Six Months Ago Flashcards, test questions and answers

Question 1

A client is in the family practice clinic. Today the client weighs 186.4 pounds (84.7 kg). Six months ago the client weighed 211.8 pounds (96.2 kg). What action by the nurse is best?

Answer

Ask the client if the weight loss was intentional. This client has had a 12% weight loss. The nurse first determines if the weight loss was intentional. If not, then the nurse proceeds to a comprehensive nutritional assessment. Food intolerances are part of this assessment. Depending on risk factors and other findings, a blood glucose test may be warranted.
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Question 2

The patient has a low-grade carcinoma on the left lateral aspect of the prostate gland and has been on “watchful waiting” status for 5 years. Six months ago his last prostate-specific antigen (PSA) level was 5 ng/mL. Which manifestations now indicate that the prostate cancer may be growing and he needs a change in his care (select all that apply)? A. Casts in his urine B. Presence of α-fetoprotein C. Serum PSA level 10 ng/mL D. Onset of erectile dysfunction E. Nodularity of the prostate gland

Answer

C. Serum PSA level 10 ng/mL E. Nodularity of the prostate gland The manifestations of increased PSA level along with the new nodularity of the prostate gland potentially indicate that the tumor may be growing. Casts in the urine, presence of α-fetoprotein, and new onset of erectile dysfunction do not indicate prostate cancer growth.
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Question 3

An adult experienced a myocardial infarction six months ago. At a follow-up visit, this adult says, “I haven’t had much interest in sex since my heart attack. I finished my rehabilitation program, but having sex strains my heart. I don’t know if my heart is strong enough.” Which nursing diagnosis applies? a. Deficient knowledge related to faulty perception of health status b. Disturbed self-concept related to required lifestyle changes c. Disturbed body image related to treatment side effects d. Sexual dysfunction related to self-esteem disturbance

Answer

ANS: A Patients who have had a myocardial infarction often believe sexual intercourse will cause another heart attack. The patient has completed the rehabilitation, but education is needed regarding sexual activity. These patients should receive information about when sexual activity may begin, positions that conserve energy, and so forth. The scenario does not suggest self-concept or body image disturbance.
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Question 4

A patient, who six months ago had a drug eluting stent placed in his right coronary artery, needs to be scheduled for an elective non-cardiac surgery. Which of the following is TRUE regarding the best management of such a patient? a. Aspirin should be stopped perioperatively b. Clopidogrel should be stopped perioperatively c. The surgery should proceed as soon as possible, continuing both aspirin and clopidogrel d. The surgery should be delayed if possible and aspirin and clopidogrel continued for at least one year prior to surgery. e. Aspirin and clopidogrel should be taken for at least 6 weeks following stent placement, and this patient can be operated on at any time since it has been six months.

Answer

D. Patients who have had a drug eluting stent placed should wait at least a year prior to having an elective surgery, and should be on aspirin and clopidogrel (Plavix) during that time. Patients who have had a bare metal stent placed should wait at least 6 weeks before undergoing an elective procedure and should be on aspirin and clopidogrel during this time. For balloon angioplasty without stent placement, a patient should wait 2 weeks and be on aspirin and clopidogrel during this time. Aspirin should be continued perioperatively in any patient with a coronary artery stent regardless of how long ago it was placed (again, unless the surgery being done dictates it be stopped – spinal or intracranial surgery). Plavix should not be stopped perioperatively during the time periods listed above, even if the surgery is urgent/emergent and cannot be delayed (again, unless the surgery being done dictates it be stopped – spinal or intracranial surgery).
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Question 5

Mable and Jack file a joint return. For the current year, they had the following items: Salaries ($120,000) Loss on sale of (law – 1244) stock acquired two years ago ($105,000) Gain on sale of (law – 1244) stock acquired six months ago ($20,000) Nonbusiness bad debt ($19,000) Determine their AGI for the current year.

Answer

Salary $120,000 § 1244 ordinary loss (limit of $100,000) (100,000) Short-term capital gain on § 1244 stock $ 20,000 Short-term capital loss (nonbusiness bad debt) (19,000) Net short-term capital gain $ 1,000 Net long-term capital loss (remaining § 1244 loss) (5,000) Net capital loss (limited to $3,000; $1,000 LTCL carryover) (3,000) Adjusted gross income $ 17,000
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Question 6

10. A patient has refused to pay for a medical procedure that was performed six months ago. The medical procedure was not listed under the patient’s schedule of benefits, and she is now fully responsible for all costs. Her account has now been turned over to a collection agency. This scenario is most likely an example of failure of the medical office assistant to properly A. code the procedure. B. bill the procedure. C. explain the non-coverage billing policies. D. explain the statute of limitations. Submit My Response

Answer

Explain the non-coverage billing policies. Making sure that the office has a policy in place to let your patients know what you expect of them and what they can expect of you. A well-crafted policy will prevent patients from being surprised about their financial obligation when they receive billing for your services. It will also give your practice some legal protection should a patient fail to pay what you are entitled to collect. The policy should be tailored to the medical office policy and practice. Being up front with the patients prevents future error or misunderstandings.
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