TEST BANK TABLE OF CONTENT
Chapter 01: Caring for Medical-Surgical Patients .......................................................................................... 4
DEWITT’S MEDICAL-SURGICAL NURSING: CONCEPTS Chapter 02: Critical Thinking and the Nursing Process ................................................................................ 14
AND PRACTICE, 4TH EDITION by Holly K. Stromberg. 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 ........................................................................................................... 208
Chapter 22: Care of Patients with Head and Spinal Cord Injuries ............................................................. 218
Chapter 23: Care of Patients with Disorders of the Brain ........................................................................... 228
Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases ...................................... 238
Chapter 25: The Sensory System: Eye and Ear ........................................................................................... 248
Chapter 26: Care of Patients with Disorders of the Eyes and Ears ............................................................ 258
Chapter 27: The Gastrointestinal System .................................................................................................... 269
Chapter 28: Care of Patients with Disorders of the Upper Gastrointestinal System .................................. 280
Chapter 29: Care of Patients with Disorders of the Lower Gastrointestinal System ................................. 291
Chapter 30: Care of Patients with Disorders of the Liver, Gallbladder, and Pancreas ................................. 302
Chapter 31: The Musculoskeletal System ................................................................................................... 313
Chapter 32: Care of Patients with Musculoskeletal and Connective Tissue Disorders .............................. 323
Chapter 33: The Urinary System ................................................................................................................. 334
Chapter 34: Care of Patients with Disorders of the Urinary System .......................................................... 346
Chapter 35: The Endocrine System ............................................................................................................. 358
Chapter 36: Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders ......................... 368
Chapter 37: Care of Patients with Diabetes and Hypoglycemia ................................................................ 380
Chapter 38: Care of Women with Reproductive Disorders ......................................................................... 392
Chapter 39: Care of Men with Reproductive Disorders .............................................................................. 404
,Chapter 40: Care of Patients with Sexually Transmitted Infections .......................................................... 416
Chapter 01: Caring for Medical-Surgical Patients
Chapter 41: The Integumentary System ...................................................................................................... 426 deWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition
Chapter 42: Care of Patents with Integumentary Disorders and Burns ...................................................... 436
Chapter 43: Care of Patients in Disasters or Bioterrorism Attack .............................................................. 447
MULTIPLE CHOICE
Chapter 44: Care of Patients with Emergencies, Trauma, and Shock ......................................................... 457
Chapter 45: Care of Patients with Anxiety, Mood, and Eating Disorders .................................................. 469 1. Which statement accurately describes the primary purpose of the state nurse practice act
(NPA)?
Chapter 46: Care of Patients with Substance Abuse Disorders .................................................................. 479 a.To test and license LPN/LVNs.
Chapter 47: Care of Patients with Cognitive Disorders .............................................................................. 490 b.To define the scope of LPN/LVN practice.
c.To improve the quality of care provided by the LPN/LVN.
Chapter 48: Care of Patients with Thought and Personality Disorders ...................................................... 500
d.To limit the LPN/LVN employment placement.
ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the
primary 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 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 should the
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.
ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the
vocational nurse 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 patient statement indicates a need for further discharge teaching that the vocational
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?”
ANS: A
Lack of knowledge at discharge about medication effects and side effects is a concern that
should 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.
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 7. The nurse compares the characteristics of a health maintenance organization (HMO) and a
preferred provider organization (PPO). Which information should the nurse include about
4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care HMOs?
facility acts in which capacity? a. HMOs require a set fee of each member monthly.
a. Working under direct supervision of an RN on the unit b. HMOs allow the member to select his health care provider.
b. Working with the RN in the building c. HMOs permit admission to any facility the member prefers.
c. Working under general supervision by the RN available on site or by phone d. HMOs offer unlimited diagnostic tests and treatments.
d. Working as an independent vocational nurse
ANS: A
ANS: C HMOs require a set fee from each member monthly (capitation). The patient will be treated by
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is
the general supervision of an RN available on site or by phone. discouraged by the HMO.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 PTS: 1 DIF: Cognitive Level: Application REF: 9
OBJ: 1 TOP: Charge Nurse/Manager KEY: Nursing Process Step: N/A OBJ: 9 TOP: Managed Care
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. The nurse is educating a patient that is a member of a health maintenance organization
(HMO). Which information should the nurse include? 8. A patient asks the nurse what Medicare Part A covers. Which response is correct?
a.Seek the opinion of an alternate health care provider. a. Medicare Part A covers inpatient hospital costs.
b.Obtain insurance approval for medical services prior to treatment. b. Medicare Part A covers reimbursement to the physician.
c.Provide detailed documentation of all care received for his condition. c. Medicare Part A covers outpatient hospital services.
d.Wait at least 6 months to see a specialist. d. Medicare Part A covers ambulance transportation.
ANS: B ANS: A
Most HMOs require preprocedure authorization for treatment. Patients are not required to Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and
seek a second opinion, provide documentation of care, or wait a specific time period before intensive care. Medicare Part B pays the physician, ambulance transport, and outpatient
visiting a specialist. services.
PTS: 1 DIF: Cognitive Level: Application REF: 9 PTS: 1 DIF: Cognitive Level: Comprehension REF: 7, Box 1-4
OBJ: 9 TOP: Charge Nurse/Manager OBJ: 9 TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The patient complains to the nurse that he is confused about his “deductible” that he owes the 9. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
hospital. Which statement accurately explains a deductible? a. Hospitals focus only on the specific diagnosis.
a. An amount of money put aside for the payment of future medical bills b. Hospitals treat and discharge patients quickly.
b. A one-time fee for service c. Reduced cost drugs are ordered for specific diagnoses.
c. An amount of money deducted from the bill by the insurance company d. Diagnostic group classification streamlines care.
d. An annual amount of money the patient must pay out-of-pocket for medical care
ANS: B
ANS: D DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
company assuming the cost. This practice improves the profit of the insurance company. discharge patients before the allotted time, hospitals get to keep the excess payment; cost is
contained, and the patient is discharged sooner.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 7
OBJ: 9 TOP: Health Care Financing PTS: 1 DIF: Cognitive Level: Comprehension REF: 8
KEY: Nursing Process Step: Implementation OBJ: 9 TOP: Government-Sponsored Health Insurance
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
, 10. The nurse is assessing a group of patients. Which patient would most likely qualify for 13. A patient furiously says, “My doctor was so busy giving me instructions that he didn’t hear
Medicaid? what I was trying to ask him!” Which response is most empathetic?
a. A 35-year-old unemployed single mother with diabetes a.“When people ignore me, I really get mad.”
b. A 70-year-old Medicare recipient with retirement income who needs to be in a b.“I’m sure that the doctor was rushed and unaware of your needs.”
long-term care facility c.“I’ll bet that made you feel very frustrated.”
c. An 80-year-old blind woman living in her own home who has inadequate private d.“Take a deep breath and plan what you will say to him tomorrow.”
insurance
ANS: C
d. A 67-year-old stroke victim with Medicare Part A and an income from investments
Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the
ANS: A emotion. Belittling the patient’s feelings, showing sympathy, or defending the doctor makes
Medicaid is a joint effort of federal and state governments geared primarily for low-income the patient feel devalued.
people with no insurance.
PTS: 1 DIF: Cognitive Level: Analysis REF: 10
PTS: 1 DIF: Cognitive Level: Application REF: 8, Box 1-5 OBJ: 10 TOP: Nurse–Patient Relationship
OBJ: 9 TOP: Government-Sponsored Health Insurance–Medicaid KEY: Nursing Process Step: Implementation
KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
14. The nurse is explaining differences in a therapeutic relationship and a social relationship to a
11. Which area is the major focus of Healthy People 2020 and the primary mechanism through patient. Which information about therapeutic relationships is most important for the nurse to
which to improve the health of Americans in the second decade of the century? include in the explanation?
a. Research funding a. Therapeutic relationships lack formal boundaries.
b. Health information distribution b. Therapeutic relationships are goal directed.
c. Healthy lifestyle encouragement c. Therapeutic relationships meet the needs of each person in the relationship.
d. Health improvement program designs d. Therapeutic relationships extend past the hospitalization period.
ANS: C ANS: B
Healthy People 2020 focuses on expanding ongoing programs to include support and The therapeutic relationship is focused on the patient and is goal directed and designed to
information to reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to meet only the needs of the patient and does not extend past the period of hospitalization.
increase effective immunizations, healthy eating habits, and healthy weight.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 9
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 OBJ: 10 TOP: Therapeutic Relationship
OBJ: 7 TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation
KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
15. The long-term care facility nurse is caring for a newly admitted 80-year-old patient who is
12. Which term explains the type of care that addresses interventions for all dimensions of a depressed. Which approach is best for the nurse to employ?
patient’s life? a. Encourage the resident to engage in an activity.
a. Focused care b. Remind the resident of reasons to be positive.
b. General care c. Point out episodes of negative behavior.
c. Directed care d. Present a bright and cheerful behavior.
d. Holistic care
ANS: A
ANS: D Activity and social interaction are helpful to depressed patients. Presenting a cheery approach
Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of and pointing out negative behavior and reasons to be positive are not therapeutic at this stage
the patient. of the relationship.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 PTS: 1 DIF: Cognitive Level: Analysis REF: 10
OBJ: 8 TOP: Holistic Care OBJ: 10 TOP: Depressed Behavior
KEY: Nursing Process Step: Planning KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation MSC: NCLEX: Psychosocial Integrity
Chapter 01: Caring for Medical-Surgical Patients .......................................................................................... 4
DEWITT’S MEDICAL-SURGICAL NURSING: CONCEPTS Chapter 02: Critical Thinking and the Nursing Process ................................................................................ 14
AND PRACTICE, 4TH EDITION by Holly K. Stromberg. 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 ........................................................................................................... 208
Chapter 22: Care of Patients with Head and Spinal Cord Injuries ............................................................. 218
Chapter 23: Care of Patients with Disorders of the Brain ........................................................................... 228
Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases ...................................... 238
Chapter 25: The Sensory System: Eye and Ear ........................................................................................... 248
Chapter 26: Care of Patients with Disorders of the Eyes and Ears ............................................................ 258
Chapter 27: The Gastrointestinal System .................................................................................................... 269
Chapter 28: Care of Patients with Disorders of the Upper Gastrointestinal System .................................. 280
Chapter 29: Care of Patients with Disorders of the Lower Gastrointestinal System ................................. 291
Chapter 30: Care of Patients with Disorders of the Liver, Gallbladder, and Pancreas ................................. 302
Chapter 31: The Musculoskeletal System ................................................................................................... 313
Chapter 32: Care of Patients with Musculoskeletal and Connective Tissue Disorders .............................. 323
Chapter 33: The Urinary System ................................................................................................................. 334
Chapter 34: Care of Patients with Disorders of the Urinary System .......................................................... 346
Chapter 35: The Endocrine System ............................................................................................................. 358
Chapter 36: Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders ......................... 368
Chapter 37: Care of Patients with Diabetes and Hypoglycemia ................................................................ 380
Chapter 38: Care of Women with Reproductive Disorders ......................................................................... 392
Chapter 39: Care of Men with Reproductive Disorders .............................................................................. 404
,Chapter 40: Care of Patients with Sexually Transmitted Infections .......................................................... 416
Chapter 01: Caring for Medical-Surgical Patients
Chapter 41: The Integumentary System ...................................................................................................... 426 deWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition
Chapter 42: Care of Patents with Integumentary Disorders and Burns ...................................................... 436
Chapter 43: Care of Patients in Disasters or Bioterrorism Attack .............................................................. 447
MULTIPLE CHOICE
Chapter 44: Care of Patients with Emergencies, Trauma, and Shock ......................................................... 457
Chapter 45: Care of Patients with Anxiety, Mood, and Eating Disorders .................................................. 469 1. Which statement accurately describes the primary purpose of the state nurse practice act
(NPA)?
Chapter 46: Care of Patients with Substance Abuse Disorders .................................................................. 479 a.To test and license LPN/LVNs.
Chapter 47: Care of Patients with Cognitive Disorders .............................................................................. 490 b.To define the scope of LPN/LVN practice.
c.To improve the quality of care provided by the LPN/LVN.
Chapter 48: Care of Patients with Thought and Personality Disorders ...................................................... 500
d.To limit the LPN/LVN employment placement.
ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the
primary 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 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 should the
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.
ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the
vocational nurse 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 patient statement indicates a need for further discharge teaching that the vocational
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?”
ANS: A
Lack of knowledge at discharge about medication effects and side effects is a concern that
should 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.
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 7. The nurse compares the characteristics of a health maintenance organization (HMO) and a
preferred provider organization (PPO). Which information should the nurse include about
4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care HMOs?
facility acts in which capacity? a. HMOs require a set fee of each member monthly.
a. Working under direct supervision of an RN on the unit b. HMOs allow the member to select his health care provider.
b. Working with the RN in the building c. HMOs permit admission to any facility the member prefers.
c. Working under general supervision by the RN available on site or by phone d. HMOs offer unlimited diagnostic tests and treatments.
d. Working as an independent vocational nurse
ANS: A
ANS: C HMOs require a set fee from each member monthly (capitation). The patient will be treated by
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is
the general supervision of an RN available on site or by phone. discouraged by the HMO.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 PTS: 1 DIF: Cognitive Level: Application REF: 9
OBJ: 1 TOP: Charge Nurse/Manager KEY: Nursing Process Step: N/A OBJ: 9 TOP: Managed Care
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. The nurse is educating a patient that is a member of a health maintenance organization
(HMO). Which information should the nurse include? 8. A patient asks the nurse what Medicare Part A covers. Which response is correct?
a.Seek the opinion of an alternate health care provider. a. Medicare Part A covers inpatient hospital costs.
b.Obtain insurance approval for medical services prior to treatment. b. Medicare Part A covers reimbursement to the physician.
c.Provide detailed documentation of all care received for his condition. c. Medicare Part A covers outpatient hospital services.
d.Wait at least 6 months to see a specialist. d. Medicare Part A covers ambulance transportation.
ANS: B ANS: A
Most HMOs require preprocedure authorization for treatment. Patients are not required to Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and
seek a second opinion, provide documentation of care, or wait a specific time period before intensive care. Medicare Part B pays the physician, ambulance transport, and outpatient
visiting a specialist. services.
PTS: 1 DIF: Cognitive Level: Application REF: 9 PTS: 1 DIF: Cognitive Level: Comprehension REF: 7, Box 1-4
OBJ: 9 TOP: Charge Nurse/Manager OBJ: 9 TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The patient complains to the nurse that he is confused about his “deductible” that he owes the 9. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
hospital. Which statement accurately explains a deductible? a. Hospitals focus only on the specific diagnosis.
a. An amount of money put aside for the payment of future medical bills b. Hospitals treat and discharge patients quickly.
b. A one-time fee for service c. Reduced cost drugs are ordered for specific diagnoses.
c. An amount of money deducted from the bill by the insurance company d. Diagnostic group classification streamlines care.
d. An annual amount of money the patient must pay out-of-pocket for medical care
ANS: B
ANS: D DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
company assuming the cost. This practice improves the profit of the insurance company. discharge patients before the allotted time, hospitals get to keep the excess payment; cost is
contained, and the patient is discharged sooner.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 7
OBJ: 9 TOP: Health Care Financing PTS: 1 DIF: Cognitive Level: Comprehension REF: 8
KEY: Nursing Process Step: Implementation OBJ: 9 TOP: Government-Sponsored Health Insurance
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
, 10. The nurse is assessing a group of patients. Which patient would most likely qualify for 13. A patient furiously says, “My doctor was so busy giving me instructions that he didn’t hear
Medicaid? what I was trying to ask him!” Which response is most empathetic?
a. A 35-year-old unemployed single mother with diabetes a.“When people ignore me, I really get mad.”
b. A 70-year-old Medicare recipient with retirement income who needs to be in a b.“I’m sure that the doctor was rushed and unaware of your needs.”
long-term care facility c.“I’ll bet that made you feel very frustrated.”
c. An 80-year-old blind woman living in her own home who has inadequate private d.“Take a deep breath and plan what you will say to him tomorrow.”
insurance
ANS: C
d. A 67-year-old stroke victim with Medicare Part A and an income from investments
Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the
ANS: A emotion. Belittling the patient’s feelings, showing sympathy, or defending the doctor makes
Medicaid is a joint effort of federal and state governments geared primarily for low-income the patient feel devalued.
people with no insurance.
PTS: 1 DIF: Cognitive Level: Analysis REF: 10
PTS: 1 DIF: Cognitive Level: Application REF: 8, Box 1-5 OBJ: 10 TOP: Nurse–Patient Relationship
OBJ: 9 TOP: Government-Sponsored Health Insurance–Medicaid KEY: Nursing Process Step: Implementation
KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
14. The nurse is explaining differences in a therapeutic relationship and a social relationship to a
11. Which area is the major focus of Healthy People 2020 and the primary mechanism through patient. Which information about therapeutic relationships is most important for the nurse to
which to improve the health of Americans in the second decade of the century? include in the explanation?
a. Research funding a. Therapeutic relationships lack formal boundaries.
b. Health information distribution b. Therapeutic relationships are goal directed.
c. Healthy lifestyle encouragement c. Therapeutic relationships meet the needs of each person in the relationship.
d. Health improvement program designs d. Therapeutic relationships extend past the hospitalization period.
ANS: C ANS: B
Healthy People 2020 focuses on expanding ongoing programs to include support and The therapeutic relationship is focused on the patient and is goal directed and designed to
information to reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to meet only the needs of the patient and does not extend past the period of hospitalization.
increase effective immunizations, healthy eating habits, and healthy weight.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 9
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 OBJ: 10 TOP: Therapeutic Relationship
OBJ: 7 TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation
KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
15. The long-term care facility nurse is caring for a newly admitted 80-year-old patient who is
12. Which term explains the type of care that addresses interventions for all dimensions of a depressed. Which approach is best for the nurse to employ?
patient’s life? a. Encourage the resident to engage in an activity.
a. Focused care b. Remind the resident of reasons to be positive.
b. General care c. Point out episodes of negative behavior.
c. Directed care d. Present a bright and cheerful behavior.
d. Holistic care
ANS: A
ANS: D Activity and social interaction are helpful to depressed patients. Presenting a cheery approach
Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of and pointing out negative behavior and reasons to be positive are not therapeutic at this stage
the patient. of the relationship.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 PTS: 1 DIF: Cognitive Level: Analysis REF: 10
OBJ: 8 TOP: Holistic Care OBJ: 10 TOP: Depressed Behavior
KEY: Nursing Process Step: Planning KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation MSC: NCLEX: Psychosocial Integrity
