Patient Care Coordination and Education practice questions

Answer: A) Once every flu season, because the recommendation includes healthy adults

CDC recommends a flu vaccine every season for everyone 6 months and older, with rare exceptions, including healthy adults. The recommendation is not limited to older adults, health care workers or people with chronic conditions.

• ACorrect. CDC recommends a flu vaccine every season for everyone 6 months and older, with rare exceptions. That includes healthy adults without chronic conditions.
• BIncorrect. Adults 65 and older are at higher risk and have preferred vaccine types, but the annual recommendation is not limited to them.
• CIncorrect. CDC recommends vaccination every season. Flu vaccines are updated each season to match the viruses expected to circulate.
• DIncorrect. Health care workers and close contacts of high-risk people are encouraged to get vaccinated, but the annual recommendation also covers healthy adults outside these groups.

Answer: B) A patient recovering from hip replacement for whom leaving the house takes considerable, taxing effort and who needs wound care

Home health care brings services into the home of a patient, such as someone recovering from surgery, who can't leave home without considerable and taxing effort and who needs intermittent skilled care. Patients who can travel easily belong in the office, and an emergency needs EMS.

• AIncorrect. This patient can easily leave home, and routine blood pressure checks can be done at an office visit. Home health care isn't needed.
• BCorrect. Home health care is meant for patients recovering from surgery or illness who normally can't leave home without considerable and taxing effort and who need intermittent skilled services, such as nursing care for a wound.
• CIncorrect. These symptoms suggest an emergency. The patient needs emergency medical services right away, not a home health referral.
• DIncorrect. This patient leaves home without difficulty and needs only one follow-up exam in the office. Home health care isn't needed.

Answer: C) As one dose during every pregnancy, preferably early in gestational weeks 27 through 36

CDC recommends one Tdap dose in every pregnancy, preferably during the early part of gestational weeks 27 through 36, so protective antibodies reach the newborn.

• AIncorrect. CDC recommends Tdap during pregnancy so that maternal antibodies pass to the baby before birth. A postpartum dose doesn't replace this.
• BIncorrect. CDC recommends a dose during every pregnancy, whatever the patient's earlier Tdap history.
• CCorrect. CDC recommends a single Tdap dose during every pregnancy, preferably during the early part of gestational weeks 27 through 36, to help protect the newborn from pertussis.
• DIncorrect. A dose in every pregnancy is right, but the preferred timing is early in weeks 27 through 36, not the first trimester.

Answer: A) A CDC-recognized yearlong lifestyle change program through the National DPP

People with prediabetes should be referred to a CDC-recognized National DPP lifestyle change program. This yearlong program builds healthy habits and cuts type 2 diabetes risk in half.

• ACorrect. The National Diabetes Prevention Program's lifestyle change program is designed for people with prediabetes. CDC says it is proven to cut type 2 diabetes risk in half.
• BIncorrect. Self-management education on insulin use is for people already diagnosed with diabetes who need it. A patient with prediabetes needs lifestyle change to prevent or delay type 2 diabetes.
• CIncorrect. A specialist referral for diabetic complications is premature for prediabetes. First-line management is lifestyle change.
• DIncorrect. Surgery is not the first-line step for prediabetes. CDC promotes the structured lifestyle change program to prevent or delay type 2 diabetes.

Answer: B) To compare against the chart so omissions, duplications and interactions can be caught

An up-to-date list of all prescription and OTC drugs, vitamins and supplements allows medication reconciliation. Comparing it with the chart helps catch omissions, duplicates and interactions.

• AIncorrect. Coverage questions may come up, but the list is mainly a safety tool. Many items on it, such as OTC products and supplements, aren't billed to insurance at all.
• BCorrect. This is medication reconciliation: checking the patient's current list against the record to find missing items, duplicates and possible interactions, which helps prevent errors.
• CIncorrect. The list is meant to be reviewed, not used to refill everything automatically. The provider still decides whether each drug should be continued, changed or stopped.
• DIncorrect. Transferring prescriptions is a pharmacy process that doesn't depend on the patient bringing a list to the provider. The list's purpose at the visit is safe, accurate care.

Answer: C) Adult day care

• AIncorrect. Physical therapy is a clinical service.
• BIncorrect. Chemotherapy is clinical treatment.
• CCorrect. Adult day care provides supervision and social support, not medical treatment.
• DIncorrect. Surgery is clinical treatment.

Answer: A) After confirming the patient was seen and the specialist's report reached the referring provider

A referral loop is closed only when the referred visit is confirmed and the specialist's report gets back to the referring provider. Earlier steps like sending, scheduling or authorizing the referral leave it open.

• ACorrect. Closing the referral loop means the referring clinician receives the specialist's report (or notice that the patient did not attend). This lets the provider act on new findings, as reflected in the CMS 'Closing the Referral Loop: Receipt of Specialist Report' measure.
• BIncorrect. Sending the referral only starts the process. Many referrals are never completed, so the referral must be tracked until the outcome is known.
• CIncorrect. A scheduled appointment does not mean the patient attended or that findings were sent back. The loop stays open until the report is received.
• DIncorrect. Authorization is an administrative step that comes before the visit. It does not confirm that the care happened or that results were sent back to the referring provider.

Answer: C) A lactation consultant to help with positioning and latch technique

Latch problems and early nipple soreness are breastfeeding technique issues, and a lactation consultant is the specialist for them. Signs of infection such as fever or a red, hot area would call for the provider instead.

• AIncorrect. A dietitian can advise on nutrition, but the problem here is the baby's latch and feeding technique, not the mother's diet. Diet changes won't fix a poor latch.
• BIncorrect. Nothing here suggests a hormonal disorder. Latch trouble and nipple soreness in the first week usually come from positioning and technique, which an endocrinologist does not handle.
• CCorrect. A lactation consultant is a breastfeeding expert who teaches mother and baby how to breastfeed. MedlinePlus notes that getting help with a proper latch right away can help nipple soreness go away faster.
• DIncorrect. The soreness comes from poor latch and positioning, not a primary skin disease. Fixing the latch addresses the cause, so a dermatology referral is not the right first step.

Answer: A) Sit quietly for 5 minutes, arm supported at heart level

• ACorrect. This improves accuracy.
• BIncorrect. Rest first.
• CIncorrect. Keep it at heart level.
• DIncorrect. Talking can raise readings.

Answer: B) MyPlate

• AIncorrect. That's a depression screen.
• BCorrect. It shows proportions of food groups.
• CIncorrect. That's a vision test.
• DIncorrect. That's for breathing.