Telephone Triage

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You must score 70% or better to pass this course. Select one answer for each question by clicking the circle at the left of your choice. To change your selection, click a different circle. Do not skip any questions.

Test Question

1. Telephone triage is defined as the safe, effective, and appropriate disposition of health-related problems by:

a. Licensed healthcare workers using electronic protocols.
b. Specially trained RNs using established protocols.
c. Trained staff using decision-tree formulas.
d. Designated healthcare professionals using special forms.

Test Question

2. The goal of telephone triage nursing is to:

a. Collect data.
b. Make nursing diagnoses.
c. Make appropriate dispositions.
d. Match symptoms patterns.

Test Question

3. Examples of typical high-risk populations include:

a. Males age 18 to 35, children, and older adults.
b. Infants, the frail elderly, and women of childbearing age.
c. Children, teenage girls, and elders.
d. Teenagers, men over 18, women of childbearing age.

Test Question

4. Three functions of nursing expertise that apply to telephone triage are:

a. Crisis intervention, communication, and consultation.
b. Helping, crisis intervention, and "presencing" (being present).
c. Helping, monitoring, and crisis intervention.
d. Critical thinking, crisis intervention, monitoring.

Test Question

5. Minimal best practices for protocols include:

a. Relevant forms, staff training, and friendly attitude.
b. Detailed lists, easy referrals, and ability to categorize.
c. Brief instructions, question/answer guidelines, and red flags.
d. Annual reviews, comprehensive coverage, and integrated forms.

Test Question

6. Two common risk management issues that are specific to telepractice are:

a. Delay of care and denial of care.
b. Denial of care and negligence.
c. Malpractice and negligence.
d. Negligence and malfeasance.

Test Question

7. The ultimate bottom line for decisions in telephone triage is which one of the following?

a. The Nurse Practice Act.
b. Protocol dispositions.
c. Professional judgment.
d. Standardized decision making.

Test Question

8. Decision support systems for protocols are designed to:

a. Remind an experienced decision maker of information once known but possibly forgotten.
b. Provide initial guidelines but defer decision making to higher levels.
c. Be strict algorithms to be followed to the letter.
d. Give staff the ability to resolve any telephone triage situation.

Test Question

9. Common pitfalls in telepractice include:

a. Inadequate talk time, insufficient history, and premature closure.
b. Leading questions, failure of protocols, or miscommunication.
c. Second-guessing callers, over-reliance on callers, and lengthy calls.
d. Failure to use protocols, Wrong Train syndrome, and snap decisions.

Test Question

10. Lephrohon and Patel identified which strategy that nurses used to make decisions?

a. Skepticism
b. References
c. Pattern recognition
d. Prioritization

Test Question

11. Because symptom presentations may be ill-structured, subtle, and novel, protocols should be:

a. Rigid algorithms.
b. Open-ended.
c. Decision-making tools.
d. Contextual.

Test Question

12. Methods to foster intuition would include which of the following?

a. Avoid fatigue, reduce sensory overload
b. Keep it simple, move cautiously
c. Work rapidly, consider every possibility
d. Follow algorithms carefully, resist change

Test Question

13. Minimum key elements to reduce uncertainty and support intuition include:

a. Adequate qualified staff, protocols, and documentation forms.
b. Electronic protocols and documentation forms.
c. Well-developed standards and training.
d. Sound abatement and adequate breaks.

Test Question

14. "Red herrings" are defined as:

a. Distractors
b. Facilitators
c. Misperceptions
d. Obstacles

Test Question

15. Rules of thumb represent a problem-solving method that is:

a. Accurate.
b. Scientific.
c. Theoretical.
d. Experience-based.

Test Question

16. The eight E's of myocardial infraction include extremes of:

a. Emotion, eating, and energy.
b. Exertion, early morning, and emotion.
c. Epigastric distress, energy, and essential hypertension.
d. Eating, early morning, and earache.

Test Question

17. In telephone triage, the nursing process is modified as follows:

a. Assessment, diagnosis, planning/intervention, evaluation
b. Assessment, provisional diagnosis, disposition, patient self-evaluation
c. Assessment, nursing diagnosis, planning/intervention, evaluation
d. Assessment, diagnosis, planning/intervention, self-evaluation

Test Question

18. The "big six"—head, abdomen, chest, respiratory, dizziness and flu—require thorough investigation because they are:

a. Associated with myocardial infarct
b. Associated with serious under-diagnosed conditions
c. Most difficult and time-consuming to evaluate
d. Most common presenting symptoms

Test Question

19. What may be the most important piece of data to obtain in addition to symptoms?

a. Age
b. Full name
c. Social Security number
d. Insurance information

Test Question

20. When assessing, resort to activities of daily living (ADLs) when:

a. The patient is not an English speaker.
b. You are unable to talk to the patient directly.
c. The patient is a poor historian.
d. Symptoms don't fit your protocols.

Test Question

21. Which of the following acronyms signifies broad categories of high-risk patients and symptoms?

a. ADL
b. PAMPER
c. SCHOLAR
d. SAVED

Test Question

22. In telephone triage, the issue of charting by inclusion or exclusion:

a. Is still controversial.
b. Should be decided by medical director.
c. Has been formally decided.
d. Is irrelevant to safe practice.

Test Question

23. The best way to begin an assessment is to elicit information by:

a. Following the order on the documentation form.
b. Utilizing SAVED, SCHOLAR, PAMPER.
c. Letting patients tell their story.
d. Implementing the protocol questions.

Test Question

24. The generic protocol is most useful when:

a. Symptoms are concrete and well defined.
b. Symptoms don't match existing protocols.
c. New staff need general training.
d. Clients need additional information.

Test Question

25. Protocols for sepsis and dehydration should always be developed for which of the following populations?

a. Adult
b. Elderly
c. Frail elderly
d. Pediatric populations

Test Question

26. Some general rules that apply to the protocols used in this course are:

a. All symptoms must be present for a "match."
b. Upgrades require the nurse to consult with a physician.
c. When in doubt, err on the side of caution.
d. You're not sick until I say you are.

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