Adult-Gerontology Primary Care Nurse Practitioner Exam Technology & Digital Applications 4 — Questions and Answers
Question 1: An AGPCNP wants to assess a patient's digital health literacy. Which approach is MOST appropriate?
- Assume all patients under 75 are digitally literate
- Use a validated tool such as the eHEALS scale to assess comfort with online health information (Correct answer)
- Only assess literacy if the patient has a college degree
- Skip assessment if the patient owns a smartphone
Correct answer: Use a validated tool such as the eHEALS scale to assess comfort with online health information
The eHealth Literacy Scale (eHEALS) is a validated 8-item instrument that measures patients' comfort finding and using online health information.
Question 2: A practice transitions to a new EHR system. To minimize disruption to quality reporting, the AGPCNP should ensure:
- All historical data is deleted to start fresh
- Data migration includes structured fields needed for HEDIS and MIPS measure calculations (Correct answer)
- Only billing data is migrated
- Quality reporting is suspended for one year post-transition
Correct answer: Data migration includes structured fields needed for HEDIS and MIPS measure calculations
Migrating structured clinical data fields required for quality measures preserves the ability to calculate HEDIS and MIPS metrics without reporting gaps.
Question 3: Which of the following BEST describes the concept of 'patient-generated health data' (PGHD) in the context of digital health?
- Lab results generated by hospital systems
- Health data created, recorded, or gathered by patients outside the clinical setting using devices or apps (Correct answer)
- Administrative billing data submitted by providers
- Imaging studies ordered by specialists
Correct answer: Health data created, recorded, or gathered by patients outside the clinical setting using devices or apps
PGHD is health-related data created and shared by patients using personal devices, apps, or wearables outside formal clinical encounters.
Question 4: An older patient with heart failure is using a home scale that auto-transmits daily weights. A 3 lb weight gain overnight triggers an alert. The AGPCNP's FIRST action should be:
- Wait for the next scheduled appointment to address the weight gain
- Contact the patient to assess for dyspnea, edema, and medication adherence and adjust the care plan accordingly (Correct answer)
- Immediately hospitalize the patient without further assessment
- Disregard the alert if the patient has not called the office
Correct answer: Contact the patient to assess for dyspnea, edema, and medication adherence and adjust the care plan accordingly
An acute weight gain alert in heart failure requires immediate phone contact to assess for decompensation symptoms before determining the next care step.
Question 5: The AGPCNP is advising a 72-year-old on choosing a health app. Which regulatory designation provides the MOST assurance that the app meets clinical safety standards?
- App Store 'Editor's Choice' award
- FDA 510(k) clearance or De Novo authorization as a medical device software (Correct answer)
- High user rating on a consumer review platform
- Endorsement by a celebrity health influencer
Correct answer: FDA 510(k) clearance or De Novo authorization as a medical device software
FDA 510(k) clearance or De Novo authorization indicates the software has met regulatory requirements for safety and effectiveness as a medical device.
Question 6: A rural AGPCNP practice wants to use store-and-forward teledermatology to manage skin conditions in older adults. Which statement is accurate?
- Store-and-forward requires synchronous video between patient and dermatologist
- High-quality images are captured and transmitted asynchronously to a dermatologist for review without real-time interaction (Correct answer)
- Store-and-forward is prohibited by Medicare
- The consulting dermatologist must be in the same state as the patient
Correct answer: High-quality images are captured and transmitted asynchronously to a dermatologist for review without real-time interaction
Store-and-forward teledermatology involves capturing and transmitting clinical images asynchronously for specialist review, enabling access in underserved areas.
Question 7: When reviewing EHR-generated clinical quality measure reports, the AGPCNP notices the colorectal cancer screening rate appears falsely low. The MOST likely cause is:
- Patients are actually not being screened
- Screening results performed outside the system (e.g., colonoscopy at another facility) were not captured in structured fields (Correct answer)
- The measure denominator is too small
- The EHR vendor made a billing error
Correct answer: Screening results performed outside the system (e.g., colonoscopy at another facility) were not captured in structured fields
Numerator gaps in quality measures frequently reflect documentation of care performed outside the system that was not entered in structured, queryable EHR fields.
Adult-Gerontology Primary Care Nurse Practitioner Exam Technology & Digital Applications 4
An AGPCNP wants to assess a patient's digital health literacy.
Which approach is MOST appropriate?