Chapter 01: Caring for Medical-Surgical Patients
m m m m m
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
m m m m m m m
MULTIPLEmCHOICE
1. Which mstatementmaccurately mdescribes mthe mprim ary mpurposemof mthe mstatemnurse mpractice mactm( NPA)?
a. To mtestmand mlicensemLPN/L VNs.
b. To mdefinemthemscopemof mLPN/L VN mpractice.
c. To mimprovemthemquality mofmcaremprov ided mby mthe mL PN/L
VN.
d. To mlimitmthemLPN/L VN memp loyment mplacem ent.
ANS: B
Whilemimprovingmquality mof mcar emprovided mby m them LPN/LVNm may mb ema mresult mof m them NPA, mthe mprim ary mpurposemof mthe mNPA
mof meach mstatemdefines mthe mscopemof mnursing mpractice min mthatmstate.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 2
OBJ: 3 TOP: NPA KEY:
NursingmProcess mStep:mImplementation
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
2. Themchargemnursemasks mthemnewmvocationalmnurse mto mstart man m intravenous m infusion, ma mskill mthatm themvocation almnurs
emhas mnotmbeen mtaughtmdur ing mher meducationalmpro gram. mHo w mshould mthe mvocationalmnursemr espond?
a. Ask mammoremexperienced mnursemto mdemonstrate mthe mprocedure.
b. Look mup mthemproceduremin mthemprocedurem manual.
c. Attemptmto mperform mthemprocedure mwith msupervision.
d. Inform mthemchargemnursemof mher m lack mof m trainin g min mthis mproce
dure.
ANS: D
Themchargemnursemshould mbeminformed mof m them lack mofm trainin g mto mperform mthe mprocedure, mand m the mvocational mnursemshould m
seek mfurther mtrainingmto m gain mproficiency. mAlthou gh mth emoth er moptions mmight mbe mhelpful, mthey mare mnot msafe.
PTS: 1 DIF: CognitivemLevel:mApplication m REF:
3
OBJ: 1 TOP: ProvidingmSafemCare KEY:
NursingmProcess mStep:mN/
A
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
3. Which mpatientmstatem entm indicates m amneed mfor mfurther mdischar ge mteachin g mthatmth emvocationalmnurse mshould maddress?
a. “I mhavemno mideamof mhowmth is mdru gm willmaff ect mme. ”
b. “Do myou mknowmif mmy mphysician mis mco min gmb ack m tod
ay?”
c. “Willmmy minsurancempay mfor mmy mstay?”
d. “Am mI mgoingmto mhave mto m go mto mamnursin g mhome?”
ANS: A
Lack mof mknowledgemat mdischar ge mabout mm edication m effects mand msidem effects mis ma mconcern m that mshould mbe maddressed mby mthe mvo
cationalmnurse. mThemother mconcerns min m themop tions mar emth emresponsibility mof mother mdepar tments mto m which mth emnursem might mrefer
mthempatient.
PTS: 1 DIF: CognitivemLevel:mApplication mmm REF: 2
OBJ: 1 TOP: Teachingm KEY:
NursingmProcess mStep:mImplementatio
n
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
4. Accordingmto mmostmstate mNPAs,m the mvocational mnursemactin g mas mch argemnurse min m amlon g-
term mcaremfacility macts min mwh ich m capacity?
a. Workingmunder mdirectmsupervision mof man m RN mon mthe munit
b. Workingmwith mthe m RN min m the mbuildin g
c. Workingmunder mgeneralmsupervision mby mthe m RNm available mon msitemor mby m
phone
d. Workingmas man mindependent mvocationalmnurse
ANS: C
Themvocationalmnursemin mthem capacity mof mthe mch argemnurse min m amlon g-
term mcaremfacility macts m with mthe m gener almsupervision mof m an m RNmav ailable mon msite mor mby mphone.
,Medical-Surgical mNursing- mConcepts mand mPracticem3th mEdition mdeWit
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 2
OBJ: 1 TOP: ChargemNurse/Manager KEY: Nursing Process mStep:mN/
A
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
,Medical-Surgical mNursing- mConcepts mand mPracticem3th mEdition mdeWit
5. Themnursemis meducatingma mpatient mthat mis m am member mof m amhealth mmaintenan ce morganization m(HMO). m Which minf
ormation mshould mthemnurseminclude?
a. Seek mthemopinion mof man malternatemh ealth mcaremprovid er.
b. Obtain minsurancemapprovalmfor mmed ical mservices mprior mto m treatment.
c. Providemdetailed mdocumentation mof mall mcaremr eceived mfor mhis m condit
ion.
d. Waitmatmleastm6 mmonths mto msee mamspecialist.
ANS: B
MostmHMOs mrequirempreprocedure mauthorization mfor m treatment. m Patients mar emnot mrequir ed m to mseek ma msecond mop inion, mprovid emd
ocumentation mof mcare,mor mwaitm amspecific mtimemp eriod mb eforemv isitin g mamspecialist.
PTS: 1 DIF: CognitivemLevel:mApplication m REF: 9
OBJ: 9 TOP: ChargemNurse/Manager
KEY: NursingmProcess mStep:mImplementation
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
6. Thempatientmcomplains mto m themnurse mthatmhe mis m confused mabout mhis m “deductible”mth at mhemo wes m themhospita
l.mWhich mstatementm accurately mexplains ma mdeductible?
a. An mamountmof mmoney mputmaside mfor mth empay ment mof mfutur emm edicalmb ills
b. Amone-timemfeemfor mservice
c. An mamountmof mmoney mdeducted mfrom mth embill mby mth eminsurancem company
d. An mannualmamountmof mmoney mth empatien tmmust mpay mout-of-
pocketmfor mmedicalmcare
ANS: D
Themdeductiblemis mthemannualmamountm the minsured mmust mpay mout-of-
pocketmprior mto mtheminsurancemco mpany m assuming mthe mcost. mThis mpr actice mimproves m themprof itmof mthe minsurance mcomp any.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 7
OBJ: 9 TOP: Health mCaremFinancing
KEY: NursingmProcess mStep:mImplementation
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
7. Themnursemcompares mthemcharacter istics mof ma mhealth m maintenancemor ganization m( HM O) m and ma mpref erred mp
rovider morganization m(PPO).m Wh ich m information mshould m themnurse mincludem aboutm HM Os?
a. HMOs mrequiremamsetmfee mof m each mmember m monthly.
b. HMOs mallowmthemm ember mto mselectmhis mhealth mcare mprovi
der.
c. HMOs mpermitmadmission mto many mfacility mth emm ember mpref
ers.
d. HMOs moffer munlimited mdiagnosticm tests mand mtreatm ents.
ANS: A
HMOs mrequiremamsetmfee mfrom meach mm ember mmonthly m(cap itation). mTh empatien tm willmbe mtreated mby m them HMO mstaff min m HM O-
approved mfacilities. mExcessivemusemof mdiagnostic mtests m and mtreatm ents mis md iscouraged mby mthe m HM O.
PTS: 1 DIF: CognitivemLevel:mApplication m REF: 9
OBJ: 9 TOP: Managed mCare
KEY: NursingmProcess mStep:mImplementation
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
8. Ampatientmasks mthemnursemwhatm Medicare mPart mA mcovers. m Wh ich mr esponsemis m correct?
a. MedicaremPartmAm covers minp atien tmhospital mcosts.
b. MedicaremPartmAm covers mreimbursement mto mthe mphysici
an.
c. MedicaremPartmA mcovers moutp atientmhospital mservices.
d. MedicaremPartmA mcovers m ambulan cem transportation.
ANS: A
MedicaremPartmAm covers minp atien tmhospital mexpenses, mdru gs,mx-
rays,mlaboratory mwork,mand mintensivemcare.m Med icare m Part m Bmpays mthe mphysician, mambu lance mtransport, mand mou tpatientmserv ices.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 7,mBox m1-
4
OBJ: 9 TOP: Government-
Sponsored mHealth mInsurance
KEY: NursingmProcess mStep:mImplementation
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
9. Which mis mthemmain m cost-containment mcompon entmof mdiagnosis-related m groups m(DRGs)?
, Medical-Surgical mNursing- mConcepts mand mPracticem3th mEdition mdeWit
a. Hospitals mfocus monly mon mthemspecific mdiagnosis.
b. Hospitals mtreatmand mdischargempatien ts mquick ly.
c. Reduced mcostmdrugs maremordered mfor mspecific mdiagnos
es.
d. Diagnosticmgroup mclassification mstreamlines mcare.
ANS: B
DRGs maremamprospectivempaymentmplan min mwhich mhospitals mreceivemamflatmfeemfor meach mpatient’s mdiagnosticmcategory mregardle
ss mof mthemlength mof mtimemin mthemhospital. mIf mhospitals mcan mtreatmand mdischargempatients mbeforemthemallotted mtime,mhospitals mget
mto mkeep mthemexcess mpayment;m costmis mcontained, m and mth empatient mis md ischar ged msooner.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 8
OBJ: 9 TOP: Government-
Sponsored mHealth mInsurance
KEY:mmmmmm NursingmProcess mStep:mImplementation
MSC:mmmmm NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
10 . Themnursemis massessingmamgroup mof mpatients. m Which mpatient mwould mmostm likely mqualify mfor mMed icaid?
a. Am35-year-old munemployed msingle mmoth er m with mdiab etes
b. Am70-year-old mMedicaremrecip ient mwith mretir ement min come mwho mneeds m to mbe min mam lon g-
term mcaremfacility
c. An m80-year-old mblind mwoman mliv in gmin mher mown mhome mwho mhas m inadequatempr ivate minsurance
d. Am67-year-old mstrokemvictim mwith mMed icar em Part mA mand man mincom emfrom minvestments
ANS: A
Medicaid mis mamjointmeffor tmof mfederalm and mstatem govern ments m geared mprimar ily mfor mlo w-incom emp eople mwith mno minsurance.
PTS: 1 DIF: CognitivemLevel:mApplication mmm REF: 8,mBox m1-
5 mOBJ: 9 TOP: Government-Sponsored mHealth mInsurance–
Medicaid mKEY: NursingmProcess mStep:mAssessment
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
11 . Which mareamis mthemm ajor mfo cus mof m HealthymP eoplem2020 m and mth emprimary m mechan ism m through mwh ich m to m improve mt
hemhealth mof mAmericans min mthe msecond md ecade mof m them century?
a. Research mfunding
b. Health minformation mdistribution
c. Healthy mlifestylemencouragem ent
d. Health mimprovementmprogram md esign
s
ANS: C
HealthymPeoplem2020 mfocuses mon mexpanding mon goin gmpro gr ams mto mincludemsupport mand m information m to mreducem infant mmorta l
ity,mcancer, mcardiovascular mdisease, mand m HIV/AI DS, mand mto mincr easem effectivem immunizations, mhealthy m eating mhab its, mand mhe
althy mweight.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 6
OBJ: 7 TOP: Healthy mPeoplem2020
KEY: NursingmProcess mStep:mImplementation
MSC: NCLEX:mSafe,mEffectivemCaremEnvironment:mCoordinated mCare
12 . Which mterm mexplains mthe mtype mofm care mthatmaddr esses minterven tions mfor mall mdim ensions mof ma mpatient’s mlife?
a. Focused mcare
b. Generalmcare
c. Directed mcare
d. Holisticmcare
ANS: D
Holisticmcaremaddresses mthemphysiolo gic, mpsycholo gical, msocial, mcultural, mand mspir itual mneeds mof m themp atien t.
PTS: 1 DIF: CognitivemLevel:mComprehension REF: 6
OBJ: 8 TOP: HolisticmCare
KEY: NursingmProcess mStep:mPlanning
MSC: NCLEX:mPsychosocialmIntegrity:mCopingmand mAdaptation
13 . Ampatientmfuriously msays,m“My mdoctor mwas mso mbusy m giv in gmm em instructions m that mhemd idn’tmh ear m whatmI mwas mtry
ingmto mask mhim!”m Which mresponsemis mmost memp athetic?
a. “When mpeoplemignore mme, mI mreally m get mmad. ”