TEST BANK FOR MEDICAL SURGICAL NURSING CONCEPTS AND PRACTICE 2ND EDITION BY SUSAN DEWIT KUMAGAI

Chapter 01:Caring for Medical-Surgical Patients
g g g g g




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




MULTIPLECHOICE

Whichstatementaccuratelydescribestheprimarypurposeofthestatenursepracticeact
g g g g g g g g g g g g




(NPA)?
g




a. TotestandlicenseLPN/LVNs. g g g g




b. TodefinethescopeofLPN/LVN
practice. g




c. Toimprovethequalityofcare
provided by the LPN/LVN. g g g g




d. To limittheLPN/LVNemployment b g




placement. g




ANS: B g




While improving quality of care provided by the LPN/LVN may be a result of the NPA,
g g g g g g g g g g g g g g g




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




state.
g




CognitiveLevel:Comprehension
PTS: 1 DIF: g




REF: 2 g




OBJ:3 TOP: NPAKEY:Nursing ProcessStep: g b


Implementation g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g




Thechargenurseasksthenewvocationalnurseto start an intravenous infusion, askill that g b g g g g




the vocational nurse has notbeen taught during her educational program. How should
g g g g g g g g g g g g




the vocational nurse respond?
g g g g




a. Askamoreexperiencednurseto g g




demonstrate the procedure. g g g




b. Lookuptheprocedureintheprocedure g




manual. g




c. Attempt toperformtheprocedurewith b g




supervision. g




d. Informthechargenurseofherlackof g




training in this procedure. g g g g




ANS: D g




The charge nurse should be informed of the lack of training to perform the procedure, and the
g g g g g g g g g g g g g g g g




vocational nurseshould seek furthertraining to gain proficiency.Althoughthe other options
g g g g g g g g g g g g g




might be helpful, they are not safe.
g g g g g g g




PTS: 1 DIF: CognitiveLevel: g 3

, Application REF: g




OBJ: 1 TOP: ProvidingSafeCare NursingProcess
KEY: Step: N/A g g g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g




Whichpatientstatementindicatesaneedforfurtherdischargeteachingthatthe vocational
g g g g g g g g g g g g




nurse should address?
g g g




a. “Ihavenoideaofhowthisdrug g




will affect me.” g g g




b. “Doyouknowifmyphysicianis g




coming back today?” g g g




c. “Willmyinsurancepayformy
stay?” g




d. “AmIgoingtohavetogotoa g




nursing home?” g g




ANS: A g




Lack of knowledge at discharge about medication effects and side effects is a concern that
g g g g g g g g g g g g g g




should be addressed by the vocationalnurse. The other concerns in the options are the
g g g g g g g g g g g g g g




responsibility of otherdepartments to which the nursemightrefer thepatient.
g g g g g g g g g g g g




Cognitive Level: Application REF:
PTS: 1 DIF: g g




2 g




OBJ:1 TOP: Teaching KEY: Nursing Process g b


Step:Implementation g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g




AccordingtomoststateNPAs,thevocationalnurseactingaschargenurseinalong- term care
g g g g g g g g g g g g g g g g




facility acts in which capacity?
g g g g g




a. WorkingunderdirectsupervisionofanRNon the g g g g g g g g




unit g




b. WorkingwiththeRNin thebuilding g g g g g g




c. WorkingundergeneralsupervisionbytheRN g




available on site or by phone
g g g g g g




d. Working as an independent vocational nurse g g g g g




ANS: C g




Thevocationalnurseinthecapacity ofthechargenurseinalong-termcarefacility acts g g g g




gwith the general supervision of an RNavailable on site orby phone.
g g g g g g g g g g g




PTS: 1
CognitiveLevel: REF: 2 DIF:
Comprehension g




OBJ:1 TOP: ChargeNurse/Manager Nursi Process
KEY: ng Step:N/A g g g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g

,Thenurseiseducating apatientthatis amemberofahealth maintenanceorganization g g g g




g(HMO). Which informationshould the nurse include?
g g g g g




a. Seektheopinionofanalternatehealth care g g g




provider. g




b. Obtaininsuranceapprovalformedical g g




services prior to treatment. g g g g




c. Providedetaileddocumentationofallcare g




received for his condition. g g g g




d. Waitatleast6months to seeaspecialist. g g g g g g g g




ANS: B g




Most HMOs require preprocedure authorization for treatment. Patients are not required
g g g g g g g g g g




to seek a second opinion,providedocumentation of care, or wait a specific time period
g g g g g g g g g g g g g g




before visiting a specialist.
g g g g




CognitiveLevel:
PTS: 1 9 DIF: g




ApplicationREF: g g




OBJ:9 TOP: ChargeNurse/Manager
KEY:NursingProcessStep:Implementation g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g




Thepatientcomplainstothenursethatheisconfusedabout his“deductible”that he g g g g




gowes the hospital. Whichstatement accurately explains a deductible?
g g g g g g g




a. Anamountofmoneyput asidefor thepaymentof b g




future medical bills g g g




b. Aone-time feefor service g g g g




c. Anamountofmoneydeductedfromthebillby the g




insurance company g g




d. Anannualamountofmoneythepatientmust pay b g




out-of-pocket for medical careg g g g




ANS: D g




Thedeductibleistheannualamounttheinsuredmustpayout-of-pocketpriortothe insurance
g g g g g g g g g g g g g g




company assuming the cost. This practice improves the profit of the insurance company.
g g g g g g g g g g g g g




CognitiveLevel:
PTS: 1 REF: 7 DIF:
Comprehension g




OBJ:9 TOP: HealthCareFinancing g g




KEY:NursingProcessStep:Implementation g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g




Thenursecomparesthecharacteristicsofahealthmaintenanceorganization(HMO) g g




gand a preferred providerorganization (PPO). Which information should the nurse
g g g g g g g g g




include about HMOs?
g g g

, a. HMOsrequireasetfeeofeach
membermonthly. g g




b. HMOsallowthemembertoselect g




his health care provider. g g g g




c. HMOspermitadmissiontoany
facility the member prefers.
g g g g




d. HMOsofferunlimiteddiagnostic
tests and treatments. g g g




ANS: A g




HMOsrequireaset feefromeachmembermonthly(capitation).Thepatientwillbe b g g g g




treatedbytheHMOstaffinHMO-approvedfacilities.Excessiveuseofdiagnostic tests
g g g g g g g g g g g g




and treatments is discouraged by the HMO.
g g g g g g g




CognitiveLevel:
PTS: 1 9 DIF: g




ApplicationREF: g g




OBJ:9 TOP: ManagedCare g




KEY:NursingProcessStep:Implementation g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g




Apatient asks the nursewhat Medicare Part A covers. Which response is correct?
g g g g g g g g g g g g g




a. MedicarePartAcoversinpatient g g g




hospitalcosts. g




b. Medicare Part A covers g g g




reimbursementtothe physician.
g g g g




c. MedicarePartAcoversoutpatient g g g




hospitalservices. g




d. MedicarePart Acoversambulance g b


transportation. g




ANS: A g




Medicare Part Acoversinpatienthospitalexpenses,drugs,x-rays,laboratorywork,
g b



and intensive care. Medicare Part B pays thephysician, ambulance transport, and
g g g g g g g g g g g




outpatient services.
g g




CognitiveLevel:
PTS: 1 REF 7,Box DIF:
Comprehension : 1-4 g




OBJ:9 TOP: Government-Sponsored
HealthInsurance g




KEY:NursingProcessStep:Implementation g




MSC:NCLEX:Safe,EffectiveCareEnvironment: Coordinated Care g g g g g




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