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Medical-Surgical Nursing: Concepts &
Practice 6th Edition By Holly K. Stromberg
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VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
, Table Of Contents
Chapter 01: Caring For Medical-Surgical Patients ................................................................................................................. 4
Chapter 02: Critical Thinking And The Nursing Process....................................................................................................... 14
Chapter 03: Fluid, Electrolytes, Acid-Base Balance, And Intravenous Therapy................................................................... 24
Chapter 04: Care Of Preoperative And Intraoperative Surgical Patients ................................................................................ 34
Chapter 05: Care Of Postoperative Patients .......................................................................................................................... 44
Chapter 06: Infection Prevention And Control ...................................................................................................................... 54
Chapter 07: Care Of Patients With Pain ................................................................................................................................ 64
Chapter 08: Care Of Patients With Cancer ............................................................................................................................ 74
Chapter 09: Chronic Illness And Rehabilitation .................................................................................................................... 84
Chapter 10: The Immune And Lymphatic System ................................................................................................................ 95
Chapter 11: Care Of Patients With Immune And Lymphatic Disorders (With HIV And AIDS) ........................................... 105
Chapter 12: The Respiratory System ................................................................................................................................... 116
Chapter 13: Care Of Patients With Disorders Of The Upper Respiratory System................................................................ 126
Chapter 14: Care Of Patients With Disorders Of The Lower Respiratory System ............................................................... 136
Chapter 15: The Hematologic System................................................................................................................................. 147
Chapter 16: Care Of Patients With Hematologic Disorders ................................................................................................. 157
Chapter 17: The Cardiovascular System............................................................................................................................. 167
Chapter 18: Care Of Patients With Hypertension And Peripheral Vascular Disease ........................................................... 177
Chapter 19: Care Of Patients With Cardiac Disorders ......................................................................................................... 187
Chapter 20: Care Of Patients With Coronary Artery Disease And Cardiac Surgery ............................................................ 197
Chapter 21: The Neurologic System.................................................................................................................................... 209
Chapter 22: Care Of Patients With Head And Spinal Cord Injuries ................................................................................... 219
Chapter 23: Care Of Patients With Disorders Of The Brain................................................................................................. 229
Chapter 24: Care Of Patients With Peripheral Nerve And Degenerative Diseases............................................................... 239
Chapter 25: The Sensory System: Eye And Ear .................................................................................................................. 249
Chapter 26: Care Of Patients With Disorders Of The Eyes And Ears................................................................................. 259
Chapter 27: The Gastrointestinal System............................................................................................................................ 270
Chapter 28: Care Of Patients With Disorders Of The Upper Gastrointestinal System ......................................................... 281
Chapter 29: Care Of Patients With Disorders Of The Lower Gastrointestinal System.......................................................... 292
Chapter 30: Care Of Patients With Disorders Of The Liver, Gallbladder, And Pancreas .................................................... 303
Chapter 31: The Musculoskeletal System........................................................................................................................... 314
Chapter 32: Care Of Patients With Musculoskeletal And Connective Tissue Disorders ...................................................... 324
Chapter 33: The Urinary System ......................................................................................................................................... 335
Chapter 34: Care Of Patients With Disorders Of The Urinary System ............................................................................... 347
Chapter 35: The Endocrine System ..................................................................................................................................... 359
Chapter 36: Care Of Patients With Pituitary, Thyroid, Parathyroid, And Adrenal disorders ............................................. 369
Chapter 37: Care Of Patients With Diabetes And Hypoglycemia ....................................................................................... 381
Chapter 38: Care Of Women With Reproductive Disorders ............................................................................................... 394
Chapter 39: Care Of Men With Reproductive Disorders ..................................................................................................... 406
Chapter 40: Care Of Patients With Sexually Transmitted Infections .................................................................................. 418
Chapter 41: The Integumentary System .............................................................................................................................. 428
Chapter 42: Care Of Patents With Integumentary Disorders And Burns ............................................................................. 438
Chapter 43: Care Of Patients In Disasters Or Bioterrorism Attack ..................................................................................... 451
,Chapter 44: Care Of Patients With Emergencies, Trauma, And Shock ................................................................................ 461
Chapter 45: Care Of Patients With Anxiety, Mood, And Eating Disorders ....................................................................... 473
Chapter 46: Care Of Patients With Substance Abuse Disorders ......................................................................................... 483
Chapter 47: Care Of Patients With Cognitive Disorders...................................................................................................... 494
Chapter 48: Care Of Patients With Thought And Personality Disorders .............................................................................. 504
,Chapter 01: Caring For Medical-Surgical Patients
Stromberg: Medical-Surgical Nursing: Concepts And Practice, 6th Edition
MULTIPLE CHOICE
1. Which Statement Accurately Describes The Primary Purpose Of The State Nurse Practice Act (NPA)?
a. To Test And License LPN/LVNs
b. To Define The Scope Of LPN/LVN Practice
c. To Improve The Quality Of Care Provided By The LPN/LVN
d. To Limit The LPN/LVN Employment Placement
ANSWER: B
While Improving Quality Of Care Provided By The LPN/LVN May Be A Result Of The
NPA, ThePrimary Purpose Of The NPA Of Each State Defines The Scope Of Nursing
Practice In That State.
DIF: Cognitive Level: Comprehension REF: P. 3 OBJ: 3
TOP: NPA KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. The Charge Nurse Asks The New Vocational Nurse To Start An Intravenous Infusion, A
Skill That The Vocational Nurse Has Not Been Taught During Her Educational Program.
How ShouldThe Vocational Nurse Respond?
a. Ask A More Experienced Nurse To Demonstrate The Procedure.
b. Look Up The Procedure In The Procedure Manual.
c. Attempt To Perform The Procedure With Supervision.
d. Inform The Charge Nurse Of Her Lack Of Training In This Procedure.
ANSWER: D
The Charge Nurse Should Be Informed Of The Lack Of Training To Perform The
Procedure, AndThe Vocational Nurse Should Seek Further Training To Gain Proficiency.
Although The Other Options Might Be Helpful, They Are Not Safe.
DIF: Cognitive Level: Application REF: P. 3 OBJ: 1
TOP: Providing Safe Care KEY: NURSING Process
Step: N/A MSC: NCLEX: Safe, Effective Care Environment:
Coordinated Care
3. Which Patient Statement Indicates A Need For Further Discharge Teaching
That TheVocational Nurse Should Address?
a. "I Have No Idea Of How This Drug Will Affect Me."
b. "Do You Know If My Physician Is Coming Back Today?"
c. "Will My Insurance Pay For My Stay?"
d. "Am I Going To Have To Go To A Nursing Home?"
ANSWER: A
Lack Of Knowledge At Discharge About Medication Effects And Side Effects Is A
Concern ThatShould Be Addressed By The Vocational Nurse. The Other Concerns In The
Options Are The Responsibility Of Other Departments To WHICH The Nurse Might
Refer The Patient.
DIF: Cognitive Level: Application REF: P. 2 OBJ: 1
TOP: Teaching KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Carez
2|Page
,4. According To Most State Npas, The Vocational NURSE Acting As Charge NURSE
In ALong-Term Care Facility Acts In WHICH Capacity?
a. Working Under Direct Supervision Of An RN On The Unit
b. Working With The RN In The Building
c. Working Under General Supervision By The RN Available On Site Or By Phone
d. Working As An Independent Vocational NURSE
ANSWER: C
The Vocational NURSE In The Capacity Of The Charge NURSE In A Long-Term Care
FacilityActs With The General Supervision Of An RN Available On Site Or By Phone.
DIF: Cognitive Level: Comprehension REF: P. 3 OBJ: 1
TOP: Charge NURSE/Manager KEY: NURSING Process
Step: N/A MSC: NCLEX: Safe, Effective Care Environment:
Coordinated Care
5. The NURSE Is Educating A Patient That Is A Member Of A Health
MaintenanceOrganization (HMO). WHICH Information Should The
NURSE Include?
a. Seek The Opinion Of An Alternate Health Care Provider.
b. Contact The Insurance Company For Coverage Details As Services May Be Limited.
c. Provide Detailed Documentation Of All Care Received For His Condition.
d. Wait At Least 6 Months To See A Specialist.
ANSWER: B
Hmos Are A Kind Of Managed Care. This Is Accomplished By Paying Providers To Care
For Groups Of Patients For A Set Capitation Fee And By Limiting Services. Patients Are
Not Required To Seek A Second Opinion, Provide Documentation Of Care, Or Wait A
Specific Time Period Before Visiting A Specialist.
DIF: Cognitive Level: Application REF: P. 9 OBJ: 9
TOP: Charge NURSE/Manager KEY: NURSING Process
Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The Patient Complains To The NURSE That He Is Confused About His "Deductible" That
He OwesThe Hospital. WHICH Statement Accurately Explains A Deductible?
a. An Amount Of Money Put Aside For The Payment Of Future Medical Bills
b. A One-Time Fee For Service
c. An Amount Of Money Deducted From The Bill By The Insurance Company
d. An Annual Amount Of Money The Patient Must Pay Out-Of-Pocket For Medical Care
ANSWER: D
The Deductible Is The Annual Amount The Insured Must Pay Out-Of-Pocket Prior
To TheInsurance Company Assuming The Cost. This Practice Improves The Profit
Of The Insurance Company.
DIF: Cognitive Level: Comprehension REF: P. 7 OBJ: 9
TOP: Health Care Financing KEY: NURSING Process
Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
7. A Patient Asks The NURSE What Medicare Part A Covers. WHICH Response Is Correct?
a. Medicare Part A Covers Inpatient Hospital Costs.
b. Medicare Part A Covers Reimbursement To The Physician.
c. Medicare Part A Covers Outpatient Hospital Services.
3|Page
, d. Medicare Part A Covers Ambulance Transportation.
ANSWER: A
Medicare Part A Covers Inpatient Hospital Expenses, Drugs, X-Rays, Laboratory
Work, And Intensive Care. Medicare Part B Pays The Physician, Ambulance Transport,
And OutpatientServices.
DIF: Cognitive Level: Comprehension REF: P. 8, Box 1-4
OBJ: 9 TOP: Government-Sponsored Health
Insurance KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. WHICH Is The Main Cost-Containment Component Of Diagnosis-Related Groups (Drgs)?
a. Hospitals Focus Only On The Specific Diagnosis.
b. Hospitals Treat And Discharge Patients Quickly.
c. Reduced Cost Drugs Are Ordered For Specific Diagnoses.
d. Diagnostic Group Classification Streamlines Care.
ANSWER: B
Drgs Are A Prospective Payment Plan In WHICH Hospitals Receive A Flat Fee For Each
Patient's Diagnostic Category Regardless Of The Length Of Time In The Hospital. If
Hospitals Can Treat And Discharge Patients Before The Allotted Time, Hospitals Get To
Keep The ExcessPayment; Cost Is Contained, And The Patient Is Discharged Sooner.
DIF: Cognitive Level: Comprehension REF: P. 8 OBJ: 9
TOP: Government-Sponsored Health Insurance
KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. The NURSE Is Assessing A Group Of Patients. WHICH Patient Would Most Likely
Qualify ForMedicaid?
a. A 35-Year-Old Unemployed Single Mother With Diabetes
b. A 70-Year-Old Medicare Recipient With Retirement Income Who Needs To
Be In ALong-Term Care Facility
c. An 80-Year-Old Blind Woman Living In Her Own Home Who Has
InadequatePrivate Insurance
d. A 67-Year-Old Stroke Victim With Medicare Part A And An Income From Investments
ANSWER: A
Medicaid Is A Joint Effort Of Federal And State Governments Geared Primarily
For Low-Income People With No Insurance.
DIF: Cognitive Level: Application REF: P. 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance—
Medicaid KEY: NURSING Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. WHICH Area Is The Major Focus Of Healthy People 2020 And The Primary Mechanism
Through WHICH To Improve The Health Of Americans In The Second Decade Of The
Century?
a. Research Funding
b. Health Information Distribution
c. Healthy Lifestyle Encouragement
d. Health Improvement Program Designs
ANSWER: C
Healthy People 2020 Focuses On Expanding Ongoing Programs To Include Support And
4|Page
, Information To Reduce Infant Mortality, Cancer, Cardiovascular Disease, And HIV/AIDS,
AndTo Increase Effective Immunizations, Healthy Eating Habits, And Healthy Weight.
DIF: Cognitive Level: Comprehension REF: P. 6 OBJ: 7
TOP: Healthy People 2020 KEY: NURSING Process
Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
11. WHICH Term Explains The Type Of Care That Addresses Interventions For All
Dimensions Of APatient's Life?
a. Focused Care
b. General Care
c. Directed Care
d. Holistic Care
ANSWER: D
Holistic Care Addresses The Physiologic, Psychological, Social, Cultural, And
SpiritualNeeds Of The Patient.
DIF: Cognitive Level: Comprehension REF: P. 9 OBJ: 8
TOP: Holistic Care KEY: NURSING Process Step:
Planning MSC: NCLEX: Psychosocial Integrity: Coping And
Adaptation
12. A Patient Furiously Says, "My Doctor Was So Busy Giving Me Instructions That He
Didn't HearWhat I Was Trying To Ask Him!" WHICH Response Is Most Empathetic?
a. "When People Ignore Me, I Really Get Mad."
b. "I'm Sure That The Doctor Was Rushed And Unaware Of Your Needs."
c. "That Sounds Really Frustrating."
d. "Take A Deep Breath And Plan What You Will Say To Him Tomorrow."
ANSWER: C
Empathy Demonstrates That The NURSE Perceives The Patient's Feelings But Does Not
Share TheEmotion. Belittling The Patient's Feelings, Showing Sympathy, Or Defending The
Doctor Makes The Patient Feel Devalued.
DIF: Cognitive Level: Analysis REF: P. 10 OBJ: 10
TOP: NURSE-Patient Relationship KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity
13. The NURSE Is Explaining Differences In A Therapeutic Relationship And A Social
Relationship To A Patient. WHICH Information About Therapeutic Relationships Is Most
Important For The NURSE To Include In The Explanation?
a. Therapeutic Relationships Lack Formal Boundaries.
b. Therapeutic Relationships Are Goal Directed.
c. Therapeutic Relationships Meet The Needs Of Each Person In The Relationship.
d. Therapeutic Relationships Extend Past The Hospitalization Period.
ANSWER: B
The Therapeutic Relationship Is Focused On The Patient And Is Goal Directed And
Designed ToMeet Only The Needs Of The Patient And Does Not Extend Past The Period
Of Hospitalization.
5|Page
, DIF: Cognitive Level: Comprehension REF: P. 9 OBJ: 10
TOP: Therapeutic Relationship KEY: NURSING Process
Step: Implementation MSC: NCLEX: Psychosocial Integrity
14. The NURSE Is Caring For A Patient Who Has Been On Antidepressants For 3 Days. The
PatientTearfully Says, "I Still Feel Terrible. I Don't Think Anything Can Help How I
Feel." WHICH Response Is Best?
a. "I Will Tell The Charge NURSE How You Are Feeling."
b. "You Just Need To Be Patient And Give Your Medicine Some Time To Work."
c. "Look How Much You Have Improved Since You Were Admitted To The Facility."
d. "It Must Be Frustrating To Be Going Through This
DifficultTime." ANSWER: D
This Response Is An Empathetic Response That Allows For Further Exploration Of The Patient's
Feelings.The Other Responses Will Block Communication With This Patient.
DIF: Cognitive Level: Application REF: P. 9 OBJ: 10
TOP: Therapeutic Communication KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity
15. An Overweight Male Patient Rips Off His Hospital Gown, Throws It Out The Door, And Shouts,
"I'm NotWearing This Stupid Gown! It Is Too Small, Too Short, And Exposes My Backside To
The World!" WHICH Response Is Most Appropriate?
a. Remind Patient Of The Need To Wear The Gown For Convenience In Care.
b. Confer With The Patient For Methods To Acquire A Larger Gown.
c. Replace The Torn Gown With Another.
d. Inform The Charge NURSE Of The Hostile Behavior.
ANSWER: B
Allowing Hostile Patients To Make Reasonable Requests Defuses The Anger And Allows Patients
To VentTheir Feelings.
DIF: Cognitive Level: Application REF: P. 10 OBJ: 10
TOP: Hostile Behavior KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity: Coping And
Adaptation
16. The NURSE Is Caring For A Patient Who States, "You Are The Only NURSE Who Understands
About MyPain. Can't You Give Me An Extra Dose Of Pain Medication?" How Should The NURSE
Respond To The Patient's Request?
a. Explain That Dosage Schedules Are By Physician's Orders.
b. Ignore The Request.
c. Tell The Patient That His Behavior Is Manipulative.
d. Agree To Give An Extra Dose Of Pain Medication.
ANSWER: A
A Matter-Of-Fact Response To A Manipulative Request Limits The Effect Of The Manipulation,
TherebyHelping The NURSE To Avoid Becoming Defensive Or Being Swayed By Flattery.
DIF: Cognitive Level: Application REF: P. 10 OBJ: 10
TOP: Manipulative Behavior KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity
17. A Female Patient Who Has Recently Been Diagnosed With An Inoperable Brain Tumor Asks The
NURSE,"Do You Think God Punishes Us?" WHICH Response Demonstrates Therapeutic
6|Page
Medical-Surgical Nursing: Concepts &
Practice 6th Edition By Holly K. Stromberg
PRINTED PDF | ORIGINAL DIRECTLY FROM THE PUBLISHER | 100%
VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
, Table Of Contents
Chapter 01: Caring For Medical-Surgical Patients ................................................................................................................. 4
Chapter 02: Critical Thinking And The Nursing Process....................................................................................................... 14
Chapter 03: Fluid, Electrolytes, Acid-Base Balance, And Intravenous Therapy................................................................... 24
Chapter 04: Care Of Preoperative And Intraoperative Surgical Patients ................................................................................ 34
Chapter 05: Care Of Postoperative Patients .......................................................................................................................... 44
Chapter 06: Infection Prevention And Control ...................................................................................................................... 54
Chapter 07: Care Of Patients With Pain ................................................................................................................................ 64
Chapter 08: Care Of Patients With Cancer ............................................................................................................................ 74
Chapter 09: Chronic Illness And Rehabilitation .................................................................................................................... 84
Chapter 10: The Immune And Lymphatic System ................................................................................................................ 95
Chapter 11: Care Of Patients With Immune And Lymphatic Disorders (With HIV And AIDS) ........................................... 105
Chapter 12: The Respiratory System ................................................................................................................................... 116
Chapter 13: Care Of Patients With Disorders Of The Upper Respiratory System................................................................ 126
Chapter 14: Care Of Patients With Disorders Of The Lower Respiratory System ............................................................... 136
Chapter 15: The Hematologic System................................................................................................................................. 147
Chapter 16: Care Of Patients With Hematologic Disorders ................................................................................................. 157
Chapter 17: The Cardiovascular System............................................................................................................................. 167
Chapter 18: Care Of Patients With Hypertension And Peripheral Vascular Disease ........................................................... 177
Chapter 19: Care Of Patients With Cardiac Disorders ......................................................................................................... 187
Chapter 20: Care Of Patients With Coronary Artery Disease And Cardiac Surgery ............................................................ 197
Chapter 21: The Neurologic System.................................................................................................................................... 209
Chapter 22: Care Of Patients With Head And Spinal Cord Injuries ................................................................................... 219
Chapter 23: Care Of Patients With Disorders Of The Brain................................................................................................. 229
Chapter 24: Care Of Patients With Peripheral Nerve And Degenerative Diseases............................................................... 239
Chapter 25: The Sensory System: Eye And Ear .................................................................................................................. 249
Chapter 26: Care Of Patients With Disorders Of The Eyes And Ears................................................................................. 259
Chapter 27: The Gastrointestinal System............................................................................................................................ 270
Chapter 28: Care Of Patients With Disorders Of The Upper Gastrointestinal System ......................................................... 281
Chapter 29: Care Of Patients With Disorders Of The Lower Gastrointestinal System.......................................................... 292
Chapter 30: Care Of Patients With Disorders Of The Liver, Gallbladder, And Pancreas .................................................... 303
Chapter 31: The Musculoskeletal System........................................................................................................................... 314
Chapter 32: Care Of Patients With Musculoskeletal And Connective Tissue Disorders ...................................................... 324
Chapter 33: The Urinary System ......................................................................................................................................... 335
Chapter 34: Care Of Patients With Disorders Of The Urinary System ............................................................................... 347
Chapter 35: The Endocrine System ..................................................................................................................................... 359
Chapter 36: Care Of Patients With Pituitary, Thyroid, Parathyroid, And Adrenal disorders ............................................. 369
Chapter 37: Care Of Patients With Diabetes And Hypoglycemia ....................................................................................... 381
Chapter 38: Care Of Women With Reproductive Disorders ............................................................................................... 394
Chapter 39: Care Of Men With Reproductive Disorders ..................................................................................................... 406
Chapter 40: Care Of Patients With Sexually Transmitted Infections .................................................................................. 418
Chapter 41: The Integumentary System .............................................................................................................................. 428
Chapter 42: Care Of Patents With Integumentary Disorders And Burns ............................................................................. 438
Chapter 43: Care Of Patients In Disasters Or Bioterrorism Attack ..................................................................................... 451
,Chapter 44: Care Of Patients With Emergencies, Trauma, And Shock ................................................................................ 461
Chapter 45: Care Of Patients With Anxiety, Mood, And Eating Disorders ....................................................................... 473
Chapter 46: Care Of Patients With Substance Abuse Disorders ......................................................................................... 483
Chapter 47: Care Of Patients With Cognitive Disorders...................................................................................................... 494
Chapter 48: Care Of Patients With Thought And Personality Disorders .............................................................................. 504
,Chapter 01: Caring For Medical-Surgical Patients
Stromberg: Medical-Surgical Nursing: Concepts And Practice, 6th Edition
MULTIPLE CHOICE
1. Which Statement Accurately Describes The Primary Purpose Of The State Nurse Practice Act (NPA)?
a. To Test And License LPN/LVNs
b. To Define The Scope Of LPN/LVN Practice
c. To Improve The Quality Of Care Provided By The LPN/LVN
d. To Limit The LPN/LVN Employment Placement
ANSWER: B
While Improving Quality Of Care Provided By The LPN/LVN May Be A Result Of The
NPA, ThePrimary Purpose Of The NPA Of Each State Defines The Scope Of Nursing
Practice In That State.
DIF: Cognitive Level: Comprehension REF: P. 3 OBJ: 3
TOP: NPA KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. The Charge Nurse Asks The New Vocational Nurse To Start An Intravenous Infusion, A
Skill That The Vocational Nurse Has Not Been Taught During Her Educational Program.
How ShouldThe Vocational Nurse Respond?
a. Ask A More Experienced Nurse To Demonstrate The Procedure.
b. Look Up The Procedure In The Procedure Manual.
c. Attempt To Perform The Procedure With Supervision.
d. Inform The Charge Nurse Of Her Lack Of Training In This Procedure.
ANSWER: D
The Charge Nurse Should Be Informed Of The Lack Of Training To Perform The
Procedure, AndThe Vocational Nurse Should Seek Further Training To Gain Proficiency.
Although The Other Options Might Be Helpful, They Are Not Safe.
DIF: Cognitive Level: Application REF: P. 3 OBJ: 1
TOP: Providing Safe Care KEY: NURSING Process
Step: N/A MSC: NCLEX: Safe, Effective Care Environment:
Coordinated Care
3. Which Patient Statement Indicates A Need For Further Discharge Teaching
That TheVocational Nurse Should Address?
a. "I Have No Idea Of How This Drug Will Affect Me."
b. "Do You Know If My Physician Is Coming Back Today?"
c. "Will My Insurance Pay For My Stay?"
d. "Am I Going To Have To Go To A Nursing Home?"
ANSWER: A
Lack Of Knowledge At Discharge About Medication Effects And Side Effects Is A
Concern ThatShould Be Addressed By The Vocational Nurse. The Other Concerns In The
Options Are The Responsibility Of Other Departments To WHICH The Nurse Might
Refer The Patient.
DIF: Cognitive Level: Application REF: P. 2 OBJ: 1
TOP: Teaching KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Carez
2|Page
,4. According To Most State Npas, The Vocational NURSE Acting As Charge NURSE
In ALong-Term Care Facility Acts In WHICH Capacity?
a. Working Under Direct Supervision Of An RN On The Unit
b. Working With The RN In The Building
c. Working Under General Supervision By The RN Available On Site Or By Phone
d. Working As An Independent Vocational NURSE
ANSWER: C
The Vocational NURSE In The Capacity Of The Charge NURSE In A Long-Term Care
FacilityActs With The General Supervision Of An RN Available On Site Or By Phone.
DIF: Cognitive Level: Comprehension REF: P. 3 OBJ: 1
TOP: Charge NURSE/Manager KEY: NURSING Process
Step: N/A MSC: NCLEX: Safe, Effective Care Environment:
Coordinated Care
5. The NURSE Is Educating A Patient That Is A Member Of A Health
MaintenanceOrganization (HMO). WHICH Information Should The
NURSE Include?
a. Seek The Opinion Of An Alternate Health Care Provider.
b. Contact The Insurance Company For Coverage Details As Services May Be Limited.
c. Provide Detailed Documentation Of All Care Received For His Condition.
d. Wait At Least 6 Months To See A Specialist.
ANSWER: B
Hmos Are A Kind Of Managed Care. This Is Accomplished By Paying Providers To Care
For Groups Of Patients For A Set Capitation Fee And By Limiting Services. Patients Are
Not Required To Seek A Second Opinion, Provide Documentation Of Care, Or Wait A
Specific Time Period Before Visiting A Specialist.
DIF: Cognitive Level: Application REF: P. 9 OBJ: 9
TOP: Charge NURSE/Manager KEY: NURSING Process
Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The Patient Complains To The NURSE That He Is Confused About His "Deductible" That
He OwesThe Hospital. WHICH Statement Accurately Explains A Deductible?
a. An Amount Of Money Put Aside For The Payment Of Future Medical Bills
b. A One-Time Fee For Service
c. An Amount Of Money Deducted From The Bill By The Insurance Company
d. An Annual Amount Of Money The Patient Must Pay Out-Of-Pocket For Medical Care
ANSWER: D
The Deductible Is The Annual Amount The Insured Must Pay Out-Of-Pocket Prior
To TheInsurance Company Assuming The Cost. This Practice Improves The Profit
Of The Insurance Company.
DIF: Cognitive Level: Comprehension REF: P. 7 OBJ: 9
TOP: Health Care Financing KEY: NURSING Process
Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
7. A Patient Asks The NURSE What Medicare Part A Covers. WHICH Response Is Correct?
a. Medicare Part A Covers Inpatient Hospital Costs.
b. Medicare Part A Covers Reimbursement To The Physician.
c. Medicare Part A Covers Outpatient Hospital Services.
3|Page
, d. Medicare Part A Covers Ambulance Transportation.
ANSWER: A
Medicare Part A Covers Inpatient Hospital Expenses, Drugs, X-Rays, Laboratory
Work, And Intensive Care. Medicare Part B Pays The Physician, Ambulance Transport,
And OutpatientServices.
DIF: Cognitive Level: Comprehension REF: P. 8, Box 1-4
OBJ: 9 TOP: Government-Sponsored Health
Insurance KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. WHICH Is The Main Cost-Containment Component Of Diagnosis-Related Groups (Drgs)?
a. Hospitals Focus Only On The Specific Diagnosis.
b. Hospitals Treat And Discharge Patients Quickly.
c. Reduced Cost Drugs Are Ordered For Specific Diagnoses.
d. Diagnostic Group Classification Streamlines Care.
ANSWER: B
Drgs Are A Prospective Payment Plan In WHICH Hospitals Receive A Flat Fee For Each
Patient's Diagnostic Category Regardless Of The Length Of Time In The Hospital. If
Hospitals Can Treat And Discharge Patients Before The Allotted Time, Hospitals Get To
Keep The ExcessPayment; Cost Is Contained, And The Patient Is Discharged Sooner.
DIF: Cognitive Level: Comprehension REF: P. 8 OBJ: 9
TOP: Government-Sponsored Health Insurance
KEY: NURSING Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. The NURSE Is Assessing A Group Of Patients. WHICH Patient Would Most Likely
Qualify ForMedicaid?
a. A 35-Year-Old Unemployed Single Mother With Diabetes
b. A 70-Year-Old Medicare Recipient With Retirement Income Who Needs To
Be In ALong-Term Care Facility
c. An 80-Year-Old Blind Woman Living In Her Own Home Who Has
InadequatePrivate Insurance
d. A 67-Year-Old Stroke Victim With Medicare Part A And An Income From Investments
ANSWER: A
Medicaid Is A Joint Effort Of Federal And State Governments Geared Primarily
For Low-Income People With No Insurance.
DIF: Cognitive Level: Application REF: P. 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance—
Medicaid KEY: NURSING Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. WHICH Area Is The Major Focus Of Healthy People 2020 And The Primary Mechanism
Through WHICH To Improve The Health Of Americans In The Second Decade Of The
Century?
a. Research Funding
b. Health Information Distribution
c. Healthy Lifestyle Encouragement
d. Health Improvement Program Designs
ANSWER: C
Healthy People 2020 Focuses On Expanding Ongoing Programs To Include Support And
4|Page
, Information To Reduce Infant Mortality, Cancer, Cardiovascular Disease, And HIV/AIDS,
AndTo Increase Effective Immunizations, Healthy Eating Habits, And Healthy Weight.
DIF: Cognitive Level: Comprehension REF: P. 6 OBJ: 7
TOP: Healthy People 2020 KEY: NURSING Process
Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
11. WHICH Term Explains The Type Of Care That Addresses Interventions For All
Dimensions Of APatient's Life?
a. Focused Care
b. General Care
c. Directed Care
d. Holistic Care
ANSWER: D
Holistic Care Addresses The Physiologic, Psychological, Social, Cultural, And
SpiritualNeeds Of The Patient.
DIF: Cognitive Level: Comprehension REF: P. 9 OBJ: 8
TOP: Holistic Care KEY: NURSING Process Step:
Planning MSC: NCLEX: Psychosocial Integrity: Coping And
Adaptation
12. A Patient Furiously Says, "My Doctor Was So Busy Giving Me Instructions That He
Didn't HearWhat I Was Trying To Ask Him!" WHICH Response Is Most Empathetic?
a. "When People Ignore Me, I Really Get Mad."
b. "I'm Sure That The Doctor Was Rushed And Unaware Of Your Needs."
c. "That Sounds Really Frustrating."
d. "Take A Deep Breath And Plan What You Will Say To Him Tomorrow."
ANSWER: C
Empathy Demonstrates That The NURSE Perceives The Patient's Feelings But Does Not
Share TheEmotion. Belittling The Patient's Feelings, Showing Sympathy, Or Defending The
Doctor Makes The Patient Feel Devalued.
DIF: Cognitive Level: Analysis REF: P. 10 OBJ: 10
TOP: NURSE-Patient Relationship KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity
13. The NURSE Is Explaining Differences In A Therapeutic Relationship And A Social
Relationship To A Patient. WHICH Information About Therapeutic Relationships Is Most
Important For The NURSE To Include In The Explanation?
a. Therapeutic Relationships Lack Formal Boundaries.
b. Therapeutic Relationships Are Goal Directed.
c. Therapeutic Relationships Meet The Needs Of Each Person In The Relationship.
d. Therapeutic Relationships Extend Past The Hospitalization Period.
ANSWER: B
The Therapeutic Relationship Is Focused On The Patient And Is Goal Directed And
Designed ToMeet Only The Needs Of The Patient And Does Not Extend Past The Period
Of Hospitalization.
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, DIF: Cognitive Level: Comprehension REF: P. 9 OBJ: 10
TOP: Therapeutic Relationship KEY: NURSING Process
Step: Implementation MSC: NCLEX: Psychosocial Integrity
14. The NURSE Is Caring For A Patient Who Has Been On Antidepressants For 3 Days. The
PatientTearfully Says, "I Still Feel Terrible. I Don't Think Anything Can Help How I
Feel." WHICH Response Is Best?
a. "I Will Tell The Charge NURSE How You Are Feeling."
b. "You Just Need To Be Patient And Give Your Medicine Some Time To Work."
c. "Look How Much You Have Improved Since You Were Admitted To The Facility."
d. "It Must Be Frustrating To Be Going Through This
DifficultTime." ANSWER: D
This Response Is An Empathetic Response That Allows For Further Exploration Of The Patient's
Feelings.The Other Responses Will Block Communication With This Patient.
DIF: Cognitive Level: Application REF: P. 9 OBJ: 10
TOP: Therapeutic Communication KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity
15. An Overweight Male Patient Rips Off His Hospital Gown, Throws It Out The Door, And Shouts,
"I'm NotWearing This Stupid Gown! It Is Too Small, Too Short, And Exposes My Backside To
The World!" WHICH Response Is Most Appropriate?
a. Remind Patient Of The Need To Wear The Gown For Convenience In Care.
b. Confer With The Patient For Methods To Acquire A Larger Gown.
c. Replace The Torn Gown With Another.
d. Inform The Charge NURSE Of The Hostile Behavior.
ANSWER: B
Allowing Hostile Patients To Make Reasonable Requests Defuses The Anger And Allows Patients
To VentTheir Feelings.
DIF: Cognitive Level: Application REF: P. 10 OBJ: 10
TOP: Hostile Behavior KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity: Coping And
Adaptation
16. The NURSE Is Caring For A Patient Who States, "You Are The Only NURSE Who Understands
About MyPain. Can't You Give Me An Extra Dose Of Pain Medication?" How Should The NURSE
Respond To The Patient's Request?
a. Explain That Dosage Schedules Are By Physician's Orders.
b. Ignore The Request.
c. Tell The Patient That His Behavior Is Manipulative.
d. Agree To Give An Extra Dose Of Pain Medication.
ANSWER: A
A Matter-Of-Fact Response To A Manipulative Request Limits The Effect Of The Manipulation,
TherebyHelping The NURSE To Avoid Becoming Defensive Or Being Swayed By Flattery.
DIF: Cognitive Level: Application REF: P. 10 OBJ: 10
TOP: Manipulative Behavior KEY: NURSING Process Step:
Implementation MSC: NCLEX: Psychosocial Integrity
17. A Female Patient Who Has Recently Been Diagnosed With An Inoperable Brain Tumor Asks The
NURSE,"Do You Think God Punishes Us?" WHICH Response Demonstrates Therapeutic
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