Chapter 25
Question 1
Which statement is true regarding potential liability issues for telehealth?
1. Malpractice costs may be decreased because lawsuits may be filed in multiple locations,
defraying costs.
2. Misinterpretation of advice provided over the telephone may cause the health care provider
to be liable for poor outcomes.
3. Telehealth services may be used in the place of any face-to-face physical examination with
the same results.
4. A nurse practitioner licensed in Wyoming may provide advice to a client in Montana
without legal repercussions.
Correct Answer: 2
Rationale 1:
Misinterpretation of advice provided over the telephone may cause the health care provider to
be liable for poor outcomes. Malpractice costs may actually be increased by an increased
number of lawsuits. Liability costs may increase if health care professionals can be sued in
more than one jurisdiction.
Rationale 2:
Major issues for nurses include questions of liability when information provided over the
telephone is misinterpreted. Any time information is misinterpreted, a liability issue exists, no
matter from which source.
Rationale 3:
Misinterpretation of advice provided over the telephone may cause the health care provider to
be liable for poor outcomes. Telehealth services should supplement and not replace hands-on
assessments by health care providers.
Rationale 4:
Misinterpretation of advice provided over the telephone may cause the health care provider to
be liable for poor outcomes. Professionals who practice across state lines deal with different
practice provisions in each state and may be subject to malpractice lawsuits in multiple
jurisdictions, raising questions about how that liability might be distributed or which state's
practice standards would apply.
Question 2
Which telehealth transmission service is best when eight MRI scans must be sent to the
consultant in a tertiary facility?
1. Switched Multimegabit Data Services (T1 line)
2. Integrated Services Digital Network (ISDN)
3. Asynchronous Transfer Mode (ATM)
4. Digital subscriber line (DSL)
Correct Answer: 3
Rationale 1:
ATM service is a high-speed data transmission link that can carry large amounts of data
quickly. Speeds range from 0.45 megabits per second (Mbps) to 2.48 gigabits per second
(Gbps). ATM works well when large sets of data, such as MRIs, need to be exchanged and
discussed. T1 lines are high-speed telephone lines that may be used to transmit high-quality,
full-motion video. T1 is not appropriate for quickly carrying such large amounts of MRI scan
data.
Rationale 2:
ATM service is a high-speed data transmission link that can carry large amounts of data
quickly. Speeds range from 0.45 megabits per second (Mbps) to 2.48 gigabits per second
(Gbps). ATM works well when large sets of data, such as MRIs, need to be exchanged and
discussed. ISDN is not appropriate for quickly carrying such large amounts of MRI scan data.
Rationale 3:
ATM service is a high-speed data transmission link that can carry large amounts of data
quickly. Speeds range from 0.45 megabits per second (Mbps) to 2.48 gigabits per second
(Gbps). ATM works well when large sets of data, such as MRIs, need to be exchanged and
discussed.
Rationale 4:
ATM service is a high-speed data transmission link that can carry large amounts of data
quickly. Speeds range from 0.45 megabits per second (Mbps) to 2.48 gigabits per second
(Gbps). ATM works well when large sets of data, such as MRIs, need to be exchanged and
discussed. DSL is not appropriate for quickly carrying such large amounts of MRI scan data.
Question 3
Which situation best fits the use of a telehealth delivery system?
1. Chronic congestive heart failure clients are assessed in rural clinics using
telecommunication technology, and are given instructions on how to best manage their care.
2. Clients may sign up with a telehealth provider, who provides the client with health
promotion information and activities.
3. Continuing education courses for health care professionals are provided to the education
department of acute-care institutions for continuing education credits.
4. A physician consultant receives an x-ray, CT scan, and EKG via the telecommunication
network to manage the care of a client with congestive heart failure and diabetes.
Correct Answer: 1
Rationale 1:
The chronic congestive heart failure situation best fits the use of a telehealth delivery system.
Telehealth utilizes telecommunication technologies and computers to exchange health care
information and to provide services to clients at another location. Telehealth services include
health promotion, disease prevention, diagnosis, consultation, education, and therapy.
Rationale 2:
Telehealth utilizes telecommunication technologies and computers to exchange health care
information and to provide services to clients at another location. Telehealth services include
health promotion, disease prevention, diagnosis, consultation, education, and therapy.
Rationale 3:
The chronic congestive heart failure situation best fits the use of a telehealth delivery system.
Telehealth utilizes telecommunication technologies and computers to exchange health care
information and to provide services to clients at another location. Telehealth services include
health promotion, disease prevention, diagnosis, consultation, education, and therapy.
Rationale 4:
Telehealth services include health promotion, disease prevention, diagnosis, consultation,
education, and therapy. The chronic congestive heart failure situation best fits the use of a
telehealth delivery system. Telehealth utilizes telecommunication technologies and computers
to exchange health care information and to provide services to clients at another location.
Question 4
Which of the following is a disadvantage of desktop videoconferencing (DTV) for telehealth?
1. DTV may not support high-resolution, high-speed transmissions.
2. DTV requires a personal computer with a modem to function.
3. DTV uses real-time synchronous encounters for face-to-face meetings.
4. DTV is more expensive than most videoconferencing systems.
Correct Answer: 1
Rationale 1:
DTV may not support high-resolution, high-speed transmissions needed to transmit accurate
assessments for telehealth. However, DTV is less expensive, can support face-to-face (F2F)
meetings in real time, and can be used with a personal computer and modem.
Rationale 2:
Support high-resolution, high-speed transmissions needed to transmit accurate assessments
for telehealth. However, DTV is less expensive, can support face-to-face (F2F) meetings in
real time, and can be used with a personal computer and modem.
Rationale 3:
However, DTV is less expensive, can support face-to-face (F2F) meetings in real time, and
can be used with a personal computer and modem.
Rationale 4:
DTV is less expensive, can support face-to-face (F2F) meetings in real time, and can be used
with a personal computer and modem. DTV may not support high-resolution, high-speed
transmissions needed to transmit accurate assessments for telehealth.
Question 5
In which setting would telehealth be least likely to be supported by government funding?
1. A small community hospital in an urban setting in the Northeast
2. A battlefield in a third-world country for the treatment of casualties
3. A space shuttle voyage during orbit around the earth
4. A prison infirmary to care for state inmates
Correct Answer: 1
Rationale 1:
Government grant monies are least likely for a small hospital in an urban setting. Such a
hospital can quickly trade files with institutions nearby, while battlefields, space shuttles, and
prison infirmaries are further away, difficult to reach, or have problematic clients. Grant
monies for telehealth have been provided by several federal and state agencies including the
U.S. Departments of Defense, Commerce, Agriculture, Education, Justice, Health and Human
Services, Veterans Affairs, and the Department of Homeland Security.
Rationale 2:
Such a hospital can quickly trade files with institutions nearby, while battlefields, space
shuttles, and prison infirmaries are further away, difficult to reach, or have problematic
clients. Grant monies for telehealth have been provided by several federal and state agencies
including the U.S. Departments of Defense, Commerce, Agriculture, Education, Justice,
Health and Human Services, Veterans Affairs, and the Department of Homeland Security.
Rationale 3:
Grant monies for telehealth have been provided by several federal and state agencies
including the U.S. Departments of Defense, Commerce, Agriculture, Education, Justice,
Health and Human Services, Veterans Affairs, and the Department of Homeland Security.
Rationale 4:
U.S. Departments of Defense, Commerce, Agriculture, Education, Justice, Health and Human
Services, Veterans Affairs, and the Department of Homeland Security.
Question 6
Which statement is true concerning telehealth?
1. Access to care may be delayed until the proper equipment can be delivered to the client's
home.
2. Clients must travel to special on-site locations where equipment and telecommunication
devices are available.
3. Nurse practitioner services may be reduced because physicians can assess and treat clients
themselves.
4. Clients may stay within their own community to be assessed and treated, lowering
potential costs.
Correct Answer: 4
Rationale 1:
Clients may stay within their own community to be assessed and treated, lowering potential
costs. Access to care is typically improved, with time and travel savings for the client. Nurse
practitioner services may actually be extended because of physician availability as resources.
Clients may or may not have equipment at home with which they may transmit information;
but access to care would not be delayed just because the equipment had not yet been
delivered.
Rationale 2:
Access to care is typically improved, with time and travel savings for the client. Nurse
practitioner services may actually be extended because of physician availability as resources.
Clients may or may not have equipment at home with which they may transmit information;
but access to care would not be delayed just because the equipment had not yet been
delivered.
Rationale 3:
Nurse practitioner services may actually be extended because of physician availability as
resources. Clients may or may not have equipment at home with which they may transmit
information; but access to care would not be delayed just because the equipment had not yet
been delivered.
Rationale 4:
Access to care is typically improved, with time and travel savings for the client. Nurse
practitioner services may actually be extended because of physician availability as resources.
Clients may or may not have equipment at home with which they may transmit information;
but access to care would not be delayed just because the equipment had not yet been
delivered. Clients may stay within their own community to be assessed and treated, lowering
potential costs.
Question 7
Which type of client information is least suited for "store-and-forward" technology?
1. A client's biopsy sample is digitally photographed and transmitted electronically to the
pathology lab.
2. A client with increasing symptoms of heart failure is instructed to come to the clinic for a
state CXR (chest x-ray).
3. A client's EEG (electroencephalogram) and brain scan are transmitted to the consulting
surgeon to follow up a craniotomy of two months ago.
4. A client with chronic asthma comes to the clinic for a routine CXR (chest x-ray).
Correct Answer: 2
Rationale 1:
Store-and-forward technology is least suited for emergent, unstable clients, such as a heart
failure client. Store-and-forward is used to transfer digital images and data from one location
to another and is appropriate for nonemergent situations, such as the asthma client with a
routine CXR, the biopsy sample, and the follow-up EEG.
Rationale 2:
Store-and-forward is used to transfer digital images and data from one location to another and
is appropriate for nonemergent situations, such as the asthma client with a routine CXR, the
biopsy sample, and the follow-up EEG.
Rationale 3:
Technology is least suited for emergent, unstable clients, such as a heart failure client. Storeand-forward is used to transfer digital images and data from one location to another and is
appropriate for nonemergent situations, such as the asthma client with a routine CXR, the
biopsy sample, and the follow-up EEG.
Rationale 4:
Digital images and data from one location to another and is appropriate for nonemergent
situations, such as the asthma client with a routine CXR, the biopsy sample, and the followup EEG.
Question 8
Which example of an online resource is inappropriate for telehealth professionals?
1. Critical pathways and client outcomes information
2. Electronic prescriptions and medication information
3. Client electronic medical records with progress and treatment
4. Abstracts, full-text literature, and research data access
Correct Answer: 3
Rationale 1:
Client electronic medical records with progress and treatment are examples of inappropriate
online resource for telehealth professionals. Online resources are many and varied, and may
be accessed by any number of people. Client records are confidential records and must be
protected..
Rationale 2:
Electronic medical records with progress and treatment are examples of inappropriate online
resource for telehealth professionals. Online resources are many and varied, and may be
accessed by any number of people. Client records are confidential records and must be
protected..
Rationale 3:
Online resources are many and varied, and may be accessed by any number of people. Client
records are confidential records and must be protected..
Rationale 4:
Client records are confidential records and must be protected. Client electronic medical
records with progress and treatment are examples of inappropriate online resource for
telehealth professionals. Online resources are many and varied, and may be accessed by any
number of people.
Question 9
Which of these home health clients is least suited for telehealth services?
1. A 63-year-old man with a large pressure ulcer who requires daily wound assessments and
dressing
2. A 54-year-old client with congestive heart failure who is developing new onset chest pain
3. A 77-year-old client who requires glucose monitoring and daily foot ulcer assessment
4. A 49-year-old woman who is pregnant for the first time and requires fetal heart rate
monitoring
Correct Answer: 2
Rationale 1:
The client least suited for telehealth services is the one with congestive heart failure and
developing chest pain. Clients with such emergent problems should not be monitored and
treated electronically. However, stable clients who must be watched closely are potential
candidates, such as the older woman pregnant for the first time, the client with a large
pressure ulcer, and the glucose monitoring client.
Rationale 2:
It is true that least suited for telehealth services is the client with congestive heart failure and
developing chest pain. Clients with such emergent problems should not be monitored and
treated electronically. However, stable clients who must be watched closely are potential
candidates, such as the older woman pregnant for the first time, the client with a large
pressure ulcer, and the glucose monitoring client.
Rationale 3:
The client least suited for telehealth services is the one with congestive heart failure and
developing chest pain. Clients with such emergent problems should not be monitored and
treated electronically. However, stable clients who must be watched closely are potential
candidates, such as the older woman pregnant for the first time, the client with a large
pressure ulcer, and the glucose monitoring client.
Rationale 4:
Clients with such emergent problems should not be monitored and treated electronically.
However, stable clients who must be watched closely are potential candidates, such as the
older woman pregnant for the first time, the client with a large pressure ulcer, and the glucose
monitoring client.
Question 10
Which statement related to telehealth technology is correct?
1. A DTV system may be used to transmit diagnostic images for third-party consultation.
2. Because international audio and visual standards are inconsistent, there is little
international communication.
3. A frame-per-second rate of 10 provides acceptable diagnostic imagery for consultation.
4. Broad bandwidth of 384 kilobits and 30 frames per second is needed for diagnostic image
interpretation.
Correct Answer: 4
Rationale 1:
Telehealth needs a broad bandwidth of 384 kilobits and 30 frames per second (FPS) for
diagnostic image interpretation. The higher the FPS, the greater the resolution, which
provides the best imaging results. DTV systems may not be able to handle the needed
bandwidth.
Rationale 2:
The higher the FPS, the greater the resolution, which provides the best imaging results. There
is quite a lot of international communication. The United States leads in the development of
technologies that enable telehealth, but Australia, Canada, Norway, and Sweden are among
the current world leaders in the use of telehealth.
Rationale 3:
The higher the FPS, the greater the resolution, which provides the best imaging results. DTV
systems may not be able to handle the needed bandwidth. Telehealth needs a broad bandwidth
of 384 kilobits and 30 frames per second (FPS) for diagnostic image interpretation.
Rationale 4:
Broad bandwidth of 384 kilobits and 30 frames per second (FPS) for diagnostic image
interpretation. The higher the FPS, the greater the resolution, which provides the best imaging
results.
Question 11
Telenursing is the use of telecommunications and computer technology for the delivery of
nursing care. The National Council of State Boards identified advantages of authority to
practice telenursing across state lines (1996). These advantages include which of the
following?
1. Establishes legitimacy and availability to practice telenursing
2. Protects the nurse from liability when practicing across state lines without a license in the
client's state
3. Establishes the nurse's responsibility and accountability to the board of nursing
4. Provides jurisdictional authority over the discipline of telenursing in the event of unsafe
delivery
5. Provides statutory authority permitting telenursing services across borders for all of the
states
Correct Answer: 1,3,4
Rationale 1:
The advantages of interstate authority for telenursing include establishing legitimacy and
availability to practice telenursing and sets the nurse's responsibility and accountability to the
board of nursing. It provides jurisdictional authority over the discipline of telenursing in the
event that unsafe delivery becomes an issue.
Rationale 2:
There is no protection for the nurse from liability when practicing across state lines without a
license in the client's state. The advantages of interstate authority for telenursing include
establishing legitimacy and availability to practice telenursing and sets the nurse's
responsibility and accountability to the board of nursing. It provides jurisdictional authority
over the discipline of telenursing in the event that unsafe delivery becomes an issue.
Rationale 3:
The advantages of interstate authority for telenursing include establishing legitimacy and
availability to practice telenursing and sets the nurse's responsibility and accountability to the
board of nursing. It provides jurisdictional authority over the discipline of telenursing in the
event that unsafe delivery becomes an issue.
Rationale 4:
It provides jurisdictional authority over the discipline of telenursing in the event that unsafe
delivery becomes an issue.
Rationale 5:
There is no statutory authority permitting telenursing services across borders for all of the
states. The advantages of interstate authority for telenursing include establishing legitimacy
and availability to practice telenursing and sets the nurse's responsibility and accountability to
the board of nursing. It provides jurisdictional authority over the discipline of telenursing in
the event that unsafe delivery becomes an issue.
Question 12
Telehealth is a tool that allows health care professionals to do which of the following?
1. Improve the overall quality of the client's record
2. Assess and monitor clients.
3. Tackle isolation and loneliness
4. Decrease hospital visits for clients with chronic conditions
5. Extend scarce health care resources
Correct Answer: 1,2,3,4,5
Rationale 1:
Telehealth can improve the overall quality of the client's record by facilitating more accurate
and comprehensive documentation of patient encounters, assessments, interventions, and
outcomes. Through telehealth platforms, healthcare professionals can securely record and
store information related to patient consultations, follow-ups, treatment plans, and medication
management, contributing to a more complete and accessible client record.
Rationale 2:
One of the primary purposes of telehealth is to assess and monitor clients remotely.
Healthcare professionals can use telehealth technologies to conduct virtual consultations,
perform remote assessments, monitor vital signs and symptoms, review treatment progress,
and provide ongoing care management without the need for in-person visits. Telehealth
enables timely monitoring and intervention, especially for patients with chronic conditions or
those in remote or underserved areas.
Rationale 3:
Telehealth can help tackle isolation and loneliness by providing virtual connections between
patients and healthcare providers, as well as between patients and their support networks.
Virtual consultations and telehealth visits can offer opportunities for social interaction,
emotional support, and reassurance, particularly for individuals who may be isolated due to
geographic location, mobility limitations, or health conditions.
Rationale 4:
Telehealth has the potential to decrease hospital visits for clients with chronic conditions by
enabling remote monitoring, proactive management, and timely intervention. With telehealth,
patients can receive regular check-ins, medication management, and lifestyle counseling from
healthcare professionals without the need for frequent hospital visits or emergency
department admissions. This can lead to better disease management, improved adherence to
treatment plans, and reduced healthcare utilization for chronic conditions.
Rationale 5:
Telehealth can extend scarce healthcare resources by leveraging technology to deliver care
remotely, reach underserved populations, and expand access to specialized services.
Telehealth platforms enable healthcare professionals to provide consultations, assessments,
interventions, and follow-ups regardless of geographic location, helping to bridge gaps in
care delivery and overcome barriers related to distance, transportation, and provider
shortages. This extension of healthcare resources is particularly valuable in rural or remote
areas, where access to healthcare services may be limited.
Question 13
Which of the following are considered to be appropriate uses of telenursing?
1. Making follow-up calls
2. Obtaining test results
3. Checking biometric measurements
4. Advanced primary practice
5. Telephone triage
Correct Answer: 1,2,3,4,5
Rationale 1:
Making follow-up calls is an appropriate use of telenursing. Telenursing involves providing
nursing care, support, and education remotely via telecommunications technologies. Followup calls allow nurses to check on patients' progress, provide medication reminders, assess for
complications, and address any concerns or questions the patients may have after a healthcare
encounter.
Rationale 2:
Obtaining test results can be done through telenursing. Nurses can use telecommunication
technologies to access and review laboratory test results, diagnostic imaging reports, and
other medical data remotely. This allows nurses to monitor patients' health status, provide
timely feedback, and coordinate further care as needed.
Rationale 3:
Checking biometric measurements is another appropriate use of telenursing. Nurses can
remotely monitor patients' biometric data, such as blood pressure, blood glucose levels, heart
rate, and oxygen saturation, using telehealth devices and remote monitoring systems. This
allows nurses to assess patients' health status, detect changes or abnormalities, and intervene
as necessary to optimize patient outcomes.
Rationale 4:
Advanced primary practice, which typically involves comprehensive assessment, diagnosis,
treatment, and management of patients' health conditions, may not be considered an
appropriate use of telenursing alone. While telenursing can support aspects of primary care
delivery, such as follow-up care, education, and monitoring, advanced practice nursing
typically requires a higher level of clinical decision-making and direct patient interaction that
may not be feasible through remote telecommunications alone.
Rationale 5:
Telephone triage is an appropriate use of telenursing. Telenurses can assess patients'
symptoms, provide medical advice, and determine the urgency of care needed over the phone.
Telephone triage allows nurses to efficiently manage patient inquiries, prioritize care based
on clinical urgency, and provide guidance on seeking appropriate care, including referrals to
healthcare providers or emergency services as needed.
Question 14
One major barrier to telehealth was removed with the passage of the Telecommunications Act
of 1996. Which of the following was the outcome of removing this major barrier?
1. Telecommunications carriers were required to provide cost-free Internet access to those in
rural areas.
2. Telecommunications carriers must offer services to urban health providers at rates higher
than those charged in rural areas.
3. The act created the Agriculture Department's information Rural Development network.
4. Vendors of cable and telephone services were allowed to compete in each others' markets.
Correct Answer: 4
Rationale 1:
When the Telecommunications Act of 1996 allowed vendors of cable and telephone services
to compete in each others' markets, this helped to open the door to create the information
superhighway needed to provide the framework to support telehealth, removing one major
barrier. The Snowe–Rockefeller Amendment required telecommunications carriers to offer
services to rural health providers at rates comparable to those charged in urban areas (not cost
free) so that affordable health care could become available to rural residents.
Rationale 2:
The major barrier to telehealth that was removed with the passage of the Telecommunications
Act of 1996 allowed vendors of cable and telephone services to compete in each others'
markets. This helped to open the door to create the information superhighway needed to
provide the framework to support telehealth. The Snowe—Rockefeller Amendment required
telecommunications carriers to offer services to rural health providers at rates comparable to
those charged in urban areas, not higher rates for rural areas, so that affordable health care
could become available to rural residents.
Rationale 3:
Telecommunications Act of 1996 allowed vendors of cable and telephone services to compete
in each others' markets. This helped to open the door to create the information superhighway
needed to provide the framework to support telehealth. A different act, the Agriculture
Department's 1991 Rural Development Act, laid the groundwork to bring the information
superhighway to rural areas for education and telehealth purposes.
Rationale 4:
When the Telecommunications Act of 1996 allowed vendors of cable and telephone services
to compete in each others' markets, this helped to open the door to create the information
superhighway needed to provide the framework to support telehealth, removing one major
barrier. The Snowe—Rockefeller Amendment required telecommunications carriers to offer
services to rural health providers at rates comparable to those charged in urban areas so that
affordable health care could become available to rural residents. The Agriculture
Department's 1991 Rural Development Act laid the groundwork to bring the information
superhighway to rural areas for education and telehealth purposes.
Question 15
Which of the following definitions is accurate?
1. Telecare is the remote delivery of health care services into the person’s home facilitated by
communication technologies that include the use of person-centered reactive monitoring
devices.
2. Teletherapy is the use of a psychology-based website to provide therapy and counseling.
3. Telesurgery is defined as the use of technology that allows surgeons to complete surgical
procedures with electronic tools.
4. Teleprevention is defined as the use of electronic databases to analyze communicable
diseases within the community.
Correct Answer: 1
Rationale 1:
Telecare is the remote delivery of health care services into the person’s home facilitated by
communication technologies that include the use of person-centered reactive monitoring
devices.
Rationale 2:
Teletherapy is the use of interactive videoconferencing to provide therapy and counseling.
Rationale 3:
Telesurgery is defined as the use of technology that allows surgeons at a remote site to
collaborate with experts at a referral center on techniques..
Rationale 4:
Not correct Teleprevention is the use of tele-education technology to provide opportunities to
promote health.
Question 16
Standards of care reflect best practices based on research findings. Which of the following is
an example of how the incorporation of national standards of care and drug information helps
health care institutions?
1. The incorporation of national standards of care and drug information helps to identify
human errors.
2. The incorporation of national standards of care and drug information helps to eliminate
wasteful spending.
3. The incorporation of national standards of care and drug information helps to eliminate copays.
4. The incorporation of national standards of care and drug information helps to decrease
malpractice claims through adherence to standards of care.
Correct Answer: 4
Rationale 1:
The incorporation of national standards of care and drug information helps health care
institutions in the following ways:
1. Eliminates redundant efforts by individual institutions to prepare their own standards and
formularies.
2. Decreases malpractice claims through adherence to standards of care.
Rationale 2:
The incorporation of national standards of care and drug information helps health care
institutions in the following ways: Eliminates redundant efforts by individual institutions to
prepare their own standards and formularies.
Rationale 3:
Eliminates redundant efforts by individual institutions to prepare their own standards and
formularies. Decreases malpractice claims through adherence to standards of care.
Rationale 4:
Eliminates redundant efforts by individual institutions to prepare their own standards and
formularies.
Question 17
Current or future trends in home health care include which of the following?
1. Helper robots
2. Biometric measurements monitored at another site
3. E-house calls
4. Sensors to detect when a frail elderly client falls down
5. Smart homes
Correct Answer: 1,2,3,4,5
Rationale 1:
Helper robots are increasingly being utilized in home healthcare settings to assist with
various tasks such as medication reminders, household chores, and mobility assistance for
elderly or disabled individuals. These robots can enhance independence and quality of life for
individuals receiving home healthcare services.
Rationale 2:
Biometric measurements monitored at another site involve the use of telehealth and remote
monitoring technologies to track patients' vital signs, biometric data, and health status from a
centralized location. This allows healthcare providers to remotely monitor patients' health and
intervene as needed, without the need for frequent in-person visits.
Rationale 3:
E-house calls refer to virtual visits or telemedicine consultations conducted between
healthcare providers and patients in their homes using telecommunication technologies. Ehouse calls enable patients to receive medical advice, assessment, and treatment remotely,
improving access to care and reducing the need for physical travel to healthcare facilities.
Rationale 4:
Sensors to detect when a frail elderly client falls down are an example of assistive technology
used in home healthcare to enhance safety and prevent accidents. These sensors can detect
falls or changes in activity levels and alert caregivers or emergency responders, enabling
timely assistance and intervention to prevent injuries.
Rationale 5:
Smart homes integrate various technologies and sensors to automate and enhance the
functionality of residential spaces, including those used by individuals receiving home
healthcare. Smart home features such as remote monitoring, voice-activated controls, and
environmental sensors can support independent living, improve safety, and enable better
management of health conditions for individuals receiving home healthcare services.
Question 18
For over 40 years, the U.S. government played a major role in the development and
promotion of telehealth through various agencies. Which of the following was the first
telehealth service provided?
1. Telephone consultations
2. Robotics telesurgery
3. Prison inmate care
4. Telepsychiatric treatment
Correct Answer: 1
Rationale 1:
Telephone consultations were indeed the first telehealth service provided. Telehealth, in its
early stages, primarily involved telephone consultations between healthcare providers and
patients or between healthcare providers themselves. Telephone consultations allowed for
remote diagnosis, advice, and treatment recommendations, laying the foundation for later
developments in telehealth technology and services.
Rationale 2:
Robotics telesurgery, while an important advancement in telehealth, came later in the timeline
of telehealth services. It involves the use of robotic systems to perform surgical procedures
remotely under the guidance of a surgeon. Robotics telesurgery requires advanced technology
and infrastructure and was not the first telehealth service provided.
Rationale 3:
Prison inmate care, including telemedicine services for inmates, is another application of
telehealth, but it was not the first telehealth service provided. Telemedicine services for
prison inmates typically involve remote consultations with healthcare providers to address
medical needs without the need for in-person visits to healthcare facilities.
Rationale 4:
Telepsychiatric treatment, which involves delivering mental health services remotely through
telecommunication technologies, is another important aspect of telehealth. However, like
other specialized telehealth services, it was not the first telehealth service provided.
Telepsychiatric treatment emerged later as telehealth technologies advanced and mental
health needs became recognized as an important area for telehealth intervention.
Question 19
Telehealth has become an attractive tool to improve the quality of health care and save
money. Savings may be realized via which of the following measures?
1. Follow-up care is more convenient.
2. Access to care improves.
3. Physician services are provided.
4. Clients may be treated in their own community.
5. Quality of care improves.
Correct Answer: 1,2,4,5
Rationale 1:
Savings may be realized via the following measures: Clients may receive treatment in their
own community where services cost less. Improved access to care allows clients to be treated
earlier when fewer interventions are required. The services of nurse practitioners and
physician assistants are extended, offering ready accessibility to physician services.
Convenient follow-up improves continuity of care.
Rationale 2:
Clients may receive treatment in their own community where services cost less. Improved
access to care allows clients to be treated earlier when fewer interventions are required. The
services of nurse practitioners and physician assistants are extended, offering ready
accessibility to physician services. Convenient follow-up improves continuity of care.
Rationale 3:
It is the extending the services of nurse practitioners (and physician assistants) through ready
accessibility to physician services that saves costs. Savings may also be realized via the
following measures: Clients may receive treatment in their own community where services
cost less. Improved access to care allows clients to be treated earlier when fewer
interventions are required. Convenient follow-up improves continuity of care.
Rationale 4:
Savings may be realized via the following measures: Clients may receive treatment in their
own community where services cost less. Improved access to care allows clients to be treated
earlier when fewer interventions are required. The services of nurse practitioners and
physician assistants are extended, offering ready accessibility to physician services.
Convenient follow-up improves continuity of care.
Rationale 5:
The services of nurse practitioners and physician assistants are extended, offering ready
accessibility to physician services. Convenient follow-up improves continuity of care.
Question 20
Which of the following statements about telenursing is true?
1. Telenursing has been in existence for decades, using available technology to serve its
purposes.
2. The American Academy of Ambulatory Care Nursing was founded to promote nursing in
telehealth.
3. Telehealth nursing practice is not yet considered to be a subspecialty of nursing.
4. Basic telehealth nursing principles have been widely integrated into basic nursing
curricula.
Correct Answer: 1
Rationale 1:
Telenursing has indeed been in existence for decades, using available technology to serve its
purposes.
Rationale 2:
Telenursing has been in existence for decades, using available technology to serve its
purposes. It was actually the International TeleNurses Association (ITNA) that was founded
to promote and support nursing involvement in telehealth; it also serves as a resource for
nurses.
Rationale 3:
Telenursing has been in existence for decades, using available technology to serve its
purposes. Telehealth nursing practice is actually considered to be a subspecialty of nursing.
Rationale 4:
Telenursing has been in existence for decades, using available technology to serve its
purposes. It is believed that basic telehealth principles should be integrated into basic nursing
curriculum; however, this has not been widely done.
Question 21
Which of the following statements is true about telehealth?
1. Telehealth can be used to treat prisoners.
2. Telehealth should not be used to offer mental health services.
3. Telehealth is not useful in treating rural patients.
4. There are not enough funds to support telehealth.
Correct Answer: 1
Rationale 1:
A large U.S. telehealth application has been the provision of care to state inmates by the
medical branch of the University of Texas at Galveston (Brown, 2002). Other states also use
telehealth to treat prisoners, avoiding the costs and danger of transporting prisoners.
Rationale 2:
The American Psychiatric Association (2010) reports telepsychiatry is one of the most
effective ways to increase access to mental health care for rural underserved populations.
Rationale 3:
One of the uses of telehealth has been to offer health care to rural residents.
Rationale 4:
The American Recovery and Reinvestment Act of 2009 provides for billions of dollars in
stimulus funding for research, operations, and grants in the telemedicine, telehealth, and
informatics sectors. More than 24 government agencies provide grant monies to fund
telehealth, telemedicine, and health information technologies, including the U.S. Departments
of Health and Human Services, Homeland Security, Defense, Veterans Affairs, Commerce,
Agriculture, Energy, Justice, Interior, Education, Labor, State, and Transportation.
Question 22
Telenursing is defined as which of the following?
1. The synthesis of nursing and information systems
2. The synthesis of nursing and telecommunications and information technology
3. The synthesis of health care and telecommunications
4. The synthesis of nursing and communication technology
Correct Answer: 2
Rationale 1:
This statement does not accurately define telenursing. While telenursing involves the
integration of nursing with information systems, it also encompasses telecommunications and
information technology, making it broader than just the synthesis of nursing and information
systems.
Rationale 2:
This statement accurately defines telenursing as the synthesis of nursing and
telecommunications and information technology. Telenursing involves the use of
telecommunications and information technology to provide nursing care, support, education,
and consultation remotely, without the need for in-person interaction between the nurse and
the patient.
Rationale 3:
While telenursing does involve the integration of healthcare and telecommunications, this
statement does not fully capture the essence of telenursing. Telenursing specifically focuses
on nursing practice and the delivery of nursing care using telecommunications technologies,
rather than encompassing all aspects of healthcare delivery.
Rationale 4:
This statement partially defines telenursing by emphasizing the integration of nursing with
communication technology. However, telenursing also involves telecommunications and
information technology, which play crucial roles in facilitating remote nursing care and
communication between nurses and patients. Therefore, this definition is not as
comprehensive as the correct answer.
Question 23
Telehealth has caused officials concern about the privacy of information as it crosses state
lines. Which of the following statements can be considered a resolution by health care
professionals?
1. Experts have called for the discontinuation of telehealth.
2. Experts have called for the creation of standards for e-health, particularly for security and
identity management.
3. Experts have enacted a number of bills stopping the growth of telehealth.
4. Experts have called for a limit in the number of telehealth patient encounters.
Correct Answer: 2
Rationale 1:
Although telehealth should not create any greater concerns or risks to medical record privacy
than any other form of consultation, records that cross state lines are subject to HIPAA
regulations and state privacy laws. Security and confidentiality of telehealth services are
crucial to acceptance by consumers and professionals (Hildebrand, Pharow, Engelbrecht,
Blobel, Savastano, & Hovsto, 2006). For this reason experts have called for the creation of
standards for e-health, particularly for security and identity management. Nurses need to be
mindful of these issues when technicians, not bound by professional codes of ethics, are
present at telehealth sessions.
Rationale 2:
Security and confidentiality of telehealth services are crucial to acceptance by consumers and
professionals (Hildebrand, Pharow, Engelbrecht, Blobel, Savastano, & Hovsto, 2006). For
this reason experts have called for the creation of standards for e-health, particularly for
security and identity management. Nurses need to be mindful of these issues when
technicians, not bound by professional codes of ethics, are present at telehealth sessions.
Rationale 3:
For this reason experts have called for the creation of standards for e-health, particularly for
security and identity management. Nurses need to be mindful of these issues when
technicians, not bound by professional codes of ethics, are present at telehealth sessions.
Rationale 4:
Telehealth services are crucial to acceptance by consumers and professionals (Hildebrand,
Pharow, Engelbrecht, Blobel, Savastano, & Hovsto, 2006). For this reason experts have
called for the creation of standards for e-health, particularly for security and identity
management. Nurses need to be mindful of these issues when technicians, not bound by
professional codes of ethics, are present at telehealth sessions.
Question 24
Which of the following technological advances are telehealth applications?
1. Videoconferencing between client and physician
2. Transmission of diagnostic images
3. Electronic prescriptions
4. Support for caregivers
5. Voice recognition for dictation
Correct Answer: 1,2,3,4,5
Rationale 1:
Telehealth applications vary greatly. Examples include monitoring activities, diagnostic
evaluations, decision-support systems, storage and dissemination of records for diagnostic
purposes, image compression for efficient storage and retrieval, research, electronic
prescriptions, voice recognition for dictation, education of health care professionals and
consumers, and support of caregivers. Sophisticated equipment is not always necessary.
Rationale 2:
Low-tech application is a home glucose-monitoring program that uses a touch-tone telephone
to report glucose results. Desktop PCs outfitted with microphones and video cameras can
provide telehealth opportunities for applications that do not require high resolution.
Rationale 3:
Videoconferencing between physicians or health care professionals and clients and the
transmission of diagnostic images and biometric data are examples of high-tech applications.
An example of a low-tech application is a home glucose-monitoring program that uses a
touch-tone telephone to report glucose results. Desktop PCs outfitted with microphones and
video cameras can provide telehealth opportunities for applications that do not require high
resolution.
Rationale 4:
Desktop PCs outfitted with microphones and video cameras can provide telehealth
opportunities for applications that do not require high resolution.
Rationale 5:
Sophisticated equipment is not always necessary. Some applications are “high tech,” whereas
others are relatively “low tech.” Real-time videoconferencing between physicians or health
care professionals and clients and the transmission of diagnostic images and biometric data
are examples of high-tech applications. An example of a low-tech application is a home
glucose-monitoring program that uses a touch-tone telephone to report glucose results.
Desktop PCs outfitted with microphones and video cameras can provide telehealth
opportunities for applications that do not require high resolution.
Question 25
Which of the following is not considered an issue pertaining to the practice of telenursing?
1. Nurses must be certified in telehealth nursing.
2. Reimbursement has been limited in several states.
3. Liability issues
4. State board of nursing regulations
Correct Answer: 1
Rationale 1:
Currently there is no certification test for telenursing.
Rationale 2:
There are issues related to which practitioners were eligible for reimbursement and how they
were paid. Reimbursement rules were loosened with the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act of 2000 but not enough to make a significant
difference in Medicaid reimbursement or to encourage other third-party payers in the United
States to pay for telehealth services. As a result, some physicians and other providers who did
teleconsultation did not receive payment for their services. Consequently, increased client
volume at referral centers has been regarded as a means to make up for lost revenue.
Rationale 3:
Major issues for nurses include questions of liability when information provided over the
telephone is misinterpreted, when advice is given across state lines without a license in the
state where the client resides, or, particularly, when an unintentional diagnosis comes from
the use of an Internet chat room. Liability is unclear in these areas.
Rationale 4:
Regulation of telenursing practice by boards of nursing is difficult when practice crosses state
lines. Unless nurses are licensed in every state in which they practice telenursing, respective
regulatory boards are unaware of their presence. The majority of states have laws or
regulations that require licensure for telehealth practice (Reed, 2005).
Question 26
A new paradigm of care called _______________________ promises to reduce costs and
improve quality by working with clients proactively
Correct Answer: connected health
Rationale:
Connected health, a new paradigm of care, promises to reduce costs and improve quality by
working with clients proactively
Question 27
Which of the following statements about telenursing is accurate?
1. Since telenursing is a new subspecialty, standards of practice have yet to be developed.
2. Telenursing should be taught at a graduate school level.
3. The International TeleNurses Association (ITNA) published International Competencies
for Telenursing in 2007.
4. The International TeleNurses Association (ITNA) was founded in 1995 to promote and
support nursing involvement in telehealth and serve as a resource for nurses.
Correct Answer: 4
Rationale 1:
The International TeleNurses Association (ITNA) was founded in 1995 to promote and
support nursing involvement in telehealth and serve as a resource for nurses. The
International Council of Nurses (ICN) published International Competencies for Telenursing
in 2007. The ICN acknowledges the role of telenurses in addressing health system challenges.
The American Nurses Association (1999) published their Core Principles on Telehealth in
1999. These guidelines are intended to help nurses protect client privacy during the delivery
of telehealth services. The American Academy of Ambulatory Care Nursing published
Telehealth Nursing Practice Essentials in 2009, the Telehealth Nursing Practice Core Course
CD-ROM, and its fourth edition of Telehealth Nursing Practice Standards in 2007. Other
health care providers have also developed policy statements or standards of practice, and
special interest groups have formed. Telehealth nursing practice is now considered to be a
subspecialty of nursing; although Grady and Schlachta-Fairchild (2007) note that the majority
of telenurses are not certified in telemedicine, telenursing, or nursing informatics at present,
they believe that basic telehealth principles should be integrated into the basic nursing
curriculum, which may lead to certification.
Rationale 2:
The American Academy of Ambulatory Care Nursing published Telehealth Nursing Practice
Essentials in 2009, the Telehealth Nursing Practice Core Course CD-ROM, and its fourth
edition of Telehealth Nursing Practice Standards in 2007. Other health care providers have
also developed policy statements or standards of practice, and special interest groups have
formed. Telehealth nursing practice is now considered to be a subspecialty of nursing;
although Grady and Schlachta-Fairchild (2007) note that the majority of telenurses are not
certified in telemedicine, telenursing, or nursing informatics at present, they believe that basic
telehealth principles should be integrated into the basic nursing curriculum, which may lead
to certification. A recent study evaluating the feasibility of telenursing in Korea indicated a
need to identify telenursing specialties, create a business model, and develop the
infrastructure to support practice (Yun & Park, 2007).
Rationale 3:
Telehealth nursing practice is now considered to be a subspecialty of nursing; although Grady
and Schlachta-Fairchild (2007) note that the majority of telenurses are not certified in
telemedicine, telenursing, or nursing informatics at present, they believe that basic telehealth
principles should be integrated into the basic nursing curriculum, which may lead to
certification. A recent study evaluating the feasibility of telenursing in Korea indicated a need
to identify telenursing specialties, create a business model, and develop the infrastructure to
support practice (Yun & Park, 2007).
Rationale 4:
A recent study evaluating the feasibility of telenursing in Korea indicated a need to identify
telenursing specialties, create a business model, and develop the infrastructure to support
practice (Yun & Park, 2007).
Test Bank for Handbook of Informatics for Nurses and Healthcare Professionals
Toni Lee Hebda, Patricia Czar, Theresa Calderone
9780132574952, 9780132959544, 9780134711010, 9780131512627, 9780130311023, 9780805373264, 9780135205433, 9780135043943
