TEST BANK
|
,Chapter 01: Caring for Medical-Surgical Patients
| | | | |
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
| | | | | | |
MULTIPLE |CHOICE
1. Which |statement |accurately |describes |the |primary |purpose |of |the |state |nurse
|practice |act |(NPA)?
a. To |test |and |license |LPN/LVNs
b. To |define |the |scope |of |LPN/LVN |practice
c. To |improve |the |quality |of |care |provided |by |the |LPN/LVN
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 |primarypurpose |of |the |NPA |of |each |state |defines |the |scope
|of |nursing |practice |in |that |state.
DIF: Cognitive |Level: |Comprehension REF: | p. |3 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.
DIF: Cognitive |Level: |Application REF: | p. |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.
DIF: Cognitive |Level: |Application REF: | p. |2 OBJ: |1
|TOP: | Teaching KEY: |Nursing |Process |Step: |Implementation
| MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
,4. According |to |most |state |NPAs, |the |vocational |nurse |acting |as |charge |nurse |in |a |long-term |care |facility
|acts |in |which |capacity?
a. Working |under |direct |supervision |of |an |RN |on |the |unit
b. Working |with |the |RN |in |the |building
c. Working |under |general |supervision |by |the |RN |available |on |site |or |by |phone
d. Working |as |an |independent |vocational |nurse
ANS: |C
The |vocational |nurse |in |the |capacity |of |the |charge |nurse |in |a |long-term |care |facility |acts |with |the |general
|supervision |of |an |RN |available |on |site |or |by |phone.
DIF: Cognitive |Level: |Comprehension REF: | p. |3 OBJ: |1
|TOP: | Charge |Nurse/Manager KEY: |Nursing |Process |Step: |N/A
|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?
a. Seek |the |opinion |of |an |alternate |health |care |provider.
b. Contact |the |insurance |company |for |coverage |details |as |services |may |be |limited.
c. Provide |detailed |documentation |of |all |care |received |for |his |condition.
d. Wait |at |least |6 |months |to |see |a |specialist.
ANS: |B
HMOs |are |a |kind |of |managed |care. |This |is |accomplished |by |paying |providers |to |care |for |groups |of
|patients |for |a |set |capitation |fee |and |by |limiting |services. |Patients |are |not |required |to |seek |a |second
|opinion, |provide |documentation |of |care, |or |wait |a |specific |time |period |before |visiting |a |specialist.
DIF: | | Cognitive |Level: |Application REF: | | p. |9 OBJ: | 9
TOP: | Charge |Nurse/Manager KEY: |Nursing |Process |Step: |Implementation
|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 |hospital.
|Which |statement |accurately |explains |a |deductible?
a. An |amount |of |money |put |aside |for |the |payment |of |future |medical |bills
b. A |one-time |fee |for |service
c. An |amount |of |money |deducted |from|the |bill |by |the |insurance |company
d. An |annual |amount |of |money |the |patient |must |pay |out-of-pocket |for |medical |care
ANS: |D
The |deductible |is |the |annual |amount |the |insured |must |pay |out-of-pocket |prior |to |the |insurance |company
|assuming |the |cost. |This |practice |improves |the |profit |of |the |insurance |company.
DIF: | | Cognitive |Level: |Comprehension | | REF: | | p. |7 OBJ: | 9
TOP: | Health |Care |Financing KEY: |Nursing |Process |Step: |Implementation
|MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
7. A |patient |asks |the |nurse |what |Medicare |Part |A |covers. |Which |response |is |correct?
a. Medicare |Part |A |covers |inpatient |hospital |costs.
b. Medicare |Part |A |covers |reimbursement |to |the |physician.
c. Medicare |Part |A |covers |outpatient |hospital |services.
d. Medicare |Part |A |covers |ambulance |transportation.
ANS: |A
Medicare |Part |A |covers |inpatient |hospital |expenses, |drugs, |x-rays, |laboratory |work, |and |intensive |care.
|Medicare |Part |B |pays |the |physician, |ambulance |transport, |and |outpatient |services.
, DIF: Cognitive |Level: |Comprehension REF: |p. |8, |Box |1-4
OBJ: | 9 TOP: |Government-Sponsored |Health |Insurance
|KEY: |Nursing |Process |Step: |Implementation
MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
8. Which |is |the |main |cost-containment |component |of |diagnosis-related |groups |(DRGs)?
a. Hospitals |focus |only |on |the |specific |diagnosis.
b. Hospitals |treat |and |discharge |patients |quickly.
c. Reduced |cost |drugs |are |ordered |for |specific |diagnoses.
d. Diagnostic |group |classification |streamlines |care.
ANS: |B
DRGs |are |a |prospective |payment |plan |in |which |hospitals |receive |a |flat |fee |for |each |patient's |diagnostic
|category |regardless |of |the |length |of |time |in |the |hospital. |If |hospitals |can |treat |and |discharge |patients
|before |the |allotted |time, |hospitals |get |to |keep |the |excess |payment; |cost |is |contained, |and |the |patient |is
|discharged |sooner.
DIF: Cognitive |Level: |Comprehension REF: | p. |8 OBJ: |9
|TOP: |Government-Sponsored |Health |Insurance
KEY: |Nursing |Process |Step: |Implementation
MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
9. The |nurse |is |assessing |a |group |of |patients. |Which |patient |would |most |likely |qualify |for |Medicaid?
a. A |35-year-old |unemployed |single |mother |with |diabetes
b. A |70-year-old |Medicare |recipient |with |retirement |income |who |needs |to |be |in |a |long-term
|care |facility
c. An |80-year-old |blind |woman |living |in |her |own |home |who |has |inadequate |private
|insurance
d. A |67-year-old |stroke |victim |with |Medicare |Part |A |and |an |income |from|investments
ANS: |A
Medicaid |is |a |joint |effort |of |federal |and |state |governments |geared |primarily |for |low-income |people |with
|no |insurance.
DIF: Cognitive |Level: |Application REF: |p. |8, |Box |1-5
OBJ: | 9 TOP: |Government-Sponsored |Health |Insurance—Medicaid
|KEY: |Nursing |Process |Step: |Assessment
MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
10. Which |area |is |the |major |focus |of |Healthy |People |2020 |and |the |primary |mechanism |through |which |to
|improve |the |health |of |Americans |in |the |second |decade |of |the |century?
a. Research |funding
b. Health |information |distribution
c. Healthy |lifestyle |encouragement
d. Health |improvement | program |designs
ANS: |C
Healthy |People |2020 |focuses |on |expanding |ongoing |programs |to |include |support |and |information |to
|reduce |infant |mortality, |cancer, |cardiovascular |disease, |and |HIV/AIDS, |and |to |increase |effective
|immunizations, |healthy |eating |habits, |and |healthy |weight.
DIF: Cognitive |Level: |Comprehension REF: | | p. |6 OBJ: | 7
TOP: | Healthy |People |2020 KEY: |Nursing |Process |Step: |Implementation
|MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
|
,Chapter 01: Caring for Medical-Surgical Patients
| | | | |
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
| | | | | | |
MULTIPLE |CHOICE
1. Which |statement |accurately |describes |the |primary |purpose |of |the |state |nurse
|practice |act |(NPA)?
a. To |test |and |license |LPN/LVNs
b. To |define |the |scope |of |LPN/LVN |practice
c. To |improve |the |quality |of |care |provided |by |the |LPN/LVN
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 |primarypurpose |of |the |NPA |of |each |state |defines |the |scope
|of |nursing |practice |in |that |state.
DIF: Cognitive |Level: |Comprehension REF: | p. |3 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.
DIF: Cognitive |Level: |Application REF: | p. |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.
DIF: Cognitive |Level: |Application REF: | p. |2 OBJ: |1
|TOP: | Teaching KEY: |Nursing |Process |Step: |Implementation
| MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
,4. According |to |most |state |NPAs, |the |vocational |nurse |acting |as |charge |nurse |in |a |long-term |care |facility
|acts |in |which |capacity?
a. Working |under |direct |supervision |of |an |RN |on |the |unit
b. Working |with |the |RN |in |the |building
c. Working |under |general |supervision |by |the |RN |available |on |site |or |by |phone
d. Working |as |an |independent |vocational |nurse
ANS: |C
The |vocational |nurse |in |the |capacity |of |the |charge |nurse |in |a |long-term |care |facility |acts |with |the |general
|supervision |of |an |RN |available |on |site |or |by |phone.
DIF: Cognitive |Level: |Comprehension REF: | p. |3 OBJ: |1
|TOP: | Charge |Nurse/Manager KEY: |Nursing |Process |Step: |N/A
|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?
a. Seek |the |opinion |of |an |alternate |health |care |provider.
b. Contact |the |insurance |company |for |coverage |details |as |services |may |be |limited.
c. Provide |detailed |documentation |of |all |care |received |for |his |condition.
d. Wait |at |least |6 |months |to |see |a |specialist.
ANS: |B
HMOs |are |a |kind |of |managed |care. |This |is |accomplished |by |paying |providers |to |care |for |groups |of
|patients |for |a |set |capitation |fee |and |by |limiting |services. |Patients |are |not |required |to |seek |a |second
|opinion, |provide |documentation |of |care, |or |wait |a |specific |time |period |before |visiting |a |specialist.
DIF: | | Cognitive |Level: |Application REF: | | p. |9 OBJ: | 9
TOP: | Charge |Nurse/Manager KEY: |Nursing |Process |Step: |Implementation
|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 |hospital.
|Which |statement |accurately |explains |a |deductible?
a. An |amount |of |money |put |aside |for |the |payment |of |future |medical |bills
b. A |one-time |fee |for |service
c. An |amount |of |money |deducted |from|the |bill |by |the |insurance |company
d. An |annual |amount |of |money |the |patient |must |pay |out-of-pocket |for |medical |care
ANS: |D
The |deductible |is |the |annual |amount |the |insured |must |pay |out-of-pocket |prior |to |the |insurance |company
|assuming |the |cost. |This |practice |improves |the |profit |of |the |insurance |company.
DIF: | | Cognitive |Level: |Comprehension | | REF: | | p. |7 OBJ: | 9
TOP: | Health |Care |Financing KEY: |Nursing |Process |Step: |Implementation
|MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
7. A |patient |asks |the |nurse |what |Medicare |Part |A |covers. |Which |response |is |correct?
a. Medicare |Part |A |covers |inpatient |hospital |costs.
b. Medicare |Part |A |covers |reimbursement |to |the |physician.
c. Medicare |Part |A |covers |outpatient |hospital |services.
d. Medicare |Part |A |covers |ambulance |transportation.
ANS: |A
Medicare |Part |A |covers |inpatient |hospital |expenses, |drugs, |x-rays, |laboratory |work, |and |intensive |care.
|Medicare |Part |B |pays |the |physician, |ambulance |transport, |and |outpatient |services.
, DIF: Cognitive |Level: |Comprehension REF: |p. |8, |Box |1-4
OBJ: | 9 TOP: |Government-Sponsored |Health |Insurance
|KEY: |Nursing |Process |Step: |Implementation
MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
8. Which |is |the |main |cost-containment |component |of |diagnosis-related |groups |(DRGs)?
a. Hospitals |focus |only |on |the |specific |diagnosis.
b. Hospitals |treat |and |discharge |patients |quickly.
c. Reduced |cost |drugs |are |ordered |for |specific |diagnoses.
d. Diagnostic |group |classification |streamlines |care.
ANS: |B
DRGs |are |a |prospective |payment |plan |in |which |hospitals |receive |a |flat |fee |for |each |patient's |diagnostic
|category |regardless |of |the |length |of |time |in |the |hospital. |If |hospitals |can |treat |and |discharge |patients
|before |the |allotted |time, |hospitals |get |to |keep |the |excess |payment; |cost |is |contained, |and |the |patient |is
|discharged |sooner.
DIF: Cognitive |Level: |Comprehension REF: | p. |8 OBJ: |9
|TOP: |Government-Sponsored |Health |Insurance
KEY: |Nursing |Process |Step: |Implementation
MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
9. The |nurse |is |assessing |a |group |of |patients. |Which |patient |would |most |likely |qualify |for |Medicaid?
a. A |35-year-old |unemployed |single |mother |with |diabetes
b. A |70-year-old |Medicare |recipient |with |retirement |income |who |needs |to |be |in |a |long-term
|care |facility
c. An |80-year-old |blind |woman |living |in |her |own |home |who |has |inadequate |private
|insurance
d. A |67-year-old |stroke |victim |with |Medicare |Part |A |and |an |income |from|investments
ANS: |A
Medicaid |is |a |joint |effort |of |federal |and |state |governments |geared |primarily |for |low-income |people |with
|no |insurance.
DIF: Cognitive |Level: |Application REF: |p. |8, |Box |1-5
OBJ: | 9 TOP: |Government-Sponsored |Health |Insurance—Medicaid
|KEY: |Nursing |Process |Step: |Assessment
MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
10. Which |area |is |the |major |focus |of |Healthy |People |2020 |and |the |primary |mechanism |through |which |to
|improve |the |health |of |Americans |in |the |second |decade |of |the |century?
a. Research |funding
b. Health |information |distribution
c. Healthy |lifestyle |encouragement
d. Health |improvement | program |designs
ANS: |C
Healthy |People |2020 |focuses |on |expanding |ongoing |programs |to |include |support |and |information |to
|reduce |infant |mortality, |cancer, |cardiovascular |disease, |and |HIV/AIDS, |and |to |increase |effective
|immunizations, |healthy |eating |habits, |and |healthy |weight.
DIF: Cognitive |Level: |Comprehension REF: | | p. |6 OBJ: | 7
TOP: | Healthy |People |2020 KEY: |Nursing |Process |Step: |Implementation
|MSC: |NCLEX: |Safe, |Effective |Care |Environment: |Coordinated |Care
