Medical-Surgical Nursing: Concepts & Practice 5th Edition by Stromberg – Nursing Textbook & Study Guide

TESTBANK
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,Chapter 01: Caring forMedical-Surgical Patients
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Stromberg:Medical-Surgical Nursing:Concepts and Practice, 5thEdition
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MULTIPLE CHOICE v




1. Which statement accuratelydescribes the primarypurpose 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 qualityof care provided by the LPN/LVN
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d. Tolimitthe LPN/LVNemployment placement
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ANS: B v




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




TOP: NPA
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vMSC: 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 vocational
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nurse has not been taught during her educational program. How should the vocational nurse respond?
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a. Ask a more experienced nurse to demonstrate the procedure.
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b. Lookup the procedure in the procedure manual. v v v v v v v




c. Attempt to performthe procedure with supervision. v v v v v v




d. Informthe charge nurse of her lack of trainingin thisprocedure. v v v v v v v v v v v




ANS: D v




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




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. "Ihave no idea of how thisdrug will affect me."
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b. "Do you know if my physician is comingbacktoday?"
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c. "Will my insurance pay for my stay?" v v v v v v




d. "Am I going to have to go to a nursinghome?" v v v v v v v v v v




ANS: A v




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 v v v v v




TOP: Teaching
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vMSC: 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 acts
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in which capacity?
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a. Workingunder direct supervision of an RN on the unit v v v v v v v v v




b. Working with the RNin thebuilding v v v v v v




c. Workingunder general supervision bythe RNavailable on site or byphone v v v v v v v v v v v v




d. Workingas anindependent vocational nurse v v v v v




ANS: C v




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 v v v v v




TOP: Charge Nurse/Manager
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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. Seekthe opinion of an alternate health care provider.
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b. Contactthe insurance company for coverage details asservices maybe limited.
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c. Providedetailed documentation of all care received forhis condition. v v v v v v v v v




d. Wait at least 6 months to see a specialist. v v v v v v v v




ANS: B v




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
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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 moneyput 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 fromthe bill by the insurance company
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d. An annual amount of moneythe patient must pay out-of-pocket for medical care
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ANS: D v




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. Apatient asks the nurse what Medicare Part Acovers.Which response iscorrect?
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a. Medicare Part Acovers inpatient hospital costs. v v v v v v




b. Medicare Part Acovers reimbursement to the physician. v v v v v v v




c. Medicare Part Acovers outpatient hospital services. v v v v v v




d. Medicare Part Acovers ambulance transportation. v v v v v




ANS: A v




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 v v v v v v




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




KEY: Nursing Process Step: Implementation
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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8. Whichisthemain cost-containment component of diagnosis-related groups(DRGs)?
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a. Hospitalsfocus onlyon thespecificdiagnosis. v v v v v v




b. Hospitals treat and discharge patientsquickly. v v v v v




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




d. Diagnosticgroupclassification streamlines care. v v v v




ANS: B v




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




TOP: Government-Sponsored Health Insurance
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KEY: NursingProcess Step: Implementation
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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9. Thenurseis assessinga group of patients. Which patient would most likelyqualifyforMedicaid?
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a. A35-year-oldunemployed single mother withdiabetes
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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. A67-year-old stroke victimwith Medicare Part Aand an income frominvestments
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ANS: A v




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




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




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 v




b. Health information distribution v v




c. Healthylifestyle encouragement v v




d. Health improvement program designs v v v




ANS: C v




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 v v v v v v




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