,Chapter 01: The Health Care System(FREE)
n n n n n
Chapter 01: The Health Care System n n n n n
Linton: Introduction to Medical-
n n n
Surgical Nursing, 6th Edition MULTIPLE CHOICE
n n n n n
1. An 89-year- n
old man, who was recently discharged from a rehabilitation hospital because of
n n n n n n n n n n n n
an inability to concentrate and frequent memory lapses, cannot be left alone wh
n n n n n n n n n n n n
ile his family works. What options should the discharge planning team suggest t
n n n n n n n n n n n n
hat will satisfy safety concerns and give the greatest quality of life to the patient
n n n n n n n n n n n n n n
?
a. Placement in a day care center from 8 AM to 5 PM daily n n n n n n n n n n n n
b. Placement in a long-term psychiatric facility n n n n n
c. Placement in a high-security nursing home n n n n n
d. Admission to a general hospital for evaluation n n n n n n
ANS: A n
Day care centers provide supervision, safety, nutritious meals, and socializa
n n n n n n n n n
tion while the caregiving family works.
n n n n n
DIF: Cognitive Level: Application REF: p. 7 OBJ: 5 TOP: Day Care Centers K
n n n n n n n n n n n n n
EY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: R
n n n n n n n n n
eduction of Risk n n
2. A 66-year- n
old hospitalized patient is anxious about how the physician will be paid now tha
n n n n n n n n n n n n n
t he is on Medicare Parts A and B, instead of his previous privately funded insur
n n n n n n n n n n n n n n n
ance plan. Who should the nurse explain is the payor to the physician on this pla
n n n n n n n n n n n n n n n
n?
a. Previous privately funded insurance plan n n n n
b. Medicare Part A n n
c. Medicare Part B n n
d. Patient or patient’s family n n n
ANS: C n
Part A pays skilled care facilities. Part B pays for physician’s services. The prev
n n n n n n n n n n n n n
iously held insurance is no longer available because of the patient’s age. The fa
n n n n n n n n n n n n n
mily or patient is not responsible because Part B is in effect.
n n n n n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
n n n n n n n n
TOP: Health Care Funding KEY: Nursing Process Step: Implementation M
n n n n n n n n n
SC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
,3. What health care plan is the best referral for an unemployed 42-year-
n n n n n n n n n n n
old patient with renal failure who has lost his job-
n n n n n n n n n
related private insurance? a. n n n
Medicare
b. Medicaid
c. Public health facility n n
d. Community-based outpatient clinic n n
ANS: B n
Medicaid is available to needy low- n n n n n
income persons younger than 65 years of age who have a permanent disability.
n n n n n n n n n n n n n
Medicare is for persons 65 years and older. Public health services are involved
n n n n n n n n n n n n n
with prevention more often than with chronic care.
n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
n n n n n n n n
TOP: Health Care Funding KEY: Nursing Process Step: Implementation M
n n n n n n n n n
SC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
4. A patient with terminal lung cancer with extensive metastasis is requesting a
n n n n n n n n n n n n
hospice transfer. What criteria are included as requirements for this transfer? a.
n n n n n n n n n n n n
The patient requests and agrees to the guidelines of hospice care without requir
n n n n n n n n n n n n
ing a physician’s order.
n n n
b. The physician confirms that the patient has 6 months or less of life remain
n n n n n n n n n n n n n n
ing and has provided a written order for hospice care.
n n n n n n n n n
c. Proof confirms that the family can no longer care for the patient at home. d. Th
n n n n n n n n n n n n n n n n
e patient’s specific diagnosis is included on a list of accepted diseases that qualif
n n n n n n n n n n n n n
ies the patient for hospice care.
n n n n n
ANS: B n
The four criteria for transfer to hospice care are (1) diagnosis of any terminal illness
n n n n n n n n n n n n n n
, (2) prognosis of less than 6 months of life, (3) informed consent of patient, and (4)
n n n n n n n n n n n n n n n n n
written physician’s order. n n
DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 5 TOP: Hospice Care KEY:
n n n n n n n n n n n n n
Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Ba
n n n n n n n n
sic Care and Comfort
n n n
5. A patient admitted yesterday with a diagnosis-
n n n n n n
related group (DRG) diagnosis of abdominal pain of an unknown cause is bei
n n n n n n n n n n n n
ng discharged this afternoon because all diagnostic test results have been neg
n n n n n n n n n n n
ative. What does this scenario exemplify?
n n n n n
, a. Effective laboratory response n n
b. Medicare guidelines limiting hospital stay n n n n
c. Cost containment related to a DRG diagnosis
n n n n n n
d. Patient who should not have been admitted in the first place
n n n n n n n n n n
ANS: C n
Cost containment is a means by which the cost of hospitalization time is reduce
n n n n n n n n n n n n n
d when the need for acute hospital care is no longer necessary. DIF: Cognitive
n n n n n n n n n n n n n n
Level: Comprehension REF: p. 11-
n n n n
12 OBJ: 6 TOP: Cost Containment per DRGs KEY: Nursing Process Step: N/
n n n n n n n n n n n n
A MSC: NCLEX: N/A
n n n
MSC: NCLEX: N/A n n
year-
old patient diagnosed with diabetes and bilateral leg amputation. What should the n
n n n n n n n n n n n n
urse inform the patient regarding the stay in the new facility? a. It will be limited to
n n n n n n n n n n n n n n n n n
25 days. n
b. It will be limited to 50 days.
n n n n n n
c. It will be limited to 75 days.
n n n n n n
d. It is totally unlimited.
n n n
ANS: D n
Medicare limitations are waived for patients who have undergone amputati
n n n n n n n n n
ons.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 4
n n n n n n n n
TOP: Stay in a Skilled Care Facility KEY: Nursing Process Step: Planning MS
n n n n n n n n n n n n
C: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
7. A patient is applying for Medicaid. What does the receipt of benefits re
n n n n n n n n n n n n
quire? a. Following a supervised health maintenance plan
n n n n n n n
b. Enrolling in the Medicare-Preferred Drug Plan n n n n n
c. Qualifying for the food stamp program n n n n n
d. Having an annual income of less than $10,000
n n n n n n n
ANS: B n
The Medicare- n
Preferred Drug Plan is a condition of Medicaid eligibility. Nonenrollment may cau
n n n n n n n n n n n
se the loss of all health care benefits.
n n n n n n n
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 4
n n n n n n n n
TOP: Medicare-Preferred Drug Plan KEY: Nursing Process Step:
n n n n n n n
n n n n n
Chapter 01: The Health Care System n n n n n
Linton: Introduction to Medical-
n n n
Surgical Nursing, 6th Edition MULTIPLE CHOICE
n n n n n
1. An 89-year- n
old man, who was recently discharged from a rehabilitation hospital because of
n n n n n n n n n n n n
an inability to concentrate and frequent memory lapses, cannot be left alone wh
n n n n n n n n n n n n
ile his family works. What options should the discharge planning team suggest t
n n n n n n n n n n n n
hat will satisfy safety concerns and give the greatest quality of life to the patient
n n n n n n n n n n n n n n
?
a. Placement in a day care center from 8 AM to 5 PM daily n n n n n n n n n n n n
b. Placement in a long-term psychiatric facility n n n n n
c. Placement in a high-security nursing home n n n n n
d. Admission to a general hospital for evaluation n n n n n n
ANS: A n
Day care centers provide supervision, safety, nutritious meals, and socializa
n n n n n n n n n
tion while the caregiving family works.
n n n n n
DIF: Cognitive Level: Application REF: p. 7 OBJ: 5 TOP: Day Care Centers K
n n n n n n n n n n n n n
EY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: R
n n n n n n n n n
eduction of Risk n n
2. A 66-year- n
old hospitalized patient is anxious about how the physician will be paid now tha
n n n n n n n n n n n n n
t he is on Medicare Parts A and B, instead of his previous privately funded insur
n n n n n n n n n n n n n n n
ance plan. Who should the nurse explain is the payor to the physician on this pla
n n n n n n n n n n n n n n n
n?
a. Previous privately funded insurance plan n n n n
b. Medicare Part A n n
c. Medicare Part B n n
d. Patient or patient’s family n n n
ANS: C n
Part A pays skilled care facilities. Part B pays for physician’s services. The prev
n n n n n n n n n n n n n
iously held insurance is no longer available because of the patient’s age. The fa
n n n n n n n n n n n n n
mily or patient is not responsible because Part B is in effect.
n n n n n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
n n n n n n n n
TOP: Health Care Funding KEY: Nursing Process Step: Implementation M
n n n n n n n n n
SC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
,3. What health care plan is the best referral for an unemployed 42-year-
n n n n n n n n n n n
old patient with renal failure who has lost his job-
n n n n n n n n n
related private insurance? a. n n n
Medicare
b. Medicaid
c. Public health facility n n
d. Community-based outpatient clinic n n
ANS: B n
Medicaid is available to needy low- n n n n n
income persons younger than 65 years of age who have a permanent disability.
n n n n n n n n n n n n n
Medicare is for persons 65 years and older. Public health services are involved
n n n n n n n n n n n n n
with prevention more often than with chronic care.
n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
n n n n n n n n
TOP: Health Care Funding KEY: Nursing Process Step: Implementation M
n n n n n n n n n
SC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
4. A patient with terminal lung cancer with extensive metastasis is requesting a
n n n n n n n n n n n n
hospice transfer. What criteria are included as requirements for this transfer? a.
n n n n n n n n n n n n
The patient requests and agrees to the guidelines of hospice care without requir
n n n n n n n n n n n n
ing a physician’s order.
n n n
b. The physician confirms that the patient has 6 months or less of life remain
n n n n n n n n n n n n n n
ing and has provided a written order for hospice care.
n n n n n n n n n
c. Proof confirms that the family can no longer care for the patient at home. d. Th
n n n n n n n n n n n n n n n n
e patient’s specific diagnosis is included on a list of accepted diseases that qualif
n n n n n n n n n n n n n
ies the patient for hospice care.
n n n n n
ANS: B n
The four criteria for transfer to hospice care are (1) diagnosis of any terminal illness
n n n n n n n n n n n n n n
, (2) prognosis of less than 6 months of life, (3) informed consent of patient, and (4)
n n n n n n n n n n n n n n n n n
written physician’s order. n n
DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 5 TOP: Hospice Care KEY:
n n n n n n n n n n n n n
Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Ba
n n n n n n n n
sic Care and Comfort
n n n
5. A patient admitted yesterday with a diagnosis-
n n n n n n
related group (DRG) diagnosis of abdominal pain of an unknown cause is bei
n n n n n n n n n n n n
ng discharged this afternoon because all diagnostic test results have been neg
n n n n n n n n n n n
ative. What does this scenario exemplify?
n n n n n
, a. Effective laboratory response n n
b. Medicare guidelines limiting hospital stay n n n n
c. Cost containment related to a DRG diagnosis
n n n n n n
d. Patient who should not have been admitted in the first place
n n n n n n n n n n
ANS: C n
Cost containment is a means by which the cost of hospitalization time is reduce
n n n n n n n n n n n n n
d when the need for acute hospital care is no longer necessary. DIF: Cognitive
n n n n n n n n n n n n n n
Level: Comprehension REF: p. 11-
n n n n
12 OBJ: 6 TOP: Cost Containment per DRGs KEY: Nursing Process Step: N/
n n n n n n n n n n n n
A MSC: NCLEX: N/A
n n n
MSC: NCLEX: N/A n n
year-
old patient diagnosed with diabetes and bilateral leg amputation. What should the n
n n n n n n n n n n n n
urse inform the patient regarding the stay in the new facility? a. It will be limited to
n n n n n n n n n n n n n n n n n
25 days. n
b. It will be limited to 50 days.
n n n n n n
c. It will be limited to 75 days.
n n n n n n
d. It is totally unlimited.
n n n
ANS: D n
Medicare limitations are waived for patients who have undergone amputati
n n n n n n n n n
ons.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 4
n n n n n n n n
TOP: Stay in a Skilled Care Facility KEY: Nursing Process Step: Planning MS
n n n n n n n n n n n n
C: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
7. A patient is applying for Medicaid. What does the receipt of benefits re
n n n n n n n n n n n n
quire? a. Following a supervised health maintenance plan
n n n n n n n
b. Enrolling in the Medicare-Preferred Drug Plan n n n n n
c. Qualifying for the food stamp program n n n n n
d. Having an annual income of less than $10,000
n n n n n n n
ANS: B n
The Medicare- n
Preferred Drug Plan is a condition of Medicaid eligibility. Nonenrollment may cau
n n n n n n n n n n n
se the loss of all health care benefits.
n n n n n n n
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 4
n n n n n n n n
TOP: Medicare-Preferred Drug Plan KEY: Nursing Process Step:
n n n n n n n
