Medical Surgical Nursing Concepts And Practice 5th Edition By Stromberg – Test Bank

Medical Surgical Nursing Concepts And Practice 5th Edition By Stromberg – Test Bank

Chapter 01: Caring for Medical-Surgical Patients

Stromberg: Medical-Surgical Nursing: Concepts & Practice, 5th Edition

MULTIPLE CHOICE

1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)?

To test and license LPN LVN

b. To define the scope of LPN LVN practice.

. To improve the quality of care provided by the LPN LVN

4. 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 primary purpose of the NPA of each state defines the scope of nursing practice in that state.

PTS: 1

DIF: Cognitive Level: Comprehension

REF: 2

OBJ: 3

TOP: NPA

KEY: Ning ProcessStep: Implementation

MSC: NCLEX: Safe Effective Care Environment: Coordinated Care

2. The charge mrse asks the new vocational surse to start an intravenous infusion, a skill that the vocational nurse has not been taught during her educational program. How should the

vocational nurse sespond? Ask a more experienced nurse to demonstrate the procedure

Look up the procedure in the procedure manual

. Anempt to perform the procedure with supervision

4. 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.

PTS: 1

DIF: Cognitive Level: Application

REF: 3

OBI 1

TOP Proving Safe Care

KEY: Norsing ProcessStep: NA

MSC: NCLEX: Sade Effective Care Environment Coordinated Care

3. Which patient statement indicates a need for further discharge teaching that the vocational nurse should address?

“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?”

4. “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.

PTS: 1

DIF: Copsitive Level: Application

REF: 2

OU: 1

TOP: Teaching

KEY: Naving ProcessStep

MSC: NCLEX: Safe Effective Care Evices 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?

Working under direct supervision of an RN on the unit

Working with the RN in the building

e. Working under general supervision by the RN available on site or by phone

4. 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.

PTS: 1

DIF: Cognitive Level: Comprehension

REF: 2

087: 1

TOP: Charge Nurse Manager

KEY: Nursing Proces 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.

Obtain insurance approval for medical services prior to treatment.

Provide detailed documentation of all care received for his condition

4. Wait at least 6 months to see a specialist

ANS: B

Most HMOs require preprocedure authorization for treatment. Patients are not required to seek a second opinion, provide documentation of care, or wait a specific time period before visiting a specialist.

PTS: 1

DIF: Cognitive Level: Application

REF: 9

0879

TOP: Charge Nurse Manager

KEY: Norning 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?

An amount of money put aside for the payment of future medical bills

A one-time fee for service

c. An amount of money deducted from the bill by the insurance company

4. 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.

FIS: 1

DIF: Cognitive Level: Comprebeasion

REF: 7

0879

TOP: Health Care Financing

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe Effective Care Coordinated Cre

7. The nurse compares the characteristics of a health maintenance organization (HMO) and a prefered provider organization (PPO). Which information should the nurse include about HMO

a. HMOs require a set fee of each member monthly.

HMOs allow the member to select his health care provider.

HMOs permit admission to any facility the member prefers.

4. HMOs offer unlimited diagnostic tests and treatments.

ANS: A

HMOs require a set fee from each member monthly (capitation). The patient will be treated by the HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is discouraged by the HMO.

PTS: 1

DIF: Cognitive Level: Application

REF: 9

OBJ: 9

TOP: Managed Care

KEY: Narning Process Step: Implementation

MSC: NCLEX: Safe Effective Care Environment Coordinated Care

8. A patient asks the nurse what Medicare Part A covers. Which response is comect?

a. Medicare Part A covers inpatient hospital costs.

b. Medicare Part A covers reimbursement to the physician

. Medicare Part A covers outpatient hospital services.

4. 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.

PTS: 1

DOF: Cognitive Level: Comprehension

REF: 7, Box 1-4

OBJ: 9

TOP: Gomment-Sponsored Health Inve

KEY: Narning Process Step: Implementation

MSC: NCLEX: Safe Effective Care Environment Coordinated Care

9. Which is the main cost-containment component of diagnosis-related groups (DRGs)?

Hospitals focus only on the specific diagnosis

Hospitals treat and discharge patients quickly.

Reduced cost drugs are ordered for specific diagnoses.

4. Diagnostic group classification streamlines care.

ANS:

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.

PTS 1

OBJ: 9

DIF: Cognitive Level: Comprehension

REF: 8

TOP Government-Sponsored Healthc

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe Effective Care Environment Coded Care

10. The nurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?

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

4. 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.

PTS 1

DIF: Cognitive Level: Application

000: 9

TOP Government-Sponsored Health insurance-Medicaid

KEY: Nursing Process Step: Assessm

MSC: NCLEX: Safe Effective Care Environment Coordinated Care

11. 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

Health information distribution

Healthy lifestyle encouragement

4. 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.

PTS: 1

DIF: Cognitive Level Compression

REF: 6

0007

TOP: Healthy People 2020

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe Effective Cave Environ Coordinated Cre

12. Which term explains the type of care that addresses interventions for all dimensions of a

patient’s life?

Focused care

General care

Directed care

4. Holistic care

ANS: D

Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of the patient.

PTS: 1

DIF: Cognitive Level Compre

REF: 6

OBJ: 8

TOP: Holistic Care

KEY: Nursing ProcessStep Planning

MSC: NCLEX: Prychosocialegrity: Coping and Adaptation

13. A patient furiously says, “My doctor was so busy giving me instructions that he didn’t hear what I was trying to ask him!” Which response is most empathetic?

“When people ignore me. I really get mad.”

“T’m sure that the doctor was rushed and unaware of your needs.”

“T’ll bet that made you feel very frustrated”

4. “Take a deep breath and plan what you will say to him tomorrow.”

ANS: C

Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the emotion Belittling the patient’s feelings, showing sympathy, or defending the doctor makes the patient feel devalued.

PTS: 1

DIF: Cognitive Level Analysis

084: 10

TOP: Nine-Patient Relation

KEY: Norning Process Step: Implementation MSC: NCLEX: Prychosocial Integrity

14. The nurse is explaining differences in a therapeutic relationship and a social relationship to a patient. Which information about therapeutic relationships is most important for these to include in the explanation?

Therapeutic relationships lack formal boundaries.

Therapeutic relationships are goal directed.

c. Therapeutic relationships meet the needs of each person in the relationship.

4. Therapeutic relationships extend past the hospitalization period.

ANS: B

The therapeutic relationship is focused on the patient and is goal directed and designed to meet only the needs of the patient and does not extend past the period of hospitalization

PTS: 1

DIF: Cognitive Level: Comprehension

REF: 9

REF: 10

087: 10

TOP: Therapeutic Relationship

KEY: Nusing Process Step:mptation MSC: NCLEX: Prychosocial Integrity

15. The long-term care facility nurse is caring for a newly admitted 80-year-old patient who is depressed. Which approach is best for the surse to employ?

a. Encourage the resident to engage in an activity. Remind the resident of reasons to be positive.

Point out episodes of negative behavior.

4. Present a bright and cheerful behavior.

ANS: A

Activity and social interaction are helpful to depressed patients. Presenting a cheery approach and pointing out negative behavior and reasons to be positive are not therapeutic at this stage of the relationship.

PTS: 1

DIF: Cognitive Level: Analys

REF: 10

083 10

TOP: Depressed Behavior

KEY: Nusing Process Step: Implementation

MSC: NCLEX: Pychosocial Integrity