,
,DIF: Cognitive Level: Application REF: 16 OBJ: 6
TOP: Medicare Provisions KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
7. The daughter of a patient who has been diagnosed with terminal cancer asks which documents
are required to allow her to make health care decisions for her parent. The nurses most
informative response is:
a. Advance directives indicate the degree of intervention desired by the patient.
b. A Do Not Resuscitate document signed by the patient transfers authority to the next
of kin.
c. A durable power of attorney for health care transfers decision-making authority for
health care to a designated person.
d. A living will transfers authority to the physician.
ANS: C
A durable power of attorney for health care transfers the authority for decision making to a
designated person.
DIF: Cognitive Level: Application REF: 19 OBJ: 11
TOP: Advance Directives KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
8. The daughter of a resident in a long-term care facility is frustrated with her 80-year-old
mothers refusal to eat. The nurse explains that the refusal to eat is a behavior that is an:
a. effort to maintain a portion of independence and self direction.
b. indication of approaching Alzheimer disease.
c. effort to gain attention.
d. indication of the dislike of the institutional food.
ANS: A
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,Loss of independence and control is a significant issue for the older adult. Some residents will
exercise whatever control they may retain.
DIF: Cognitive Level: Application REF: 21 OBJ: 11
TOP: Loss of Independence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
9. The nurse clarifies that the conditions of a living will go into effect when:
a. the patient declares that desire in writing.
b. a family member indicates the desire for curative therapy to cease.
c. two physicians agree in writing that the criteria in the living will have been met.
d. the physician and a family member agree that the criteria in the living will have
been met.
ANS: C
Two physicians must agree in writing that the criteria of the living will have been met before the
document can go into effect.
DIF: Cognitive Level: Application REF: 19 OBJ: 11
TOP: Living Wills KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce
hospital costs by:
a. classifying various diagnoses as ineligible for hospitalization.
b. allotting a set amount of hospital days and prospective payment on the basis of the
admitting diagnosis.
c. specifying particular physicians to treat specified diagnoses.
d. using frequency of a particular diagnosis to set a payment schedule.
ANS: B
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, DRGs set up a system of preset hospitalization time and payment on the basis of the admitting
diagnosis.
DIF: Cognitive Level: Comprehension REF: 16 OBJ: 6
TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
11. When discussing extended care with a patient who has had a hip replacement and needs
physical therapy, the nurse would recommend a(n):
a. basic care facility.
b. skilled care facility.
c. subacute care facility.
d. assisted-living residence.
ANS: B
Skilled care facilities offer not only basic care but also services from trained licensed
professionals such as nurses, physical therapists, speech therapists, and occupational therapists.
DIF: Cognitive Level: Application REF: 16 OBJ: 9
TOP: Extended-Care Facilities KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
12. The 80-year-old woman who is recovering from a stroke is being sent to an extended-care
facility. She is concerned about the expense. The nurse can allay anxiety by explaining that
Medicare will cover extended-care facility costs:
a. for a period of 30 days.
b. for a period of 45 days for physical therapy.
c. for a period of 100 days for needed skilled care.
d. until she is able to be discharged home.
ANS: C
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