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medical_surgical_nursing_concepts___practice_5th_edition_by_stromberg_test

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TESTBANK
Q

,Chapter 01: Caring for Medical-Surgical Patients
Q Q Q Q Q




Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
Q Q Q Q Q Q Q




MULTIPLE CHOICE Q




1. Which statement accurately describes the primary purpose of the state nurse
Q Q Q Q Q Q Q Q Q Q




practice act (NPA)?
Q Q Q




a. To test and license LPN/LVNs
Q Q Q Q




b. To define the scope of LPN/LVN practice
Q Q Q Q Q Q




c. To improve the quality of care provided by the LPN/LVN
Q Q Q Q Q Q Q Q Q




d. To limit the LPN/LVN employment placement
Q Q Q Q Q




ANS: B Q




While improving quality of care provided by the LPN/LVN may be a result of
Q Q Q Q Q Q Q Q Q Q Q Q Q




the NPA, the primarypurpose of the NPA of each state defines the scope of
Q Q Q Q Q Q Q Q Q Q Q Q Q Q




nursing practice in that state.
Q Q Q Q Q




DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 Q Q Q Q Q




TOP: NPA
Q KEY: Nursing Process Step: Implementation
Q Q Q Q Q




QMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q




2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




nurse has not been taught during her educational program. How should the vocational nurse respond?
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




a. Ask a more experienced nurse to demonstrate the procedure.
Q Q Q Q Q Q Q Q




b. Look up the procedure in the procedure manual.Q Q Q Q Q Q Q




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




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




ANS: D Q




The charge nurse should be informed of the lack of training to perform the procedure, and the vocational
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




nurse should seek further training to gain proficiency. Although the other options might be helpful, they
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




are not safe.
Q Q Q




DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 Q Q Q Q Q




TOP: Providing Safe Care
Q Q KEY: Nursing Process Step: N/A Q Q Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q Q




3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
Q Q Q Q Q Q Q Q Q Q Q Q Q




should address?
Q Q




a. "I have no idea of how this drug will affect me."
Q Q Q Q Q Q Q Q Q Q




b. "Do you know if my physician is coming back today?"
Q Q Q Q Q Q Q Q Q




c. "Will my insurance pay for my stay?" Q Q Q Q Q Q




d. "Am I going to have to go to a nursing home?"
Q Q Q Q Q Q Q Q Q Q




ANS: A Q




Lack of knowledge at discharge about medication effects and side effects is a concern that should be
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




addressed by the vocational nurse. The other concerns in the options are the responsibility of other
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




departments to which the nurse might refer the patient.
Q Q Q Q Q Q Q Q Q




DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 Q Q Q Q Q




TOP: Teaching
Q KEY: Nursing Process Step: Implementation
Q Q Q Q Q




QMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q

,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




acts in which capacity?
Q Q Q Q




a. Working under direct supervision of an RN on the unit Q Q Q Q Q Q Q Q Q




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




c. Working under general supervision by the RN available on site or by phone
Q Q Q Q Q Q Q Q Q Q Q Q




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




ANS: C Q




The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




supervision of an RN available on site or by phone.
Q Q Q Q Q Q Q Q Q Q




DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 Q Q Q Q Q




TOP: Charge Nurse/Manager
Q Q KEY: Nursing Process Step: N/A Q Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q Q




5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




information should the nurse include?
Q Q Q Q Q




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




b. Contact the insurance company for coverage details as services may be limited.
Q Q Q Q Q Q Q Q Q Q Q




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




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




ANS: B Q




HMOs are a kind of managed care. This is accomplished by paying providers to care for groups of
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




patients for a set capitation fee and by limiting services. Patients are not required to seek a second
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




DIF: Cognitive Level: Application
Q Q REF: p. 9 OBJ: 9 Q Q Q Q Q Q




TOP: Charge Nurse/Manager
Q KEY: Nursing Process Step: Implementation
Q Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q Q




6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




Which statement accurately explains a deductible?
Q Q Q Q Q Q




a. An amount of money put aside for the payment of future medical bills
Q Q Q Q Q Q Q Q Q Q Q Q




b. A one-time fee for service
Q Q Q Q




c. An amount of money deducted from the bill by the insurance company
Q Q Q Q Q Q Q Q Q Q Q




d. An annual amount of money the patient must pay out-of-pocket for medical care
Q Q Q Q Q Q Q Q Q Q Q Q




ANS: D Q




The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




assuming the cost. This practice improves the profit of the insurance company.
Q Q Q Q Q Q Q Q Q Q Q Q




DIF: Cognitive Level: Comprehension
Q Q REF: p. 7 OBJ: 9 Q Q Q Q Q Q Q Q




TOP: Health Care Financing
Q KEY: Nursing Process Step: Implementation
Q Q Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q Q




7. A patient asks the nurse what Medicare Part A covers. Which response is correct?
Q Q Q Q Q Q Q Q Q Q Q Q Q




a. Medicare Part A covers inpatient hospital costs. Q Q Q Q Q Q




b. Medicare Part A covers reimbursement to the physician. Q Q Q Q Q Q Q




c. Medicare Part A covers outpatient hospital services. Q Q Q Q Q Q




d. Medicare Part A covers ambulance transportation. Q Q Q Q Q




ANS: A Q




Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
Q Q Q Q Q Q Q Q Q Q Q Q Q




Medicare Part B pays the physician, ambulance transport, and outpatient services.
Q Q Q Q Q Q Q Q Q Q Q

, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 Q Q Q Q Q Q




OBJ: 9 Q TOP: Government-Sponsored Health Insurance Q Q Q




KEY: Nursing Process Step: Implementation
Q Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q




8. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
Q Q Q Q Q Q Q Q Q




a. Hospitals focus only on the specific diagnosis. Q Q Q Q Q Q




b. Hospitals treat and discharge patients quickly. Q Q Q Q Q




c. Reduced cost drugs are ordered for specific diagnoses. Q Q Q Q Q Q Q




d. Diagnostic group classification streamlines care. Q Q Q Q




ANS: B Q




DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




category regardless of the length of time in the hospital. If hospitals can treat and discharge patients
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




before the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




discharged sooner.
Q Q




DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 Q Q Q Q Q




TOP: Government-Sponsored Health Insurance
Q Q Q Q




KEY: Nursing Process Step: Implementation
Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q




9. The nurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




a. A 35-year-old unemployed single mother with diabetes
Q Q Q Q Q Q




b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
Q Q Q Q Q Q Q Q Q Q Q Q Q




care facility
Q Q




c. An 80-year-old blind woman living in her own home who has inadequate private
Q Q Q Q Q Q Q Q Q Q Q Q




insurance
Q




d. A 67-year-old stroke victim with Medicare Part A and an income frominvestments
Q Q Q Q Q Q Q Q Q Q Q Q




ANS: A Q




Medicaid is a joint effort of federal and state governments geared primarily for low-income people with
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




no insurance.
Q Q




DIF: Cognitive Level: Application REF: p. 8, Box 1-5 Q Q Q Q Q Q




OBJ: 9 Q TOP: Government-Sponsored Health Insurance—Medicaid Q Q Q




KEY: Nursing Process Step: Assessment
Q Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q




10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q




improve the health of Americans in the second decade of the century?
Q Q Q Q Q Q Q Q Q Q Q Q




a. Research funding Q




b. Health information distribution Q Q




c. Healthy lifestyle encouragement Q Q




d. Health improvement program designs Q Q Q




ANS: C Q




Healthy People 2020 focuses on expanding ongoing programs to include support and information to
Q Q Q Q Q Q Q Q Q Q Q Q Q




reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
Q Q Q Q Q Q Q Q Q Q Q Q




immunizations, healthy eating habits, and healthy weight.
Q Q Q Q Q Q Q




DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 Q Q Q Q Q Q




TOP: Healthy People 2020
Q KEY: Nursing Process Step: Implementation Q Q Q Q Q Q




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Q Q Q Q Q Q Q Q
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