TEST BANK FOR DEWITS MEDICAL SURGICAL NURSING CONCEPTS AND PRACTICE 5TH EDITION BY STROMBERG/ALL CHAPTERS 1-49 |NEWEST UPDATE

TEST BANK FOR DEWITS MEDICAL SURGICAL NURSING CONCEPTS AND PRACTICE 5TH EDITION BY STROMBERG/ALL CHAPTERS 1-49 |NEWEST UPDATE Test Bank For Dewits Medical Surgical Nursing Concepts and Practice 5th Edition Chapter 01: Caring for Medical-Surgical Clients deWit: Medical-Surgical Nursing: Concepts & Practice, 5th Edition MULTIPLE ANSWER QUESTIONS 1. Which statement accurately describes the primary purpose of the state Caregiver 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. CORRECT FEEDBACK: B EXPLANATION :->>>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. PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 OBJ: 3 TOP: NPA KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 2. The charge Caregiver asks the new vocational Caregiver to start an intravenous infusion, a skill that the vocational Caregiver has not been taught during her educational program. How should the vocational Caregiver respond? a. Ask a more experienced Caregiver 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 Caregiver of her lack of training in this procedure. CORRECT FEEDBACK: D EXPLANATION :->>>The charge Caregiver should be informed of the lack of training to perform the procedure, and the vocational Caregiver should seek further training to gain proficiency. Although the other options might be helpful, they are not safe. PTS: 1 DIF: Cognitive Level: Application REF: 3 OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 3. Which client statement indicates a need for further discharge teaching that the vocational Caregiver 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?” CORRECT FEEDBACK: A EXPLANATION :->>>Lack of knowledge at discharge about medication effects and side effects is a concern that should be addressed by the vocational Caregiver. The other concerns in the options are the responsibility of other departments to which the Caregiver might refer the client. PTS: 1 DIF: Cognitive Level: Application REF: 2 OBJ: 1 TOP: Teaching KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 4. According to most state NPAs, the vocational Caregiver acting as charge Caregiver in a long-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 Caregiver CORRECT FEEDBACK: C EXPLANATION :->>>The vocational Caregiver in the capacity of the charge Caregiver in a long-term care facility acts with the general supervision of an RN available on site or by phone. PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 OBJ: 1 TOP: Charge Caregiver/Manager KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 5. The Caregiver is educating a client that is a member of a health maintenance organization (HMO). Which information should the Caregiver include? a. Seek the opinion of an alternate health care provider. b. Obtain insurance approval for medical services prior to treatment. c. Provide detailed documentation of all care received for his condition. d. Wait at least 6 months to see a specialist. CORRECT FEEDBACK: B EXPLANATION :->>>Most HMOs require preprocedure authorization for treatment. Clients are not required to seek a second opinion, provide documentation of care, or wait a specific time period before visiting a specialist. PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 9 TOP: Charge Caregiver/Manager KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 6. The client complains to the Caregiver that he is confused about his “deductible” that he owes the 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 client must pay out-of-pocket for medical care CORRECT FEEDBACK: D EXPLANATION :->>>The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company assuming the cost. This practice improves the profit of the insurance company. PTS: 1 DIF: Cognitive Level: Comprehension REF: 7 OBJ: 9 TOP: Health Care Financing KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 7. The Caregiver compares the characteristics of a health maintenance organization (HMO) and a preferred provider organization (PPO). Which information should the Caregiver include about HMOs? a. HMOs require a set fee of each member monthly. b. HMOs allow the member to select his health care provider. c. HMOs permit admission to any facility the member prefers. d. HMOs offer unlimited diagnostic tests and treatments. CORRECT FEEDBACK: A EXPLANATION :->>>HMOs require a set fee from each member monthly (capitation). The client will be treated by the HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is discouraged by the HMO. PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 9 TOP: Managed Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 8. A client asks the Caregiver what Medicare Part A covers. Which response is correct? a. Medicare Part A covers inclient hospital costs. b. Medicare Part A covers reimbursement to the physician. c. Medicare Part A covers outclient hospital services. d. Medicare Part A covers ambulance trCorrect Feedbackportation. CORRECT FEEDBACK: A EXPLANATION :->>>Medicare Part A covers inclient hospital expenses, drugs, x-rays, laboratory work, and intensive care. Medicare Part B pays the physician, ambulance trCorrect Feedbackport, and outclient services. PTS: 1 DIF: Cognitive Level: Comprehension REF: 7, Box 1-4 OBJ: 9 TOP: Government-Sponsored Health Insurance KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 9. 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 clients quickly. c. Reduced cost drugs are ordered for specific diagnoses. d. Diagnostic group classification streamlines care. CORRECT FEEDBACK: B EXPLANATION :->>>DRGs are a prospective payment plan in which hospitals receive a flat fee for each client’s diagnostic category regardless of the length of time in the hospital. If hospitals can treat and discharge clients before the allotted time, hospitals get to keep the excess payment; cost is contained, and the client is discharged sooner. PTS: 1 DIF: Cognitive Level: Comprehension REF: 8 OBJ: 9 TOP: Government-Sponsored Health Insurance KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 10. The Caregiver is assessing a group of clients. Which client would most likely qualify for Medicaid? 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 a long-term care facility c. An 80-year-old blind woman living in her own home who has inadequate private insurance d. A 67-year-old stroke victim with Medicare Part A and an income from investments CORRECT FEEDBACK: A EXPLANATION :->>>Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no insurance. PTS: 1 DIF: Cognitive Level: Application REF: 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 11. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to improve the health of AmericCorrect Feedback in the second decade of the century? a. Research funding b. Health information distribution c. Healthy lifestyle encouragement d. Health improvement program designs CORRECT FEEDBACK: C EXPLANATION :->>>Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective immunizations, healthy eating habits, and healthy weight. PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 OBJ: 7 TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 12. Which term explains the type of care that addresses interventions for all dimensions of a client’s life? a. Focused care b. General care c. Directed care d. Holistic care CORRECT FEEDBACK: D EXPLANATION :->>>Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of the client. PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 OBJ: 8 TOP: Holistic Care KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 13. A client furiously says, “My doctor was so busy giving me instructions that he didn’t hear what 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. “I’ll bet that made you feel very frustrated.” d. “Take a deep breath and plan what you will say to him tomorrow.” CORRECT FEEDBACK: C EXPLANATION :->>>Empathy demonstrates that the Caregiver perceives the client’s feelings but does not share the emotion. Belittling the client’s feelings, showing sympathy, or defending the doctor makes the client feel devalued. PTS: 1 DIF: Cognitive Level: Analysis REF: 10 OBJ: 10 TOP: Caregiver–Client Relationship KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 14. The Caregiver is explaining differences in a therapeutic relationship and a social relationship to a client. Which information about therapeutic relationships is most important for the Caregiver 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. CORRECT FEEDBACK: B EXPLANATION :->>>The therapeutic relationship is focused on the client and is goal directed and designed to meet only the needs of the client and does not extend past the period of hospitalization. PTS: 1 DIF: Cognitive Level: Comprehension REF: 9 OBJ: 10 TOP: Therapeutic Relationship KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 15. The long-term care facility Caregiver is caring for a newly admitted 80-year-old client who is depressed. Which approach is best for the Caregiver to employ? a. Encourage the resident to engage in an activity. b. Remind the resident of reasons to be positive. c. Point out episodes of negative behavior. d. Present a bright and cheerful behavior. CORRECT FEEDBACK: A EXPLANATION :->>>Activity and social interaction are helpful to depressed clients. Presenting a cheery approach and pointing out negative behavior and reasons to be positive are not therapeutic at this stage of the relationship. PTS: 1 DIF: Cognitive Level: Analysis REF: 10 OBJ: 10 TOP: Depressed Behavior KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 16. The Caregiver is caring for a client who has been on antidepressants for 3 days. The client tearfully 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 Caregiver how you are feeling.” b. “You just need to be client 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 difficult time.” CORRECT FEEDBACK: D EXPLANATION :->>>This response is an empathetic response that allows for further exploration of the client’s feelings. The other responses will block communication with this client. PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 10 TOP: Therapeutic Communication KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 17. An overweight male client rips off his hospital gown, throws it out the door, and shouts, “I’m not wearing this stupid gown! It is too small, too short, and exposes my backside to the world!” Which response is most appropriate? a. Remind client of the need to wear the gown for convenience in care. b. Confer with the client for methods to acquire a larger gown. c. Replace the torn gown with another. d. Inform the charge Caregiver of the hostile behavior. CORRECT FEEDBACK: B EXPLANATION :->>>Allowing hostile clients to make reasonable requests defuses the anger and allows clients to vent their feelings. PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 10 TOP: Hostile Behavior KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 18. The Caregiver is caring for a client who states, “You are the only Caregiver who understands about my pain. Can’t you give me an extra dose of pain medication?” How should the Caregiver respond to the client’s request? a. Explain that dosage schedules are by physician’s orders. b. Ignore the request. c. Tell the client that his behavior is manipulative. d. Agree to give an extra dose of pain medication. CORRECT FEEDBACK: A EXPLANATION :->>>A matter-of-fact response to a manipulative request limits the effect of the manipulation, thereby helping the Caregiver to avoid becoming defensive or being swayed by flattery. PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 10 TOP: Manipulative Behavior KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 19. A female client who has recently been diagnosed with an inoperable brain tumor asks the Caregiver, “Do you think God punishes us?” Which response demonstrates therapeutic communication? a. “What do you think?” b. “God loves you.” c. “Would like to speak with the chaplain?” d. “God will not give you more than you can bear.” CORRECT FEEDBACK: A EXPLANATION :->>>Sitting with the client and offering oneself to listen to the client’s concerns and encouraging reflection is the best approach rather than responding with a cliché or suggesting speaking with the chaplain. PTS: 1 DIF: Cognitive Level: Application REF: 10 OBJ: 10 TOP: Spiritual Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 20. The Caregiver is communicating with a client who voices concern about an upcoming high-risk procedure. Which statement best demonstrates empathy? a. “Would you like to talk about your feelings regarding the procedure?” b. “My mother had the same procedure and did very well.” c. “I can’t imagine how you feel.” d. “It must be difficult preparing for the procedure; how are you feeling?” CORRECT FEEDBACK: D EXPLANATION :->>>This statement by the Caregiver displays empathy by trying to place oneself in the client’s circumstance and validating the client’s feelings. Simply asking clients if they would like to talk about their feelings does not show empathy and may elicit a “yes” or “no” response. Telling the client one’s mother had the procedure or stating “I can’t imagine how you feel” does not show empathy toward the client. PTS: 1 DIF: Cognitive Level: Application REF: 10 OBJ: 10 TOP: Caregiver–Client Relationship KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity