gb gb gb gb gb gb gb gb gb gb gb gb
Chapters 1-49 | Latest Update gb gb gb gb gb
Chapter 01: Caring for Medical-Surgical Patients
gb gb gb gb gb
deWit: Medical-Surgical Nursing: Concepts & Practice, 5th Edition
gb gb gb gb gb gb gb
MULTIPLE CHOICE gb
Which statement accurately describes the primary purpose of the state nurse practice act
gb gb gb gb gb gb gb gb gb gb gb gb
(NPA)?
gb
a. To test and license LPN/LVNs. gb gb gb gb
b. To define the scope of LPN/LVN gb gb gb gb gb
practice.
c. To improve the quality of care gb gb gb gb gb
provided by the LPN/LVN. gb gb gb
d. To limit the LPN/LVN employment gb gb gb gb
placement.
ANS: B gb
While improving quality of care provided by the LPN/LVN may be a result of the NPA,
gb gb gb gb gb gb gb gb gb gb gb gb gb gb gb
the primary purpose of the NPA of each state defines the scope of nursing practice in
gb gb gb gb gb gb gb gb gb gb gb gb gb gb gb gb
that state.
gb gb
PTS: 1
Cognitive Level: Comprehension DIF: gb gb
REF: 2 g b
OBJ:3 TOP: NPA KEY: Nursing Process Step: g b gb gb gb
Implementation
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill
gb gb gb gb gb gb gb gb gb gb gb gb gb gb
that the vocational nurse has notbeen taught during her educational program. How
gb gb gb gb gb gb gb gb gb gb gb gb
should the vocational nurse respond?
gb gb gb gb gb
a. Ask a more experienced nurse to gb gb gb gb gb
demonstrate the procedure. gb gb
b. Look up the procedure in the procedure gb gb gb gb gb gb
manual.
c. Attempt to perform the procedure with gb gb gb gb gb
supervision.
d. Inform the charge nurse of her lack of gb gb gb gb gb gb gb
training in this procedure. gb gb gb
ANS: D gb
The charge nurse should be informed of the lack of training to perform the procedure,
gb gb gb gb gb gb gb gb gb gb gb gb gb gb
and the vocational nurse should seek further training to gain proficiency. Although the
gb gb gb gb gb gb gb gb gb gb gb gb gb
other options might be helpful, they are not safe.
gb gb gb gb gb gb gb gb gb
PTS: 1 DIF: Cognitive Level: gb 3
, Application REF: g b
OBJ: 1 TOP: Providing Safe Care Nursing Process gb gb gb
KEY: Step: N/A gb
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
Which patient statement indicates a need for further discharge teaching that the vocational
gb gb gb gb gb gb gb gb gb gb gb gb
nurse should address?
gb gb gb
a. “I have no idea of how this drug gb gb gb gb gb gb gb
will affect me.” gb gb
b. “Do you know if my physician is gb gb gb gb gb gb
coming back today?” gb gb
c. “Will my insurance pay for my gb gb gb gb gb
stay?”
d. “Am I going to have to go to a gb gb gb gb gb gb gb gb
nursing home?” gb
ANS: A gb
Lack of knowledge at discharge about medication effects and side effects is a concern
gb gb gb gb gb gb gb gb gb gb gb gb gb
that should be addressed by the vocationalnurse. The other concerns in the options are
gb gb gb gb gb gb gb gb gb gb gb gb gb gb
the responsibility of other departments to which the nurse might refer the patient.
gb gb gb gb gb gb gb gb gb gb gb gb gb
PTS: 1
Cognitive Level: Application REF: DIF: gb gb
2
OBJ:1 TOP: Teaching KEY: Nursing Process g b gb
Step: Implementation gb
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
According to most state NPAs, the vocational nurse acting as charge nurse in a long- term
gb gb gb gb gb gb gb gb gb gb gb gb gb gb gb
care facility acts in which capacity?
gb gb gb gb gb gb
a. Working under direct supervision of an RN on gb gb gb gb gb gb gb
the unit gb
b. Working with the RN in the building gb gb gb gb gb gb
c. Working under general supervision by the RN gb gb gb gb gb gb
available on site or by phone gb gb gb gb gb
d. Working as an independent vocational nurse gb gb gb gb gb
ANS: C gb
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts
gb gb gb gb gb gb gb gb gb gb gb gb gb gb gb
with the general supervision of an RNavailable on site or by phone.
gb gb gb gb gb gb gb gb gb gb gb gb
PTS: 1
Cognitive Level: REF: 2 DIF: gb
Comprehension
OBJ:1 TOP: Charge Nurse/Manager Nursi Process gb
KEY: ng Step: N/A gb
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
,The nurse is educating a patient that is a member of a health maintenance organization
gb gb gb gb gb gb gb gb gb gb gb gb gb gb
(HMO). Which informationshould the nurse include?
gb gb gb gb gb gb
a. Seek the opinion of an alternate health care gb gb gb gb gb gb gb
provider.
b. Obtain insurance approval for medical gb gb gb gb
services prior to treatment. gb gb gb
c. Provide detailed documentation of all care gb gb gb gb gb
received for his condition. gb gb gb
d. Wait at least 6 months to see a specialist. gb gb gb gb gb gb gb gb
ANS: B gb
Most HMOs require preprocedure authorization for treatment. Patients are not
gb gb gb gb gb gb gb gb gb
required to seek a second opinion, providedocumentation of care, or wait a specific
gb gb gb gb gb gb gb gb gb gb gb gb gb
time period before visiting a specialist.
gb gb gb gb gb gb
PTS: 1
Cognitive Level: 9 DIF: gb
Application REF: g b
OBJ:9 TOP: Charge Nurse/Manager gb
KEY: Nursing Process Step: Implementation
gb gb gb gb
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
The patient complains to the nurse that he is confused about his “deductible” that he owes
gb gb gb gb gb gb gb gb gb gb gb gb gb gb gb
the hospital. Whichstatement accurately explains a deductible?
gb gb gb gb gb gb gb
a. An amount of money put aside for the payment of gb gb gb gb gb gb gb gb gb
future medical bills gb gb
b. A one-time fee for service gb gb gb gb
c. An amount of money deducted from the bill by gb gb gb gb gb gb gb gb
the insurance company gb gb
d. An annual amount of money the patient must pay gb gb gb gb gb gb gb gb
out-of-pocket for medical care gb gb gb
ANS: D gb
The deductible is the annual amount the insured must pay out-of-pocket prior to the
gb gb gb gb gb gb gb gb gb gb gb gb gb
insurance company assuming the cost. Thispractice improves the profit of the insurance
gb gb gb gb gb gb gb gb gb gb gb gb gb
company.
gb
PTS: 1
Cognitive Level: REF: 7 DIF: gb
Comprehension
OBJ:9 TOP: Health Care Financing gb gb
KEY: Nursing Process Step: Implementation
gb gb gb gb
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
The nurse compares the characteristics of a health maintenance organization (HMO) and
gb gb gb gb gb gb gb gb gb gb gb
a preferred providerorganization (PPO). Which information should the nurse include
gb gb gb gb gb gb gb gb gb gb
about HMOs?
gb gb
, a. HMOs require a set fee of each gb gb gb gb gb gb
member monthly. gb
b. HMOs allow the member to select gb gb gb gb gb
his health care provider. gb gb gb
c. HMOs permit admission to any gb gb gb gb
facility the member prefers. gb gb gb
d. HMOs offer unlimited diagnostic gb gb gb
tests and treatments. gb gb
ANS: A gb
HMOs require a set fee from each member monthly (capitation). The patient will be
gb gb gb gb gb gb gb gb gb gb gb gb gb
treated by the HMO staff in HMO-approvedfacilities. Excessive use of diagnostic tests
gb gb gb gb gb gb gb gb gb gb gb gb
and treatments is discouraged by the HMO.
gb gb gb gb gb gb gb
PTS: 1
Cognitive Level: 9 DIF: gb
Application REF: g b
OBJ:9 TOP: Managed Care gb
KEY: Nursing Process Step: Implementation
gb gb gb gb
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
A patient asks the nurse what Medicare Part A covers. Which response is correct?
gb gb gb gb gb gb gb gb gb gb gb gb gb
a. Medicare Part A covers inpatient gb gb gb gb
hospital costs. gb
b. Medicare Part A covers gb gb gb
reimbursement to the physician. gb gb gb
c. Medicare Part A covers outpatient gb gb gb gb
hospital services. gb
d. Medicare Part A covers ambulance gb gb gb gb
transportation.
ANS: A gb
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and
gb gb gb gb gb gb gb gb gb gb gb
intensive care. Medicare Part B pays thephysician, ambulance transport, and outpatient
gb gb gb gb gb gb gb gb gb gb gb
services.
gb
PTS: 1
Cognitive Level: REF 7, Box DIF: gb gb
Comprehension : 1-4
OBJ:9 TOP: Government-Sponsored
Health Insurance gb
KEY: Nursing Process Step: Implementation
gb gb gb gb
MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care
gb gb gb gb gb gb gb
Which is the main cost-containment component of diagnosis-related groups (DRGs)?
gb gb gb gb gb gb gb gb gb