NCLEX RN Test Bank Chapter 1-3 (The
Health Care System / Patient Care Settings
/ Legal and Ethical Considerations
)
1. An 89-year-old man, recently discharged from a rehabilitation
hospital because of his inability to concentrate and frequent memory
lapses, cannot be left alone while his family works because of safety
concerns. What options can the discharge planning team suggest that
will give the greatest quality of life to the patient?
1. Placement in a day care center from 8 AM to 5 PM daily
2. Placement in a long-term psychiatric facility
3. Placement in a high-security nursing home
4. Admission to a general hospital for evaluation
ANS: 1
Day care centers provide supervision, safety, nutritious meals, and
socialization while the caregiving family works.
2. A 66-year-old hospitalized patient is anxious about how the physician
will be paid now that the patient is on Medicare Part A and Part B,
instead of his previous privately funded insurance plan. The nurse
explains that the physician will be paid by:
1. the previously private funded insurance.
2. Medicare Part A.
3. Medicare Part B.
4. the patient or his family.
ANS: 3
Part A pays skilled care facilities; Part B pays for physician's services.
The previous insurance is no longer available because of the patient's
age. The family or patient is not responsible, because Part B is in
effect.
3. A nurse could best refer an unemployed 42-year-old renal failure
patient who has lost his job-related private insurance to which health
care plan for his medical care?
1. Medicare
2. Medicaid
3. Public health facility
4. Community-based outpatient clinic
, ANS: 2
Medicaid is available to needy low-income persons under 65 who
have a permanent disability. Medicare is for persons over 65. Public
health services are involved with prevention more than with chronic
care.
4. A 50-year-old woman with terminal cancer of the lung with extensive
metastasis is requesting a hospice transfer. The requirements for this
transfer include:
1. the patient requesting and agreeing to the guidelines of hospice
care, but not requiring a physician's order.
2. physician confirmation that the patient has 6 months or less of life
remaining and a written order for hospice care.
3. proof that the family can no longer care for the patient at home.
4. a specific diagnosis on a list of accepted diseases that qualifies the
patient for hospice care.
ANS: 2
The four criteria for transfer to hospice care are diagnosis of any
terminal illness, prognosis of less than 6 months of life, informed
consent of patient, and written physician's order.
5. A 42-year-old patient admitted yesterday with a DRG (diagnosis-
related group) diagnosis of Abdominal Pain, cause unknown, is being
discharged this afternoon, because all diagnostic tests have been
negative. This is an example of:
1. effective laboratory response.
2. Medicare guidelines limiting hospital stay.
3. cost containment related to DRG.
4. a patient who should not have been admitted in the first place.
ANS: 3
Cost containment is a means by which the cost of hospitalization time
is reduced when the need for acute hospital care is no longer
necessary.
6. In discussing the discharge to a transitional sub-acute facility with a
72-year-old diabetic who has had both legs amputated, the nurse
informs the patient that his stay in the new facility will be:
1. limited to 25 days.
2. limited to 50 days.
3. limited to 75 days.
4. totally unlimited.
, ANS: 4
Medicare limitations are waived in the case of amputations.
7. Two of the primary branches of the Department of Health and Human
Services (DHHS) are the:
1. Social Security Administration and Health Care Financing
Administration.
2. National Institutes of Health and Food and Drug Administration.
3. Health Services Administration and Centers for Disease Control
and Prevention.
4. Health Resources Administration and Alcohol, Drug Abuse, and
Mental Health Administration.
ANS: 1
Two of the four branches of DHHS are the Social Security
Administration (SSA) and the Health Care Financing Administration
(HCFA).
8. Which of the following is true about proprietary agencies?
1. They are organized to be a nonprofit operation.
2. They are organized to make a profit on their operation.
3. Any profit they make is used immediately for better equipment and
services.
4. The Balanced Budget Act affected only psychiatric state hospitals.
ANS: 2
These agencies are usually owned by large corporations and
established for the purpose of profit making.
9. Which patient would the nurse recognize as eligible for referral to
Medicaid?
1. A military auto mechanic with severe asthma
2. A pregnant unmarried young woman employed at a discount retail
store for 3 years
3. A college student on scholarship who works part time at the college
library who needs medication for arthritis
4. An unemployed young mother on welfare who needs diabetic
medication for one of her children
ANS: 4
Medicaid covers medication and health care for welfare recipients.
Health Care System / Patient Care Settings
/ Legal and Ethical Considerations
)
1. An 89-year-old man, recently discharged from a rehabilitation
hospital because of his inability to concentrate and frequent memory
lapses, cannot be left alone while his family works because of safety
concerns. What options can the discharge planning team suggest that
will give the greatest quality of life to the patient?
1. Placement in a day care center from 8 AM to 5 PM daily
2. Placement in a long-term psychiatric facility
3. Placement in a high-security nursing home
4. Admission to a general hospital for evaluation
ANS: 1
Day care centers provide supervision, safety, nutritious meals, and
socialization while the caregiving family works.
2. A 66-year-old hospitalized patient is anxious about how the physician
will be paid now that the patient is on Medicare Part A and Part B,
instead of his previous privately funded insurance plan. The nurse
explains that the physician will be paid by:
1. the previously private funded insurance.
2. Medicare Part A.
3. Medicare Part B.
4. the patient or his family.
ANS: 3
Part A pays skilled care facilities; Part B pays for physician's services.
The previous insurance is no longer available because of the patient's
age. The family or patient is not responsible, because Part B is in
effect.
3. A nurse could best refer an unemployed 42-year-old renal failure
patient who has lost his job-related private insurance to which health
care plan for his medical care?
1. Medicare
2. Medicaid
3. Public health facility
4. Community-based outpatient clinic
, ANS: 2
Medicaid is available to needy low-income persons under 65 who
have a permanent disability. Medicare is for persons over 65. Public
health services are involved with prevention more than with chronic
care.
4. A 50-year-old woman with terminal cancer of the lung with extensive
metastasis is requesting a hospice transfer. The requirements for this
transfer include:
1. the patient requesting and agreeing to the guidelines of hospice
care, but not requiring a physician's order.
2. physician confirmation that the patient has 6 months or less of life
remaining and a written order for hospice care.
3. proof that the family can no longer care for the patient at home.
4. a specific diagnosis on a list of accepted diseases that qualifies the
patient for hospice care.
ANS: 2
The four criteria for transfer to hospice care are diagnosis of any
terminal illness, prognosis of less than 6 months of life, informed
consent of patient, and written physician's order.
5. A 42-year-old patient admitted yesterday with a DRG (diagnosis-
related group) diagnosis of Abdominal Pain, cause unknown, is being
discharged this afternoon, because all diagnostic tests have been
negative. This is an example of:
1. effective laboratory response.
2. Medicare guidelines limiting hospital stay.
3. cost containment related to DRG.
4. a patient who should not have been admitted in the first place.
ANS: 3
Cost containment is a means by which the cost of hospitalization time
is reduced when the need for acute hospital care is no longer
necessary.
6. In discussing the discharge to a transitional sub-acute facility with a
72-year-old diabetic who has had both legs amputated, the nurse
informs the patient that his stay in the new facility will be:
1. limited to 25 days.
2. limited to 50 days.
3. limited to 75 days.
4. totally unlimited.
, ANS: 4
Medicare limitations are waived in the case of amputations.
7. Two of the primary branches of the Department of Health and Human
Services (DHHS) are the:
1. Social Security Administration and Health Care Financing
Administration.
2. National Institutes of Health and Food and Drug Administration.
3. Health Services Administration and Centers for Disease Control
and Prevention.
4. Health Resources Administration and Alcohol, Drug Abuse, and
Mental Health Administration.
ANS: 1
Two of the four branches of DHHS are the Social Security
Administration (SSA) and the Health Care Financing Administration
(HCFA).
8. Which of the following is true about proprietary agencies?
1. They are organized to be a nonprofit operation.
2. They are organized to make a profit on their operation.
3. Any profit they make is used immediately for better equipment and
services.
4. The Balanced Budget Act affected only psychiatric state hospitals.
ANS: 2
These agencies are usually owned by large corporations and
established for the purpose of profit making.
9. Which patient would the nurse recognize as eligible for referral to
Medicaid?
1. A military auto mechanic with severe asthma
2. A pregnant unmarried young woman employed at a discount retail
store for 3 years
3. A college student on scholarship who works part time at the college
library who needs medication for arthritis
4. An unemployed young mother on welfare who needs diabetic
medication for one of her children
ANS: 4
Medicaid covers medication and health care for welfare recipients.
