Ambulatory Care Test Ambulatory Care Nursing 2 — Questions and Answers
Question 1: A patient calls the ambulatory care clinic reporting chest tightness and shortness of breath after starting a new ACE inhibitor. What is the nurse's priority action?
- Advise the patient to take an antacid and call back if symptoms worsen
- Instruct the patient to call 911 immediately and stop the medication (Correct answer)
- Schedule an appointment for the following week
- Tell the patient this is a normal side effect that will resolve
Correct answer: Instruct the patient to call 911 immediately and stop the medication
Angioedema is a life-threatening ACE inhibitor side effect; symptoms of throat/airway involvement require emergency services immediately.
Question 2: Which documentation element is most critical when a nurse triages a telephone call in an ambulatory care setting?
- The patient's insurance information
- The time, caller's name, chief complaint, advice given, and follow-up plan (Correct answer)
- A summary of the patient's last office visit
- The prescribing physician's contact number
Correct answer: The time, caller's name, chief complaint, advice given, and follow-up plan
Complete telephone triage documentation must capture time, caller identity, complaint, nursing advice, and disposition to ensure continuity and legal protection.
Question 3: A nurse is preparing a patient with type 2 diabetes for a colonoscopy. The patient takes metformin daily. What instruction is most important?
- Continue metformin the morning of the procedure with a sip of water
- Hold metformin 48 hours before the procedure and after until renal function is confirmed normal (Correct answer)
- Switch to insulin the day before the procedure
- Reduce the metformin dose by half for one week prior
Correct answer: Hold metformin 48 hours before the procedure and after until renal function is confirmed normal
Metformin must be held before procedures using contrast and for 48 hours after to prevent lactic acidosis if contrast-induced nephropathy occurs.
Question 4: An ambulatory care nurse is reviewing quality improvement data showing a high rate of patients not filling new prescriptions. Which intervention is most likely to improve adherence?
- Mailing reminder postcards one week after the visit
- Providing medication counseling and teach-back before the patient leaves the clinic (Correct answer)
- Calling patients one month after the visit to ask if they filled the prescription
- Asking the physician to write a second copy of the prescription
Correct answer: Providing medication counseling and teach-back before the patient leaves the clinic
Teach-back education at the point of care addresses health literacy barriers and confirms patient understanding before they leave, improving first-fill rates.
Question 5: A patient with chronic obstructive pulmonary disease (COPD) presents for a routine visit. Which finding should the ambulatory nurse prioritize reporting to the provider?
- FEV1/FVC ratio of 0.68 documented in the chart from last year
- Oxygen saturation of 87% on room air today (Correct answer)
- Pack-year history of 30 years
- Mild bilateral ankle edema consistent with prior visits
Correct answer: Oxygen saturation of 87% on room air today
An oxygen saturation of 87% indicates significant hypoxemia requiring prompt provider notification and possible intervention.
Question 6: When performing a medication reconciliation for a newly established patient in an ambulatory care clinic, which source of information is considered the gold standard?
- The medication list from the patient's previous electronic health record
- A brown-bag review where the patient brings all current medications to the visit (Correct answer)
- The pharmacy's prescription fill history
- The patient's self-reported verbal list
Correct answer: A brown-bag review where the patient brings all current medications to the visit
Brown-bag medication review allows the nurse to physically inspect all bottles, identify discrepancies, and confirm doses and adherence.
Question 7: A nurse administers an influenza vaccine to a patient who then reports feeling faint. What is the first action the nurse should take?
- Administer epinephrine 0.3 mg IM immediately
- Have the patient lie down and elevate the legs, then monitor vital signs (Correct answer)
- Call 911 before doing anything else
- Give the patient juice and crackers to raise blood sugar
Correct answer: Have the patient lie down and elevate the legs, then monitor vital signs
Vasovagal syncope is common post-vaccination; placing the patient supine with legs elevated restores cerebral perfusion and is the first intervention.
Ambulatory Care Test Ambulatory Care Nursing 2
A patient calls the ambulatory care clinic reporting chest tightness and shortness of breath after starting a new ACE inhibitor.
What is the nurse's priority action?