Test Bank For Medical-Surgical Nursing, Concepts and Practice, 5th Edition By Holly K. Stromberg

Medical-Surgical Nursing
Test Bank For Medical-Surgical Nursing, Concepts and Practice, 5th

Edition By Holly K. Stromberg


Testbankscove

,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 m




1. Which statement accurately describes the primary purpose of the state nurse practice
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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
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LPN/LVN
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d. To limit the LPN/LVN employment placement
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ANS: m B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the
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primary purpose of the NPA of each state defines the scope of nursing practice in that state.
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DIF: Cognitive Level: Comprehension REF: p. 3 OBJ:
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m3 TOP: NPA
m KEY: Nursing Process Step: Implementation
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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
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the vocational nurse has not been taught during her educational program. How should the
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vocational nurse 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.
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c. Attempt to perform the procedure with supervision.
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d. Inform the charge nurse of her lack of training in this
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procedure.
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ANS: m D
The charge nurse should be informed of the lack of training to perform the procedure, and
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the vocational nurse should seek further training to gain proficiency. Although the other
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options might be helpful, they are not safe.
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DIF: Cognitive Level: Application REF: p. 3 OBJ: 1
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TOP: Providing Safe Care
m m KEY: Nursing Process Step: m m m m m


N/A 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
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vocational nurse 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?‖ m m m m m m


d. ―Am I going to have to go to a nursing home?‖
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ANS: m A
Lack of knowledge at discharge about medication effects and side effects is a concern that
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should be addressed by the vocational nurse. The other concerns in the options are the
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responsibility of other departments to which the nurse might refer the patient.
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DIF: Cognitive Level: Application REF: p. 2 OBJ:m m m m


m1 TOP: Teaching KEY: Nursing Process Step: Implementation
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, 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
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mcare facility acts in which capacity?
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a. Working under direct supervision of an RN on the unit
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b. Working with the RN in the building m m m m m m


c. Working under general supervision by the RN available on site or by
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phone
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d. Working as an independent vocational nurse
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ANS: m C
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts
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with the general supervision of an RN available on site or by phone.
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DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1
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TOP: Charge Nurse/Manager
m m KEY: Nursing Process Step:
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N/A 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
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organization (HMO). Which 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
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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: m B
HMOs are a kind of managed care. This is accomplished by paying providers to care for
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groups of patients for a set capitation fee and by limiting services. Patients are not
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required to seek a second opinion, provide documentation of care, or wait a specific time
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period before visiting a specialist.
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DIF: Cognitive Level: Application REF: p. 9 OBJ: 9
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TOP: Charge Nurse/Manager
m KEY: Nursing Process Step:
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Implementation 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
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mthe hospital. 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
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care
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ANS: m D
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance
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company assuming the cost. This practice improves the profit of the insurance company.
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DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 9
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TOP: Health Care Financing
m KEY: Nursing Process Step:
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Implementation 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. m m m m m m


b. Medicare Part A covers reimbursement to the m m m m m m


physician.
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c. Medicare Part A covers outpatient hospital m m m m m


services.m


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




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


OBJ: 9 TOP: Government-Sponsored Health
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Insurance 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. m m m m m m


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


c. Reduced cost drugs are ordered for specific m m m m m m


diagnoses.
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d. Diagnostic group classification streamlines care. m m m m




ANS: m B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s
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diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
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discharge patients before the allotted time, hospitals get to keep the excess payment; cost is
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contained, and the patient is discharged sooner.
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DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: m m m m


m9 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
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mfor 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
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long-term care facility m m


c. An 80-year-old blind woman living in her own home who has inadequate private
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insurance
d. A 67-year-old stroke victim with Medicare Part A and an income from
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investments
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ANS: m A
Medicaid is a joint effort of federal and state governments geared primarily for low-income
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people with no insurance.
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DIF: Cognitive Level: Application REF: p. 8, Box 1-5 m m m m m m


OBJ: 9 TOP: Government-Sponsored Health Insurance—
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Medicaid KEY: Nursing Process Step: Assessment
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