TESTBANK
t
,Chapter01:Caring forMedical-Surgical Patients
t t t t t
Stromberg:Medical-Surgical Nursing:ConceptsandPractice,5thEdition
t t t t t t t
MULTIPLE CHOICE t
1. Whichstatement accuratelydescribesthe primarypurpose ofthestate nurse
t t t t t t t t t t
practice act (NPA)?
t t t
a. Totest andlicense LPN/LVNs t t t t
b. Todefine thescope of LPN/LVNpractice t t t t t t
c. Toimprove the qualityof care providedbythe LPN/LVN
t t t t t t t t t
d. TolimittheLPN/LVNemployment placement t t t t t
ANS: B t
While improving quality of care provided by the LPN/LVN may be a result of
t t t t t t t t t t t t t
the NPA, the primarypurpose of the NPA of each state defines the scope of
t t t t t t t t t t t t t t
nursing practice in that state.
t t t t t
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ:3 t t t t t
TOP: NPA
t KEY: Nursing Process Step: Implementation MSC:
t t t t t t
NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
t t t t t t t t t t t t t t t t t
nurse has not been taught during her educational program. How should the vocational nurse respond?
t t t t t t t t t t t t t t t
a. Aska more experienced nursetodemonstratetheprocedure. t t t t t t t t
b. Lookup the procedure inthe procedure manual. t t t t t t t
c. Attempttoperformthe procedure withsupervision. t t t t t t
d. Informthecharge nurse ofherlackof trainingin thisprocedure. 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 the vocational
t t t t t t t t t t t t t t t t t
nurse should seek further training to gain proficiency. Although the other options might be helpful, they are
t t t t t t t t t t t t t t t t t
not safe.
t t
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 t t t t t
TOP: Providing Safe Care
t tKEY: NursingProcess Step: N/A t t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
t t t t t t t t t t t t t
should address?
t t
a. "Ihaveno idea of howthisdrugwill affect me."
t t t t t t t t t t
b. "Do you knowif myphysician is comingbacktoday?" t t t t t t t t t
c. "Will myinsurance payformystay?" t t t t t t
d. "AmIgoingto have to go to a nursinghome?" t t t t t t t t t t
ANS: A t
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
t t t t t t t t t t t t t t t t
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
t t t t t t t t t t t t t t t t
departments to which the nurse might refer the patient.
t t t t t t t t t
DIF: Cognitive Level: Application REF: p. 2 OBJ:1 t t t t t
TOP: Teaching
t KEY: Nursing Process Step: Implementation MSC:
t t t t t t
NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts in
t t t t t t t t t t t t t t t t t t
which capacity?
t t
a. Workingunder direct supervision of an RNontheunit t t t t t t t t t
b. Workingwiththe RNin thebuilding t t t t t t
c. Workingundergeneral supervision bythe RNavailable on site or byphone t t t t t t t t t t t t
d. Workingas anindependentvocational nurse t t t t t
ANS: C t
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
t t t t t t t t t t t t t t t t t t
supervision of an RN available on site or by phone.
t t t t t t t t t t
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 t t t t t
TOP: Charge Nurse/Manager
t t KEY: NursingProcess Step: N/A t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
t t t t t t t t t t t t t t t t
information should the nurse include?
t t t t t
a. Seekthe opinion of analternatehealthcareprovider. t t t t t t t t
b. Contacttheinsurance companyforcoverage details asservices maybelimited. t t t t t t t t t t t
c. Providedetailed documentationof all carereceived forhiscondition. t t t t t t t t t
d. Wait at least 6 months tosee 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 groups of
t t t t t t t t t t t t t t t t t
patients for a set capitation fee and by limiting services. Patients are not required to seek a second
t t t t t t t t t t t t t t t t t t
opinion, provide documentation of care, or wait a specific time period before visitinga specialist.
t t t t t t t t t t t t t t t
DIF: CognitiveLevel: Application
t t REF: p. 9 OBJ: 9 t t t t t t
TOP: Charge Nurse/Manager
t KEY: NursingProcess Step: Implementation t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital. Which
t t t t t t t t t t t t t t t t t t
statement accurately explains a deductible?
t t t t t
a. An amount of moneyput asideforthepayment of future medical bills
t t t t t t t t t t t t
b. Aone-time fee forservice
t t t t
c. An amount of moneydeductedfromthe bill bythe insurancecompany
t t t t t t t t t t t
d. Anannual amount of moneythe patient must payout-of-pocket for medicalcare
t t t t t t t t t t t t
ANS: D t
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
t t t t t t t t t t t t t t t
assuming the cost. This practice improves the profit of the insurance company.
t t t t t t t t t t t t
DIF: Cognitive Level: Comprehension
t t REF: p. 7 OBJ: 9 t t t t t t t t
TOP: Health Care Financing t KEY: NursingProcess Step: Implementation t t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
7. Apatientasks the nurse what Medicare Part Acovers.Which responseiscorrect?
t t t t t t t t t t t t t
a. Medicare Part Acoversinpatient hospitalcosts. t t t t t t
b. Medicare Part Acoversreimbursement tothephysician. t t t t t t t
c. MedicarePart Acoversoutpatient hospitalservices. t t t t t t
d. Medicare Part Acovers ambulancetransportation. t t t t t
ANS: A t
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
t t t t t t t t t t t t t
Medicare Part B pays the physician, ambulance transport, and outpatient services.
t t t t t t t t t t t
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 t t t t t t
OBJ: 9 TOP:Government-SponsoredHealthInsurance
t t t t
KEY: Nursing Process Step: Implementation
t t t t t
MSC:NCLEX:Safe,EffectiveCareEnvironment:CoordinatedCare
t t t t t t t
8. Whichisthemaincost-containment component of diagnosis-related groups(DRGs)?
t t t t t t t t t
a. Hospitalsfocusonlyon thespecificdiagnosis. t t t t t t
b. Hospitalstreat and discharge patientsquickly. t t t t t
c. Reducedcost drugs are orderedforspecificdiagnoses. t t t t t t t
d. Diagnosticgroupclassificationstreamlinescare. t t t t
ANS: B t
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
t t t t t t t t t t t t t t t t
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before
t t t t t t t t t t t t t t t t t t
the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged
t t t t t t t t t t t t t t t t t t
sooner.
t
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ:9 t t t t t
TOP: Government-Sponsored Health Insurance
t t t t
KEY:NursingProcessStep: Implementation
t t t t
MSC:NCLEX:Safe,EffectiveCareEnvironment:CoordinatedCare
t t t t t t t
9. Thenurseisassessinga groupof patients.Which patient would most likelyqualifyforMedicaid?
t t t t t t t t t t t t t t t
a. A35-year-oldunemployedsinglemother withdiabetes
t t t t t t
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term care
t t t t t t t t t t t t t t
facility t
c. An 80-year-old blind woman living in her own home who has inadequate private
t t t t t t t t t t t t
insurance t
d. A67-year-oldstrokevictimwithMedicare Part Aandan income frominvestments
t t t t t t t t t t t t
ANS: A t
Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no
t t t t t t t t t t t t t t t t
insurance.
t
DIF: CognitiveLevel:Application REF: p. 8, Box 1-5 t t t t t t
OBJ: 9 TOP: Government-Sponsored HealthInsurance—Medicaid
t t t t
KEY: Nursing Process Step: Assessment
t t t t t
MSC:NCLEX:Safe,EffectiveCareEnvironment:CoordinatedCare
t t t t t t t
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
t t t t t t t t t t t t t t t t
improve the health of Americans in the second decade of the century?
t t t t t t t t t t t t
a. Researchfunding t
b. Health information distribution t t
c. Healthylifestyle encouragement t t
d. Health improvement programdesigns t t t
ANS: C t
Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce
t t t t t t t t t t t t t t
infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective immunizations,
t t t t t t t t t t t t
healthy eating habits, and healthy weight.
t t t t t t
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 t t t t t t
TOP: Healthy People 2020 t KEY: NursingProcess Step: Implementation t t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
t
,Chapter01:Caring forMedical-Surgical Patients
t t t t t
Stromberg:Medical-Surgical Nursing:ConceptsandPractice,5thEdition
t t t t t t t
MULTIPLE CHOICE t
1. Whichstatement accuratelydescribesthe primarypurpose ofthestate nurse
t t t t t t t t t t
practice act (NPA)?
t t t
a. Totest andlicense LPN/LVNs t t t t
b. Todefine thescope of LPN/LVNpractice t t t t t t
c. Toimprove the qualityof care providedbythe LPN/LVN
t t t t t t t t t
d. TolimittheLPN/LVNemployment placement t t t t t
ANS: B t
While improving quality of care provided by the LPN/LVN may be a result of
t t t t t t t t t t t t t
the NPA, the primarypurpose of the NPA of each state defines the scope of
t t t t t t t t t t t t t t
nursing practice in that state.
t t t t t
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ:3 t t t t t
TOP: NPA
t KEY: Nursing Process Step: Implementation MSC:
t t t t t t
NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
t t t t t t t t t t t t t t t t t
nurse has not been taught during her educational program. How should the vocational nurse respond?
t t t t t t t t t t t t t t t
a. Aska more experienced nursetodemonstratetheprocedure. t t t t t t t t
b. Lookup the procedure inthe procedure manual. t t t t t t t
c. Attempttoperformthe procedure withsupervision. t t t t t t
d. Informthecharge nurse ofherlackof trainingin thisprocedure. 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 the vocational
t t t t t t t t t t t t t t t t t
nurse should seek further training to gain proficiency. Although the other options might be helpful, they are
t t t t t t t t t t t t t t t t t
not safe.
t t
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 t t t t t
TOP: Providing Safe Care
t tKEY: NursingProcess Step: N/A t t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
t t t t t t t t t t t t t
should address?
t t
a. "Ihaveno idea of howthisdrugwill affect me."
t t t t t t t t t t
b. "Do you knowif myphysician is comingbacktoday?" t t t t t t t t t
c. "Will myinsurance payformystay?" t t t t t t
d. "AmIgoingto have to go to a nursinghome?" t t t t t t t t t t
ANS: A t
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
t t t t t t t t t t t t t t t t
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
t t t t t t t t t t t t t t t t
departments to which the nurse might refer the patient.
t t t t t t t t t
DIF: Cognitive Level: Application REF: p. 2 OBJ:1 t t t t t
TOP: Teaching
t KEY: Nursing Process Step: Implementation MSC:
t t t t t t
NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts in
t t t t t t t t t t t t t t t t t t
which capacity?
t t
a. Workingunder direct supervision of an RNontheunit t t t t t t t t t
b. Workingwiththe RNin thebuilding t t t t t t
c. Workingundergeneral supervision bythe RNavailable on site or byphone t t t t t t t t t t t t
d. Workingas anindependentvocational nurse t t t t t
ANS: C t
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
t t t t t t t t t t t t t t t t t t
supervision of an RN available on site or by phone.
t t t t t t t t t t
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 t t t t t
TOP: Charge Nurse/Manager
t t KEY: NursingProcess Step: N/A t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
t t t t t t t t t t t t t t t t
information should the nurse include?
t t t t t
a. Seekthe opinion of analternatehealthcareprovider. t t t t t t t t
b. Contacttheinsurance companyforcoverage details asservices maybelimited. t t t t t t t t t t t
c. Providedetailed documentationof all carereceived forhiscondition. t t t t t t t t t
d. Wait at least 6 months tosee 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 groups of
t t t t t t t t t t t t t t t t t
patients for a set capitation fee and by limiting services. Patients are not required to seek a second
t t t t t t t t t t t t t t t t t t
opinion, provide documentation of care, or wait a specific time period before visitinga specialist.
t t t t t t t t t t t t t t t
DIF: CognitiveLevel: Application
t t REF: p. 9 OBJ: 9 t t t t t t
TOP: Charge Nurse/Manager
t KEY: NursingProcess Step: Implementation t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital. Which
t t t t t t t t t t t t t t t t t t
statement accurately explains a deductible?
t t t t t
a. An amount of moneyput asideforthepayment of future medical bills
t t t t t t t t t t t t
b. Aone-time fee forservice
t t t t
c. An amount of moneydeductedfromthe bill bythe insurancecompany
t t t t t t t t t t t
d. Anannual amount of moneythe patient must payout-of-pocket for medicalcare
t t t t t t t t t t t t
ANS: D t
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
t t t t t t t t t t t t t t t
assuming the cost. This practice improves the profit of the insurance company.
t t t t t t t t t t t t
DIF: Cognitive Level: Comprehension
t t REF: p. 7 OBJ: 9 t t t t t t t t
TOP: Health Care Financing t KEY: NursingProcess Step: Implementation t t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
7. Apatientasks the nurse what Medicare Part Acovers.Which responseiscorrect?
t t t t t t t t t t t t t
a. Medicare Part Acoversinpatient hospitalcosts. t t t t t t
b. Medicare Part Acoversreimbursement tothephysician. t t t t t t t
c. MedicarePart Acoversoutpatient hospitalservices. t t t t t t
d. Medicare Part Acovers ambulancetransportation. t t t t t
ANS: A t
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
t t t t t t t t t t t t t
Medicare Part B pays the physician, ambulance transport, and outpatient services.
t t t t t t t t t t t
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 t t t t t t
OBJ: 9 TOP:Government-SponsoredHealthInsurance
t t t t
KEY: Nursing Process Step: Implementation
t t t t t
MSC:NCLEX:Safe,EffectiveCareEnvironment:CoordinatedCare
t t t t t t t
8. Whichisthemaincost-containment component of diagnosis-related groups(DRGs)?
t t t t t t t t t
a. Hospitalsfocusonlyon thespecificdiagnosis. t t t t t t
b. Hospitalstreat and discharge patientsquickly. t t t t t
c. Reducedcost drugs are orderedforspecificdiagnoses. t t t t t t t
d. Diagnosticgroupclassificationstreamlinescare. t t t t
ANS: B t
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
t t t t t t t t t t t t t t t t
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before
t t t t t t t t t t t t t t t t t t
the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged
t t t t t t t t t t t t t t t t t t
sooner.
t
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ:9 t t t t t
TOP: Government-Sponsored Health Insurance
t t t t
KEY:NursingProcessStep: Implementation
t t t t
MSC:NCLEX:Safe,EffectiveCareEnvironment:CoordinatedCare
t t t t t t t
9. Thenurseisassessinga groupof patients.Which patient would most likelyqualifyforMedicaid?
t t t t t t t t t t t t t t t
a. A35-year-oldunemployedsinglemother withdiabetes
t t t t t t
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term care
t t t t t t t t t t t t t t
facility t
c. An 80-year-old blind woman living in her own home who has inadequate private
t t t t t t t t t t t t
insurance t
d. A67-year-oldstrokevictimwithMedicare Part Aandan income frominvestments
t t t t t t t t t t t t
ANS: A t
Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no
t t t t t t t t t t t t t t t t
insurance.
t
DIF: CognitiveLevel:Application REF: p. 8, Box 1-5 t t t t t t
OBJ: 9 TOP: Government-Sponsored HealthInsurance—Medicaid
t t t t
KEY: Nursing Process Step: Assessment
t t t t t
MSC:NCLEX:Safe,EffectiveCareEnvironment:CoordinatedCare
t t t t t t t
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
t t t t t t t t t t t t t t t t
improve the health of Americans in the second decade of the century?
t t t t t t t t t t t t
a. Researchfunding t
b. Health information distribution t t
c. Healthylifestyle encouragement t t
d. Health improvement programdesigns t t t
ANS: C t
Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce
t t t t t t t t t t t t t t
infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective immunizations,
t t t t t t t t t t t t
healthy eating habits, and healthy weight.
t t t t t t
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 t t t t t t
TOP: Healthy People 2020 t KEY: NursingProcess Step: Implementation t t t t t t
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
t t t t t t t t
