Ambulatory Care Test Ambulatory Care Nursing 4 — Questions and Answers
Question 1: An ambulatory care nurse is preparing a patient for discharge after an outpatient procedure. The patient's adult child, who will drive the patient home, has not yet arrived. The patient reports feeling well. What is the correct action?
- Allow the patient to take a taxi home since they feel well
- Keep the patient in the recovery area until a responsible adult escort arrives (Correct answer)
- Have the patient sign an AMA form and release them
- Call the patient later that evening to ensure they arrived home safely
Correct answer: Keep the patient in the recovery area until a responsible adult escort arrives
Patients who received sedation or anesthesia must be discharged into the care of a responsible adult; feeling well does not override this safety requirement.
Question 2: Which pain scale is MOST appropriate for assessing pain in a non-verbal older adult patient in the ambulatory care setting?
- Numeric Rating Scale (NRS) 0–10
- PAINAD (Pain Assessment in Advanced Dementia) scale (Correct answer)
- Visual Analog Scale (VAS)
- Wong-Baker FACES scale
Correct answer: PAINAD (Pain Assessment in Advanced Dementia) scale
The PAINAD scale uses behavioral indicators such as breathing, vocalization, and body language to assess pain in patients who cannot self-report.
Question 3: A nurse working in an ambulatory infusion center is administering rituximab to a patient with rheumatoid arthritis. After 15 minutes, the patient develops flushing, chills, and hypotension. What is the priority intervention?
- Slow the infusion rate and administer acetaminophen
- Stop the infusion immediately, maintain IV access, and notify the provider (Correct answer)
- Administer diphenhydramine and resume the infusion at a slower rate
- Discontinue the IV line and prepare the patient for discharge
Correct answer: Stop the infusion immediately, maintain IV access, and notify the provider
These signs indicate an infusion reaction or anaphylaxis; stopping the infusion immediately while maintaining IV access allows for emergency medication delivery.
Question 4: An ambulatory care nurse receives a call from a patient who reports taking twice the prescribed dose of warfarin by mistake. The patient's last INR was 3.2. What is the nurse's best action?
- Reassure the patient that one extra dose is harmless and advise watching for bruising
- Instruct the patient to come in immediately for an INR check and assessment (Correct answer)
- Tell the patient to skip the next two scheduled doses and recheck INR in a week
- Advise the patient to take vitamin K supplements to counteract the dose
Correct answer: Instruct the patient to come in immediately for an INR check and assessment
A supratherapeutic INR combined with an accidental double dose creates significant bleeding risk; urgent assessment and INR rechecking are required.
Question 5: Which element is included in the Ambulatory Care Nursing Conceptual Framework developed by AAACN?
- Inpatient staffing ratios
- The interdependent functions of clinical nursing, care coordination, and telehealth (Correct answer)
- Hospital discharge planning protocols
- Emergency department triage algorithms
Correct answer: The interdependent functions of clinical nursing, care coordination, and telehealth
The AAACN Conceptual Framework identifies clinical nursing, care coordination and advocacy, and telehealth/technology as the three core interdependent nursing practice dimensions.
Question 6: A clinic nurse is assessing health literacy in a new patient. Which approach is most effective and least stigmatizing?
- Ask the patient to read a section of the consent form aloud
- Use the 'Newest Vital Sign' or ask 'How confident are you filling out medical forms?' screening questions (Correct answer)
- Review years of education completed in the intake form
- Observe how long it takes the patient to complete intake paperwork
Correct answer: Use the 'Newest Vital Sign' or ask 'How confident are you filling out medical forms?' screening questions
Validated screening tools like the Newest Vital Sign or a single confidence question identify low health literacy without embarrassing the patient.
Question 7: A patient with hypertension has a blood pressure of 178/106 mmHg at a routine follow-up visit in the ambulatory clinic. The patient denies symptoms. What is the nurse's priority action?
- Reschedule the patient to return in one month for a recheck
- Recheck the blood pressure in the opposite arm after the patient has rested 5 minutes, then notify the provider (Correct answer)
- Administer an extra dose of the patient's home antihypertensive immediately
- Send the patient to the emergency department without provider consultation
Correct answer: Recheck the blood pressure in the opposite arm after the patient has rested 5 minutes, then notify the provider
Confirming the reading with a repeat measurement after rest, then notifying the provider, is the evidence-based ambulatory response to an unexpectedly elevated BP before further action is taken.
Ambulatory Care Test Ambulatory Care Nursing 4
An ambulatory care nurse is preparing a patient for discharge after an outpatient procedure.
The patient's adult child, who will drive the patient home, has not yet arrived.
The patient reports feeling well.
What is the correct action?