Test Bank For Introduction To Medical-Surgical Nursing, 6th Edition
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Chapter 01: The Health Care
System
Chapter 01: The Health Care System
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. 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.
DIF: Cognitive Level: Application REF: p. 7 OBJ: 5
TOP: Day Care Centers KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. 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
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
System
Chapter 01: The Health Care System
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. 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.
DIF: Cognitive Level: Application REF: p. 7 OBJ: 5
TOP: Day Care Centers KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. 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
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
Chapter 01: The Health Care
System
Chapter 01: The Health Care System
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. 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.
DIF: Cognitive Level: Application REF: p. 7 OBJ: 5
TOP: Day Care Centers KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. 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
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
System
Chapter 01: The Health Care System
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. 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.
DIF: Cognitive Level: Application REF: p. 7 OBJ: 5
TOP: Day Care Centers KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. 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
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.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Health Care Funding KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
3. 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.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Health Care Funding KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
4. 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.
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.
Part B is in effect.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Health Care Funding KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
3. 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.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Health Care Funding KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
4. 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.
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.
DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 5
TOP: Hospice Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. 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 laboratory 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.
DIF: Cognitive Level: Comprehension REF: p. 11-12 OBJ: 6
TOP: Cost Containment per DRGs KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
6. 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.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 4
TOP: Stay in a Skilled Care Facility KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
7. 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
TOP: Hospice Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. 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 laboratory 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.
DIF: Cognitive Level: Comprehension REF: p. 11-12 OBJ: 6
TOP: Cost Containment per DRGs KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
6. 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.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 4
TOP: Stay in a Skilled Care Facility KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
7. 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.
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 4
TOP: Medicare-Preferred Drug Plan KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
8. 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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 6
TOP: Proprietary Agencies KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
9. 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
Medicaid covers medication and health care services for welfare recipients for child health and long-
term care.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Medicaid Services Eligibility KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
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.
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 4
TOP: Medicare-Preferred Drug Plan KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
8. 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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 6
TOP: Proprietary Agencies KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
9. 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
Medicaid covers medication and health care services for welfare recipients for child health and long-
term care.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Medicaid Services Eligibility KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
10. 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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 6
TOP: Balanced Budget Act of 1997 KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. 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.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 1
TOP: Leaders and Founders of Public Health Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
12. 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.
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.
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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 6
TOP: Balanced Budget Act of 1997 KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. 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.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 1
TOP: Leaders and Founders of Public Health Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
12. 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.
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.
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DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: 5
TOP: Voluntary Agencies KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
13. 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.
DIF: Cognitive Level: Application REF: p. 11 OBJ: 4
TOP: Skilled Care Limitation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
14. 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.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Coordinating Medicaid/Medicare Benefits
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
15. 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
TOP: Voluntary Agencies KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
13. 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.
DIF: Cognitive Level: Application REF: p. 11 OBJ: 4
TOP: Skilled Care Limitation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
14. 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.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4
TOP: Coordinating Medicaid/Medicare Benefits
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
15. 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
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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.
DIF: Cognitive Level: Application REF: p. 4 OBJ: 6
TOP: Postoperative Care for Outpatients KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
16. 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.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: 5
TOP: Skilled Nursing Facilities Staffing Requirements
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
17. 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
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.
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.
DIF: Cognitive Level: Application REF: p. 4 OBJ: 6
TOP: Postoperative Care for Outpatients KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
16. 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.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: 5
TOP: Skilled Nursing Facilities Staffing Requirements
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
17. 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
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.
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DIF: Cognitive Level: Comprehension REF: p. 9 OBJ: 5
TOP: Long-Term Care Facilities KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
18. 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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: Swallowing Difficulties KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Coordinated Care
19. 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 quality improvement, and
(5) using information technology.
DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 8
TOP: IOM Report KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
MULTIPLE RESPONSE
TOP: Long-Term Care Facilities KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
18. 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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: Swallowing Difficulties KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Coordinated Care
19. 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 quality improvement, and
(5) using information technology.
DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 8
TOP: IOM Report KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
MULTIPLE RESPONSE
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20. 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.
DIF: Cognitive Level: Comprehension REF: p. 5 | p. 7 | p. 10
OBJ: 4 TOP: Comparison of HMO to Fee-for-Service
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
21. 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.
DIF: Cognitive Level: Comprehension REF: p. 11-12 OBJ: 4
TOP: Home Health Care for Children KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
22. 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.)
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.
DIF: Cognitive Level: Comprehension REF: p. 5 | p. 7 | p. 10
OBJ: 4 TOP: Comparison of HMO to Fee-for-Service
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
21. 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.
DIF: Cognitive Level: Comprehension REF: p. 11-12 OBJ: 4
TOP: Home Health Care for Children KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
22. 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.)
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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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: Home Health Aid Utilization KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
23. 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.
DIF: Cognitive Level: Comprehension REF: p. 5-6 OBJ: 5
TOP: Home Health Care KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
24. 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.
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.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: Home Health Aid Utilization KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
23. 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.
DIF: Cognitive Level: Comprehension REF: p. 5-6 OBJ: 5
TOP: Home Health Care KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
24. 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.
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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.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 3
TOP: Public Health Service KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
25. 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.
DIF: Cognitive Level: Comprehension REF: p. 10-11 OBJ: 4
TOP: Medicare Prescription Plan KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
26. Why do physicians prefer to use e-prescription systems? (Select all that apply.)
a. Drug requests are processed more efficiently.
b. Drug duplications 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.
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.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 3
TOP: Public Health Service KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
25. 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.
DIF: Cognitive Level: Comprehension REF: p. 10-11 OBJ: 4
TOP: Medicare Prescription Plan KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
26. Why do physicians prefer to use e-prescription systems? (Select all that apply.)
a. Drug requests are processed more efficiently.
b. Drug duplications 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.
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DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 8
TOP: Topic: E-prescriptions KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
27. 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).
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 5
TOP: DHHS KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
COMPLETION
28. The nurse clarifies that the insurance plan that pays the physician in advance each month for each
enrolled patient, whether or not the patient is treated by the physician, is a strategy known as _____.
ANS:
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.
DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 4
TOP: Capitation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
TOP: Topic: E-prescriptions KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
27. 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).
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 5
TOP: DHHS KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
COMPLETION
28. The nurse clarifies that the insurance plan that pays the physician in advance each month for each
enrolled patient, whether or not the patient is treated by the physician, is a strategy known as _____.
ANS:
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.
DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 4
TOP: Capitation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
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Chapter 02: Nursing in Varied
Patient Care Settings
Chapter 02: Nursing in Varied Patient Care Settings
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. 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.”
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
2. 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.”
d. “Yes, anyone who is willing to pay can be placed in a skilled nursing facility.”
Patient Care Settings
Chapter 02: Nursing in Varied Patient Care Settings
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. 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.”
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
2. 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.”
d. “Yes, anyone who is willing to pay can be placed in a skilled nursing facility.”
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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
3. 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.
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
4. 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.”
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.
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
3. 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.
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
4. 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.”
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.
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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
5. 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. Intermediate care
c. Sheltered housing
d. Domiciliary care
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
6. 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
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
7. 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
TOP: Rehabilitation Goals KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
5. 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. Intermediate care
c. Sheltered housing
d. Domiciliary care
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
6. 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
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
7. 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
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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
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
8. 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
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
9. 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?
disabled?
a. I
b. II
c. III
d. IV
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
8. 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
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
9. 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?
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a. “Based on your room number, you get bathed on Monday, Wednesday, and Friday. Today is
Tuesday.”
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
10. 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
11. A partially paralyzed forklift operator is to be retrained by vocational rehabilitation services for
less demanding office work. What law provides for this rehabilitation?
a. Vocational Rehabilitation Act of 1920
b. Social Security Act of 1935
c. Rehabilitation Act of 1973
d. Americans with Disabilities Act of 1990
Tuesday.”
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
10. 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
11. A partially paralyzed forklift operator is to be retrained by vocational rehabilitation services for
less demanding office work. What law provides for this rehabilitation?
a. Vocational Rehabilitation Act of 1920
b. Social Security Act of 1935
c. Rehabilitation Act of 1973
d. Americans with Disabilities Act of 1990
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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
12. 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
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
13. A patient with multiple sclerosis must be fed, bathed, and dressed. How should the nurse assess
this patient?
a. Disabled
b. Disadvantaged
c. Handicapped
d. Impaired
ANS: D
Feeding oneself, dressing, and bathing are activities of daily living. The patient is impaired in this
scenario.
DIF: Cognitive Level: Analysis REF: p. 21 OBJ: 4
TOP: Principles of Rehabilitation | Defining Levels of Loss of Functioning Independently
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
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
12. 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
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
13. A patient with multiple sclerosis must be fed, bathed, and dressed. How should the nurse assess
this patient?
a. Disabled
b. Disadvantaged
c. Handicapped
d. Impaired
ANS: D
Feeding oneself, dressing, and bathing are activities of daily living. The patient is impaired in this
scenario.
DIF: Cognitive Level: Analysis REF: p. 21 OBJ: 4
TOP: Principles of Rehabilitation | Defining Levels of Loss of Functioning Independently
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
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14. Which law initially provided for rehabilitation of disabled Americans?
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: A
The U.S. government has passed four pieces of legislation to identify and meet the needs of disabled
individuals with each one being more inclusive. The first one was passed in 1920.
DIF: Cognitive Level: Knowledge REF: p. 22 OBJ: 7
TOP: Rehabilitation Legislation KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
15. A client was admitted to a long-term residential care facility. On what should the admitting nurse
tell the family the concepts of long-term care are based?
a. Amount of activities the resident can do for herself
b. Maintenance care with an emphasis on incontinence
c. Successful adaptation to the regulations of the home
d. Maintenance of as much function as possible
ANS: D
Maintenance of function and encouraging autonomy and independence are some of the basic
concepts of long-term care.
DIF: Cognitive Level: Comprehension REF: p. 27 OBJ: 11
TOP: Principles of Nursing Home Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
16. A 58-year-old patient with diabetes is recuperating from a broken hip and is concerned about how
to pay for rehabilitation. The nurse should inform this patient that funds for rehabilitation are
available from which resource?
a. Vocational Rehabilitation Act of 1920
b. Rehabilitation Act of 1973
c. Disabled American Veterans Act of 1990
d. Title V, Health of Crippled Americans 1935
ANS: B
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: A
The U.S. government has passed four pieces of legislation to identify and meet the needs of disabled
individuals with each one being more inclusive. The first one was passed in 1920.
DIF: Cognitive Level: Knowledge REF: p. 22 OBJ: 7
TOP: Rehabilitation Legislation KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
15. A client was admitted to a long-term residential care facility. On what should the admitting nurse
tell the family the concepts of long-term care are based?
a. Amount of activities the resident can do for herself
b. Maintenance care with an emphasis on incontinence
c. Successful adaptation to the regulations of the home
d. Maintenance of as much function as possible
ANS: D
Maintenance of function and encouraging autonomy and independence are some of the basic
concepts of long-term care.
DIF: Cognitive Level: Comprehension REF: p. 27 OBJ: 11
TOP: Principles of Nursing Home Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
16. A 58-year-old patient with diabetes is recuperating from a broken hip and is concerned about how
to pay for rehabilitation. The nurse should inform this patient that funds for rehabilitation are
available from which resource?
a. Vocational Rehabilitation Act of 1920
b. Rehabilitation Act of 1973
c. Disabled American Veterans Act of 1990
d. Title V, Health of Crippled Americans 1935
ANS: B
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The Rehabilitation Act of 1973 assists in paying for rehabilitation for those who are younger than 65
years of age and who will benefit from vocational rehabilitation through teaching.
DIF: Cognitive Level: Comprehension REF: p. 22 OBJ: 7
TOP: Legislation for Funding Health Care
KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
17. What is an example of a description of community health nursing?
a. Visiting patients in their homes after hospital discharge to assess their personal health status
b. Asking a nursing assistant (NA) to identify the health services most needed in the patient’s
personal life
c. Meeting with residents of low-income housing to identify their health care needs
d. Developing a hospital-based home health care service
ANS: C
Whereas community-based nursing looks at identified community needs and provides care at all
levels of wellness and illness, community health nursing seeks to provide services to groups to
modify or create systems of care.
DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 2
TOP: Defining Community-Based Nursing versus Community Health Nursing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
18. Home health nurses have some different nursing activities than those of community health
nurses. Which statement best describes the home health nurse’s activities?
a. Conducting health education classes in a senior citizens’ common residence building
b. Conducting blood pressure screening on a regular basis at a local mall
c. Visiting and assessing the home care and further teaching needs of a patient who has been recently
discharged from the hospital
d. Acting as a nurse consultant to a chronic psychiatric section in a state institution
ANS: C
The home health nurse works with individuals in the home; the other descriptors are community
nurse activities.
years of age and who will benefit from vocational rehabilitation through teaching.
DIF: Cognitive Level: Comprehension REF: p. 22 OBJ: 7
TOP: Legislation for Funding Health Care
KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
17. What is an example of a description of community health nursing?
a. Visiting patients in their homes after hospital discharge to assess their personal health status
b. Asking a nursing assistant (NA) to identify the health services most needed in the patient’s
personal life
c. Meeting with residents of low-income housing to identify their health care needs
d. Developing a hospital-based home health care service
ANS: C
Whereas community-based nursing looks at identified community needs and provides care at all
levels of wellness and illness, community health nursing seeks to provide services to groups to
modify or create systems of care.
DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 2
TOP: Defining Community-Based Nursing versus Community Health Nursing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
18. Home health nurses have some different nursing activities than those of community health
nurses. Which statement best describes the home health nurse’s activities?
a. Conducting health education classes in a senior citizens’ common residence building
b. Conducting blood pressure screening on a regular basis at a local mall
c. Visiting and assessing the home care and further teaching needs of a patient who has been recently
discharged from the hospital
d. Acting as a nurse consultant to a chronic psychiatric section in a state institution
ANS: C
The home health nurse works with individuals in the home; the other descriptors are community
nurse activities.
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DIF: Cognitive Level: Comprehension REF: p. 16-17 | p. 19
OBJ: 1 TOP: Activities of the Home Health Nurse
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
19. Based on guidelines from the Americans with Disability Act (ADA), which question is an
appropriate choice for the director of nurses to ask a nurse with an artificial leg who is applying for a
staff position in an extended care facility?
a. “How long have you had your prosthesis?”
b. “How many flights of stairs are you able to climb without assistance?”
c. “Are you able to lift a load of 45 lb?”
d. “Has your disability caused you to miss work?”
ANS: C
Queries to disabled job applicants can be made relative to specific job functions, but they cannot be
asked relative to the severity of the disability or the degree of disability in general.
DIF: Cognitive Level: Application REF: p. 22 OBJ: 7
TOP: ADA KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
MULTIPLE RESPONSE
20. What care skills are safe and appropriate for the licensed practical nurse (LPN) to teach family
members in the home health care setting? (Select all that apply.)
a. Insulin injection
b. Sterile dressing changes
c. Venipunctures
d. Periodic Foley catheter insertions
e. Instillation of eye drops
f. Changing dressings on small wounds
ANS: A, E, F
Insulin injections, instillation of eye drops, and small wound dressing changes are safe to teach a
nonprofessional caregiver. Sterile dressings, venipunctures, and inserting Foley catheters are
considered skilled, and the costs for these are reimbursed by Medicare.
DIF: Cognitive Level: Comprehension REF: p. 19 OBJ: 3
TOP: Skills Taught by Home Health Nurse
OBJ: 1 TOP: Activities of the Home Health Nurse
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
19. Based on guidelines from the Americans with Disability Act (ADA), which question is an
appropriate choice for the director of nurses to ask a nurse with an artificial leg who is applying for a
staff position in an extended care facility?
a. “How long have you had your prosthesis?”
b. “How many flights of stairs are you able to climb without assistance?”
c. “Are you able to lift a load of 45 lb?”
d. “Has your disability caused you to miss work?”
ANS: C
Queries to disabled job applicants can be made relative to specific job functions, but they cannot be
asked relative to the severity of the disability or the degree of disability in general.
DIF: Cognitive Level: Application REF: p. 22 OBJ: 7
TOP: ADA KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
MULTIPLE RESPONSE
20. What care skills are safe and appropriate for the licensed practical nurse (LPN) to teach family
members in the home health care setting? (Select all that apply.)
a. Insulin injection
b. Sterile dressing changes
c. Venipunctures
d. Periodic Foley catheter insertions
e. Instillation of eye drops
f. Changing dressings on small wounds
ANS: A, E, F
Insulin injections, instillation of eye drops, and small wound dressing changes are safe to teach a
nonprofessional caregiver. Sterile dressings, venipunctures, and inserting Foley catheters are
considered skilled, and the costs for these are reimbursed by Medicare.
DIF: Cognitive Level: Comprehension REF: p. 19 OBJ: 3
TOP: Skills Taught by Home Health Nurse
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KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
21. The nursing care plan in a long-term care facility calls for the documentation of regressive
behavior of a newly admitted 82-year-old resident who has had congestive heart failure and
osteoarthritis. Of these behaviors observed by the nurse, which should be documented as regression?
(Select all that apply.)
a. Talks nonstop to staff and other residents
b. Wets and soils self several times a day
c. Wakes in the middle of the night and is unable to return to sleep
d. Wears the same clothes day after day
e. Cries frequently for no apparent reason
ANS: B, D, E
Behaviors that are infantile or immature in the absence of dementia are considered regressive.
Frequent episodes of crying and inattention to personal hygiene are regressive in nature. Excessive
talking and wakefulness may be related to relocation anxiety, but they are not considered regressive.
DIF: Cognitive Level: Analysis REF: p. 26-27 OBJ: 10
TOP: Impact of Relocation KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
22. From what do most quality-of-care problems in home health care result? (Select all that apply.)
a. Patient’s noncompliance
b. Family’s reluctance to participate in the care
c. Inadequate documentation
d. Limited funding
e. Defective communication among care team members
ANS: C, E
Inadequate communication and incomplete documentation create most of the quality-of-care
problems.
DIF: Cognitive Level: Comprehension REF: p. 20 OBJ: 2
TOP: Communication in Home Health Setting
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
21. The nursing care plan in a long-term care facility calls for the documentation of regressive
behavior of a newly admitted 82-year-old resident who has had congestive heart failure and
osteoarthritis. Of these behaviors observed by the nurse, which should be documented as regression?
(Select all that apply.)
a. Talks nonstop to staff and other residents
b. Wets and soils self several times a day
c. Wakes in the middle of the night and is unable to return to sleep
d. Wears the same clothes day after day
e. Cries frequently for no apparent reason
ANS: B, D, E
Behaviors that are infantile or immature in the absence of dementia are considered regressive.
Frequent episodes of crying and inattention to personal hygiene are regressive in nature. Excessive
talking and wakefulness may be related to relocation anxiety, but they are not considered regressive.
DIF: Cognitive Level: Analysis REF: p. 26-27 OBJ: 10
TOP: Impact of Relocation KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
22. From what do most quality-of-care problems in home health care result? (Select all that apply.)
a. Patient’s noncompliance
b. Family’s reluctance to participate in the care
c. Inadequate documentation
d. Limited funding
e. Defective communication among care team members
ANS: C, E
Inadequate communication and incomplete documentation create most of the quality-of-care
problems.
DIF: Cognitive Level: Comprehension REF: p. 20 OBJ: 2
TOP: Communication in Home Health Setting
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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23. An 80-year-old man is newly admitted to a long-term care facility and suddenly becomes
incontinent of urine at night. What nursing interventions should be used to help restore self-toileting?
(Select all that apply.)
a. Waking the resident every 2 hours and escorting him to the bathroom
b. Leaving a night-light on
c. Discouraging the use of long-legged pajama bottoms
d. Placing a urinal at the bedside
e. Keeping the room uncluttered
ANS: B, C, D, E
Providing light in an uncluttered room, encouraging clothing that does not impede self-toileting, and
making the urinal available increase independence and alleviate situations that make self-toileting
difficult. Waking a resident not only disturbs his or her rest, but doing so also increases dependency
on the staff.
DIF: Cognitive Level: Application REF: p. 27 OBJ: 1
TOP: Independence in Long-Term Care Center
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
COMPLETION
24. The nurse clarifies that an impairment that creates a measurable diminished capacity to work is
a(n) _______.
ANS:
disability
When there is a measurable impairment that changes the individual’s lifestyle, it is referred to as a
disability.
DIF: Cognitive Level: Knowledge REF: p. 21 OBJ: 5
TOP: Rehabilitation Concepts KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
OTHER
25. A home health nurse, while in the home to change a decubitus dressing, notices that the wound
has a musky odor and is weepier than the previous visit, 2 days earlier. Place the following nursing
incontinent of urine at night. What nursing interventions should be used to help restore self-toileting?
(Select all that apply.)
a. Waking the resident every 2 hours and escorting him to the bathroom
b. Leaving a night-light on
c. Discouraging the use of long-legged pajama bottoms
d. Placing a urinal at the bedside
e. Keeping the room uncluttered
ANS: B, C, D, E
Providing light in an uncluttered room, encouraging clothing that does not impede self-toileting, and
making the urinal available increase independence and alleviate situations that make self-toileting
difficult. Waking a resident not only disturbs his or her rest, but doing so also increases dependency
on the staff.
DIF: Cognitive Level: Application REF: p. 27 OBJ: 1
TOP: Independence in Long-Term Care Center
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
COMPLETION
24. The nurse clarifies that an impairment that creates a measurable diminished capacity to work is
a(n) _______.
ANS:
disability
When there is a measurable impairment that changes the individual’s lifestyle, it is referred to as a
disability.
DIF: Cognitive Level: Knowledge REF: p. 21 OBJ: 5
TOP: Rehabilitation Concepts KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
OTHER
25. A home health nurse, while in the home to change a decubitus dressing, notices that the wound
has a musky odor and is weepier than the previous visit, 2 days earlier. Place the following nursing
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interventions in order of priority from most to least. (Separate the letters with a comma and space: A,
B, C, D.)
A. Contact the case manager.
B. Assess the patient’s entire skin and vital signs and be prepared to describe the wound findings.
C. Cleanse the decubitus area well and redress the wound.
D. Chart the appearance of the decubitus completely.
D. Assess the patient’s mobility.
ANS:
B, C, E, D, A
The decubitus finding is important to communicate to the case manager but not until the nurse at the
bedside has fully assessed the patient, signs and symptoms, vital signs, and other areas of change that
need to be promptly communicated. Then the case manager will be able to give directions for further
care.
DIF: Cognitive Level: Application REF: p. 20 OBJ: 1
TOP: Communication among Home Health Staff
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
26. What should the home health nurse do when teaching a family member the skill of injecting
insulin effectively? Prioritize these nursing interventions for this situation. (Separate the letters with a
comma and space: A, B, C, D.)
A. Offer instruction at an appropriate pace.
B. Write down the steps of the procedure.
C. Assess the level of knowledge of the family member.
D. Inquire about the preferred learning style.
E. Evaluate the family member’s performance.
ANS:
C, B, D, A, E
Effective teaching depends on assessing the level of knowledge, breaking down the skill in steps,
offering instruction in the preferred style, pacing the instruction appropriately, and evaluating the
performance.
B, C, D.)
A. Contact the case manager.
B. Assess the patient’s entire skin and vital signs and be prepared to describe the wound findings.
C. Cleanse the decubitus area well and redress the wound.
D. Chart the appearance of the decubitus completely.
D. Assess the patient’s mobility.
ANS:
B, C, E, D, A
The decubitus finding is important to communicate to the case manager but not until the nurse at the
bedside has fully assessed the patient, signs and symptoms, vital signs, and other areas of change that
need to be promptly communicated. Then the case manager will be able to give directions for further
care.
DIF: Cognitive Level: Application REF: p. 20 OBJ: 1
TOP: Communication among Home Health Staff
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
26. What should the home health nurse do when teaching a family member the skill of injecting
insulin effectively? Prioritize these nursing interventions for this situation. (Separate the letters with a
comma and space: A, B, C, D.)
A. Offer instruction at an appropriate pace.
B. Write down the steps of the procedure.
C. Assess the level of knowledge of the family member.
D. Inquire about the preferred learning style.
E. Evaluate the family member’s performance.
ANS:
C, B, D, A, E
Effective teaching depends on assessing the level of knowledge, breaking down the skill in steps,
offering instruction in the preferred style, pacing the instruction appropriately, and evaluating the
performance.
Loading page 25...
DIF: Cognitive Level: Application REF: p. 19 OBJ: 1
TOP: Home Health Teaching KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
Chapter 03: Legal and Ethical
Considerations
Chapter 03: Legal and Ethical Considerations
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A good friend of a licensed practical/vocational nurse (LPN/LVN) confides that she is in a serious
romantic relationship with a man the LPN/LVN had as a patient when he was diagnosed with the
human immunodeficiency virus (HIV). The policies of the Health Insurance Portability and
Accountability Act (HIPAA) prevent the nurse from warning her friend. What is this situation
considered?
a. Moral dilemma
b. Moral uncertainty
c. Moral distress
d. Moral outrage
ANS: C
Moral distress occurs when a nurse feels powerless because moral beliefs cannot be honored because
of institutional or other barriers.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 1
TOP: Moral Distress KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. A nurse reminds a resident in a long-term care facility that he has autonomy in many aspects of his
institutionalization. What is an example of autonomy?
a. Selection of medication times
b. Availability of his own small electrical appliances
c. Smoking in the privacy of his own room
d. Application of advance directives
TOP: Home Health Teaching KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
Chapter 03: Legal and Ethical
Considerations
Chapter 03: Legal and Ethical Considerations
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A good friend of a licensed practical/vocational nurse (LPN/LVN) confides that she is in a serious
romantic relationship with a man the LPN/LVN had as a patient when he was diagnosed with the
human immunodeficiency virus (HIV). The policies of the Health Insurance Portability and
Accountability Act (HIPAA) prevent the nurse from warning her friend. What is this situation
considered?
a. Moral dilemma
b. Moral uncertainty
c. Moral distress
d. Moral outrage
ANS: C
Moral distress occurs when a nurse feels powerless because moral beliefs cannot be honored because
of institutional or other barriers.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 1
TOP: Moral Distress KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. A nurse reminds a resident in a long-term care facility that he has autonomy in many aspects of his
institutionalization. What is an example of autonomy?
a. Selection of medication times
b. Availability of his own small electrical appliances
c. Smoking in the privacy of his own room
d. Application of advance directives
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ANS: D
The application of advance directives is an autonomous decision. Agency protocols relative to
medication times, access to private electrical devices, and smoking are rarely waived; these policies
are not in the control of the resident.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 2
TOP: Autonomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. How might an LPN/LVN exhibit beneficence?
a. Remove defective equipment from the patient’s room.
b. Willingly work extra shifts during a staff shortage.
c. Adhere to agency policy.
d. Join the National Association for Practical Nurse Education and Service (NAPNES) and attend
educational seminars.
ANS: A
Beneficence means promoting good and reducing harm. Removing defective equipment
demonstrates that the LPN/LVN is reducing possible harm to the patient. Working extra shifts,
adhering to policy, and joining NAPNES are personal values, not beneficence.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 2
TOP: Beneficence KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
4. An LPN/LVN is educating a group of nursing students regarding values demonstrated in their
nursing practice. Where will the LPN/LVN indicate the base of these values is derived?
a. Nursing school education
b. Family influence
c. Peer relationships
d. Agency policies
ANS: B
The family shapes values that are demonstrated in later life. These values may be enhanced or
challenged by life experiences, but the base is forged in the family.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 3
TOP: Values KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
The application of advance directives is an autonomous decision. Agency protocols relative to
medication times, access to private electrical devices, and smoking are rarely waived; these policies
are not in the control of the resident.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 2
TOP: Autonomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. How might an LPN/LVN exhibit beneficence?
a. Remove defective equipment from the patient’s room.
b. Willingly work extra shifts during a staff shortage.
c. Adhere to agency policy.
d. Join the National Association for Practical Nurse Education and Service (NAPNES) and attend
educational seminars.
ANS: A
Beneficence means promoting good and reducing harm. Removing defective equipment
demonstrates that the LPN/LVN is reducing possible harm to the patient. Working extra shifts,
adhering to policy, and joining NAPNES are personal values, not beneficence.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 2
TOP: Beneficence KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
4. An LPN/LVN is educating a group of nursing students regarding values demonstrated in their
nursing practice. Where will the LPN/LVN indicate the base of these values is derived?
a. Nursing school education
b. Family influence
c. Peer relationships
d. Agency policies
ANS: B
The family shapes values that are demonstrated in later life. These values may be enhanced or
challenged by life experiences, but the base is forged in the family.
DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 3
TOP: Values KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
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5. One obstetric nurse remarks, “I don’t see how these young single women can keep on having
babies without being married. Everyone knows a child needs a father.” What is this nurse exhibiting?
a. Ethnocentrism
b. Moral uncertainty
c. Values clarification
d. Professional concern
ANS: A
Ethnocentricity is the belief that one’s own culture and values are superior to those of another. Such
statements are based on values clarification and, perhaps, on moral outrage.
DIF: Cognitive Level: Comprehension REF: p. 33 OBJ: 5
TOP: Ethnocentrism/Values Clarification KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
6. A nursing student asks the instructor to define the philosophic stand of utilitarianism. What
example should the instructor provide?
a. An army officer sacrifices six paratroopers to save 100 prisoners of war.
b. A priest burns down his church because it was defiled by Satanists.
c. A mother jumps off a cliff with her baby to avoid being captured by Indians.
d. A soldier murders captured enemies to prevent their divulging military secrets.
ANS: A
The sacrifice of six to save 100 is an example of the greater good. The other options are based on the
philosophy of deontology.
DIF: Cognitive Level: Comprehension REF: p. 33 OBJ: 6
TOP: Utilitarianism KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. An LPN/LVN explains to a patient that the hospital has an institutional ethics committee. What is
the main function of this committee?
a. Preside over policy implementation.
b. Revoke the license of someone who violates the law.
c. Solve personnel disputes.
d. Ensure that hiring adheres to ethnic equality.
ANS: A
babies without being married. Everyone knows a child needs a father.” What is this nurse exhibiting?
a. Ethnocentrism
b. Moral uncertainty
c. Values clarification
d. Professional concern
ANS: A
Ethnocentricity is the belief that one’s own culture and values are superior to those of another. Such
statements are based on values clarification and, perhaps, on moral outrage.
DIF: Cognitive Level: Comprehension REF: p. 33 OBJ: 5
TOP: Ethnocentrism/Values Clarification KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
6. A nursing student asks the instructor to define the philosophic stand of utilitarianism. What
example should the instructor provide?
a. An army officer sacrifices six paratroopers to save 100 prisoners of war.
b. A priest burns down his church because it was defiled by Satanists.
c. A mother jumps off a cliff with her baby to avoid being captured by Indians.
d. A soldier murders captured enemies to prevent their divulging military secrets.
ANS: A
The sacrifice of six to save 100 is an example of the greater good. The other options are based on the
philosophy of deontology.
DIF: Cognitive Level: Comprehension REF: p. 33 OBJ: 6
TOP: Utilitarianism KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. An LPN/LVN explains to a patient that the hospital has an institutional ethics committee. What is
the main function of this committee?
a. Preside over policy implementation.
b. Revoke the license of someone who violates the law.
c. Solve personnel disputes.
d. Ensure that hiring adheres to ethnic equality.
ANS: A
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The main job of the institutional ethics committee is to preside over the implementation of agency
policy.
DIF: Cognitive Level: Comprehension REF: p. 34 OBJ: 8
TOP: Institutional Ethics Committee KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. An LPN/LVN charts that “the patient is drunk and acting in a crazy manner.” The team leader
cautions the LPN/LVN that this documentation is not appropriate. What charges of commission of
the intentional tort is this an example of?
a. Assault
b. Wrongful publication
c. Defamation of character
d. Invasion of privacy
ANS: C
Charting or saying unsupported defamatory statements can lead to tort litigation.
DIF: Cognitive Level: Comprehension REF: p. 38 OBJ: 2
TOP: Torts KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. When an LPN/LVN assists an older woman to stand after a fall in a shopping mall parking lot, the
woman twists and sprains her ankle. What protects the LPN/LVN from litigation or an unintentional
tort?
a. Hospital malpractice insurance
b. Good faith agreement
c. Good Samaritan law
d. Personal professional insurance
ANS: C
The Good Samaritan law protects individuals who assist at an accident scene if they act in good faith.
Professional insurance is not in effect because the actions were not performed while the LPN/LVN
was on duty.
DIF: Cognitive Level: Comprehension REF: p. 39 OBJ: 2
TOP: Torts KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
policy.
DIF: Cognitive Level: Comprehension REF: p. 34 OBJ: 8
TOP: Institutional Ethics Committee KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. An LPN/LVN charts that “the patient is drunk and acting in a crazy manner.” The team leader
cautions the LPN/LVN that this documentation is not appropriate. What charges of commission of
the intentional tort is this an example of?
a. Assault
b. Wrongful publication
c. Defamation of character
d. Invasion of privacy
ANS: C
Charting or saying unsupported defamatory statements can lead to tort litigation.
DIF: Cognitive Level: Comprehension REF: p. 38 OBJ: 2
TOP: Torts KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. When an LPN/LVN assists an older woman to stand after a fall in a shopping mall parking lot, the
woman twists and sprains her ankle. What protects the LPN/LVN from litigation or an unintentional
tort?
a. Hospital malpractice insurance
b. Good faith agreement
c. Good Samaritan law
d. Personal professional insurance
ANS: C
The Good Samaritan law protects individuals who assist at an accident scene if they act in good faith.
Professional insurance is not in effect because the actions were not performed while the LPN/LVN
was on duty.
DIF: Cognitive Level: Comprehension REF: p. 39 OBJ: 2
TOP: Torts KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
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10. An LPN/LVN trimmed the toenails of a patient with diabetes too short, which results in a toe
amputation from infections. What is the LPN/LVN guilty of?
a. Unintentional tort
b. Intentional tort
c. Negligence
d. Malpractice
ANS: D
Malpractice occurs when an unintentional tort causes an injury to a patient.
DIF: Cognitive Level: Comprehension REF: p. 39 OBJ: 2
TOP: Malpractice KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
11. What must an LPN/LVN acquiring a signature on a surgical informed consent document ensure?
a. The patient is not sedated.
b. The physician is present.
c. The family member is a witness.
d. The signature is in ink.
ANS: A
Before surgery, the consent form must be signed before any preoperative sedation is administered. A
sedated person cannot give a valid consent.
DIF: Cognitive Level: Application REF: p. 40 OBJ: 9
TOP: Informed Consent KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
12. A physician has written an order for Synthroid, 137 mg. The LPN/LVN is aware that the drug is
measured in micrograms. What action should the nurse implement?
a. Transcribe the order as if it were written in micrograms.
b. Notify the nursing supervisor.
c. Transcribe the order as written.
d. Call the prescribing physician.
ANS: D
The LPN/LVN may call the physician to clarify the order but may not alter the written order in any
way. The order for the correct dose will be written as a new order.
amputation from infections. What is the LPN/LVN guilty of?
a. Unintentional tort
b. Intentional tort
c. Negligence
d. Malpractice
ANS: D
Malpractice occurs when an unintentional tort causes an injury to a patient.
DIF: Cognitive Level: Comprehension REF: p. 39 OBJ: 2
TOP: Malpractice KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
11. What must an LPN/LVN acquiring a signature on a surgical informed consent document ensure?
a. The patient is not sedated.
b. The physician is present.
c. The family member is a witness.
d. The signature is in ink.
ANS: A
Before surgery, the consent form must be signed before any preoperative sedation is administered. A
sedated person cannot give a valid consent.
DIF: Cognitive Level: Application REF: p. 40 OBJ: 9
TOP: Informed Consent KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
12. A physician has written an order for Synthroid, 137 mg. The LPN/LVN is aware that the drug is
measured in micrograms. What action should the nurse implement?
a. Transcribe the order as if it were written in micrograms.
b. Notify the nursing supervisor.
c. Transcribe the order as written.
d. Call the prescribing physician.
ANS: D
The LPN/LVN may call the physician to clarify the order but may not alter the written order in any
way. The order for the correct dose will be written as a new order.
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DIF: Cognitive Level: Application REF: p. 40 OBJ: 12
TOP: Doctor’s Orders KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
13. A physician has written an order for morphine sulfate, 100 mg. The LPN/LVN inquires if he
meant to write 10 mg. The physician confirms that he meant 100 mg. What action should the
LPN/LVN implement?
a. Call a member of the hospital administration.
b. Refuse to transcribe the order.
c. Call the pharmacist.
d. Notify the nursing supervisor.
ANS: D
In the event of a physician’s refusal to clarify a questionable order, the LPN/LVN should notify the
nursing supervisor to intervene.
DIF: Cognitive Level: Application REF: p. 40 OBJ: 12
TOP: Doctor’s Orders KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
MULTIPLE RESPONSE
14. On what are health care ethics based? (Select all that apply.)
a. Autonomy
b. Fidelity
c. Professionalism
d. Justice
e. Nonmaleficence
ANS: A, B, D, E
Health care ethics are based on autonomy, fidelity, beneficence, justice, and nonmaleficence
DIF: Cognitive Level: Knowledge REF: p. 32 OBJ: 2
TOP: Health Care Ethics KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
15. How does values clarification support nursing practice? (Select all that apply.)
a. Guides decision making
TOP: Doctor’s Orders KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
13. A physician has written an order for morphine sulfate, 100 mg. The LPN/LVN inquires if he
meant to write 10 mg. The physician confirms that he meant 100 mg. What action should the
LPN/LVN implement?
a. Call a member of the hospital administration.
b. Refuse to transcribe the order.
c. Call the pharmacist.
d. Notify the nursing supervisor.
ANS: D
In the event of a physician’s refusal to clarify a questionable order, the LPN/LVN should notify the
nursing supervisor to intervene.
DIF: Cognitive Level: Application REF: p. 40 OBJ: 12
TOP: Doctor’s Orders KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
MULTIPLE RESPONSE
14. On what are health care ethics based? (Select all that apply.)
a. Autonomy
b. Fidelity
c. Professionalism
d. Justice
e. Nonmaleficence
ANS: A, B, D, E
Health care ethics are based on autonomy, fidelity, beneficence, justice, and nonmaleficence
DIF: Cognitive Level: Knowledge REF: p. 32 OBJ: 2
TOP: Health Care Ethics KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
15. How does values clarification support nursing practice? (Select all that apply.)
a. Guides decision making
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Subject
Nursing