Medical-Surgical Nursing: Concepts & Practice, 3rd Edition deWit – Test Bank & Study Guide (Chapter 1-12 Q&A)

MEDICAL g




SURGICALNUR g




SING CONCEPTS
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AND PRACTICE
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3THEDITION DE
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WIT TESTBAN g g




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,Chapterg 01:g Caringg forg Medical-Surgicalg Patients
deWit:g Medical-Surgicalg Nursing:g Conceptsg &g Practice,g 3rdg Edition

MULTIPLEgCHOICE

1. Whichgstatementgaccuratelygdescribesgthegprimarygpurposegofgthegstategnursegpracticegactg(NPA)?
a. TogtestgandglicensegLPN/LVNs.
b. TogdefinegthegscopegofgLPN/LVNgpractice.
c. TogimprovegthegqualitygofgcaregprovidedgbygthegLPN/LVN.
d. ToglimitgthegLPN/LVNgemploymentgplacement.

ANS: B
WhilegimprovinggqualitygofgcaregprovidedgbygthegLPN/LVNgmaygbegagresultgofgthegNPA,gthegprimarygpurposegofgthegNPAgofgea
chgstategdefinesgthegscopegofgnursinggpracticegingthatgstate.

PTS: 1 DIF: CognitivegLevel:gComprehension REF: 2
OBJ: 3 TOP: NPA KEY: NursinggProcessgStep:gImplementation
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

2. Thegchargegnursegasksgthegnewgvocationalgnursegtogstartgangintravenousginfusion,gagskillgthatgthegvocationalgnurseghasgn
otgbeengtaughtgduringghergeducationalgprogram.gHowgshouldgthegvocationalgnursegrespond?
a. Askgagmoregexperiencedgnursegtogdemonstrategthegprocedure.
b. Lookgupgthegproceduregingthegproceduregmanual.
c. Attemptgtogperformgthegprocedure gwithgsupervision.
d. Informgthegchargegnursegofgherglackgofgtraininggingthisgprocedure.

ANS: D
Thegchargegnursegshouldgbeginformedgofgtheglackgofgtraininggtogperformgthegprocedure,gandgthegvocationalgnursegshouldgseekgfur
thergtraininggtoggaingproficiency.gAlthoughgthegothergoptionsgmightgbeghelpful,gtheygaregnotgsafe.

PTS: 1 DIF: CognitivegLevel:gApplicationg REF: 3
OBJ: 1 TOP: ProvidinggSafegCare KEY: NursinggProcessgStep:gN/A
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

3. Whichgpatientgstatementgindicatesgagneedgforgfurthergdischargegteachinggthatgthegvocationalgnursegshouldgaddress?
a. “Ighavegnogideagofghowgthisgdruggwillgaffectgme.”
b. “Dogyougknowgifgmygphysiciangisgcominggbackgtoday?”
c. “Willgmyginsurancegpaygforgmygstay?”
d. “AmgIggoinggtoghavegtoggogtogagnursingghome?”

ANS: A
Lackgofgknowledgegatgdischargegaboutgmedicationgeffectsgandgsidegeffectsgisgagconcerngthatgshouldgbegaddressedgbygthegvocation
algnurse.gThegothergconcernsgingthegoptionsgaregthegresponsibilitygofgothergdepartmentsgtogwhichgthegnursegmightgrefergthegpatien
t.

PTS: 1 DIF: CognitivegLevel:gApplicationg g REF: 2
OBJ: 1 TOP: Teachingg KEY: NursinggProcessgStep:gImplementation
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

4. AccordinggtogmostgstategNPAs,gthegvocationalgnursegactinggasgchargegnursegingaglong-
termgcaregfacilitygactsgingwhichgcapacity?
a. Workinggundergdirectgsupervision gofgangRNgongthegunit
b. WorkinggwithgthegRNgingthegbuilding
c. WorkinggunderggeneralgsupervisiongbygthegRNgavailablegongsitegorgbygphone
d. Workinggasgangindependentgvocationalgnurse

ANS: C
Thegvocationalgnursegingthegcapacitygofgthegchargegnursegingaglong-
termgcaregfacilitygactsgwithgtheggeneralgsupervisiongofgangRNgavailablegongsitegorgbygphone.

PTS: 1 DIF: CognitivegLevel:gComprehension REF: 2
OBJ: 1 TOP: ChargegNurse/Manager KEY: Nursing ProcessgStep:gN/A
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare




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, 5. Thegnursegisgeducatinggagpatientgthatgisgagmembergofgaghealthgmaintenancegorganizationg(HMO).gWhichginformatio
ngshouldgthegnurseginclude?
a. Seekgthegopiniongofgangalternateghealthgcaregprovider.
b. Obtainginsurancegapprovalgforgmedicalgservicesgpriorgtogtreatment.
c. Providegdetailedgdocumentationgofgallgcaregreceivedgforghisgcondition.
d. Waitgatgleastg6gmonthsgtogseegagspecialist.

ANS: B
MostgHMOsgrequiregpreproceduregauthorizationgforgtreatment.gPatientsgaregnotgrequiredgtogseekgagsecondgopinion,gprovidegdocu
mentationgofgcare,gorgwaitgagspecificgtimegperiodgbeforegvisitinggagspecialist.

PTS: 1 DIF: CognitivegLevel:gApplicationg REF: 9
OBJ: 9 TOP: ChargegNurse/Manager
KEY: NursinggProcessgStep:gImplementation
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

6. Thegpatientgcomplainsgtogthegnursegthatghegisgconfusedgaboutghisg“deductible”gthatghegowesgtheghospital.gWhic
hgstatementgaccuratelygexplainsgagdeductible?
a. Angamountgofgmoneygputgasidegforgthegpaymentgofgfuturegmedicalgbills
b. Agone-timegfeegforgservice
c. Angamountgofgmoneygdeductedgfromgthegbillgbygtheginsurancegcompany
d. Angannualgamountgofgmoneygthegpatientgmustgpaygout-of-pocketgforgmedicalgcare

ANS: D
Thegdeductiblegisgthegannualgamountgtheginsuredgmustgpaygout-of-
pocketgpriorgtogtheginsurancegcompanygassuminggthegcost.gThisgpracticegimprovesgthegprofitgofgtheginsurancegcompany.

PTS: 1 DIF: CognitivegLevel:gComprehension REF: 7
OBJ: 9 TOP: HealthgCaregFinancing
KEY: NursinggProcessgStep:gImplementation
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

7. Thegnursegcomparesgthegcharacteristicsgofgaghealthgmaintenancegorganizationg(HMO)gandgagpreferredgprovid
ergorganizationg(PPO).gWhichginformationgshouldgthegnursegincludegaboutgHMOs?
a. HMOsgrequiregagsetgfeegofgeachgmembergmonthly.
b. HMOsgallowgthegmembergtogselectghisghealthgcaregprovider.
c. HMOsgpermitgadmissiongtoganygfacilitygthegmembergprefers.
d. HMOsgoffergunlimitedgdiagnosticgtestsgandgtreatments.

ANS: A
HMOsgrequiregagsetgfeegfromgeachgmembergmonthlyg(capitation).gThegpatientgwillgbegtreatedgbygthegHMOgstaffgingHMO-
approvedgfacilities.gExcessivegusegofgdiagnosticgtestsgandgtreatmentsgisgdiscouragedgbygthegHMO.

PTS: 1 DIF: CognitivegLevel:gApplicationg REF: 9
OBJ: 9 TOP: ManagedgCare
KEY: NursinggProcessgStep:gImplementation
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

8. AgpatientgasksgthegnursegwhatgMedicaregPartgAgcovers.gWhichgresponsegisgcorrect?
a. MedicaregPartgAgcoversginpatientghospitalgcosts.
b. MedicaregPartgAgcoversgreimbursementgtogthegphysician.
c. MedicaregPartgAgcoversgoutpatientghospitalgservices.
d. MedicaregPartgAgcoversgambulancegtransportation.

ANS: A
MedicaregPartgAgcoversginpatientghospitalgexpenses,gdrugs,gx-
rays,glaboratorygwork,gandgintensivegcare.gMedicaregPartgBgpaysgthegphysician,gambulancegtransport,gandgoutpatientgservices.

PTS: 1 DIF: CognitivegLevel:gComprehension REF: 7,gBoxg1-4
OBJ: 9 TOP: Government-Sponsoredg Healthg Insurance
KEY: NursinggProcessgStep:gImplementation
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

9. Whichgisgthegmaingcost-containmentgcomponentgofgdiagnosis-relatedggroupsg(DRGs)?



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, a. Hospitalsgfocusgonlygongthegspecificgdiagnosis.
b. Hospitalsgtreatgandgdischargegpatientsgquickly.
c. Reducedgcostgdrugsgaregorderedgforgspecificgdiagnoses.
d. Diagnosticggroupgclassificationgstreamlinesgcare.

ANS: B
DRGsgaregagprospectivegpaymentgplangingwhichghospitalsgreceivegagflatgfeegforgeachgpatient’sgdiagnosticgcategorygregardlessgofgth
eglengthgofgtimegingtheghospital.gIfghospitalsgcangtreatgandgdischargegpatientsgbeforegthegallottedgtime,ghospitalsggetgtogkeepg thegex
cessgpayment;gcostgisgcontained,gandgthegpatientgisgdischargedgsooner.

PTS: 1 DIF: CognitivegLevel:gComprehension REF: 8
OBJ: 9 TOP: Government-Sponsoredg Healthg Insurance
KEY:g g NursinggProcessgStep:gImplementation
MSC:g g NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare



10. Thegnursegisgassessinggaggroupgofgpatients.gWhichgpatientgwouldgmostglikelygqualifygforgMedicaid?
a. Ag35-year-oldgunemployedgsinglegmothergwithgdiabetes
b. Ag70-year-oldgMedicaregrecipientgwithgretirementgincomegwhogneedsgtogbegingaglong-termgcaregfacility
c. Ang80-year-oldgblindgwomanglivingginghergownghomegwhoghasginadequategprivateginsurance
d. Ag67-year-oldgstrokegvictimgwithgMedicaregPartgAgandgangincomegfromginvestments

ANS: A
Medicaidgisgagjointgeffortgofgfederalgandgstateggovernmentsggearedgprimarilygforglow-incomegpeoplegwithgnoginsurance.

PTS: 1 DIF: CognitivegLevel:gApplicationg REF: 8,gBoxg1-
5gOBJ: 9 TOP: Government-SponsoredgHealthgInsurance–
MedicaidgKEY: NursinggProcessgStep:gAssessment
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

11. WhichgareagisgthegmajorgfocusgofgHealthygPeopleg2020gandgthegprimarygmechanismgthroughgwhichgtogimprovegthegheal
thgofgAmericansgingthegsecondgdecadegofgthegcentury?
a. Researchgfunding
b. Healthginformationgdistribution
c. Healthyglifestylegencouragement
d. Healthgimprovementgprogramgdesigns

ANS: C
HealthygPeopleg2020gfocusesgongexpandinggongoinggprogramsgtogincludegsupportgandginformationgtogreduceginfantgmortality,gca
ncer,gcardiovasculargdisease,gandgHIV/AIDS,gandgtogincreasegeffectivegimmunizations,ghealthygeatingghabits,gandghealthygweight
.

PTS: 1 DIF: CognitivegLevel:gComprehension REF: 6
OBJ: 7 TOP: HealthygPeopleg2020
KEY: NursinggProcessgStep:gImplementation
MSC: NCLEX:gSafe,gEffectivegCaregEnvironment:gCoordinatedgCare

12. Whichgtermgexplainsgthegtypegofgcaregthatgaddressesginterventionsgforgallgdimensionsgofgagpatient’sglife?
a. Focusedgcare
b. Generalgcare
c. Directedgcare
d. Holisticgcare

ANS: D
Holisticgcaregaddressesgthegphysiologic,gpsychological,gsocial,gcultural,gandgspiritualgneedsgofgthegpatient.

PTS: 1 DIF: CognitivegLevel:gComprehension REF: 6
OBJ: 8 TOP: HolisticgCare
KEY: NursinggProcessgStep:gPlanning
MSC: NCLEX:gPsychosocialgIntegrity:gCopinggandgAdaptation

13. Agpatientgfuriouslygsays,g“Mygdoctorgwasgsogbusyggivinggmeginstructionsgthatghegdidn’tgheargwhatgIgwasgtryinggtoga
skghim!”gWhichgresponsegisgmostgempathetic?
a. “Whengpeoplegignoregme,gIgreallyggetgmad.”




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