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덤프는 구체적인 업데이트주기가 존재하지 않습니다. 하지만 저희는 수시로 Nursing ACNS 시험문제 변경을 체크하여Nursing ACNS덤프를 가장 최신버전으로 업데이트하도록 최선을 다하고 있습니다. Nursing ACNS덤프를 구매하면 1년간 업데이트될떼마다 최신버전을 구매시 사용한 메일로 전송해드립니다.
| Section | Objectives |
|---|---|
| Clinical Judgment and Advanced Practice Nursing | - Comprehensive health assessment and differential diagnosis
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| Evidence-Based Practice and Research | - Translation of research into clinical practice
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| Systems Leadership and Quality Improvement | - Healthcare systems improvement
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| Patient and Family Outcomes Management | - Care coordination and chronic disease management
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| Professional Role Development | - Advanced practice nursing roles and ethics
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Nursing ACNS인증시험을 패스하고 자격증 취득으로 하여 여러분의 인생은 많은 인생역전이 이루어질 것입니다. 회사, 생활에서는 물론 많은 업그레이드가 있을 것입니다. 하지만ACNS시험은Nursing인증의 아주 중요한 시험으로서ACNS시험패스는 쉬운 것도 아닙니다.
질문 # 123
When counseling concerning the hepatitis B vaccination, the ACCRN understands that a contraindication is:
정답：B
설명：
When counseling about the hepatitis B vaccination, it is crucial for healthcare providers, such as those accredited by the American College of Clinical Pharmacy (ACCRN), to be aware of the specific contraindications to vaccination. One significant contraindication is a history of prior anaphylaxis or severe hypersensitivity to any component of the hepatitis B vaccine.
Anaphylaxis is a severe, potentially life-threatening allergic reaction that can occur very quickly after exposure to an allergen. Symptoms may include difficulty breathing, a rapid drop in blood pressure, and skin reactions such as hives or swelling. Given the serious nature of anaphylaxis, any individual who has previously experienced this kind of reaction to the hepatitis B vaccine, or any of its components, should not receive the vaccination. This precaution helps to prevent the risk of triggering another anaphylactic event.
Severe hypersensitivity reactions, though not always as acute or severe as anaphylaxis, are also critical to consider. These reactions can include various symptoms that significantly impair the individual and may pose a health threat if re-exposure occurs. For patients with a known severe hypersensitivity to the vaccine, alternative preventive measures should be considered.
It is important to note that other situations such as a history of poliomyelitis, mild viral illnesses, or conditions like pregnancy and lactation are not contraindications for the hepatitis B vaccine. While each patient's situation should be evaluated individually, these conditions generally do not preclude the use of the hepatitis B vaccine.
In summary, recognizing the history of prior anaphylaxis or severe hypersensitivity to the hepatitis B vaccine or its components is crucial in vaccine counseling. This understanding ensures that the vaccine is administered safely and effectively, adhering to the principle of "do no harm" in medical practice.
질문 # 124
You are providing care to a patient who has undergone heart surgery. He will be discharged soon. Which of the following is NOT appropriate patient education regarding wound care for this patient?
정답：B
설명：
The correct answer for the question on what is NOT appropriate patient education regarding wound care for a patient who has undergone heart surgery is: "Some redness, oozing, and swelling around the incision will be normal." This statement is incorrect because any redness, oozing, or swelling around a surgical incision is potentially indicative of an infection or other complications that should be promptly assessed by a healthcare provider. It is essential to educate patients and their caregivers to recognize these signs early and seek medical advice, rather than assuming they are normal post-surgical reactions.
Post-operative wound care is crucial for the prevention of infection and ensuring proper healing of the surgical site. The key points of proper care should include keeping the incision clean and dry, regularly changing dressings as instructed by the healthcare provider, and monitoring the wound for any signs of infection. These signs can include increased redness, swelling, warmth around the incision, pus or other discharge, worsening pain, or fever.
Instructing a patient to wash the incision with warm water and plain soap can be appropriate if advised by their healthcare provider. However, it is important to follow specific instructions regarding how often to clean the incision and what products to use, as harsh chemicals can irritate the wound.
Furthermore, advising the patient to keep the incision clean and dry is typically appropriate advice, as moisture can be a breeding ground for bacteria that may lead to infection.
In summary, it is not appropriate to educate the patient that some redness, oozing, and swelling around the incision will be normal after heart surgery. Instead, patients should be informed that these are signs of possible complications and should prompt immediate contact with their healthcare provider. Proper wound care education is essential to prevent infection and promote healing following surgery.
질문 # 125
Tight, aching, or squeezing pain in the legs and buttocks, which worsens with exercise and is relieved by rest, is known as what?
정답：D
설명：
The correct answer to the question regarding tight, aching, or squeezing pain in the legs and buttocks that worsens with exercise and is alleviated by rest is "Intermittent claudication." This condition is symptomatic of Peripheral Arterial Disease (PAD), a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. When walking or exercising, the muscles in the legs require increased blood flow. If the arteries are narrowed or blocked, these muscles do not receive enough blood, which leads to the characteristic pain of intermittent claudication.
Intermittent claudication typically manifests as muscle pain, cramping, or fatigue in the legs or arms that starts during exercise and stops with rest. The discomfort is often felt in the calf but can occur in the buttocks, thighs, or feet depending on the location of the arterial blockage. The severity of the condition can vary; in mild cases, it might only be noticeable when walking uphill or at a brisk pace, while in more severe cases, it could occur with very minimal activity or even at rest in advanced stages.
PAD, the underlying cause of intermittent claudication, is typically due to atherosclerosis, a buildup of fatty deposits or plaques in the arterial walls. Risk factors for PAD include smoking, diabetes, obesity, high blood pressure, high cholesterol, aging, and a family history of vascular disease. Early diagnosis and treatment are crucial in managing PAD and alleviating symptoms like intermittent claudication.
Treatment for intermittent claudication focuses on improving symptoms and stopping the progression of PAD to avoid more serious complications. Lifestyle modifications such as quitting smoking, exercising, and managing diet are critical. Medications may be prescribed to improve blood flow and prevent blood clots. In more severe cases, procedures like angioplasty or surgery such as a femoropopliteal (fem-pop) bypass may be necessary. In a fem-pop bypass, a blood vessel from another part of the body or a synthetic vessel is used to bypass the blocked artery in the leg, helping to restore proper blood circulation.
Intermittent claudication is a significant indicator of the health of an individual's circulatory system and should not be ignored. Regular check-ups and reporting such symptoms early to a healthcare provider can lead to timely and effective management of the condition.
질문 # 126
You have agreed to participate in the Medicare health insurance program and work for a small privately owned physician office. Medicare paid 80% of the charges billed for a clinic visit when the patient was seen by the Adult Clinical Nurse Specialist. What could your employer do about the remaining 20% that is owed to the facility?
정답：D
설명：
When a Medicare beneficiary visits a healthcare provider, such as an Adult Clinical Nurse Specialist (CNS) in a small privately owned physician's office, Medicare usually covers a part of the total service cost, typically 80%. This payment model leaves a balance, often referred to as the 20% co-insurance, which is the patient's responsibility to pay. In this specific scenario, the CNS has agreed to participate in the Medicare program by accepting assignment.
Accepting assignment means that the provider agrees to accept the Medicare Approved Amount (MAA) as the total payment for their services. The MAA is a pre-determined rate that Medicare considers reasonable for a specific medical service within a specific geographical area. For participating providers, this agreement also stipulates that they cannot charge the patient more than the Medicare deductible and the 20% co-insurance. Therefore, the CNS, by agreeing to accept assignment, is bound to this pricing structure.
Since the CNS has accepted Medicare's terms, after Medicare pays its share of 80%, the facility where the CNS practices has the right and the ability to bill the patient for the remaining 20%. This is a standard practice in the healthcare industry where the patient pays a portion of the cost, ensuring that Medicare's payments and the patient's contributions together cover the total approved charge for the service.
It's important to note that if the CNS had not accepted assignment, the billing dynamics would be different. A non-participating provider can choose to accept assignment on a case-by-case basis. If they do not accept assignment, they can charge the patient more than the Medicare approved amount, up to the limiting charge, which is typically 15% over the Medicare approved amount in most states. However, in this scenario, because the CNS is a participating provider, they must adhere to the terms of assignment, thus limiting the charge to the patient to no more than the deductible and 20% co-insurance.
In summary, the facility where the Adult Clinical Nurse Specialist works, under the obligations of Medicare assignment, can and should bill the patient for the remaining 20% of the Medicare approved charge after Medicare has paid its 80% share. This process ensures that the provider is compensated for the total approved amount for their services, while also adhering to the legal and ethical standards set forth by Medicare.
질문 # 127
In Health Maintenance Organizations and Preferred Provider Organizations, providers are paid a monthly fee for each patient enrolled in their panel. What is this fee called?
정답：D
설명：
The correct term for the monthly fee paid to providers by Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs) for each patient enrolled in their panel is called a "capitation fee." This system is fundamentally different from other payment methods in healthcare, such as fee-for-service or reimbursement charges.
In a capitation model, the healthcare provider receives a set amount of money per patient per month regardless of how many times the patient visits or the type of medical care required. This payment structure is designed to encourage providers to focus on maintaining the overall health of their patients, as their income is not dependent on the number of services rendered.
Contrary to other options like "enrollment fee," "reimbursement charge," or "premium," which have different implications in healthcare finance, a capitation fee specifically relates to the payment agreement between providers and insurance networks (HMOs or PPOs). An enrollment fee might be a one-time charge when a patient joins a new service, a reimbursement charge often refers to payments made after services are rendered based on specific billing claims, and a premium is generally the amount paid by beneficiaries for health coverage, paid monthly or annually to the insurance provider.
Thus, understanding the term "capitation fee" is crucial for grasping how healthcare providers manage their financial operations and patient care strategies within the frameworks of HMOs and PPOs. This model aims to optimize healthcare outcomes by making the providers less reliant on a fee-for-service system, which can sometimes incentivize unnecessary treatments. Instead, capitation encourages providers to deliver necessary and preventive care efficiently to keep patients healthy under a fixed budget.
질문 # 128
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