Medical-Surgical Nursing 8th Edition Mary Ann Linton Test Bank

4 Download All Chapters Here: https://www.stuvia.com/doc/3809109/ Chapter 02: Medical-Surgical Practice Settings Linton: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. While a home health nurse is making the entry to a service assessment on a homebound patient, the spouse of the patient asks whether Medicare will cover the patient’s ventilator therapy and insulin injections. Which response by the nurse is the best response? 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 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. Which is the 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.” 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, a physical therapist, or a speech therapist must exist. DIF: Cognitive Level: Analysis 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. Which type of relocation response is the resident exhibiting? a. regression.

5 Download All Chapters Here: https://www.stuvia.com/doc/3809109/ b. social withdrawal. c. depersonalization. d. passive aggressive. ANS: B Social withdrawal is a frequent response to relocation. DIF: Cognitive Level: Comprehension 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. Which 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. DIF: Cognitive Level: Comprehension OBJ: 7 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. Which type of 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 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

7 Download All Chapters Here: https://www.stuvia.com/doc/3809109/ 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 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. Which disability level applies to this 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 OBJ: N/A 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. Which 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 ANS: C The Rehabilitation Act of 1973 provided a comprehensive approach and expanded resources for public vocational training. DIF: Cognitive Level: Knowledge OBJ: 8 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 action 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.

8 Download All Chapters Here: https://www.stuvia.com/doc/3809109/ DIF: Cognitive Level: Comprehension OBJ: 4 TOP: Medicare Reimbursable Actions KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 13. Which assessment is correct for a patient with multiple sclerosis who requires being fed, bathed, and dressed? 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 OBJ: N/A TOP: Principles of Rehabilitation, Defining Levels of Loss of Functioning Independently KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 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 OBJ: 8 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. Which information should the admitting nurse provide to the family to determine the basis for the concepts of long-term care? 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 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. Which resource would provide funds for rehabilitation for this patient?

10 Download All Chapters Here: https://www.stuvia.com/doc/3809109/ 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: Comprehension OBJ: 8 TOP: ADA KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 20. 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. Which term describes this ituation? 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 OBJ: 1 TOP: Moral Distress KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment ;Coordinated Care 21. A nurse reminds a resident in a long-term care facility that he has autonomy in many aspects of his institutionalization. Which situation 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 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 OBJ: 2 TOP: Autonomy KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 22. Which action is an example of an LPN/LVN exhibiting beneficence? a. Removes defective equipment from the patient’s room. b. Willingly works extra shifts during a staff shortage. c. Adheres to agency policy. d. Joins the National Association for Practical Nurse Education and Service (NAPNES) and attend educational seminars.

11 Download All Chapters Here: https://www.stuvia.com/doc/3809109/ 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 OBJ: 1 TOP: Beneficence KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 23. An LPN/LVN is educating a group of nursing students regarding values demonstrated in their nursing practice. Which area of the LPN/LVN’s life identifies where 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: Knowledge OBJ: 1 TOP: Values KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 24. 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.” Which term identifies what this nurse is 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 OBJ: 5 TOP: Ethnocentrism/Values Clarification KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 25. A nursing student asks the instructor to define the philosophical stand of utilitarianism. Which 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 OBJ: N/A TOP: Utilitarianism KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

13 Download All Chapters Here: https://www.stuvia.com/doc/3809109/ d. Malpractice ANS: D Malpractice occurs when an unintentional tort causes an injury to a patient. DIF: Cognitive Level: Comprehension OBJ: 1 TOP: Malpractice KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 30. Which situation 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: Comprehension OBJ: 1 TOP: Informed Consent KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 31. A physician has written an order for Synthroid, 137 mg. The LPN/LVN is aware that the drug is measured in micrograms. Which 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. DIF: Cognitive Level: Application OBJ: 11 TOP: Doctor’s Orders KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 32. 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. Which 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 OBJ: 11 TOP: Doctor’s Orders KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care