Ambulatory Care Test Telehealth Nursing Practice — Questions and Answers
Question 1: A nurse in Ohio is about to give telehealth advice to a patient who is currently in Kentucky. Which factor primarily decides whether the nurse may legally practice in this encounter?
- The state where the nurse's employer is headquartered
- The state where the patient is located at the time of the encounter (Correct answer)
- The state where the nurse completed their nursing education
- The state where the patient's insurance plan is issued
Correct answer: The state where the patient is located at the time of the encounter
Under the NCSBN model, nursing practice happens where the patient is located. The nurse must hold a license that is valid in the patient's state, either a Kentucky license or a multistate Nurse Licensure Compact (NLC) privilege.
Question 2: What is the main purpose of using evidence-based, standardized protocols during telephone or virtual nursing encounters?
- To remove the need for nursing judgment
- To shorten every call to under five minutes
- To support consistent, safe decisions while still allowing nursing judgment (Correct answer)
- To let unlicensed staff perform independent triage
Correct answer: To support consistent, safe decisions while still allowing nursing judgment
Telehealth protocols give the nurse a structured, evidence-based framework that reduces variation and risk. They do not replace the RN's clinical judgment, and they do not allow unlicensed staff to perform triage on their own.
Question 3: A patient enrolled in a heart failure remote monitoring program sends a weight gain of 2.5 lb overnight. What should the ambulatory care nurse do first?
- Record the value and review it at the next scheduled visit
- Contact the patient to assess symptoms and follow the HF action plan (Correct answer)
- Tell the patient to stop all diuretics
- Send the patient directly to the emergency department
Correct answer: Contact the patient to assess symptoms and follow the HF action plan
A gain of more than 2 lb in a day (or 5 lb in a week) is a common heart failure alert threshold. The nurse should assess the patient promptly, checking for dyspnea and edema, and then act on the action plan or escalate. Waiting until the next visit wastes the benefit of remote monitoring, and sending the patient to the ED without an assessment skips a step.
Question 4: Which practice best protects patient privacy during a video visit?
- Using any free consumer video app the patient prefers
- Confirming patient identity and using a secure, HIPAA-compliant platform from a private location (Correct answer)
- Recording every visit by default without telling the patient
- Holding visits in an open shared workspace so colleagues can help
Correct answer: Confirming patient identity and using a secure, HIPAA-compliant platform from a private location
Telehealth privacy requires verifying the patient's identity, using a secure platform covered by a Business Associate Agreement, and making sure both ends of the call are private.
Question 5: During a telephone encounter, which approach best compensates for the nurse's inability to see the patient?
- Asking only yes/no questions to save time
- Using open-ended questions and asking the patient or caregiver to describe or measure findings (Correct answer)
- Relying on the chart history instead of current symptoms
- Giving the patient a diagnosis early so the call stays focused
Correct answer: Using open-ended questions and asking the patient or caregiver to describe or measure findings
Without visual cues, nurses gather data through open-ended questions, active listening, and guided self-assessment, such as asking the patient to take their temperature, describe a rash, or count respirations.
Question 6: Which documentation element is essential for every telehealth nursing encounter?
- The patient's favorite pharmacy only
- The modality used, patient location, assessment, protocol followed, advice given, and the patient's understanding (Correct answer)
- Only the final disposition
- A full transcript of the conversation
Correct answer: The modality used, patient location, assessment, protocol followed, advice given, and the patient's understanding
Complete telehealth documentation records the modality, the patient's location (needed for licensure), the assessment, the protocol used, the advice and disposition, and confirmation that the patient understood (for example, by teach-back). This supports continuity of care and legal defensibility.
