Updated/Latest Medical-Surgical Nursing Concepts and Practice 5th Edition Stromberg Test Bank Comprehensive Examination Questions and Answers Study Guide for Adult Health Nursing Medical Surgical Care Pathophysiology Clinical Reasoning Patient Assessment

TESBANK
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,Chapter 01: Caring for Medical-Surgical Patients
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition



MULTIPLE CHOICE

1. Whichstatement accuratelydescribesthe primarypurpose ofthe state nurse
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practice act (NPA)? J J




a. Totest and license LPN/LVNs J J J J




b. Todefine thescope of LPN/LVNpractice
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c. Toimprove the qualityof care provided bythe LPN/LVN
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d. TolimittheLPN/LVNemployment placement
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ANS: B J




While improving quality of care provided by the LPN/LVN may be a result of
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the NPA, the primarypurpose of the NPA of each state defines the scope of
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nursing practice in that state. J J J J




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




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




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
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nurse has not been taught during her educational program. How should the vocational nurse respond?
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a. Aska more experienced nurseto demonstrate theprocedure.
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b. Lookup the procedure inthe procedure manual. J J J J J J J




c. Attempttoperformthe procedure withsupervision. J J J J J J




d. Informthecharge nurse ofher lackof trainingin thisprocedure. J J J J J J J J J J J




ANS: D J




The charge nurse should be informed of the lack of training to perform the procedure, and the vocational
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nurse should seek further training to gain proficiency. Although the other options might be helpful, they are
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not safe.
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DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 J J J J J J




TOP: Providing Safe Care
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
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should address? J




a. "Ihave no idea of how thisdrugwill affect me."
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b. "Do you know if myphysician is comingbacktoday?" J J J J J J J J J




c. "Will myinsurance payformystay?" J J J J J J




d. "AmIgoingto have to go to a nursinghome?" J J J J J J J J J J




ANS: A J




Lack of knowledge at discharge about medication effects and side effects is a concern that should be
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addressed by the vocational nurse. The other concerns in the options are the responsibility of other
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departments to which the nurse might refer the patient. J J J J J J J J




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




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




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts
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in which capacity?
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a. Workingunder direct supervision of an RNon theunit J J J J J J J J J




b. Workingwith the RNin thebuilding J J J J J J




c. Workingunder general supervision bythe RNavailable on site or byphone J J J J J J J J J J J J




d. Workingas anindependentvocational nurse J J J J J




ANS: C J




The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
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supervision of an RN available on site or by phone. J J J J J J J J J




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




TOP: Charge Nurse/Manager
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
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information should the nurse include? J J J J




a. Seekthe opinion of an alternate healthcareprovider.
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b. Contacttheinsurance companyfor coverage details asservices maybe limited.
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c. Providedetailed documentationof all carereceived forhis condition. J J J J J J J J J




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




ANS: B J




HMOs are a kind of managed care. This is accomplished by paying providers to care for groups of
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patients for a set capitation fee and by limiting services. Patients are not required to seek a second
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opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
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DIF: Cognitive Level: Application
J J REF: p. 9 OBJ: 9 J J J J J J




TOP: Charge Nurse/Manager
J KEY: NursingProcess Step: Implementation J J J J J J




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
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Which statement accurately explains a deductible?
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a. An amount of moneyput asidefor thepayment of future medical bills
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b. Aone-time fee forservice
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c. An amount of moneydeducted fromthe bill bythe insurancecompany
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d. Anannual amount of moneythe patient must payout-of-pocket for medicalcare
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ANS: D J




The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
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assuming the cost. This practice improves the profit of the insurance company.
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DIF: Cognitive Level: Comprehension
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TOP: Health Care Financing
J KEY: NursingProcess Step: Implementation J J J J J J J




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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7. Apatientasks the nurse what Medicare Part Acovers.Which responseiscorrect?
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a. Medicare Part Acoversinpatient hospitalcosts. J J J J J J




b. Medicare Part Acoversreimbursement tothephysician. J J J J J J J




c. MedicarePart Acoversoutpatient hospital services. J J J J J J




d. Medicare Part Acovers ambulancetransportation. J J J J J




ANS: A J




Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
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Medicare Part B pays the physician, ambulance transport, and outpatient services.
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, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 J J J J J J




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




KEY: Nursing Process Step: Implementation
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MSC:NCLEX:Safe,EffectiveCareEnvironment: CoordinatedCare
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8. Whichisthemaincost-containment component of diagnosis-related groups(DRGs)?
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a. Hospitalsfocus onlyon thespecificdiagnosis. J J J J J J




b. Hospitals treat and discharge patientsquickly. J J J J J




c. Reducedcost drugs are orderedforspecificdiagnoses. J J J J J J J




d. Diagnosticgroupclassificationstreamlinescare. J J J J




ANS: B J




DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
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category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before
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the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged
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sooner.

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




TOP: Government-Sponsored Health Insurance
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KEY:NursingProcessStep: Implementation
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MSC:NCLEX:Safe,EffectiveCareEnvironment: CoordinatedCare
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9. Thenurseisassessinga groupof patients.Which patient would most likelyqualifyforMedicaid?
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a. A35-year-oldunemployedsingle mother withdiabetes
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b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term care
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facility
c. An 80-year-old blind woman living in her own home who has inadequate private
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insurance
d. A67-year-oldstroke victimwithMedicare Part Aandan income frominvestments
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ANS: A J




Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no
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insurance.

DIF: CognitiveLevel:Application REF: p. 8, Box 1-5 J J J J J J




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




KEY: Nursing Process Step: Assessment
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MSC:NCLEX:Safe,EffectiveCareEnvironment: CoordinatedCare
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10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
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improve the health of Americans in the second decade of the century?
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a. Researchfunding J




b. Health information distribution J J




c. Healthylifestyle encouragement J J




d. Health improvement programdesigns J J J




ANS: C J




Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce
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infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective immunizations,
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healthy eating habits, and healthy weight.
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DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 J J J J J J




TOP: Healthy People 2020
J KEY: NursingProcess Step: Implementation J J J J J J J




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