Caring for Medical-Surgical Patients Medical-Surgical Nursing: Concepts & Practice.

CHAPTER01:CARINGFORMEDICAL-SURGICAL t t t t




PATIENTS t




STROMBERG: MEDICAL-SURGICAL NURSING: t t




t CONCEPTSANDPRACTICE,5THEDITIONEXAMTEST t t t t t t




WITH COMPLETE SOLUTIONS AND 100% NEWLY
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UPDATED t




MULTIPLE CHOICE t




1. Which statement accurately describes the primary purpose of the state nurse practice act
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(NPA)?
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a. To test and license LPN/LVNs t t t t




b. To define the scope of LPN/LVN practice
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c. To improve the quality of care provided by the LPN/LVN
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d. To limit the LPN/LVN employment placement
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ANS: B t




While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary
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purpose of the NPA of each state defines the scope of nursing practice in that state.
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DIF: Cognitive Level: Comprehension REF: p. 3 t t t




OBJ: 3TOP: NPA t t t t




KEY: Nursing Process Step: Implementation t t t t




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that
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thevocational nurse has not been taught during her educational program. How should the v ocational
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nurse respond?
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a. Ask a more experienced nurse to demonstrate the procedure.
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b. Look up the procedure in the procedure manual. t t t t t t t




c. Attempt to perform the procedure with supervision. t t t t t t




d. Inform the charge nurse of her lack of training in this procedure t t t t t t t t t t t




.

, ANS: D t




The charge nurse should be informed of the lack of training to perform the procedure, and t
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hevocational nurse should seek further training to gain proficiency. Although the other opti ons
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might be helpful, they are not safe.
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DIF: Cognitive Level: Application REF: p. 3 t t t




OBJ: 1 TOP: Providing Safe Care
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KEY: Nursing Process Step: N/AMSC: NCLEX: Safe, Effective Ca re
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Environment: Coordinated Care
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3. Which patient statement indicates a need for further discharge teaching that the vocatio
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nalnurse should address?
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a. ―I have no idea of how this drug will affect me.‖
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b. ―Do you know if myphysician is coming back today?‖
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c. ―Willmyinsurancepayformystay?‖ t t t t t t




d. ―Am I going to have to go to a nursing home?‖
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ANS: A t




Lack of knowledge at discharge about medication effects and side effects is a concern thatsh ould be
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addressed by the vocational nurse. The other concerns in the options are the responsi bility of other
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departments to which the nurse might refer the patient.
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DIF: Cognitive Level: Application REF: p. 2 t t t




OBJ: 1TOP: Teaching
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KEY: Nursing Process Step: Implementation t t t t

, MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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4. According to most state NPAs, the vocational nurse acting as charge nurse in a long- term t t t t t t t t t t t t t t t




carefacility acts in which capacity?
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a. Working under direct supervision of an RN on the unit t t t t t t t t t




b. Working with the RN in the building t t t t t t




c. Working under general supervision by the RN available on site or by phon e t t t t t t t t t t t t t




d. Working as an independent vocational nurse t t t t t




ANS: C t




The vocational nurse in the capacity of the charge nurse in a long-
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term care facility acts withthe general supervision of an RN available on site or by phone.
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DIF: Cognitive Level: Comprehension REF: p. 3 t t t




OBJ: 1 TOP: Charge Nurse/Manager t t t t t




KEY: Nursing Process Step: N/AMSC: NCLEX: Safe, Effective Ca re t t t t t t t t t t




Environment: Coordinated Care
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5. The nurse is educating a patient that is a member of a health maintenance organizat
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t ion(HMO). Which information should the nurse include? t t t t t t




a. Seek the opinion of an alternate health care provider. t t t t t t t t




b. Contact the insurance company forbcoverage details as services may be limited t t t t t t t t t t




.
c. Provide detailed documentation of all care received for his condition. t t t t t t t t t




d. Wait at least 6 months to see a specialist. t t t t t t t t




ANS: B t




HMOs are a kind of managed care. This is accomplished by paying providers to care for g roups of
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patients for a set capitation fee and by limiting services. Patients are not required toseek a second
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opinion, provide documentation of care, or wait a specific time period bef ore visiting a specialist.
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DIF: Cognitive Level: Application t t REF: p. 9 t OBJ: 9 t




TOP: Charge Nurse/Manager
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KEY: Nursing Process Step: Implementatio n t t t t t




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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6. The patient complains to the nurse that he is confused about his ―deductible‖ that he owes the
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hospital. Which statement accurately explains a deductible?
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a. An amount of money put aside for the payment of future medical bills
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b. A one-time fee for service
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c. An amount of money deducted from the bill by the insurance company
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d. An annual amount of money the patient must pay out-of- pocket
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forbmedical care
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ANS: D t




The deductible is the annual amount the insured must pay out-of-
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pocket prior to the insurancecompany assuming the cost. This practice improves the profit of the
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insurance company.
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DIF: Cognitive Level: Comprehension t t REF: p. 7 t OBJ: 9 t




TOP: Health Care Financing
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KEY: Nursing Process Step: Implementatio n t t t t t




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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7. A patient asks the nurse what Medicare Part A covers. Which response is correct?
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, a. Medicare Part A covers inpatient hospital costs.
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b. Medicare Part A covers reimbursement to the physician.
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