Question 1

The nurse is assessing a group of patients.Which patient would most likely qualify for Medicaid?

Accepted Answer

Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no insurance.

Question 2

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

Accepted Answer

DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic category regardless of the length of time in the hospital.If hospitals can treat and discharge patients before the allotted time,hospitals get to keep the excess payment; cost is contained,and the patient is discharged sooner.

Question 3

The nurse is educating a patient that is a member of a health maintenance organization (HMO).Which information should the nurse include?

Accepted Answer

Most HMOs require preprocedure authorization for treatment.Patients are not required to seek a second opinion,provide documentation of care,or wait a specific time period before visiting a specialist.

Question 4

The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.Which statement accurately explains a deductible?

Accepted Answer

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.

Question 5

Which term explains the type of care that addresses interventions for all dimensions of a patient's life?

Accepted Answer

Holistic care addresses the physiologic,psychological,social,cultural,and spiritual needs of the patient.

Question 6

A patient asks the nurse what Medicare Part A covers.Which response is correct?

Accepted Answer

Medicare Part A covers inpatient hospital expenses,drugs,x-rays,laboratory work,and intensive care.Medicare Part B pays the physician,ambulance transport,and outpatient services.

Question 7

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?

Accepted Answer

Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce infant mortality,cancer,cardiovascular disease,and HIV/AIDS,and to increase effective immunizations,healthy eating habits,and healthy weight.

Question 8

An overweight male patient rips off his hospital gown,throws it out the door,and shouts,"I'm not wearing this stupid gown! It is too small,too short,and exposes my backside to the world!" Which response is most appropriate?

Accepted Answer

Allowing hostile patients to make reasonable requests defuses the anger and allows patients to vent their feelings.

Question 9

The long-term care facility nurse is caring for a newly admitted 80-year-old patient who is depressed.Which approach is best for the nurse to employ?

Accepted Answer

Activity and social interaction are helpful to depressed patients.Presenting a cheery approach and pointing out negative behavior and reasons to be positive are not therapeutic at this stage of the relationship.

Question 10

The nurse compares the characteristics of a health maintenance organization (HMO)and a preferred provider organization (PPO).Which information should the nurse include about HMOs?

Accepted Answer

HMOs require a set fee from each member monthly (capitation).The patient will be treated by the HMO staff in HMO-approved facilities.Excessive use of diagnostic tests and treatments is discouraged by the HMO.

Question 11

The nurse is caring for a patient who has been on antidepressants for 3 days.The patient tearfully says,"I still feel terrible.I don't think anything can help how I feel." Which response is best?

Accepted Answer

This response is an empathetic response that allows for further exploration of the patient's feelings.The other responses will block communication with this patient.

Question 12

A patient furiously says,"My doctor was so busy giving me instructions that he didn't hear what I was trying to ask him!" Which response is most empathetic?

Accepted Answer

Empathy demonstrates that the nurse perceives the patient's feelings but does not share the emotion.Belittling the patient's feelings,showing sympathy,or defending the doctor makes the patient feel devalued.

Question 13

According to most state NPAs,the vocational nurse acting as charge nurse in a long-term care facility acts in which capacity?

Accepted Answer

The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general supervision of an RN available on site or by phone.

Question 14

The nurse is caring for a patient who states,"You are the only nurse who understands about my pain.Can't you give me an extra dose of pain medication?" How should the nurse respond to the patient's request?

Accepted Answer

A matter-of-fact response to a manipulative request limits the effect of the manipulation,thereby helping the nurse to avoid becoming defensive or being swayed by flattery.

Question 15

The nurse is communicating with a patient who voices concern about an upcoming high-risk procedure.Which statement best demonstrates empathy?

Accepted Answer

This statement by the nurse displays empathy by trying to place oneself in the patient's circumstance and validating the patient's feelings.Simply asking patients if they would like to talk about their feelings does not show empathy and may elicit a "yes" or "no" response.Telling the patient one's mother had the procedure or stating "I can't imagine how you feel" does not show empathy toward the patient.

Question 16

Which patient statement indicates a need for further discharge teaching that the vocational nurse should address?

Accepted Answer

Lack of knowledge at discharge about medication effects and side effects is a concern that should be addressed by the vocational nurse.The other concerns in the options are the responsibility of other departments to which the nurse might refer the patient.

Question 17

Which statement accurately describes the primary purpose of the state nurse practice act (NPA)?

Accepted Answer

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.

Question 18

The nurse is explaining differences in a therapeutic relationship and a social relationship to a patient.Which information about therapeutic relationships is most important for the nurse to include in the explanation?

Accepted Answer

The therapeutic relationship is focused on the patient and is goal directed and designed to meet only the needs of the patient and does not extend past the period of hospitalization.

Question 19

The charge nurse asks the new vocational nurse to start an intravenous infusion,a skill that the vocational nurse has not been taught during her educational program.How should the vocational nurse respond?

Accepted Answer

The charge nurse should be informed of the lack of training to perform the procedure,and the vocational nurse should seek further training to gain proficiency.Although the other options might be helpful,they are not safe.

Question 20

A female patient who has recently been diagnosed with an inoperable brain tumor asks the nurse,"Do you think God punishes us?" Which response demonstrates therapeutic communication?

Accepted Answer

Sitting with the patient and offering oneself to listen to the patient's concerns and encouraging reflection is the best approach rather than responding with a cliché or suggesting speaking with the chaplain.

Quiz 1: Caring for Medical-Surgical Patients