1 . In an attempt to persuade employees to bargain for another type of health
insurance, a handout is circulated that describes the present employees' health
care insurance as being insensitive, limiting choices of care providers, and
providing inferior care. This reflects which aspect of Lewin's planned change?
a. Unfreeze
b. Move
c. Refreeze
d. Acceptance Correct Answer: A
Unfreeze is correct because the change agent promotes problem identification
and encourages awareness of the need for change. In alignment with Lewin's
stages of change (unfreezing, moving, and refreezing), education and involvement
are keys to successful change. People must believe that improvement is possible
before they will be willing to consider change.
DIF: Comprehension REF: p. 311
1. A client arrives in active labor and exhibits toxemia with irregular fetal heart
tones. The client is an immigrant and is uninsured. Which act would prevent the
client from being transferred to another facility?
a. Emergency Medical Treatment and Active Labor Law
b. Health Insurance Portability and Accountability Act
,c. Patient Self-Determination Act
d. The Patient Safety and Quality Improvement Act Correct Answer: A
The Emergency Medical Treatment and Active Labor Law is a federal statute that
was enacted in 1986 to prohibit the transfer of unstable clients, including women
in labor, from one facility to another. This law also prohibits refusal of care for
indigent and uninsured clients who seek medical assistance in the emergency
department.
DIF: Comprehension REF: p. 123
1. A nurse is listening to a patient's apical heart rate. The patient asks, "Is
everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is
demonstrating:
a. open communication.
b. filtration.
c. blocking.
d. false assurance. Correct Answer: C
Blocking occurs when the nurse responds with noncommittal or generalized
answers.
DIF: Comprehension REF: p. 335
1. A nurse is preparing to administer a medication by using the vastus lateralis site
and is unfamiliar with the process. A step-by-step reference that shows how to
complete the process is called a:
a. deployment flowchart.
b. top-down flowchart.
,c. Pareto chart.
d. control plot. Correct Answer: B
A top-down flowchart shows the sequence of steps in a job or process such as
medication administration.
DIF: Comprehension REF: p. 379 |p. 388
1. According to the Palliative Performance Scale which patient is considered to
possess 70% of normal function?
a. 40 year old diagnosed with AIDS whose condition makes it impossible to hold a
job.
b. 70 year old diagnosed with end stage renal failure who spends most of the day
in bed.
c. 50 year old diagnosed with emphysema whose disease has begun to impact
normal ambulate.
d. 30 year old diagnosed with muscular dystrophy who is bed bound. Correct
Answer: A
70% function implies that the patient has a reduction in ambulation and the
disease process affect ability to hold a job.
DIF: Application REF: p. 225, Table 12-3
1. Accrediting agencies such as The Joint Commission address staffing by:
a. imposing maximum staffing levels.
b. requiring a specific staff mix.
c. stipulating nurse-patient ratios.
, d. looking for evidence that patients receive satisfactory care. Correct Answer: D
Accrediting agencies do not address minimum staffing levels; however, they do
look for evidence that patients receive adequate care, and this can occur only
with adequate staffing.
DIF: Comprehension REF: p. 369
1. An older adult client was admitted to the hospital with the condition classified
as "pneumonia." Reimbursement was based on a predetermined fixed price. This
classification system is referred to as:
a. diagnosis-related groups (DRGs).
b. subjective symptom management.
c. acuity classification system.
d. organized managed care. Correct Answer: A
DRGs are used in reimbursement for health care services based on a
predetermined fixed price per case or diagnosis in 468 categories. Under DRGs,
each Medicare client is assigned to a diagnostic grouping on the basis of his or her
primary diagnosis at hospital admission. Medicare limits total payment to the
hospital to the amount pre-established for that DRG.
DIF: Comprehension REF: p. 3 |pp. 9-10 |p. 106 | pp. 108-109
1. Consumers are concerned with security issues related to their confidential
health information being placed in an electronic health record (EHR). However,
when the security of the EHR is compared with that of paper-and-pencil records,
the EHR is:
a. more secure.
b. less secure.
insurance, a handout is circulated that describes the present employees' health
care insurance as being insensitive, limiting choices of care providers, and
providing inferior care. This reflects which aspect of Lewin's planned change?
a. Unfreeze
b. Move
c. Refreeze
d. Acceptance Correct Answer: A
Unfreeze is correct because the change agent promotes problem identification
and encourages awareness of the need for change. In alignment with Lewin's
stages of change (unfreezing, moving, and refreezing), education and involvement
are keys to successful change. People must believe that improvement is possible
before they will be willing to consider change.
DIF: Comprehension REF: p. 311
1. A client arrives in active labor and exhibits toxemia with irregular fetal heart
tones. The client is an immigrant and is uninsured. Which act would prevent the
client from being transferred to another facility?
a. Emergency Medical Treatment and Active Labor Law
b. Health Insurance Portability and Accountability Act
,c. Patient Self-Determination Act
d. The Patient Safety and Quality Improvement Act Correct Answer: A
The Emergency Medical Treatment and Active Labor Law is a federal statute that
was enacted in 1986 to prohibit the transfer of unstable clients, including women
in labor, from one facility to another. This law also prohibits refusal of care for
indigent and uninsured clients who seek medical assistance in the emergency
department.
DIF: Comprehension REF: p. 123
1. A nurse is listening to a patient's apical heart rate. The patient asks, "Is
everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is
demonstrating:
a. open communication.
b. filtration.
c. blocking.
d. false assurance. Correct Answer: C
Blocking occurs when the nurse responds with noncommittal or generalized
answers.
DIF: Comprehension REF: p. 335
1. A nurse is preparing to administer a medication by using the vastus lateralis site
and is unfamiliar with the process. A step-by-step reference that shows how to
complete the process is called a:
a. deployment flowchart.
b. top-down flowchart.
,c. Pareto chart.
d. control plot. Correct Answer: B
A top-down flowchart shows the sequence of steps in a job or process such as
medication administration.
DIF: Comprehension REF: p. 379 |p. 388
1. According to the Palliative Performance Scale which patient is considered to
possess 70% of normal function?
a. 40 year old diagnosed with AIDS whose condition makes it impossible to hold a
job.
b. 70 year old diagnosed with end stage renal failure who spends most of the day
in bed.
c. 50 year old diagnosed with emphysema whose disease has begun to impact
normal ambulate.
d. 30 year old diagnosed with muscular dystrophy who is bed bound. Correct
Answer: A
70% function implies that the patient has a reduction in ambulation and the
disease process affect ability to hold a job.
DIF: Application REF: p. 225, Table 12-3
1. Accrediting agencies such as The Joint Commission address staffing by:
a. imposing maximum staffing levels.
b. requiring a specific staff mix.
c. stipulating nurse-patient ratios.
, d. looking for evidence that patients receive satisfactory care. Correct Answer: D
Accrediting agencies do not address minimum staffing levels; however, they do
look for evidence that patients receive adequate care, and this can occur only
with adequate staffing.
DIF: Comprehension REF: p. 369
1. An older adult client was admitted to the hospital with the condition classified
as "pneumonia." Reimbursement was based on a predetermined fixed price. This
classification system is referred to as:
a. diagnosis-related groups (DRGs).
b. subjective symptom management.
c. acuity classification system.
d. organized managed care. Correct Answer: A
DRGs are used in reimbursement for health care services based on a
predetermined fixed price per case or diagnosis in 468 categories. Under DRGs,
each Medicare client is assigned to a diagnostic grouping on the basis of his or her
primary diagnosis at hospital admission. Medicare limits total payment to the
hospital to the amount pre-established for that DRG.
DIF: Comprehension REF: p. 3 |pp. 9-10 |p. 106 | pp. 108-109
1. Consumers are concerned with security issues related to their confidential
health information being placed in an electronic health record (EHR). However,
when the security of the EHR is compared with that of paper-and-pencil records,
the EHR is:
a. more secure.
b. less secure.
