m
,Chapterm01:mCaringmformMedical-SurgicalmPatients
deWit:mMedical-
SurgicalmNursing:mConceptsm&mPractice,m3rdmEditionmMULTIPLEmC
HOICE
1. Whichmstatementmaccuratelymdescribesmthemprimarympurposemofmthemstatemnursempracticemactm(NPA)?
a. TomtestmandmlicensemLPN/LVNs.
b. TomdefinemthemscopemofmLPN/LVNmpractice.
c. TomimprovemthemqualitymofmcaremprovidedmbymthemLPN/L
VN.
d. TomlimitmthemLPN/LVNmemploymentmplacement.
ANS: B
WhilemimprovingmqualitymofmcaremprovidedmbymthemLPN/LVNmmaymbemamresultmofmthemNPA,mthemprimarympurposemofmthemN
PAmofmeachmstatemdefinesmthemscopemofmnursingmpracticeminmthatmstate.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 2
OBJ: 3 TOP: NPA KEY:
NursingmProcessmStep:mImplementation
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinatedmCare
2. Themchargemnursemasksmthemnewmvocationalmnursemtomstartmanmintravenousminfusion, mamskillmthatmthemvocational mnurs
emhasmnotmbeenmtaughtmduringmhermeducational mprogram.mHowmshouldmthemvocational mnursemrespond?
a. Askmammoremexperienced mnursemtomdemonstratemthemprocedure.
b. Lookmupmthemprocedureminmthemproceduremmanual.
c. Attemptmtomperformmthemproceduremwithmsupervision.
d. Informmthemchargemnursemofmhermlackmofmtrainingminmthismproced
ure.
ANS: D
Themchargemnursemshouldmbeminformedmofmthemlackmofmtrainingmtomperformmthemprocedure, mandmthemvocational mnursemshouldm
seekmfurthermtrainingmtomgainmproficiency.mAlthoughmthemothermoptionsmmightmbemhelpful,mtheymaremnotmsafe.
PTS: 1 DIF: CognitivemLevel:mApplicationm REF: 3
OBJ: 1 TOP: ProvidingmSafemCare KEY:
NursingmProcessmStep:mN/A
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
3. Whichmpatientmstatement mindicatesmamneedmformfurthermdischargemteachingmthatmthemvocational mnursemshouldmaddress?
a. “Imhavemnomideamofmhowmthismdrugmwillmaffectmme.”
b. “Domyoumknowmifmmymphysicianmismcomingmbackmtoda
y?”
c. “Willmmyminsurancempaymformmymstay?”
d. “AmmImgoingmtomhavemtomgomtomamnursingmhome?”
ANS: A
Lackmofmknowledgematmdischarge maboutmmedicationmeffectsmandmsidemeffectsmismamconcernmthatmshouldmbemaddressedmbymthemvoca
tiomnalmnurse.mThemothermconcernsminmthemoptionsmaremthemresponsibilitymofmothermdepartments mtomwhichmthemnursemmightmrefermt
hempatient.
PTS: 1 DIF: CognitivemLevel:mApplicationm m REF: 2
OBJ: 1 TOP: Teachingm KEY:
NursingmProcessmStep:mImplementatio
n
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
4. AccordingmtommostmstatemNPAs,mthemvocationalmnursemactingmasmchargemnurseminmamlong-
termmcaremfacilitymactsminmwhichmcapacity?
a. WorkingmundermdirectmsupervisionmofmanmRNmonmthemunit
b. WorkingmwithmthemRNminmthembuilding
c. Workingmundermgeneral msupervisionmbymthemRNmavailablemonmsitemormbymp
hone
d. Workingmasmanmindependent mvocationalmnurse
ANS: C
Themvocationalmnurseminmthemcapacitymofmthemchargemnurseminmamlong-
termmcaremfacilitymactsmwithmthemgeneralmsupervisionmofmanmRNmavailablemonmsitemormbymphone.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 2
OBJ: 1 TOP: ChargemNurse/Manager KEY:
NursingmProcessmStep:mN/A
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
,5. Themnursemismeducatingmampatientmthatmismammembermofmamhealthmmaintenancemorganization m(HMO).mWhichminf
ormationmshouldmthemnurseminclude?
a. Seekmthemopinionmofmanmalternatemhealthmcaremprovider.
b. Obtainminsurancemapprovalmformmedicalmservicesmpriormtomtreatment.
c. Providemdetailedmdocumentationmofmallmcaremreceivedmformhismconditi
on.
d. Waitmatmleastm6mmonthsmtomseemamspecialist.
ANS: B
MostmHMOsmrequirempreproceduremauthorizationmformtreatment.mPatientsmaremnotmrequiredmtomseekmamsecondmopinion,mprovidemdo
cumentationmofmcare,mormwaitmamspecificmtimemperiodmbeforemvisitingmamspecialist.
PTS: 1 DIF: CognitivemLevel:mApplicationm REF: 9
OBJ: 9 TOP: ChargemNurse/Manager
KEY: NursingmProcessmStep:mImplementation
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
6. Thempatientmcomplainsmtomthemnursemthatmhemismconfusedmaboutmhism“deductible”mthatmhemowesmthemhospita
l.mWhichmstatementmaccuratelymexplainsmamdeductible?
a. Anmamountmofmmoneymputmasidemformthempaymentmofmfuturemmedicalmbills
b. Amone-timemfeemformservice
c. Anmamountmofmmoneymdeductedmfrommthembillmbymtheminsurancemcompany
d. Anmannualmamountmofmmoneymthempatientmmustmpaymout-of-
pocketmformmedicalmcare
ANS: D
Themdeductiblemismthemannual mamountmtheminsuredmmustmpaymout-of-
pocketmpriormtomtheminsurance mcompanymassumingmthemcost.mThismpracticemimprovesmthemprofitmofmtheminsurancemcompany.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 7
OBJ: 9 TOP: HealthmCaremFinancing
KEY: NursingmProcessmStep:mImplementation
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
7. Themnursemcomparesmthemcharacteristicsmofmamhealthmmaintenancemorganizationm(HMO)mandmampreferredmp
rovidermorganizationm(PPO).mWhichminformationmshouldmthemnursemincludemaboutmHMOs?
a. HMOsmrequiremamsetmfeemofmeachmmembermmonthly.
b. HMOsmallowmthemmembermtomselectmhismhealthmcaremprovid
er.
c. HMOsmpermitmadmissionmtomanymfacilitymthemmembermprefe
rs.
d. HMOsmoffermunlimitedmdiagnosticmtestsmandmtreatments.
ANS: A
HMOsmrequiremamsetmfeemfrommeachmmembermmonthlym(capitation).mThempatientmwillmbemtreatedmbymthemHMOmstaffminmHMO-
approvedmfacilities.mExcessivemusemofmdiagnosticmtestsmandmtreatmentsmismdiscouragedmbymthemHMO.
PTS: 1 DIF: CognitivemLevel:mApplicationm REF: 9
OBJ: 9 TOP: ManagedmCare
KEY: NursingmProcessmStep:mImplementation
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
8. AmpatientmasksmthemnursemwhatmMedicaremPartmAmcovers.mWhichmresponsemismcorrect?
a. MedicaremPartmAmcoversminpatientmhospitalmcosts.
b. MedicaremPartmAmcoversmreimbursement mtomthemphysicia
n.
c. MedicaremPartmAmcoversmoutpatientmhospitalmservices.
d. MedicaremPartmAmcoversmambulancemtransportation.
ANS: A
MedicaremPartmAmcoversminpatientmhospitalmexpenses,mdrugs, mx-
rays,mlaboratorymwork,mandmintensivemcare.mMedicaremPartmBmpaysmthemphysician,mambulancemtransport,mandmoutpatientmservices.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 7,mBoxm1-
4
OBJ: 9 TOP: Government-SponsoredmHealthmInsurance
KEY: NursingmProcessmStep:mImplementation
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
9. Whichmismthemmainmcost-containmentmcomponent mofmdiagnosis-relatedmgroupsm(DRGs)?
, a. Hospitalsmfocusmonlymonmthemspecificmdiagnosis.
b. Hospitalsmtreatmandmdischarge mpatientsmquickly.
c. Reducedmcostmdrugsmaremorderedmformspecificmdiagnos
es.
d. Diagnosticm groupm classificationm streamlinesm care.
ANS: B
DRGsmaremamprospectivempaymentmplanminmwhichmhospitalsmreceivemamflatmfeemformeachmpatient’smdiagnosticmcategorymregardle
ssmof mthemlengthmofmtimeminmthemhospital.mIfmhospitalsmcanmtreatmandmdischargempatientsmbeforemthemallottedmtime,mhospitalsmget
mtomkeep mthe mexcess mpayment;mcostmismcontained,mand mthem patientmis mdischarged msooner.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 8
OBJ: 9 TOP: Government-SponsoredmHealthmInsurance
KEY:m m NursingmProcessmStep:mImplementation
MSC:m m NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinatedmCare
10. Themnursemismassessingmamgroupmofmpatients.mWhichmpatientmwouldmmostmlikelymqualifymformMedicaid?
a. Am35-year-oldmunemployedmsinglemmothermwithmdiabetes
b. Am70-year-oldmMedicaremrecipientmwithmretirementmincomemwhomneedsmtombeminmamlong-
termmcaremfacility
c. Anm80-year-oldmblindmwomanmlivingminmhermownmhomemwhomhasminadequatemprivateminsurance
d. Am67-year-oldmstrokemvictimmwithmMedicaremPartmAmandmanmincomemfromminvestments
ANS: A
Medicaidmismamjointmeffortmofmfederalmandmstatemgovernmentsmgearedmprimarilymformlow-incomempeoplemwithmnominsurance.
PTS: 1 DIF: CognitivemLevel:mApplicationm REF: 8,mBoxm1-
5mOBJ: 9 TOP: Government-SponsoredmHealthmInsurance–
MedicaidmKEY: NursingmProcessmStep:mAssessment
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m Coordinatedm Care
11. WhichmareamismthemmajormfocusmofmHealthymPeoplem2020mandmthemprimarymmechanismmthroughmwhichmtomimprovemt
hemhealthmofmAmericansminmthemsecondmdecademofmthemcentury?
a. Researchm funding
b. Healthm informationm distribution
c. Healthym lifestylem encouragement
d. Healthm improvementm programm designs
ANS: C
HealthymPeoplem2020mfocusesmonmexpandingmongoingmprogramsmtomincludemsupportmandminformationmtomreduceminfantmmortali
ty,mcancer,mcardiovascular mdisease,mandmHIV/AIDS,mandmtomincreasemeffectivemimmunizations, mhealthymeatingmhabits,mandmhe
althymweight.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 6
OBJ: 7 TOP: HealthymPeoplem2020
KEY: NursingmProcessmStep:mImplementation
MSC: NCLEX:m Safe,m Effectivem CaremEnvironment:m CoordinatedmCare
12. Whichmtermmexplainsmthemtypemofmcaremthatmaddresses minterventionsmformallmdimensions mofmampatient’smlife?
a. Focusedmcare
b. Generalmcare
c. Directedm care
d. Holisticmcare
ANS: D
Holisticmcaremaddressesmthemphysiologic,mpsychological,msocial,mcultural,mandmspiritualmneedsmofmthempatient.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 6
OBJ: 8 TOP: HolisticmCare
KEY: NursingmProcessmStep:mPlanning
MSC: NCLEX:mPsychosocialm Integrity:m CopingmandmAdaptation
13. Ampatientmfuriouslymsays,m“Mymdoctormwasmsombusymgivingmmeminstructionsmthatmhemdidn’tmhearmwhatmImwasmtry
ingmtomaskmhim!”mWhichmresponsemismmostmempathetic?