TESTBANK
v
,Chapter 01: Caring forMedical-Surgical Patients
v v v v v
Stromberg:Medical-Surgical Nursing:Concepts and Practice, 5thEdition
v v v v v v v
MULTIPLE CHOICE v
1. Which statement accuratelydescribes the primarypurpose of the state nurse
v v v v v v v v v v
practice act (NPA)?
v v v
a. To test and license LPN/LVNs
v v v v
b. To define the scope of LPN/LVN practice
v v v v v v
c. To improve the qualityof care provided by the LPN/LVN
v v v v v v v v v
d. Tolimitthe LPN/LVNemployment placement
v v v v v
ANS: B v
While improving quality of care provided by the LPN/LVN may be a result of
v v v v v v v v v v v v v
the NPA, the primarypurpose of the NPA of each state defines the scope of
v v v v v v v v v v v v v v
nursing practice in that state.
v v v v v
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 v v v v v
TOP: NPA
v KEY: Nursing Process Step: Implementation
v v v v v
vMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
v v v v v v v v v v v v v v v v v
nurse has not been taught during her educational program. How should the vocational nurse respond?
v v v v v v v v v v v v v v v
a. Ask a more experienced nurse to demonstrate the procedure.
v v v v v v v v
b. Lookup the procedure in the procedure manual. v v v v v v v
c. Attempt to performthe procedure with supervision. v v v v v v
d. Informthe charge nurse of her lack of trainingin thisprocedure. v v v v v v v v v v v
ANS: D v
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational
v v v v v v v v v v v v v v v v v
nurse should seek further training to gain proficiency. Although the other options might be helpful, they
v v v v v v v v v v v v v v v v
are not safe.
v v v
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 v v v v v
TOP: Providing Safe Care
v v KEY: Nursing Process Step: N/A v v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
v v v v v v v v v v v v v
should address?
v v
a. "Ihave no idea of how thisdrug will affect me."
v v v v v v v v v v
b. "Do you know if my physician is comingbacktoday?"
v v v v v v v v v
c. "Will my insurance pay for my stay?" v v v v v v
d. "Am I going to have to go to a nursinghome?" v v v v v v v v v v
ANS: A v
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
v v v v v v v v v v v v v v v v
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
v v v v v v v v v v v v v v v v
departments to which the nurse might refer the patient.
v v v v v v v v v
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 v v v v v
TOP: Teaching
v KEY: Nursing Process Step: Implementation
v v v v v
vMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts
v v v v v v v v v v v v v v v v v
in which capacity?
v v v
a. Workingunder direct supervision of an RN on the unit v v v v v v v v v
b. Working with the RNin thebuilding v v v v v v
c. Workingunder general supervision bythe RNavailable on site or byphone v v v v v v v v v v v v
d. Workingas anindependent vocational nurse v v v v v
ANS: C v
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
v v v v v v v v v v v v v v v v v v
supervision of an RN available on site or by phone.
v v v v v v v v v v
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 v v v v v
TOP: Charge Nurse/Manager
v v KEY: Nursing Process Step: N/A v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
v v v v v v v v v v v v v v v v
information should the nurse include?
v v v v v
a. Seekthe opinion of an alternate health care provider.
v v v v v v v v
b. Contactthe insurance company for coverage details asservices maybe limited.
v v v v v v v v v v v
c. Providedetailed documentation of all care received forhis condition. v v v v v v v v v
d. Wait at least 6 months to see a specialist. v v v v v v v v
ANS: B v
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups of
v v v v v v v v v v v v v v v v v
patients for a set capitation fee and by limiting services. Patients are not required to seek a second
v v v v v v v v v v v v v v v v v v
opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
v v v v v v v v v v v v v v v
DIF: Cognitive Level: Application
v v REF: p. 9 OBJ: 9 v v v v v v
TOP: Charge Nurse/Manager
v KEY: Nursing Process Step: Implementation v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
v v v v v v v v v v v v v v v v v
Which statement accurately explains a deductible?
v v v v v v
a. An amount of moneyput aside for the payment of future medical bills
v v v v v v v v v v v v
b. A one-time fee for service
v v v v
c. An amount of money deducted fromthe bill by the insurance company
v v v v v v v v v v v
d. An annual amount of moneythe patient must pay out-of-pocket for medical care
v v v v v v v v v v v v
ANS: D v
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
v v v v v v v v v v v v v v v
assuming the cost. This practice improves the profit of the insurance company.
v v v v v v v v v v v v
DIF: Cognitive Level: Comprehension
v v REF: p. 7 OBJ: 9 v v v v v v v v
TOP: Health Care Financing
v KEY: Nursing Process Step: Implementation v v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
7. Apatient asks the nurse what Medicare Part Acovers.Which response iscorrect?
v v v v v v v v v v v v v
a. Medicare Part Acovers inpatient hospital costs. v v v v v v
b. Medicare Part Acovers reimbursement to the physician. v v v v v v v
c. Medicare Part Acovers outpatient hospital services. v v v v v v
d. Medicare Part Acovers ambulance transportation. v v v v v
ANS: A v
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
v v v v v v v v v v v v v
Medicare Part B pays the physician, ambulance transport, and outpatient services.
v v v v v v v v v v v
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 v v v v v v
OBJ: 9 v TOP: Government-Sponsored Health Insurance v v v
KEY: Nursing Process Step: Implementation
v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
8. Whichisthemain cost-containment component of diagnosis-related groups(DRGs)?
v v v v v v v v v
a. Hospitalsfocus onlyon thespecificdiagnosis. v v v v v v
b. Hospitals treat and discharge patientsquickly. v v v v v
c. Reduced cost drugs are ordered for specific diagnoses. v v v v v v v
d. Diagnosticgroupclassification streamlines care. v v v v
ANS: B v
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
v v v v v v v v v v v v v v v v
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before
v v v v v v v v v v v v v v v v v v
the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged
v v v v v v v v v v v v v v v v v v
sooner.
v
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 v v v v v
TOP: Government-Sponsored Health Insurance
v v v v
KEY: NursingProcess Step: Implementation
v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
9. Thenurseis assessinga group of patients. Which patient would most likelyqualifyforMedicaid?
v v v v v v v v v v v v v v v
a. A35-year-oldunemployed single mother withdiabetes
v v v v v v
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
v v v v v v v v v v v v v
care facility
v v
c. An 80-year-old blind woman living in her own home who has inadequate private
v v v v v v v v v v v v
insurance
v
d. A67-year-old stroke victimwith Medicare Part Aand an income frominvestments
v v v v v v v v v v v v
ANS: A v
Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no
v v v v v v v v v v v v v v v v
insurance.
v
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 v v v v v v
OBJ: 9 v TOP: Government-Sponsored Health Insurance—Medicaid v v v
KEY: Nursing Process Step: Assessment
v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
v v v v v v v v v v v v v v v v
improve the health of Americans in the second decade of the century?
v v v v v v v v v v v v
a. Research funding v
b. Health information distribution v v
c. Healthylifestyle encouragement v v
d. Health improvement program designs v v v
ANS: C v
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
v v v v v v v v v v v v v
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
v v v v v v v v v v v v
immunizations, healthy eating habits, and healthy weight.
v v v v v v v
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 v v v v v v
TOP: Healthy People 2020
v KEY: Nursing Process Step: Implementation v v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
v
,Chapter 01: Caring forMedical-Surgical Patients
v v v v v
Stromberg:Medical-Surgical Nursing:Concepts and Practice, 5thEdition
v v v v v v v
MULTIPLE CHOICE v
1. Which statement accuratelydescribes the primarypurpose of the state nurse
v v v v v v v v v v
practice act (NPA)?
v v v
a. To test and license LPN/LVNs
v v v v
b. To define the scope of LPN/LVN practice
v v v v v v
c. To improve the qualityof care provided by the LPN/LVN
v v v v v v v v v
d. Tolimitthe LPN/LVNemployment placement
v v v v v
ANS: B v
While improving quality of care provided by the LPN/LVN may be a result of
v v v v v v v v v v v v v
the NPA, the primarypurpose of the NPA of each state defines the scope of
v v v v v v v v v v v v v v
nursing practice in that state.
v v v v v
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 v v v v v
TOP: NPA
v KEY: Nursing Process Step: Implementation
v v v v v
vMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
v v v v v v v v v v v v v v v v v
nurse has not been taught during her educational program. How should the vocational nurse respond?
v v v v v v v v v v v v v v v
a. Ask a more experienced nurse to demonstrate the procedure.
v v v v v v v v
b. Lookup the procedure in the procedure manual. v v v v v v v
c. Attempt to performthe procedure with supervision. v v v v v v
d. Informthe charge nurse of her lack of trainingin thisprocedure. v v v v v v v v v v v
ANS: D v
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational
v v v v v v v v v v v v v v v v v
nurse should seek further training to gain proficiency. Although the other options might be helpful, they
v v v v v v v v v v v v v v v v
are not safe.
v v v
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 v v v v v
TOP: Providing Safe Care
v v KEY: Nursing Process Step: N/A v v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
v v v v v v v v v v v v v
should address?
v v
a. "Ihave no idea of how thisdrug will affect me."
v v v v v v v v v v
b. "Do you know if my physician is comingbacktoday?"
v v v v v v v v v
c. "Will my insurance pay for my stay?" v v v v v v
d. "Am I going to have to go to a nursinghome?" v v v v v v v v v v
ANS: A v
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
v v v v v v v v v v v v v v v v
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
v v v v v v v v v v v v v v v v
departments to which the nurse might refer the patient.
v v v v v v v v v
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 v v v v v
TOP: Teaching
v KEY: Nursing Process Step: Implementation
v v v v v
vMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts
v v v v v v v v v v v v v v v v v
in which capacity?
v v v
a. Workingunder direct supervision of an RN on the unit v v v v v v v v v
b. Working with the RNin thebuilding v v v v v v
c. Workingunder general supervision bythe RNavailable on site or byphone v v v v v v v v v v v v
d. Workingas anindependent vocational nurse v v v v v
ANS: C v
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
v v v v v v v v v v v v v v v v v v
supervision of an RN available on site or by phone.
v v v v v v v v v v
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 v v v v v
TOP: Charge Nurse/Manager
v v KEY: Nursing Process Step: N/A v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
v v v v v v v v v v v v v v v v
information should the nurse include?
v v v v v
a. Seekthe opinion of an alternate health care provider.
v v v v v v v v
b. Contactthe insurance company for coverage details asservices maybe limited.
v v v v v v v v v v v
c. Providedetailed documentation of all care received forhis condition. v v v v v v v v v
d. Wait at least 6 months to see a specialist. v v v v v v v v
ANS: B v
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups of
v v v v v v v v v v v v v v v v v
patients for a set capitation fee and by limiting services. Patients are not required to seek a second
v v v v v v v v v v v v v v v v v v
opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
v v v v v v v v v v v v v v v
DIF: Cognitive Level: Application
v v REF: p. 9 OBJ: 9 v v v v v v
TOP: Charge Nurse/Manager
v KEY: Nursing Process Step: Implementation v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
v v v v v v v v v v v v v v v v v
Which statement accurately explains a deductible?
v v v v v v
a. An amount of moneyput aside for the payment of future medical bills
v v v v v v v v v v v v
b. A one-time fee for service
v v v v
c. An amount of money deducted fromthe bill by the insurance company
v v v v v v v v v v v
d. An annual amount of moneythe patient must pay out-of-pocket for medical care
v v v v v v v v v v v v
ANS: D v
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
v v v v v v v v v v v v v v v
assuming the cost. This practice improves the profit of the insurance company.
v v v v v v v v v v v v
DIF: Cognitive Level: Comprehension
v v REF: p. 7 OBJ: 9 v v v v v v v v
TOP: Health Care Financing
v KEY: Nursing Process Step: Implementation v v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
7. Apatient asks the nurse what Medicare Part Acovers.Which response iscorrect?
v v v v v v v v v v v v v
a. Medicare Part Acovers inpatient hospital costs. v v v v v v
b. Medicare Part Acovers reimbursement to the physician. v v v v v v v
c. Medicare Part Acovers outpatient hospital services. v v v v v v
d. Medicare Part Acovers ambulance transportation. v v v v v
ANS: A v
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
v v v v v v v v v v v v v
Medicare Part B pays the physician, ambulance transport, and outpatient services.
v v v v v v v v v v v
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 v v v v v v
OBJ: 9 v TOP: Government-Sponsored Health Insurance v v v
KEY: Nursing Process Step: Implementation
v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
8. Whichisthemain cost-containment component of diagnosis-related groups(DRGs)?
v v v v v v v v v
a. Hospitalsfocus onlyon thespecificdiagnosis. v v v v v v
b. Hospitals treat and discharge patientsquickly. v v v v v
c. Reduced cost drugs are ordered for specific diagnoses. v v v v v v v
d. Diagnosticgroupclassification streamlines care. v v v v
ANS: B v
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
v v v v v v v v v v v v v v v v
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before
v v v v v v v v v v v v v v v v v v
the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged
v v v v v v v v v v v v v v v v v v
sooner.
v
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 v v v v v
TOP: Government-Sponsored Health Insurance
v v v v
KEY: NursingProcess Step: Implementation
v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
9. Thenurseis assessinga group of patients. Which patient would most likelyqualifyforMedicaid?
v v v v v v v v v v v v v v v
a. A35-year-oldunemployed single mother withdiabetes
v v v v v v
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
v v v v v v v v v v v v v
care facility
v v
c. An 80-year-old blind woman living in her own home who has inadequate private
v v v v v v v v v v v v
insurance
v
d. A67-year-old stroke victimwith Medicare Part Aand an income frominvestments
v v v v v v v v v v v v
ANS: A v
Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no
v v v v v v v v v v v v v v v v
insurance.
v
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 v v v v v v
OBJ: 9 v TOP: Government-Sponsored Health Insurance—Medicaid v v v
KEY: Nursing Process Step: Assessment
v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
v v v v v v v v v v v v v v v v
improve the health of Americans in the second decade of the century?
v v v v v v v v v v v v
a. Research funding v
b. Health information distribution v v
c. Healthylifestyle encouragement v v
d. Health improvement program designs v v v
ANS: C v
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
v v v v v v v v v v v v v
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
v v v v v v v v v v v v
immunizations, healthy eating habits, and healthy weight.
v v v v v v v
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 v v v v v v
TOP: Healthy People 2020
v KEY: Nursing Process Step: Implementation v v v v v v
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
v v v v v v v v
