The Elements of Interprofessional Care domain makes up 17% of your test, accounting for 21 of the 125 scored items. You will answer questions about care coordination, discharge planning, and working with case managers to secure rehabilitation placements. Try our 4100+ practice questions to evaluate your readiness for this section.
Question 1
91 of 150. A 28-year-old patient admitted for infective endocarditis secondary to intravenous drug use is completing antibiotic therapy. The patient expresses a strong desire to attend outpatient rehabilitation.
- A) Print a list of local rehabilitation centers for the patient's review.
- B) Partner with the social worker to secure a rehabilitation program placement.✓
- C) Ask the case manager to extend the hospital stay for rehabilitation.
- D) Instruct the patient to call their insurance company after hospital discharge.
💡 Key Takeaway
Social workers coordinate complex outpatient transitions, including securing placements for substance use rehabilitation programs.
Show rationale
Coordinating outpatient substance use rehabilitation requires verifying insurance benefits, confirming bed availability, and ensuring a safe, warm handoff. Social workers excel at this type of interprofessional coordination and are crucial for securing a rehabilitation placement before the patient leaves the hospital. Printing a list of centers (A) or instructing the patient to call their insurance later (D) are passive approaches that abandon the patient at a highly vulnerable transition point, significantly increasing the risk of relapse and readmission. Asking the case manager to extend the acute hospital stay (C) is inappropriate, as acute care hospitals do not extend inpatient admissions solely to wait for outpatient rehabilitation spots; the patient must meet acute medical necessity criteria to remain admitted. The social worker ensures a seamless and supportive transition to the next level of care.
Question 2
49 of 150. An RN delegates vital signs to an experienced nursing assistant for a patient with worsening sepsis. The assistant reports an abnormal temperature but feels ignored by the RN.
- A) Reassess the vital signs personally without acknowledging the assistant's initial clinical report.
- B) Remind the assistant that interpreting vital signs falls outside their defined scope.
- C) Report the assistant to the manager for expressing dissatisfaction during patient care.
- D) Validate the assistant's prompt reporting and explain the immediate planned clinical interventions.✓
💡 Key Takeaway
Validating the contributions of unlicensed personnel fosters mutual respect and ensures critical ongoing communication.
Show rationale
Fostering a collaborative team environment includes valuing the contributions of unlicensed personnel. When an experienced nursing assistant recognizes and reports signs of worsening sepsis, validating their input reinforces mutual respect and encourages future reporting. Option A dismisses their contribution, which can lead to communication breakdowns later. Option B is condescending; while UAPs do not assess, recognizing abnormal parameters is within their training. Option C is punitive and damages team trust, discouraging the assistant from speaking up about critical patient changes in the future.
Question 3
55 of 150. A 72-year-old patient with heart failure with reduced ejection fraction is preparing for discharge. The patient has a serum creatinine of 2.4 mg/dL and reports living alone without reliable transportation. Which intervention best addresses the patient's primary readmission risks?
- A) Arrange social work consult and early transitional care follow-up.✓
- B) Provide comprehensive written materials on low-sodium diet management.
- C) Schedule physical therapy evaluation for home exercise program planning.
- D) Request dietary consult to review strict fluid restriction guidelines.
💡 Key Takeaway
Social determinants of health and renal comorbidities significantly increase heart failure readmission risk requiring care coordination.
Show rationale
The correct answer is A. The patient's primary risks involve social determinants like living alone without transportation, combined with renal impairment, which strongly predict early readmission. A social work consult and transitional care directly address these specific logistical and medical barriers. Option B is incorrect because written materials do not solve transportation or isolation issues, and health literacy is not confirmed. Option C is incorrect as physical therapy does not address the immediate systemic and social risks for readmission. Option D is incorrect because while dietary education is important, it does not mitigate the high-risk psychosocial and renal factors identified in the stem.
Question 4
70 of 150. A 72-year-old living alone is preparing for discharge after recovering from a total hip arthroplasty and is currently unable to stand for more than five minutes. Which intervention best addresses this patient's nutritional needs upon returning home?
- A) Refer to a local Meals on Wheels program.✓
- B) Arrange a daily grocery delivery service.
- C) Provide a list of community food pantries.
- D) Request a home health aide for meal prep.
💡 Key Takeaway
Meals on Wheels is the optimal resource for homebound older adults unable to safely prepare their own food.
Show rationale
This patient meets the criteria for Meals on Wheels because they are an older adult who is temporarily homebound and physically unable to stand long enough to cook. Arranging a grocery delivery service is inadequate because the patient still cannot stand to prepare the delivered food. Providing a list of food pantries is unhelpful since the patient cannot safely travel or carry groceries. Requesting a home health aide solely for meal preparation is generally not covered by insurance and represents an inappropriate use of home health resources when community nutrition programs are available.
Question 5
39 of 150. A patient with post-stroke hemiparesis is preparing for discharge from the medical-surgical unit. The patient requires moderate assistance with ADLs and consistently tolerates 3 hours of therapy daily. Which discharge destination should the nurse advocate for during the interprofessional care conference?
- A) Transfer to an acute inpatient rehabilitation facility✓
- B) Discharge to a skilled nursing facility for therapy
- C) Relocate to a long-term acute care hospital unit
- D) Arrange for home health care services with nursing
💡 Key Takeaway
Acute inpatient rehabilitation requires patients to tolerate intensive daily therapy to qualify for admission.
Show rationale
This patient is an ideal candidate for an acute inpatient rehabilitation facility because they can tolerate the strict intensive therapy requirement of at least three hours per day while needing moderate assistance. A skilled nursing facility is better suited for patients who require rehabilitation but cannot tolerate the physical demands of intensive daily therapy. A long-term acute care hospital is reserved for patients with complex medical needs like prolonged mechanical ventilation rather than primary physical rehabilitation. Home health care services would not provide the intensive multidisciplinary therapy this patient can tolerate and might be unsafe given the moderate assistance required for daily activities.
Question 6
23 of 150. A patient with right-sided hemiparesis following a stroke is cleared for a pureed diet but struggles to bring utensils to their mouth. Which interprofessional team member should the nurse consult to address this specific deficit?
- A) Consult the speech-language pathologist for swallowing.
- B) Consult the occupational therapist for adaptive tools.✓
- C) Consult the physical therapist for motor strength.
- D) Consult the registered dietitian for caloric intake.
💡 Key Takeaway
Occupational therapists specialize in fine motor skills and adaptive equipment for activities of daily living.
Show rationale
The occupational therapist is the correct choice because they focus on fine motor skills and providing adaptive tools to help patients perform activities of daily living, such as feeding themselves. Since the patient is already cleared for a pureed diet, their swallowing is safe, making the speech-language pathologist incorrect, as their role focuses on dysphagia and speech deficits. The physical therapist addresses gross motor mobility and gait, not upper extremity fine motor tasks required for feeding. The registered dietitian manages nutritional requirements and meal planning, but does not address the mechanical inability to use utensils. By consulting occupational therapy, the nurse ensures the patient regains independence in feeding despite their right-sided hemiparesis.
Question 7
48 of 150. A patient recovering from a right parietal lobe stroke exhibits left-sided visual neglect by consistently eating only from the right side of their meal tray. Which collaborative intervention is most appropriate?
- A) Rotate the meal tray so all the food is placed on the right side.
- B) Instruct the dietary aide to feed the patient entirely from the left side.
- C) Collaborate with occupational therapy to implement structured visual scanning exercises during meals.✓
- D) Request physical therapy to improve the patient's core stability and independent sitting balance.
💡 Key Takeaway
Occupational therapy addresses cognitive and perceptual deficits that interfere with activities of daily living.
Show rationale
Occupational therapy is essential for addressing perceptual deficits that impact daily tasks, and they use strategies like visual scanning to help patients overcome unilateral neglect. Simply rotating the tray (Option A) is a temporary compensatory measure that does not promote neurological rehabilitation. Having someone feed the patient (Option B) removes their independence entirely. Physical therapy (Option D) focuses on gross motor function and balance, which does not address the underlying visual-perceptual deficit causing the feeding issue.
Question 8
77 of 150. A newly graduated nurse receives an order for high-dose IV potassium for a patient with end-stage renal disease. The nurse feels intimidated by the senior nephrologist who wrote the order. Which action demonstrates appropriate interprofessional assertiveness?
- A) Administer the medication slowly while continuously monitoring the patient's cardiac rhythm.
- B) Ask another senior nurse to call the nephrologist to question the order.
- C) Hold the medication and document that the dose is unsafe for administration.
- D) Call the nephrologist to clarify the order using the SBAR communication tool.✓
💡 Key Takeaway
Structured communication tools like SBAR help nurses overcome power gradients to ensure patient safety.
Show rationale
Overcoming a power gradient requires structured, assertive communication. Option D uses SBAR to safely and professionally question an inappropriate order directly with the prescribing provider. Option A is dangerous because administering high-dose potassium to a patient with renal failure can cause fatal arrhythmias. Option B avoids personal accountability and fails to build the new nurse's communication skills. Option C is incomplete; while holding the medication is correct, failing to close the communication loop with the provider leaves the clinical issue unresolved.
Question 9
32 of 150. A patient with heart failure is discharged with a new prescription for bumetanide. The home medication list includes furosemide.
- A) Hold the discharge and contact the provider to clarify the regimen.✓
- B) Instruct the patient to alternate the two diuretics on consecutive days.
- C) Advise the patient to discontinue the furosemide and start the bumetanide.
- D) Consult the clinical pharmacist to adjust the dosage of the bumetanide.
💡 Key Takeaway
Nurses must verify therapeutic duplications with the provider rather than independently altering home medication regimens.
Show rationale
This scenario highlights a potential therapeutic duplication during transitions of care. The nurse must contact the provider to clarify the orders because nurses cannot independently discontinue a home medication without an explicit order. Advising the patient to discontinue the furosemide is outside the nurse's scope of practice, even if the duplication seems obvious. Instructing the patient to alternate the medications is unsafe and also constitutes practicing beyond the nursing scope. Consulting the pharmacist is helpful for medication information, but the pharmacist cannot adjust the dosage or discontinue the home medication without a provider's order in this context. The provider must explicitly address the discrepancy to ensure a safe discharge medication reconciliation process.
Question 10
8 of 150. A nurse is assessing a patient's complex pressure injury and is considering copying and pasting yesterday's detailed wound assessment to save time. Which action represents the safest documentation practice?
- A) Copy the previous note and leave the date unchanged to maintain historical accuracy.
- B) Copy the previous note and delete the wound measurements to save charting time.
- C) Create a new entry to accurately reflect the current condition and prevent cloning.✓
- D) Copy the previous note and add a disclaimer that the wound appears unchanged.
💡 Key Takeaway
Creating fresh documentation entries prevents cloning errors and ensures the medical record reflects the patient's current status.
Show rationale
The nurse must create a new entry based on the current assessment to ensure the medical record is accurate and to avoid cloning errors that can propagate outdated information. Option A, Option B, and Option D all rely on copying and pasting (cloning), which is a high-risk practice that compromises the integrity of the health record. Even if a wound appears unchanged, the nurse must independently document today's specific findings rather than carrying forward yesterday's data.
Question 11
33 of 150. A homeless patient with poorly controlled diabetes is preparing for discharge from the medical-surgical unit. The patient lacks transportation and cannot afford insulin. How should the case manager collaborate with the unit social worker to address these needs?
- A) The case manager provides emotional counseling while the social worker orders medications.
- B) The case manager secures permanent housing while the social worker arranges transport.
- C) The case manager teaches injection skills while the social worker buys insulin.
- D) The case manager arranges health services while the social worker explores funding.✓
💡 Key Takeaway
Case managers focus on clinical health services while social workers address psychosocial and financial barriers.
Show rationale
The correct answer is D because it accurately reflects the distinct scope of practice for both roles during interprofessional collaboration. The case manager focuses on coordinating clinical health services, such as arranging home health care for a patient with poorly controlled diabetes. Meanwhile, the social worker specializes in psychosocial and financial barriers, such as exploring funding options for insulin or addressing homelessness. Option A is incorrect because social workers do not order medications. Option B is incorrect because securing permanent housing is a complex social work task, while arranging transport is often shared but not the social worker's primary clinical role here. Option C is incorrect because teaching injection skills is the bedside nurse's duty. Understanding these boundaries ensures efficient teamwork and comprehensive patient support.
Question 12
16 of 150. A nurse is admitting an older adult with severe Alzheimer's dementia who is recovering from a hip arthroplasty. The standard post-operative joint pathway includes early ambulation and patient-controlled analgesia. Which adaptation should the nurse make to individualize this patient's care plan?
- A) Initiate the standard patient-controlled intravenous analgesia protocol.
- B) Request a scheduled around-the-clock oral analgesic regimen.✓
- C) Delay physical therapy ambulation until cognition fully clears.
- D) Provide written discharge educational materials to the patient.
💡 Key Takeaway
Standard pain management pathways must be adapted for patients with cognitive impairments to ensure safety and comfort.
Show rationale
Adapting standard pathways requires recognizing when default interventions are unsafe. A patient with severe Alzheimer's dementia cannot reliably use a patient-controlled analgesia pump, making option A dangerous. Option B is correct because a scheduled analgesic regimen ensures consistent pain control without relying on cognitive participation. Option C is incorrect as early ambulation is crucial to prevent post-operative complications and should be modified with assistance rather than delayed. Option D fails to address the cognitive barrier, as standard written materials are ineffective for severe dementia.
Question 13
25 of 150. A diaphoretic patient with Parkinson's disease is on telemetry. The central monitor alarms for ventricular fibrillation, showing a chaotic, wandering baseline. The nurse enters the room and finds the patient alert and conversing with family. Which action is most appropriate?
- A) Initiate cardiopulmonary resuscitation immediately and call a code blue.
- B) Dry the skin thoroughly and apply fresh telemetry electrodes.✓
- C) Administer a prescribed dose of intravenous amiodarone right away.
- D) Decrease the monitor sensitivity settings to filter out tremors.
💡 Key Takeaway
Clinical assessment must always validate telemetry alarms to differentiate life-threatening arrhythmias from equipment artifact.
Show rationale
When a monitor shows a lethal arrhythmia but the patient is alert and conversing, the nurse must first suspect telemetry artifact. In a diaphoretic patient with Parkinson's disease, tremors and poor electrode adhesion frequently cause wandering baselines and false alarms. Drying the skin and applying fresh electrodes directly addresses the poor adhesion. Initiating CPR or administering amiodarone is clinically inappropriate and dangerous because the patient has a pulse and is hemodynamically stable. Decreasing monitor sensitivity is unsafe because it alters the diagnostic capability of the equipment and might cause the system to miss true life-threatening arrhythmias.
Question 14
80 of 150. A patient with an acute ischemic stroke is being prepared for transfer from a rural community hospital to a comprehensive stroke center. The nurse is initiating the facility-to-facility transfer protocol.
- A) Confirm the receiving facility has an available bed and accepting physician.✓
- B) Print the complete electronic health record for the transport team to carry.
- C) Administer all scheduled daily oral medications prior to the transport team arrival.
- D) Instruct the patient family to drive separately to the receiving facility immediately.
💡 Key Takeaway
Confirming receiving facility capability and provider acceptance is legally required before initiating transfer.
Show rationale
Under EMTALA and standard transfer protocols, the sending facility must ensure the receiving facility has the capability, an available bed, and an accepting provider before transferring an acute patient. Option A addresses this critical facility-to-facility transfer requirement. Option B is incorrect because only relevant documents are typically sent to avoid information overload for the receiving team. Option C is inappropriate as administering all oral medications might delay transfer or cause adverse events en route. Option D is a psychosocial action that does not address the primary regulatory and safety requirement for an acute ischemic stroke transfer.
Question 15
57 of 150. A patient admitted with acute severe pancreatitis reports tingling around the mouth and spasms in the hand while a blood pressure is being taken. Which action should the nurse take next?
- A) Check the patient for a positive Chvostek sign.✓
- B) Prepare to administer a prescribed intravenous potassium dose.
- C) Assess the patient for signs of alcohol withdrawal.
- D) Request a stat order for a brain scan.
💡 Key Takeaway
Perioral tingling and carpopedal spasms in pancreatitis are early cues of severe hypocalcemia requiring immediate assessment.
Show rationale
Severe pancreatitis can cause calcium to bind with fatty acids in areas of fat necrosis, leading to abrupt hypocalcemia. The tingling and hand spasms, which represent Trousseau's sign when triggered by a blood pressure cuff, are classic cues. Option A is correct because checking for a Chvostek sign further validates the presence of neuromuscular irritability related to low calcium. Option B is incorrect because the cues point to calcium deficiency, not potassium deficiency. Option C is a near-miss distractor; while alcohol abuse can cause pancreatitis and withdrawal causes tremors, specific perioral tingling and carpopedal spasms are unique to hypocalcemia. Option D inappropriately suspects a primary neurological event.