medical_surgical_nursing_concepts___practice_5th_edition_by_stromberg_test_bank (1).pdf

TEST BANK
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,Chapter 01: Caring for Medical-Surgical Patients
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Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
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MULTIPLE CHOICE n




1. Which statement accurately describes the primary purpose of the state nurse
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practice act (NPA)?
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a. To test and license LPN/LVNs
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b. To define the scope of LPN/LVN practice
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c. To improve the quality of care provided by the LPN/LVN
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d. To limit the LPN/LVN employment placement
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ANS: B n



While improving quality of care provided by the LPN/LVN may be a result
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of the NPA, the primarypurpose of the NPA of each state defines the scope
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of nursing practice in that state.
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DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 n n n n n



TOP: NPA
n KEY: Nursing Process Step: Implementation
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nMSC: 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
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vocational nurse has not been taught during her educational program. How should the vocational nurse
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respond?
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a. Ask a more experienced nurse to demonstrate the procedure.
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b. Look up the procedure in the procedure manual.n n n n n n n



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



d. Inform the charge nurse of her lack of training in this procedure.
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ANS: D n



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



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?
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a. "I have no idea of how this drug will affect me."
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b. "Do you know if my physician is coming back today?"
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c. "Will my insurance pay for my stay?" n n n n n n



d. "Am I going to have to go to a nursing home?"
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ANS: A n



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



TOP: Teaching
n KEY: Nursing Process Step: Implementation
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nMSC: 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
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acts in which capacity?
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a. Working under direct supervision of an RN on the unit n n n n n n n n n



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



c. Working under general supervision by the RN available on site or by phone
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d. Working as an independent vocational nurse n n n n n




ANS: C n



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



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



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?
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a. Seek the opinion of an alternate health care provider.
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b. Contact the insurance company for coverage details as services may be limited.
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c. Provide detailed documentation of all care received for his condition.
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d. Wait at least 6 months to see a specialist.
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ANS: B n



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
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TOP: Charge Nurse/Manager
n KEY: Nursing Process Step: Implementation
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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 money put aside for the payment of future medical bills
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b. A one-time fee for service
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c. An amount of money deducted from the bill by the insurance company
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d. An annual amount of money the patient must pay out-of-pocket for medical care
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ANS: D n



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
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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7. A patient asks the nurse what Medicare Part A covers. Which response is correct?
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a. Medicare Part A covers inpatient hospital costs. n n n n n n



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



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



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




ANS: A n



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 n n n n n n



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



KEY: Nursing Process Step: Implementation
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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8. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
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a. Hospitals focus only on the specific diagnosis. n n n n n n



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



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



d. Diagnostic group classification streamlines care. n n n n




ANS: B n



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
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before the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is
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discharged sooner.
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DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 n n n n n



TOP: Government-Sponsored Health Insurance
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KEY: Nursing Process Step: Implementation
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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9. The nurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
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a. A 35-year-old unemployed single mother with diabetes
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b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
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care facility
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c. An 80-year-old blind woman living in her own home who has inadequate private
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insurance
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d. A 67-year-old stroke victim with Medicare Part A and an income frominvestments
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ANS: A n



Medicaid is a joint effort of federal and state governments geared primarily for low-income people with
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no insurance.
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DIF: Cognitive Level: Application REF: p. 8, Box 1-5 n n n n n n



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



KEY: Nursing Process Step: Assessment
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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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. Research funding n



b. Health information distribution n n



c. Healthy lifestyle encouragement n n



d. Health improvement program designs n n n




ANS: C n



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



TOP: Healthy People 2020
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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