and the handicapped
D Mandates subsidized rent payments to low income families
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Which team model is UNCOMMON in rehabilitation practice?
A Multidisciplinary
B Interdisciplinary
C Medical
D Transdisciplinary
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Which tool should be used in the nursing assessment of pressure ulcer risk?
A Rancho Los Amigos Scale
B McGill Questionnaire
C Braden Scale
D CARF Scale
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Rebound occurs when an individual spends insufficient time in certain stages of sleep. For which of the following stages is rebound an IMPORTANT concept?
A Stage 1
B Stage 2
C Stage 3
D Stage 4
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Which of the following statements is incorporated in Orem's self care theory?
A Investigation/decision making where the patient has control and input regarding activity
B Handicap as the limitation of a person's normal role function
C Sociobiological activities such as bathing and dressing that are hierarchically related to each other
D Reciprocal interaction, simultaneous action and reaction
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Which nursing theorist views the person as a biological, symbolic, and social unit?
A Lydia Hall
B Imogene King
C Dorothea Orem
D Martha Rogers
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Which spinal cord injury syndrome causes paralysis and loss of position sense on the same side as the injury and loss of pain and temperature sensations on the opposite side?
A Anterior cord syndrome
B Brown-Sequard syndrome
C Cauda equina syndrome
D Central cord syndrome
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An obese male patient is admitted to your unit. The night nurse reports that the patient snores loudly and has recurrent periods of very shallow breathing. Which of the following sleep disorders do you suspect?
A Narcolepsy
B Insomnia
C Sleep apnea
D Parasomnia
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What are the two PRIMARY goals of the interdisciplinary team in pediatric rehabilitation?
A Collaboration and effective communication
B Provision of care and self-maintenance
C Mutual respect and shared responsibility
D Planning and implementing appropriate interventions
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Which of the following levels of wellness views rehabilitation activities and the monitoring of health care processes to prevent complications or further illness, injury or disability?
A Health promotion
B Primary prevention
C Secondary prevention
D Tertiary prevention
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How does an independent living program support an individual with a disability?
A Provides twenty four hour care in the home environment
B Integrates patients with multiple disabilities in one setting
C Allows patients to remain in their own dwellings while offering support services
D Provides caregivers as needed by the patient
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Which of the following techniques allows the user to determine the volume of patients required for a program to be financially self-sufficient?
A Marginal cost analysis
B Regression analysis
C Break-even analysis
D Cost-benefit analysis
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A 45 year old female has a reflex neurogenic bowel associated with thoracic transverse myelitis. She has a history of smoking and obesity, drinks six cans of soda a day, eats out often, and defecates every other morning. Her inpatient bowel program involves a mild suppository every day at 8:30 a.m., a stool softener BID, and drinking 2500cc of decaffeinated drinks per day. Which pattern of stool consistency and size listed below indicates a trial QOD suppository program?
A Results of no stool after the suppository but involuntary soft stool later in the day
B Results of several soft stools throughout the day
C Results of soft stool after the suppository and no stool the next day
D Results of soft stool every third day
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When comparing one facility's selected outcomes with those of another facility's outstanding outcomes this is considered which process?
A Projected resource utilization
B Benchmarking
C Cost-effectiveness analysis
D Evaluation of clinical pathways
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Which of the following strategies, when implemented prior to discharge, promotes communication, defines the roles of each party, clearly outlines expected outcomes, defines the limitations of care, and establishes home health care agency liability?
A Life care plan
B Discharge instructions
C Health contract
D Limited cost projection
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Which of the following defines impairment?
A The interaction of a person with a disability with the environment
B The inability to perform some key life function
C The residual limitation that results from disease, injury, or a congenital defect
D The loss of the ability to perform self-care tasks
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Patients with which of the following diagnoses would be likely to have restrictive lung disease?
A Aspiration pneumonia
B Parkinson's disease
C Chronic bronchitis and emphysema
D High level spinal cord injury
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Which of the following theories did Bandura develop to guide the assessment of the individual's ability to promote health and reduce risk?
A Hardiness
B Self-efficacy
C Locus of control
D Conservation
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What is the role of an interdisciplinary team?
A Know only the skills of their discipline
B Have only one or two providers to implement the treatment plan
C Reach a common goal through team meetings and go beyond their respective disciplines
D Define goals in a minimum amount of time
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Which of the following medications would be MOST likely to cause male ejaculation and impotence problems?
A Warfarin (Coumadin)
B Docusate sodium (Colace)
C Lansoprazole (Prevacid)
D Chlorothiazide (Hygroton)
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Which nursing theorist views health as a value-laden term imposed by society?
A Dorothea Orem
B Martha Rogers
C Imogene King
D Lydia Hall
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The major focus of King's nursing theory is which of the following?
A The practice of activities that people initiate and perform on their own behalf
B Goal attainment through interaction
C Holistic biopsychosocial adaptation
D Relationship and reaction to stressors and regenerative factors
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Which ethical principle is exemplified by the rehabilitation nurse who spends numerous hours in the preparation of a teaching plan for the patient and future family caregivers?
A Utility
B Justice
C Fidelity
D Beneficence
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What is an IMPORTANT condition that MUST be present for a team to be successful?
A A commitment to a common purpose and specific goals
B A focus on individual effort and performance
C A basic level of problem solving skills
D A high level of formal compliance by team members
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Which member of the rehabilitation team has the PRIMARY responsibility for assisting patients in gaining skills for community reentry?
A Case manager
B Speech therapist
C Recreational therapist
D Music therapist
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What is involved in the planning and implementation process for patient community re-entry?
A Coordinating and securing community resources
B Prescribing medication
C Delivering homecare equipment
D Providing transportation
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What should be emphasized when assessing whether an elderly person can be safely discharged to the home environment?
A Ability to pay for on-going medical care
B Specific diagnosis
C Relationship with his or her spouse
D Functional abilities
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In which rehabilitation team model is communication more vertical than lateral, with the leader controlling team conferences?
A Medical model
B Multidisciplinary model
C Interdisciplinary model
D Transdisciplinary model
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Self-efficacy is an important concept in relation to changing health behaviors. Which of the following statements BEST describes self-efficacy?
A The feelings one has about his or her physical self.
B The amount of ambition a person has.
C The degree to which someone has met his or her life goals.
D The degree of confidence a person has about his or her ability to perform a specific activity.
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One lump sum payment made to the provider for each patient's treatment during a month or year is referred to as which one of the following?
A Prospective payment
B Fee-for-service reimbursement
C Episode-of-illness reimbursement
D Capitation payment
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Parenting a child with a disability can be a difficult balancing act. Failure of parents to set appropriate limits for children 1 to 4 years of age with special needs may interfere with which age appropriate developmental task?
A Socialization
B Physical autonomy
C Impulse control
D Emotional autonomy
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In which of the following health care delivery models does a health maintenance organization (HMO) contract with more than one physician group practice to provide services?
A Group model
B Independent Practice Association (IPA) model
C Network model
D Staff model
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The Americans with Disabilities Act of 1990 is an expansion of which previous law?
A The Public Access Act of 1979
B The Rehabilitation Act of 1973
C The Housing and Community Development Act of 1974
D The Urban Mass Transportation Act of 1964
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What should the rehabilitation nurse do to assure that a patient with rheumatoid arthritis who lives alone receives adequate nutrition?
A Encourage the patient to order fast foods that can be delivered
B Encourage the patient to transfer to a skilled nursing facility where meals are prepared by others
C Discourage any non medical remedies for the rheumatoid arthritis
D Coordinate an occupational therapy visit to provide strategies for joint protection during meal preparation and cleanup
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Who is responsible for developing, implementing, documenting and evaluating the treatment plan?
A Nurse
B Physician
C Social worker
D Interdisciplinary team
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Communicating physically (caressing, stroking, kissing, and coitus) and emotionally (feeling valued, needed, cared about and experiencing trust in another) expresses which sexual "need" between two human beings?
A Intimacy
B Libido
C Affection
D Romance
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Which of the following initiatives below was developed by Medicare to reimburse physicians under the Omnibus Budget Reconciliation Act of 1989 (OBRA-89)?
A Prospective reimbursement
B Cost-plus reimbursement
C Resource-based relative value reimbursement
D Fee-for-service reimbursement
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The Vice President for Nursing has requested a study to compare the costs of acute rehabilitation nursing services and the same services provided in a sub-acute facility. There is no data related to patient outcomes, so which analysis might be beneficial?
A Cost-identification
B Cost-benefit
C Cost-effectiveness
D Cost-utility
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Which of the following attributes or traits is a characteristic of a change-resilient person?
A Avoidance
B Distancing
C Cynicism
D Self-discipline
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Which member of the rehabilitation team assists with functional restoration?
A Physical therapist
B Occupational therapist
C Recreation therapist
D Teacher
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What is the ideal time to involve the external case manager?
A Onset of the disability
B Transfer to acute rehabilitation
C Admission to a sub - acute facility
D Discharge to home
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When faced with an ethical dilemma what must the rehabilitation nurse do FIRST?
A Determine the moral standards that apply to the situation
B Assess her or his own personal values
C Identify several alternative solutions
D Consult with colleagues about the cause of the dilemma
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Which of the following ascending spinal cord tracts is responsible for transmitting pain and temperature sensations?
A The anterior spinocerebellar tract
B The lateral spinothalamic tract
C The posterior columns
D The anterior spinothalamic tract
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