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deWit: Medical-Surgical Nursing: Concepts & Practice, 5th Edition
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MULTIPLECHOICE
Whichstatementaccuratelydescribestheprimarypurposeofthestatenursepracticeact
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(NPA)?
m
a. TotestandlicenseLPN/LVNs. m m m m
b. TodefinethescopeofLPN/LVN
practice. m
c. Toimprovethequalityofcare
provided by the LPN/LVN. m m m m
d. To limittheLPN/LVNemployment b m
placement. m
ANS: B m
While improving quality of care provided by the LPN/LVN may be a result of the NPA,
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the primary purpose of the NPA of each state defines the scope of nursing practice in that
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state.
m
CognitiveLevel:Comprehension
PTS: 1 DIF: m
REF: 2 m
OBJ:3 TOP: NPAKEY:Nursing ProcessStep: m b
Implementation m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m
Thechargenurseasksthenewvocationalnurseto start an intravenous infusion, askill that m b m m m m
the vocational nurse has notbeen taught during her educational program. How should
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the vocational nurse respond?
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a. Askamoreexperiencednurseto m m
demonstrate the procedure. m m m
b. Lookuptheprocedureintheprocedure m
manual. m
c. Attempt toperformtheprocedurewith b m
supervision. m
d. Informthechargenurseofherlackof m
training in this procedure. m m m m
ANS: D m
The charge nurse should be informed of the lack of training to perform the procedure, and
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the vocational nurse should seek further training to gain proficiency. Although the other
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options might be helpful, they are not safe.
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PTS: 1 DIF: CognitiveLevel: m 3
, Application REF: m
OBJ: 1 TOP: ProvidingSafeCare NursingProcess
KEY: Step: N/A m m m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m
Whichpatientstatementindicatesaneedforfurtherdischargeteachingthatthe vocational
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nurse should address?
m m m
a. “Ihavenoideaofhowthisdrug m
will affect me.” m m m
b. “Doyouknowifmyphysicianis m
coming back today?” m m m
c. “Willmyinsurancepayformy
stay?” m
d. “AmIgoingtohavetogotoa m
nursing home?” m m
ANS: A m
Lack of knowledge at discharge about medication effects and side effects is a concern that
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should be addressed by the vocationalnurse. The other concerns in the options are the
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responsibility of otherdepartments to which the nursemightrefer thepatient.
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Cognitive Level: Application REF:
PTS: 1 DIF: m m
2 m
OBJ:1 TOP: Teaching KEY: Nursing Process m b
Step:Implementation m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m
AccordingtomoststateNPAs,thevocationalnurseactingaschargenurseinalong- term care
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facility acts in which capacity?
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a. WorkingunderdirectsupervisionofanRNon the m m m m m m m m
unit m
b. WorkingwiththeRNin thebuilding m m m m m m
c. WorkingundergeneralsupervisionbytheRN m
available on site or by phone
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d. Working as an independent vocational nurse m m m m m
ANS: C m
Thevocationalnurseinthecapacity ofthechargenurseinalong-termcarefacility acts m m m m
mwith the general supervision of an RNavailable on site or by phone.
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PTS: 1
CognitiveLevel: REF: 2 DIF:
Comprehension m
OBJ:1 TOP: ChargeNurse/Manager Nursi Process
KEY: ng Step:N/A m m m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m
,Thenurseiseducating apatientthatis amemberofahealth maintenanceorganization m m m m
m(HMO). Which informationshould the nurse include?
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a. Seektheopinionofanalternatehealth care m m m
provider. m
b. Obtaininsuranceapprovalformedical m m
services prior to treatment.
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c. Providedetaileddocumentationofallcare m
received for his condition.
m m m m
d. Waitatleast6months to seeaspecialist. m m m m m m m m
ANS: B m
Most HMOs require preprocedure authorization for treatment. Patients are not required
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to seek a second opinion,providedocumentation of care, or wait a specific time period
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before visiting a specialist.
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CognitiveLevel:
PTS: 1 9 DIF: m
ApplicationREF: m m
OBJ:9 TOP: ChargeNurse/Manager
KEY:NursingProcessStep:Implementation m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m
Thepatientcomplainstothenursethatheisconfusedabout his“deductible”that he m m m m
mowes the hospital. Whichstatement accurately explains a deductible?
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a. Anamountofmoneyput asidefor thepaymentof b m
future medical bills m m m
b. Aone-time feefor service m m m m
c. Anamountofmoneydeductedfromthebillby the m
insurance company m m
d. Anannualamountofmoneythepatientmust pay b m
out-of-pocket for medical care
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ANS: D m
Thedeductibleistheannualamounttheinsuredmustpayout-of-pocketpriortothe insurance
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company assuming the cost. This practice improves the profit of the insurance company.
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CognitiveLevel:
PTS: 1 REF: 7 DIF:
Comprehension m
OBJ:9 TOP: HealthCareFinancing m m
KEY:NursingProcessStep:Implementation m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m
Thenursecomparesthecharacteristicsofahealthmaintenanceorganization(HMO) m m
mand a preferred providerorganization (PPO). Which information should the nurse
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include about HMOs?
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, a. HMOsrequireasetfeeofeach
membermonthly. m m
b. HMOsallowthemembertoselect m
his health care provider.
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c. HMOspermitadmissiontoany
facility the member prefers.
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d. HMOsofferunlimiteddiagnostic
tests and treatments.m m m
ANS: A m
HMOsrequireaset feefromeachmembermonthly(capitation).Thepatientwillbe b m m m m
treatedbytheHMOstaffinHMO-approvedfacilities.Excessiveuseofdiagnostic tests
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and treatments is discouraged by the HMO.
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CognitiveLevel:
PTS: 1 9 DIF: m
ApplicationREF: m m
OBJ:9 TOP: ManagedCare m
KEY:NursingProcessStep:Implementation m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care
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Apatient asks the nursewhat Medicare Part A covers. Which response is correct?
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a. MedicarePartAcoversinpatient m m m
hospitalcosts. m
b. Medicare Part A covers m m m
reimbursementtothe physician.
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c. MedicarePartAcoversoutpatient m m m
hospitalservices. m
d. MedicarePart Acoversambulance m b
transportation. m
ANS: A m
Medicare Part Acoversinpatienthospitalexpenses,drugs,x-rays,laboratorywork,
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and intensive care. Medicare Part B pays thephysician, ambulance transport, and
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outpatient services.
m m
CognitiveLevel:
PTS: 1 REF 7,Box DIF:
Comprehension : 1-4 m
OBJ:9 TOP: Government-Sponsored
HealthInsurance m
KEY:NursingProcessStep:Implementation m
MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care
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Which is the main cost-containment component of diagnosis-related groups (DRGs)?
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