(Test Bank) Introduction to Medical Surgical Nursing

Linton, 6

Nursing

Test Bank

6th Edition

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Test Bank for Introduction to Medical Surgical Nursing, The downloadable file consists of 158 pages, and the total size of the file is 0.95 MB. Purchase now only for highly discounted price.

Author(s): Linton

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Stuvia.com - The Marketplace to Buy and Sell your Study Material Test bank Introduction to Medical Surgical Nursing 6th edition Linton chapter 01-chapter 03 Chapter 01: The Health Care System Chapter 01: The Health Care System Linton: Introduction to Medical -Surgical Nursing, 6th Edition MULTIPLE CHOICE An 89 -year -old man, who was recently discharged from a rehabilitation hospital because of an inability to concentrate and frequent memory lapses, cannot be left alone while his family works. What options should the discharge planning team suggest that will satisfy safety concerns and give the greatest quality of life to the patient? a. Placement in a day care center from 8 AM to 5 PM daily b. Placement in a long -term psychiatric facility c. Placement in a high -security nursing home d. Admission to a general hospital for evaluation ANS: A Day care centers provide supervision, safety, nutritious meals, and socialization while the caregiving family works. A 66 -year -old hospitalized patient is anxious about how the physician will be paid now that he is on Medicare Parts A and B, instead of his previous privately funded insurance plan. Who should the nurse explain is the payor to the physician on this plan? a. Previous privately funded insurance plan b. Medicare Part A Stuvia.com - The Marketplace to Buy and Sell your Study Material c. Medicare Part B d. Patient or patient’s family ANS: C Part A pays skilled care facilities. Part B pays for physician’s services. The previously held insurance is no longer available because of the patient’s age. The family or patient is not responsible because Part B is in effect. What health care plan is the best referral for an unemployed 42-year -old patient with renal failure who has lost his job-related private insurance? a. Medicare b. Medicaid c. Public health facility d. Community -based outpatient clinic ANS: B Medicaid is available to needy low -income persons younger than 65 years of age who have a permanent disability. Medicare is for persons 65 years and older. Public health services are involved with prevention more often than with chronic care. A patient with terminal lung cancer with extensive metastasis is requesting a hospice transfer. What criteria are included as requirements for this transfer? a. The patient requests and agrees to the guidelines of hospice care without requiring a physician’s order. b. The physician confirms that the patient has 6 months or less of life remaining and has provided a written order for hospice care. c. Proof confirms that the family can no longer care for the patient at home. d. The patient’s specific diagnosis is included on a list of accepted diseases that qualifies the patient for hospice care. Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: B The four criteria for transfer to hospice care are (1) diagnosis of any terminal illness, (2) prognosis of less than 6 months of life, (3) informed consent of patient, and (4) written physician’s order. A patient admitted yesterday with a diagnosis -related group (DRG) diagnosis of abdominal pain of an unknown cause is being discharged this afternoon because all diagnostic test results have been negative. What does this scenario exemplify? a. Effective laborat ory response b. Medicare guidelines limiting hospital stay c. Cost containment related to a DRG diagnosis d. Patient who should not have been admitted in the first place ANS: C Cost containment is a means by which the cost of hospitalization time is reduced when the need for acute hospital care is no longer necessary. A nurse is discussing discharge to a transitional subacute facility with a 72 -year -old patient diagnosed with diabetes and bilateral leg amputation. What should the nurse inform the patient regarding the stay in the new facility? a. It will be limited to 25 days. b. It will be limited to 50 days. c. It will be limited to 75 days. d. It is totally unlimited. ANS: D Medicare limitations are waived for patients who have undergone amputations. Stuvia.com - The Marketplace to Buy and Sell your Study Material A patient is applying for Medicaid. What does the receipt of benefits require? a. Following a supervised health maintenance plan b. Enrolling in the Medicare -Preferred Drug Plan c. Qualifying for the food stamp program d. Having an annual income of less than $10,000 ANS: B The Medicare -Preferred Drug Plan is a condition of Medicaid eligibility. Nonenrollment may cause the loss of all health care benefits. Which is true concerning proprietary agencies? a. They are organized to be nonprofit operations. b. They are organized to make a profit on their operation. c. Any profit they make is immediately used to purchase better equipment and services. d. They must participate in Medicare. ANS: B These agencies are usually owned by large corporations and established for the purpose of making a profit. Although most such agencies do participate in Medicare, it is not required. Which patient should the nurse recognize as eligible for a referral to Medicaid? a. Military automobile mechanic with severe asthma b. Pregnant unmarried young woman employed at a discount retail store for 3 years c. College student on scholarship who works part-time at the college library and who needs medication for arthritis d. Unemployed young mother on welfare who needs diabetic medication for one of her children ANS: D Stuvia.com - The Marketplace to Buy and Sell your Study Material Medicaid covers medication and health care services for welfare recipients for child health and long - term care. Why was the Balanced Budget Act of 1997 the cause of closures of many proprietary home health care agencies? a. It specified that all care be given by registered nurses (RNs). b. It listed specific diagnoses that could qualify a patient for home health care. c. It limited the amount of money that could be spent on a patient. d. It increased the criteria for patient eligibility for home care. ANS: C The Balanced Budget Act of 1997 placed a limit on the amount of money that could be spent on a patient’s home health care regardless of diagnosis or needs. Who is considered the forerunner of modern public health nursing in the United States? a. Vincent DePaul b. William Rathbone c. Florence Nightingale d. Lillian Wald ANS: D Lillian Wald is recognized as the forerunner of modern public health nursing. What is true about voluntary health care agencies? a. They are supported by tax dollars. b. They are governed by boards made up of community members. Stuvia.com - The Marketplace to Buy and Sell your Study Material c. They receive no fee for services. d. They use volunteers as health care providers. ANS: B Voluntary agencies are governed by boards made up of community members and are supported by a variety of sources. They are not supported by tax dollars. A client who is hospitalized for treatment after a stroke asks the nurse how long Medicare can be expected to cover his treatment. What is the nurse’s most informative response? a. “Your Part B will cover your hospital care as long as is necessary.” b. “Your health care provider will determine how long your Medicare coverage will be in effect.” c. “You are allowed 50 days of inpatient care annually.” d. “You can receive skilled care for up to 100 days.” ANS: D Persons hospitalized for skilled nursing care receive 100 days of Medicare coverage. What statement exemplifies that health care benefits are supported by both federal and state funding? a. Cost -containment prospective funding b. Department of Health and Human Services (DHHS) Social Security benefits for dentures c. Centers for Disease Control and Prevention (CDC) surveillance of persons at risk for acquired immunodeficiency syndrome (AIDS) d. Medicaid provision for skilled care in the home ANS: D Federal and state cooperation are involved in home skilled care issues. Stuvia.com - The Marketplace to Buy and Sell your Study Material A nurse is assessing a 65-year -old patient scheduled for outpatient cataract removal surgery in 10 days. What should the nurse stress this patient will need? a. Adequate insurance b. Adequate postoperative care at home c. Specialized glasses d. Preservation and protection of vision ANS: B Outpatient surgical patients are at great risk for postoperative complications in the absence of professional monitoring. This risk emphasizes the need for preoperative teaching and the provision of postoperative support in the home. With what type of professionals are skilled nursing facilities mandated to staff facilities? a. Licensed health professionals around the clock b. RN in charge on each shift c. RNs to supervise the patient care given by aides d. Only RNs to provide complex care ANS: A A skilled facility must have licensed health care professionals around the clock. Licensed practical nurses (LPNs) may supervise nursing assistants (NAs), who are the major caregivers. LPNs can provide wound care and ostomy care and monitor intravenous therapies. What is the purpose of a long -term care facility? a. Rehabilitation of patients to their former level of functioning b. Restoration of patients to their optimal level of independence c. To offer care to patients who do not need hospitalization but cannot care for themselves Stuvia.com - The Marketplace to Buy and Sell your Study Material d. Exclusive care for patients with dementia ANS: C Long -term care facilities care for patients who do not need to be hospitalized but who cannot care for themselves. Although many patients with dementia are residents in a long -term care facility, the purpose of such facilities is not to provide their care exclusively. A resident in a long -term care facility has difficulty swallowing and frequently chokes on food and liquids. The nurse identifies an increased risk of aspiration. To whom should the nurse initiate a referral for a swallowing evaluation? a. Physician who specializes in throat disorders b. Dietitian c. Nutritionist d. Speech therapist ANS: D Speech therapists are qualified to evaluate swallowing disorders. What did the 2003 report from the Institute of Medicine (IOM), “Health Professions Education: A Bridge to Quality,” outline? a. Specific software technology to increase efficiency in health care b. Evaluation tool to evaluate the quality of health care c. Recommendations for curriculum changes in professional health care schools d. Five core competencies for health care professionals ANS: D The 2003 IOM report “Health Professions Education: A Bridge to Quality” stressed the need for health professionals to be proficient in five areas: (1) providing patient -centered care, (2) working as a member of a team, (3) using evidence -based medicine, (4) focusing on qualit y improvement, and (5) using information technology. Stuvia.com - The Marketplace to Buy and Sell your Study Material MULTIPLE RESPONSE What is the difference between a health maintenance organization (HMO) and a fee-for-service plan? (Select all that apply.) a. An HMO requires a set fee from each client. b. An HMO allows clients to select their own health care providers. c. An HMO permits admission to any inpatient facility. d. An HMO offers limited referral options. e. An HMO provides both inpatient and outpatient care. ANS: A, E HMOs require a set fee from each client to use health care providers specified or hired by each HMO. Inpatient and outpatient care are provided in specified facilities. HMOs have a large group of specialists to whom it refers clients. Fee-for-service plans are more expensive, but they allow clients to choose the health care provider and facility. What should a nurse assure the parents of a newborn with a congenital heart defect that will ease and support the home care for their child? (Select all that apply.) a. Availability of smaller and more compact equipment b. Specialized DRGs for home care of children c. Medicaid -funded home care services d. Home care services funded by private insurance e. Grants and stipends from various drug manufacturers ANS: A, B, C, D Medicaid funds home care for children, specialized DRGs, and home -sized equipment make home care for children more easily accomplished. Stuvia.com - The Marketplace to Buy and Sell your Study Material A nurse outlines the benefits of using a home health aide to a homebound patient. With what should the home health aide assist this patient? (Select all that apply.) a. Bathing b. Doing laundry c. Shopping for groceries d. Administering medications e. Ambulating ANS: A, E Home health aides may assist with bathing, ambulation, skin care, and minor homemaking chores. They are not qualified to administer medications. Tasks of laundry, heavy house cleaning, and grocery shopping are inappropriate for home health aides and are more appropriately assigned to a homemaker serviceperson. A patient inquires about eligibility for home health care. What should the nurse explain is the criteria for skilled home health care? (Select all that apply.) a. Annual income less than $20,000 b. Need for physical or speech therapy c. Nonavailability of transportation d. Must be homebound e. Need for wound dressing changes ANS: B, D, E Eligibility for skilled care from a home health care aide includes the need for nursing care for IV therapies, respirators, wound dressing changes, and physical or speech therapy. No requirement relative to low income or the lack of transportation exists, but the patient must be homebound. Stuvia.com - The Marketplace to Buy and Sell your Study Material What is the mission of the Public Health Service (PHS)? (Select all that apply.) a. Ensure safety of foods and cosmetics. b. Provide access to health care services for low-income individuals. c. Conduct medical research. d. Support substance abuse prevention and treatment. e. Monitor and prevent disease outbreaks. f. Provide insurance coverage for low-income individuals. ANS: A, B, C, D, E The PHS focus is on all levels of ensuring community health, both in providing treatment and supporting prevention. The PHS also supports medical research. What is true regarding the Medicare Prescription Drug Plan? (Select all that apply.) a. It is included in Medicare Part A. b. There is a $250 deductible. c. Approximately 25% of prescription drug expenses are covered. d. Only prescriptions written by a medical physician are covered. e. It reimburses 95% of out-of-pocket expenses over $3600. ANS: B, E Medicare Prescription Plan (Medicare Part D) requires a separate enrollment, pays 50% of drug expenses after the $250 deductible is satisfied, honors all prescriptions written by licensed medical personnel who have prescriptive power, and covers 95% of out-of-pocket expenses up to $3600. Why do physicians prefer to use e-prescription systems? (Select all that apply.) a. Drug requests are processed more efficiently. Stuvia.com - The Marketplace to Buy and Sell your Study Material b. Drug duplicat ions are prevented. c. Less expensive drugs are used. d. Contraindications for a drug are identified. e. Both the generic and trade names are labeled. ANS: A, B, D E-prescription systems that expedite the request also generate drug information related to contraindications and side effects and can identify duplication of drugs. What services are considered to be under the administration of the U.S. Department of Health and Human Services (HHS)? (Select all that apply.) a. Public Health Service (PHS) b. Administration for Children and Families c. Administration on Aging d. American Medical Association e. Centers for Medicare and Medicaid ANS: A, B, C, E The Public Health Service (PHS), Administration for Children and Families, Administration on Aging, and Centers for Medicare and Medicaid all share the administration of the Department of Health and Human Services (HHS). COMPLETION The nurse clarifies that the insurance plan that pays the physician in advance each month for each enrolled patient, whet her or not the patient is treated by the physician, is a strategy known as . ANS: Stuvia.com - The Marketplace to Buy and Sell your Study Material capitation Capitation is the system of payment that collects monthly “fees” from enrollees and pays the physician whether the patient has been treated or not. It is rather like a salary that assures the attention of a physician in the event of an illness Chapter 02: Nursing in Varied Patient Care Settings Linton: Introduction to Medical -Surgical Nursing, 6th Edition MULTIPLE CHOICE While a home health nurse is making the entry to a service assessment on a home -bound patient, the spouse of the patient asks whether Medicare will cover the patient’s ventilator therapy and insulin injections. What is the best response by the nurse? a. “Yes, Medicare will cover both the ventilator therapy and the insulin injections.” b. “No, Medicare will not cover either of these ongoing therapies.” c. “Medicare will cover the ventilator therapy, but it does not cover the insulin injections.” d. “Medicare will cover the ongoing insulin therapy, but it does not cover a highly technical skill such as ventilator therapy.” Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: C Medicare will cover skilled nursing tasks such as ventilator therapy, but common tasks that can be taught to the family or the patient are not covered. DIF: Cognitive Level: Application REF: p. 18 OBJ: 3 TOP: Medicare Coverage for Home Health KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care The wife of a patient asks the nurse whether her husband would be considered for placement in a skilled nursing care facility when he is discharged from the general hospital. The patient is incontinent, has mild dementia but is able to ambulate with a walker, and must have help to eat and dress himself. What is the nurse’s most appropriate response? a. “Yes, your husband would qualify for a skilled care facility because of his inability to feed and dress himself.” b. “No, your husband’s disabilities would not qualify him for a skilled facility.” c. “Yes, your husband qualifies for placement in a skilled care facility because of his dementia.” Stuvia.com - The Marketplace to Buy and Sell your Study Material d. “Yes, anyone who is willing to pay can be placed in a skilled nursing facility.” ANS: B Placement in a skilled nursing facility must be authorized by a physician. A clear need for rehabilitation must be evident, or severe deficits in self -care that have a potential for improvement and require the services of a registered nurse, physical therapist, or speech therapist must exist. DIF: Cognitive Level: Analysis REF: p. 19 OBJ: 9 TOP: Placement Qualifications for Skilled Nursing Facility KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment A nurse has noted that a newly admitted resident to an extended care facility stays in her room, does not take active part in activities, and leaves the meal table after having eaten very little. The nurse should analyze this relocation response as a. regression. Stuvia.com - The Marketplace to Buy and Sell your Study Material b. social withdrawal. c. depersonalization. d. passive aggressive. ANS: B Social withdrawal is a frequent response to relocation. DIF: Cognitive Level: Application REF: p. 27 OBJ: 10 TOP: Relocation Response KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation A nurse clarifies to a new patient in a rehabilitation center what rehabilitation means. What statement made by the patient indicates a correct understanding? a. “I will return to my previous level of functioning.” b. “I will be counseled into a new career.” c. “I will develop better coping skills to accept his disability.” Stuvia.com - The Marketplace to Buy and Sell your Study Material d. “I will attain the greatest degree of independence possible.” ANS: D The rehabilitation process works to promote independence at whatever level the patient is capable of achieving. DIF: Cognitive Level: Comprehension REF: p. 21 OBJ: 4 TOP: Rehabilitation Goals KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care A nurse assesses a patient who needs to be reminded to take premeasured oral medications, wash, go to meals, and undress and come to bed at night, but coming and going as he pleases is considered safe for him. What facility placement would be most appropriate for this patient? a. Skilled care b. Interm ediate care c. Sheltered housing d. Domiciliary care Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: D Domiciliary care provides room, board, and supervision, and residents may come and go as they please. Sheltered housing does not provide 24 -hour care. DIF: Cognitive Level: Comprehension REF: p. 25 OBJ: 3 TOP: “Levels of Care, Criteria for Domiciliary Residence” KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care A nurse is making a list of the members of the rehabilitation team so the different types of services available to patients may be taught to a group of families. Which lists should be used? a. Physical therapist, nurse, family members, and personal physician b. Occupational therapist, dietitian, nurse, and patient c. Rehabilitation physician, laboratory technician, patient, and family Stuvia.com - The Marketplace to Buy and Sell your Study Material d. Vocational rehabilitation specialist, patient, and psychiatrist ANS: A The rehabilitation team usually consists of all of the choices except the laboratory technician, dietitian, and psychiatrist. (The mental health role is represented by the psychologist.) DIF: Cognitive Level: Comprehension REF: p. 23 OBJ: 8 TOP: Rehabilitation Team Members KEY: Nursing Process Step: Planning MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care A nurse explains the level of disability to a patient who was injured in a construction accident that resulted in the loss of both his right arm and right leg. This loss has affected his quality of life and ability to return to previous employment. At what level should the client be classified as being disabled? a. I b. II c. III d. IV Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: B The patient is limited in the use of his right arm for feeding himself, dressing himself, and driving his car, which are three main activities of daily living. He may be able to work if workplace modifications are made. DIF: Cognitive Level: Application REF: p. 21 OBJ: 5 TOP: Levels of Disability KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care A nurse explains that in 1990, the Americans with Disabilities Act (ADA) was passed. For which extended services for the disabled persons did this act provide? a. Covering the costs for the rehabilitation of disabled World War I servicemen by providing job training b. Extending protection to the disabled in the military sector, such as wheelchair ramps on military bases c. Extending protection to the disabled in private areas, such as accessibility to public restaurant bathrooms and telephones Stuvia.com - The Marketplace to Buy and Sell your Study Material d. Affording disabled persons full access to all health care services ANS: C The ADA of 1990 extended the previous legislative Acts of 1920, 1935, and 1973. The ADA now covers private sector individuals and public businesses in particular. DIF: Cognitive Level: Comprehension REF: p. 22-23 OBJ: 7 TOP: Americans with Disabilities Act (ADA) of 1990 KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care A frail patient in a long -term care facility asks the nurse if a bath is to be given this morning. What is the best reply by the nurse to encourage independence and give the patient the most flexibility? a. “Based on your room number, you get bathed on Monday, Wednesday, and Friday. Today is Tuesday.” Stuvia.com - The Marketplace to Buy and Sell your Study Material b. “If you want to eat breakfast in the dining room with the others, you may sponge yourself off in your bathroom.” c. “When your daughter comes this evening, ask her if she can give you a bath.” d. “I will bring a basin of water for a sponge off for right now. After breakfast, we will talk about a bath schedule.” ANS: D The resident should be provided as much flexibility as possible and support for independence. DIF: Cognitive Level: Application REF: p. 28 OBJ: 11 TOP: Maintenance of Autonomy in Extended Care Facility KEY: Nursing Process Step: Implementation MSC: NCLEX Physiological Integrity: Basic Care and Comfort Stuvia.com - The Marketplace to Buy and Sell your Study Material A computer programmer who lost both legs is being retained by his employer, who has made arrangements for a ramp and a special desk to accommodate the patient’s wheelchair. What is the disability level of the computer programmer? a. I b. II c. III d. IV ANS: B Level II allows for workplace accommodation, which is the desk modification in this case. DIF: Cognitive Level: Analysis REF: p. 21 OBJ: 5 TOP: Reasonable Accommodation KEY: Nursing Process Step: N/A MSC: NCLEX: N/A A partially paralyzed forklift operator is to be retrained by vocational rehabilitation services for less demanding office work. What law provides for this rehabilitation? Stuvia.com - The Marketplace to Buy and Sell your Study Material a. Vocational Rehabilitation Act of 1920 b. Social Security Act of 1935 c. Rehabilitation Act of 1973 d. Americans with Disabilities Act of 1990 ANS: C The Rehabilitation Act of 1973 provided a comprehensive approach and expanded resources for public vocational training. DIF: Cognitive Level: Comprehension REF: p. 22 OBJ: 7 TOP: Rehabilitation Legislation KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care The home health care nurse performs all the following actions. Which is the only action that is reimbursable under Medicare payment rules? a. Observing a spouse cleaning and changing a dressing Stuvia.com - The Marketplace to Buy and Sell your Study Material b. Taking a frail couple for a walk to provide exercise c. Watching a patient measure out all medications d. Teaching a patient to self-administer insulin ANS: D Medicare reimburses skilled techniques that are clearly spelled out; these include teaching but not return demonstration –type actions by patient or family. DIF: Cognitive Level: Comprehension REF: p. 19 OBJ: 3 TOP: Medicare Reimbursable Actions KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care A patient with multiple sclerosis must be fed, bathed, and dressed. How should the nurse assess this patient? a. Disabled b. Disadvantaged