Test Bank-Medical Surgical Nursing Concepts and Practice||Stromberg
Chap 01: Caring for Medical-Surgical Clients
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,Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
MULTIPLE CHOICE
1. Which statement accurately describes the primary purpose of the state professional nurse practice
act (NPA)?
a. To test and license LPN/LVNs
b. To define the scope of LPN/LVN practice
c. To improve the quality of care provided by the LPN/LVN
d. To limit the LPN/LVN employment placement
CORRECT ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the
primary purpose of the NPA of each state defines the scope of nursing practice in that state.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3
TOP: NPA KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. The charge professional nurse asks the new vocational professional nurse to start an
intravenous infusion, a skill that the vocational professional nurse has not been taught
during her educational program. How should the vocational professional nurse respond?
a. Ask a more experienced professional nurse to demonstrate the procedure.
b. Look up the procedure in the procedure manual.
c. Attempt to perform the procedure with supervision.
d. Inform the charge professional nurse of her lack of training in this procedure.
CORRECT ANS: D
The charge professional nurse should be informed of the lack of training to perform the
procedure, andthe vocational professional nurse should seek further training to gain
proficiency. Although the other options might be helpful, they are not safe.
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1
TOP: Providing Safe Care KEY: Nursing Process Step:
N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
3. Which client statement indicates a need for further discharge teaching that the
vocational professional nurse should address?
a. "I have no idea of how this drug will affect me."
b. "Do you know if my physician is coming back today?"
c. "Will my insurance pay for my stay?"
d. "Am I going to have to go to a nursing home?"
CORRECT ANS: A
Lack of knowledge at discharge about medication effects and side effects is a concern that
should be addressed by the vocational professional nurse. The other concerns in the
options are the responsibility of other departments to which the professional nurse might
refer the client.
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1
TOP: Teaching KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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4. According to most state NPAs, the vocational professional nurse acting as charge
professional nurse in a long-termcare facility acts in which capacity?
a. Working under direct supervision of an RN on the unit
b. Working with the RN in the building
c. Working under general supervision by the RN available on site or by phone
d. Working as an independent vocational professional nurse
CORRECT ANS: C
The vocational professional nurse in the capacity of the charge professional nurse in a
long-term care facility actswith the general supervision of an RN available on site or by
phone.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1
TOP: Charge Professional nurse/Manager KEY:
Nursing Process Step:N/A MSC: NCLEX: Safe, Effective Care
Environment: Coordinated Care
5. The professional nurse is educating a client that is a member of a health maintenance
organization(HMO). Which information should the professional nurse include?
a. Seek the opinion of an alternate health care provider.
b. Contact the insurance company for coverage details as services may be limited.
c. Provide detailed documentation of all care received for his condition.
d. Wait at least 6 months to see a specialist.
CORRECT ANS: B
HMOs are a kind of managed care. This is accomplished by paying providers to care for
groups of clients for a set capitation fee and by limiting services. Clients are not required
to seek a second opinion, provide documentation of care, or wait a specific time period
before visiting a specialist.
DIF: Cognitive Level: Application REF: p. 9 OBJ: 9
TOP: Charge Professional nurse/Manager KEY:
Nursing Process Step:Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The client complains to the professional nurse that he is confused about his "deductible" that
he owes thehospital. Which statement accurately explains a deductible?
a. An amount of money put aside for the payment of future medical bills
b. A one-time fee for service
c. An amount of money deducted from the bill by the insurance company
d. An annual amount of money the client must pay out-of-pocket for medical care
CORRECT ANS: D
The deductible is the annual amount the insured must pay out-of-pocket prior to the
insurance company assuming the cost. This practice improves the profit of the
insurance company.
DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 9
TOP: Health Care Financing KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
7. A client asks the professional nurse what Medicare Part A covers. Which response is correct?
a. Medicare Part A covers inclient hospital costs.
b. Medicare Part A covers reimbursement to the physician.
c. Medicare Part A covers outclient hospital services.
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, d. Medicare Part A covers ambulance transportation.
CORRECT ANS: A
Medicare Part A covers inclient hospital expenses, drugs, x-rays, laboratory work, and
intensive care. Medicare Part B pays the physician, ambulance transport, and outclient
services.
DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4
OBJ: 9 TOP: Government-Sponsored Health
Insurance KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
a. Hospitals focus only on the specific diagnosis.
b. Hospitals treat and discharge clients quickly.
c. Reduced cost drugs are ordered for specific diagnoses.
d. Diagnostic group classification streamlines care.
CORRECT ANS: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each client's
diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
discharge clients before the allotted time, hospitals get to keep the excess payment; cost is
contained, and the client is discharged sooner.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9
TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. The professional nurse is assessing a group of clients. Which client would most likely qualify for
Medicaid?
a. A 35-year-old unemployed single mother with diabetes
b. A 70-year-old Medicare recipient with retirement income who needs to be in a
long-term care facility
c. An 80-year-old blind woman living in her own home who has inadequate
private insurance
d. A 67-year-old stroke victim with Medicare Part A and an income from investments
CORRECT ANS: A
Medicaid is a joint effort of federal and state governments geared primarily for low-
income people with no insurance.
DIF: Cognitive Level: Application REF: p. 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance—
Medicaid KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through
which to improve the health of Americans in the second decade of the century?
a. Research funding
b. Health information distribution
c. Healthy lifestyle encouragement
d. Health improvement program designs
CORRECT ANS: C
Healthy People 2020 focuses on expanding ongoing programs to include support and
information to reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and
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