Assess and Evaluate
40%of exam
TriageTelehealthChronic DiseaseAssessment Data
Plan and Implement
18%of exam
Professional Role
22%of exam
Education
19%of exam
Quick Facts
- Exam
- AMB-BC
- Credential
- RN-BC Ambulatory Care
- Questions
- 150 total, 125 scored
- Time
- 3 hours
- Pass
- Scaled score of 350
- Scale Range
- 100 to 500
- Format
- Computer-based at Prometric
- Level
- Post-licensure specialty
- Renewal
- Every 5 years
- Blueprint
- Current TCO, upd 2025
Triage Acuity Order
Emergent, Urgent, Non-urgent, then Self-care
Emergent: right nowUrgent: within hoursNon-urgent: within daysSelf-care: manage home
Triage vs Diagnosis
Triage
- Determines urgency level
- Assigns care disposition
- No diagnosis given
Diagnosis
- Identifies specific condition
- Provider scope typically
- Guides treatment plan
Sort urgency vs identify disease
Triage Channel Picker
- Chest pain reported→Direct to ER(Emergent)
- Fever with mild cough→Telephone advice line(Self-care guidance)
- Medication refill question→Asynchronous message reply(No visit needed)
- Wound needs assessment→Schedule in-person visit(Physical exam required)
- Chronic symptom check-in→Video telehealth visit(Synchronous encounter)
Triage Levels
- Emergent
- Immediate life threat
- Urgent
- Care within hours
- Non-urgent
- Routine scheduling appropriate
- Self-care
- Home management guidance
- Schmitt-Thompson
- Telephone triage protocols
- Callback
- Verify advice followed
Domain Weight Order
Assess 40, Role 22, Educate 19, Plan 18
Assess and Evaluate: 40%Professional Role: 22%Education: 19%Plan and Implement: 18%
Synchronous vs Asynchronous Telehealth
Synchronous
- Real-time video or audio
- Immediate two-way interaction
Asynchronous
- Store-and-forward data sent
- Reviewed at later time
Live visit vs delayed review
Telehealth Standards
- Synchronous
- Real-time video visit
- Asynchronous
- Store-and-forward data
- RPM
- Remote patient monitoring
- Informed consent
- Required before telehealth
- Licensure
- State where patient located
- Originating site
- Patient's location
Chronic Disease Management
- A1C goal
- Below 7% most adults
- BP goal
- Below 130 80 mmHg
- Treat-to-target
- Adjust to reach goal
- Self-management support
- Build patient skills
- Medication reconciliation
- Compare all sources
- Polypharmacy
- Multiple interacting medications
Assessment Data Sources
- Psychosocial assessment
- Mood support stressors
- Physical assessment
- Head-to-toe exam
- Chart review
- Verify patient history
- Patient-generated data
- Home device readings
- EBP
- Evidence-based practice
- Clinical guidelines
- Standardized care pathways
Case Management vs Coordination
Case Management
- Individual complex case oversight
- Resource-intensive long-term involvement
Care Coordination
- Broader team communication
- Smooths routine care transitions
Intensive vs routine oversight
Care Coordination Picker
- Complex multi-provider case→Assign case manager
- Missed screening identified→Proactive outreach call
- Hospital discharge pending→Warm handoff to team
- High-risk panel found→Apply risk stratification
- Community need identified→Refer to resources
Care Coordination
- Case management
- Coordinate complex care
- Warm handoff
- Direct provider-to-provider transfer
- Referral tracking
- Close the loop
- Care transitions
- Hospital to home
- Patient navigator
- Guides through system
- Community resources
- Social service links
Population Health vs Individual Care
Population Health
- Panel-level outcome tracking
- Registry-based risk identification
Individual Care
- One patient encounter
- Personalized care plan
Panel view vs person view
Population Health
- Population management
- Panel-level outcomes focus
- Registry
- Track patient cohorts
- Risk stratification
- Rank patients by acuity
- Outreach
- Proactive patient contact
- Gaps in care
- Missed screenings or labs
- Shared medical appointments
- Group visit model
Clinical Tasks
- Point-of-care testing
- Bedside lab results
- Wound care
- Dressing and debridement
- Immunization admin
- Follow vaccine schedule
- Equipment checks
- Crash cart glucometer
- Standing orders
- Protocol-driven tasks
ANCC Scaled Score
Scale 100 to 500, pass 350
Minimum: 100Passing: 350Maximum: 500
Incident Report vs RCA
Incident Report
- Documents single event
- Immediate notification required
Root Cause Analysis
- Investigates systemic cause
- Prevents future recurrence
Report event vs investigate cause
Fiscal Action Picker
- Service needs payer approval→Obtain prior authorization
- Service was performed→Apply correct CPT code
- Staffing does not match demand→Reallocate resources
- Suspect a billing error→Trigger compliance review
Scope and Standards
- Scope of practice
- What RN may do
- Delegation
- Assign to unlicensed staff
- AAACN standards
- Specialty practice benchmark
- Nurse practice act
- Legal scope authority
- Certification
- Validates specialty competence
Fiscal and Reimbursement
- Prior authorization
- Payer approval needed
- CPT coding
- Bills services rendered
- CMS
- Medicare and Medicaid rules
- Resource allocation
- Match staff to demand
- Billable services
- Reimbursable RN activities
Leadership and Quality
- Root cause analysis
- Find error source
- Near miss
- Error caught early
- Performance improvement
- PDSA cycle change
- Benchmarking
- Compare to a standard
- Mentoring
- Develop newer staff
- Peer review
- Colleague practice evaluation
Safety and Advocacy
- Incident reporting
- Document adverse events
- Disaster training
- Emergency preparedness drills
- Patient advocacy
- Voice patient needs
- Whistleblowing
- Report unsafe practice
- Advance directives
- Document care wishes
Motivational Interviewing OARS
Open questions, Affirm, Reflect, Summarize
O: open questionsA: affirmations givenR: reflective listening usedS: summarize key points
MI vs Traditional Teaching
Motivational Interviewing
- Patient-led change talk
- Explores patient ambivalence
Traditional Teaching
- Nurse-led information delivery
- Direct instruction given
Elicit change vs instruct
Education Approach Picker
- Confirm patient understanding→Use teach-back method
- Ambivalent about behavior change→Apply motivational interviewing
- Low health literacy→Give plain language materials
- Language barrier present→Use qualified interpreter
- Group topic overlap→Shared medical appointment
- Remote monitoring needed→Teach RPM device use
Teaching and Learning
- Teach-back
- Patient repeats instructions
- Readiness to learn
- Assess before teaching
- Health literacy
- Understand health information
- Learning styles
- Visual auditory kinesthetic
- E-learning
- Digital patient education
Motivational Interviewing OARS
- Open-ended questions
- Encourage patient elaboration
- Affirmations
- Reinforce patient strengths
- Reflective listening
- Mirror patient statements
- Summarizing
- Recap key points
- Change talk
- Patient voices motivation
- Ambivalence
- Mixed feelings about change
Communication Barriers
- Language barrier
- Use qualified interpreter
- Low literacy
- Use plain language
- Cultural competency
- Respect beliefs and traditions
- Sensory disability
- Adapt teaching format
- Technology barrier
- Bridge digital access gap
Common Traps
Triage vs Diagnosis
Triage sorts by urgency ≠ Diagnosis names the condition
Telephone Triage vs Telehealth Visit
Triage only screens symptoms ≠ Visit provides full assessment
Case Management vs Care Coordination
Case management is intensive oversight ≠ Coordination is routine team linking
Scaled Score vs Raw Score
Scaled score is reported ≠ Raw score stays unscaled
Pretest Items vs Scored Items
Pretest questions never count ≠ Scored items decide pass or fail
Population Health vs Individual Care
Population health tracks the panel ≠ Individual care treats one patient
Synchronous vs Asynchronous Telehealth
Synchronous happens in real time ≠ Asynchronous data reviewed later
Last Minute
- 1.Assess and Evaluate weighs 40%
- 2.Professional Role weighs 22%
- 3.Education weighs 19% of exam
- 4.Plan and Implement weighs 18%
- 5.150 questions, 125 scored
- 6.3-hour time limit total
- 7.Scaled score passes at 350
- 8.New TCO effective September 2026
- 9.Triage sorts urgency, not diagnosis
- 10.OARS drives motivational interviewing
- 11.Teach-back confirms patient understanding
- 12.Prior authorization precedes many services
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