Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update TestBank Chapter 7 Question 1 Type: MCSA Which of the following are characteristic duties of the industrial nurse? 1. Monitoring the client's vital signs every four hours 2. Providing annual screening for tuberculosis 3. Evaluating the client's response to medications 4. Preparing the client for examination by the doctor Correct Answer: 2 Rationale 1: Typically, the industrial nurse provides health screenings, such as TB testing, and client teaching after a work injury. The nurse working in the clinic or physician's office prepares clients to be seen by the doctor. Monitoring client's vital signs every four hours and their response to medication therapy are typical of inpatient nursing care. Rationale 2: Typically, the industrial nurse provides health screenings, such as TB testing, and client teaching after a work injury. The nurse working in the clinic or physician's office prepares clients to be seen by the doctor. Monitoring client's vital signs every four hours and their response to medication therapy are typical of inpatient nursing care. Rationale 3: Typically, the industrial nurse provides health screenings, such as TB testing, and client teaching after a work injury. The nurse working in the clinic or physician's office prepares clients to be seen by the doctor. Monitoring client's vital signs every four hours and their response to medication therapy are typical of inpatient nursing care. Rationale 4: Typically, the industrial nurse provides health screenings, such as TB testing, and client teaching after a work injury. The nurse working in the clinic or physician's office prepares clients to be seen by the doctor. Monitoring client's vital signs every four hours and their response to medication therapy are typical of inpatient nursing care. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Learning Outcome: Compare the characteristics of nursing in the outpatient setting to those of institutionalized nursing care. Question 2 Type: MCSA The nurse is considering working in a center that performs outpatient surgery. The nurse expects that preparation for working in this setting might involve which of the following? 1. Learning new and special skills to care for operative clients 2. Augmenting vital sign skills 3. Learning how to give IV push medications 4. Learning how to contact insurance companies Correct Answer: 1 Rationale 1: The nurse in a special one-day surgery center will learn new skills related to caring for the client having surgery on an outpatient basis. The nurse should already have vital sign skills. The LPN/LVN does not give IV push medications in many locations, and likely would not need this particular skill for outpatient surgery centers. The payment status of the client is handled by business office personnel, not by the nurse. Rationale 2: The nurse in a special one-day surgery center will learn new skills related to caring for the client having surgery on an outpatient basis. The nurse should already have vital sign skills. The LPN/LVN does not give IV push medications in many locations, and likely would not need this particular skill for outpatient surgery centers. The payment status of the client is handled by business office personnel, not by the nurse. Rationale 3: The nurse in a special one-day surgery center will learn new skills related to caring for the client having surgery on an outpatient basis. The nurse should already have vital sign skills. The LPN/LVN does not give IV push medications in many locations, and likely would not need this particular skill for outpatient surgery centers. The payment status of the client is handled by business office personnel, not by the nurse. Rationale 4: The nurse in a special one-day surgery center will learn new skills related to caring for the client having surgery on an outpatient basis. The nurse should already have vital sign skills. The LPN/LVN does not give IV push medications in many locations, and likely would not need this particular skill for outpatient surgery centers. The payment status of the client is handled by business office personnel, not by the nurse. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Compare the characteristics of nursing in the outpatient setting to those of institutionalized nursing care. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Question 3 Type: MCSA Health care agencies present a mission statement and goals for public review. The nurse would anticipate which of the following as a goal for the agency providing culturally proficient care? 1. To display signs in simple English for clients learning the language 2. To display a sign in the waiting area outlining risks for various cultural groups 3. To sponsor seminars for various cultural groups on health-promotion activities 4. To provide classes in English for clients from another country Correct Answer: 3 Rationale 1: Providing seminars for clients in the area would assist the client to be able to participate in her own health promotion. Simple English will not help the client who speaks no English. Displaying signs about risks for different groups is prejudicial and insensitive. Providing information regarding local classes in English, not actually teaching classes, might be a service offered by the agency. Rationale 2: Providing seminars for clients in the area would assist the client to be able to participate in her own health promotion. Simple English will not help the client who speaks no English. Displaying signs about risks for different groups is prejudicial and insensitive. Providing information regarding local classes in English, not actually teaching classes, might be a service offered by the agency. Rationale 3: Providing seminars for clients in the area would assist the client to be able to participate in her own health promotion. Simple English will not help the client who speaks no English. Displaying signs about risks for different groups is prejudicial and insensitive. Providing information regarding local classes in English, not actually teaching classes, might be a service offered by the agency. Rationale 4: Providing seminars for clients in the area would assist the client to be able to participate in her own health promotion. Simple English will not help the client who speaks no English. Displaying signs about risks for different groups is prejudicial and insensitive. Providing information regarding local classes in English, not actually teaching classes, might be a service offered by the agency. Global Rationale: Cognitive Level: Applying Client Need: Psychosocial Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Describe the functions and purposes of the healthcare agencies outlined in this chapter. Question 4 Type: MCSA Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. The nurse is caring for a 15-year-old on the postpartum unit who is also being treated for a sexually transmitted disease. As part of the discharge planning, the nurse suggests that the client be referred to which of the following agencies after discharge? 1. A day care center to care for the baby 2. A home health care agency 3. The Centers for Disease Control and Prevention 4. Planned Parenthood Correct Answer: 4 Rationale 1: The services of Planned Parenthood include offering education about sexually transmitted diseases, as well as confidential treatment regarding birth control without notifying the adolescent's family. The day care will offer no follow-up or educational information for the teen. The CDC is an agency that provides broad surveillance of many diseases but does not provide direct client care, and a home health care agency would provide nursing care for the mother and baby. Rationale 2: The services of Planned Parenthood include offering education about sexually transmitted diseases, as well as confidential treatment regarding birth control without notifying the adolescent's family. The day care will offer no follow-up or educational information for the teen. The CDC is an agency that provides broad surveillance of many diseases but does not provide direct client care, and a home health care agency would provide nursing care for the mother and baby. Rationale 3: The services of Planned Parenthood include offering education about sexually transmitted diseases, as well as confidential treatment regarding birth control without notifying the adolescent's family. The day care will offer no follow-up or educational information for the teen. The CDC is an agency that provides broad surveillance of many diseases but does not provide direct client care, and a home health care agency would provide nursing care for the mother and baby. Rationale 4: The services of Planned Parenthood include offering education about sexually transmitted diseases, as well as confidential treatment regarding birth control without notifying the adolescent's family. The day care will offer no follow-up or educational information for the teen. The CDC is an agency that provides broad surveillance of many diseases but does not provide direct client care, and a home health care agency would provide nursing care for the mother and baby. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Describe the functions and purposes of the healthcare agencies outlined in this chapter. Question 5 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Type: MCSA The nurse is caring for a client who has been diagnosed with a terminal illness. The physician has explained the proposed therapy to the client, who declines to sign the informed consent. The nurse's best response to the client's refusal of therapy is which of the following? 1. "I think you should sign the consent form." 2. "You have the right to decline treatment. Would you like to discuss your decision?" 3. "Remember that you have children and grandchildren who love you." 4. "I think I had better tell your wife about this." Correct Answer: 2 Rationale 1: The nurse is acknowledging the client's rights and is making himself available if the client withes to discuss it further. The other options are personal opinions of the nurse, and would be inappropriate because it is the nurse's place not to make decisions for the client but rather to support the client's decision. Rationale 2: The nurse is acknowledging the client's rights and is making himself available if the client withes to discuss it further. The other options are personal opinions of the nurse, and would be inappropriate because it is the nurse's place not to make decisions for the client but rather to support the client's decision. Rationale 3: The nurse is acknowledging the client's rights and is making himself available if the client withes to discuss it further. The other options are personal opinions of the nurse, and would be inappropriate because it is the nurse's place not to make decisions for the client but rather to support the client's decision. Rationale 4: The nurse is acknowledging the client's rights and is making himself available if the client withes to discuss it further. The other options are personal opinions of the nurse, and would be inappropriate because it is the nurse's place not to make decisions for the client but rather to support the client's decision. Global Rationale: Cognitive Level: Analyzing Client Need: Psychosocial Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Discuss health care as a right and the essentials of the Patient's Bill of Rights. Question 6 Type: MCSA The nurse is caring for a client whose family is visiting for the morning. The client has a wound that must be irrigated with medication and redressed before noon. Which of the following actions should the nurse initiate? 1. Irrigate and redress the wound during the family visit. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 2. Ask the family to step out of the room for a while. 3. Ask the client, in private, if he wants the family present during treatment. 4. Have the client ask the family to leave. Correct Answer: 3 Rationale 1: The client has a right to privacy and confidentiality. It is best to ask the client, without the family present, if the client wishes the family present during the procedure. The burden of asking the family to leave the room should not be placed on the client. The nurse, as the client advocate, should ask the family to leave if the client requests it. Rationale 2: The client has a right to privacy and confidentiality. It is best to ask the client, without the family present, if the client wishes the family present during the procedure. The burden of asking the family to leave the room should not be placed on the client. The nurse, as the client advocate, should ask the family to leave if the client requests it. Rationale 3: The client has a right to privacy and confidentiality. It is best to ask the client, without the family present, if the client wishes the family present during the procedure. The burden of asking the family to leave the room should not be placed on the client. The nurse, as the client advocate, should ask the family to leave if the client requests it. Rationale 4: The client has a right to privacy and confidentiality. It is best to ask the client, without the family present, if the client wishes the family present during the procedure. The burden of asking the family to leave the room should not be placed on the client. The nurse, as the client advocate, should ask the family to leave if the client requests it. Global Rationale: Cognitive Level: Applying Client Need: Psychosocial Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Discuss health care as a right and the essentials of the Patient's Bill of Rights. Question 7 Type: MCSA The nurse is working in a team nursing model of care under the direction of an RN. Which action demonstrates an understanding of the LPN/LVN role in relationship to the RN? 1. The nurse performs a complete assessment of the client to determine plan of care. 2. The nurse determines the nursing diagnosis appropriate for the client. 3. The nurse consults the RN when a new problem with the client is identified. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 4. The nurse asks the RN to perform wound care on the client. Correct Answer: 3 Rationale 1: When a new problem is found, the LPN/LVN notifies the RN so that the plan of care can be adjusted. The LPN/LVN performs wound care for the client, and does not need to consult the RN unless the wound changes, the LPN/LVN is not certain of how to proceed, or assistance is required. The RN is responsible for nursing diagnosis and complete assessment. Rationale 2: When a new problem is found, the LPN/LVN notifies the RN so that the plan of care can be adjusted. The LPN/LVN performs wound care for the client, and does not need to consult the RN unless the wound changes, the LPN/LVN is not certain of how to proceed, or assistance is required. The RN is responsible for nursing diagnosis and complete assessment. Rationale 3: When a new problem is found, the LPN/LVN notifies the RN so that the plan of care can be adjusted. The LPN/LVN performs wound care for the client, and does not need to consult the RN unless the wound changes, the LPN/LVN is not certain of how to proceed, or assistance is required. The RN is responsible for nursing diagnosis and complete assessment. Rationale 4: When a new problem is found, the LPN/LVN notifies the RN so that the plan of care can be adjusted. The LPN/LVN performs wound care for the client, and does not need to consult the RN unless the wound changes, the LPN/LVN is not certain of how to proceed, or assistance is required. The RN is responsible for nursing diagnosis and complete assessment. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Identify the roles of various healthcare professionals. Question 8 Type: MCSA The nurse is reviewing the client's chart for new orders, and finds the nurse practitioner has ordered a chest x-ray and antibiotics to be provided prior to discharge. The nurse does which of the following? 1. Carry out the orders as written. 2. Notify the physician of the nurse practitioner's orders for verification. 3. Notify the supervisor of the orders. 4. Tell the nurse practitioner to carry out the orders. Correct Answer: 1 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 1: The nurse practitioner has prescriptive authority, and may order diagnostic tests and medications, so the nurse should carry out the orders as written. There is no need to notify the supervisor, and the nurse, not the nurse practitioner, would carry out the orders. There is no need to obtain approval from the physician for these orders unless the nurse questions the correctness of the order, and then the nurse practitioner, not the physician, would be consulted. Rationale 2: The nurse practitioner has prescriptive authority, and may order diagnostic tests and medications, so the nurse should carry out the orders as written. There is no need to notify the supervisor, and the nurse, not the nurse practitioner, would carry out the orders. There is no need to obtain approval from the physician for these orders unless the nurse questions the correctness of the order, and then the nurse practitioner, not the physician, would be consulted. Rationale 3: The nurse practitioner has prescriptive authority, and may order diagnostic tests and medications, so the nurse should carry out the orders as written. There is no need to notify the supervisor, and the nurse, not the nurse practitioner, would carry out the orders. There is no need to obtain approval from the physician for these orders unless the nurse questions the correctness of the order, and then the nurse practitioner, not the physician, would be consulted. Rationale 4: The nurse practitioner has prescriptive authority, and may order diagnostic tests and medications, so the nurse should carry out the orders as written. There is no need to notify the supervisor, and the nurse, not the nurse practitioner, would carry out the orders. There is no need to obtain approval from the physician for these orders unless the nurse questions the correctness of the order, and then the nurse practitioner, not the physician, would be consulted. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Identify the roles of various healthcare professionals. Question 9 Type: MCSA The nurse is participating in a mobile health screening project in a rural area of the state. A family brings their children in for their health screening, and the nurse determines that the children are behind in receiving immunizations. The nurse reasons this problem might be the result of which of the following? 1. Demographic changes in the population 2. Uneven distribution of health care services 3. The increase in elders consumes more resources. 4. Rising cost of health care Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Correct Answer: 2 Rationale 1: There is a severe shortage of health care workers in parts of the country, as evidenced by the number of health care workers per capita of population available, resulting in some rural areas having insufficient providers to meet needs. Demographic changes would not be the likely cause of this family's issues, because rural demographics have not changed significantly. The elderly, while rapidly increasing in representation, are not consuming all the resources. Ability to pay for a child's immunizations is not at issue. If immunizations cannot be afforded, they will be provided at little or no cost. Rationale 2: There is a severe shortage of health care workers in parts of the country, as evidenced by the number of health care workers per capita of population available, resulting in some rural areas having insufficient providers to meet needs. Demographic changes would not be the likely cause of this family's issues, because rural demographics have not changed significantly. The elderly, while rapidly increasing in representation, are not consuming all the resources. Ability to pay for a child's immunizations is not at issue. If immunizations cannot be afforded, they will be provided at little or no cost. Rationale 3: There is a severe shortage of health care workers in parts of the country, as evidenced by the number of health care workers per capita of population available, resulting in some rural areas having insufficient providers to meet needs. Demographic changes would not be the likely cause of this family's issues, because rural demographics have not changed significantly. The elderly, while rapidly increasing in representation, are not consuming all the resources. Ability to pay for a child's immunizations is not at issue. If immunizations cannot be afforded, they will be provided at little or no cost. Rationale 4: There is a severe shortage of health care workers in parts of the country, as evidenced by the number of health care workers per capita of population available, resulting in some rural areas having insufficient providers to meet needs. Demographic changes would not be the likely cause of this family's issues, because rural demographics have not changed significantly. The elderly, while rapidly increasing in representation, are not consuming all the resources. Ability to pay for a child's immunizations is not at issue. If immunizations cannot be afforded, they will be provided at little or no cost. Global Rationale: Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Describe factors that affect healthcare delivery. Question 10 Type: MCSA The nurse is practicing in an acute care facility, and provides care for a group of clients along with unlicensed assistive personnel (UAP) under the direction of the professional nurse. The nurse is responsible for delegating care to the UAP. One disadvantage of this type of nursing care delivery model might be which of the following? 1. The licensed professional has little time to supervise the UAP. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 2. The UAP does not document any care given. 3. The acuity level of the clients might be too high to delegate to the UAP. 4. The fragmented care provided is unsafe. Correct Answer: 3 Rationale 1: The trend in client care today is such that clients in the hospital are far sicker. Moderately ill clients are now treated at home, in skilled nursing facilities, or in outpatient settings. There might not be enough care that can be delegated to the UAP to make the position cost-effective. The licensed professional is responsible for supervising and evaluating care given by the UAP, and lack of time is an unacceptable excuse. The UAP generally documents vital signs and other tasks, such as intake and output. Facility policies are designed to maintain client safety, no matter what model of nursing care is used Rationale 2: The trend in client care today is such that clients in the hospital are far sicker. Moderately ill clients are now treated at home, in skilled nursing facilities, or in outpatient settings. There might not be enough care that can be delegated to the UAP to make the position cost-effective. The licensed professional is responsible for supervising and evaluating care given by the UAP, and lack of time is an unacceptable excuse. The UAP generally documents vital signs and other tasks, such as intake and output. Facility policies are designed to maintain client safety, no matter what model of nursing care is used Rationale 3: The trend in client care today is such that clients in the hospital are far sicker. Moderately ill clients are now treated at home, in skilled nursing facilities, or in outpatient settings. There might not be enough care that can be delegated to the UAP to make the position cost-effective. The licensed professional is responsible for supervising and evaluating care given by the UAP, and lack of time is an unacceptable excuse. The UAP generally documents vital signs and other tasks, such as intake and output. Facility policies are designed to maintain client safety, no matter what model of nursing care is used Rationale 4: The trend in client care today is such that clients in the hospital are far sicker. Moderately ill clients are now treated at home, in skilled nursing facilities, or in outpatient settings. There might not be enough care that can be delegated to the UAP to make the position cost-effective. The licensed professional is responsible for supervising and evaluating care given by the UAP, and lack of time is an unacceptable excuse. The UAP generally documents vital signs and other tasks, such as intake and output. Facility policies are designed to maintain client safety, no matter what model of nursing care is used Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Differentiate among the various models of care. Question 11 Type: MCSA Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. The nurse is working with a client who is scheduled to have an electrocardiogram (ECG) done this morning before breakfast. The nurse arrives at the client bedside to find the respiratory therapist taking vital signs and preparing to do the ECG. The nurse recognizes this as which of the following types of care delivery system? 1. The functional care system 2. The client-focused system 3. The case method of delivering care 4. The team approach to care Correct Answer: 2 Rationale 1: The client-focused care system brings the care to the client. Typically, services are moved closer to the client, and employees are cross-trained to tasks that do not necessarily belong in their domains. The functional system delivers care by assigning tasks to different levels of caregivers. The case method utilizes the RN to deliver total care for a group of clients during the assigned shift. The team approach assigns the care of a group of clients to a team headed by the RN. Rationale 2: The client-focused care system brings the care to the client. Typically, services are moved closer to the client, and employees are cross-trained to tasks that do not necessarily belong in their domains. The functional system delivers care by assigning tasks to different levels of caregivers. The case method utilizes the RN to deliver total care for a group of clients during the assigned shift. The team approach assigns the care of a group of clients to a team headed by the RN. Rationale 3: The client-focused care system brings the care to the client. Typically, services are moved closer to the client, and employees are cross-trained to tasks that do not necessarily belong in their domains. The functional system delivers care by assigning tasks to different levels of caregivers. The case method utilizes the RN to deliver total care for a group of clients during the assigned shift. The team approach assigns the care of a group of clients to a team headed by the RN. Rationale 4: The client-focused care system brings the care to the client. Typically, services are moved closer to the client, and employees are cross-trained to tasks that do not necessarily belong in their domains. The functional system delivers care by assigning tasks to different levels of caregivers. The case method utilizes the RN to deliver total care for a group of clients during the assigned shift. The team approach assigns the care of a group of clients to a team headed by the RN. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Differentiate among the various models of care. Question 12 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Type: MCSA The client asks the nurse if there is a health care plan that focuses on wellness. The nurse's best response would be to describe which of the following health care reimbursement plans? 1. Preferred provider organization (PPO) 2. Physician/hospital organization (PHO) 3. Preferred provider arrangement (PPA) 4. Health maintenance organization (HMO) Correct Answer: 4 Rationale 1: The focus of an HMO is on wellness. The other options have no particular focus on a specific type of health care. Rationale 2: The focus of an HMO is on wellness. The other options have no particular focus on a specific type of health care. Rationale 3: The focus of an HMO is on wellness. The other options have no particular focus on a specific type of health care. Rationale 4: The focus of an HMO is on wellness. The other options have no particular focus on a specific type of health care. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Compare various systems of payment for healthcare services. Question 13 Type: MCSA The nurse recognizes that the rehabilitation facility has met its obligation to the client when which of the following goals is met? 1. To completely cure the client 2. To deliver care to the acutely ill client 3. To provide short-term care in order to stabilize the client's condition Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 4. To restore the ill or injured person to an optimum level of wellness Correct Answer: 4 Rationale 1: The rehabilitation center focuses on restoring the client to the previous level of functioning or to as optimum a level as possible. Caring for the acutely ill or curing a person of a disease is generally the domain of the acute care facility. Stabilization of condition is also conducted in acute care facilities. Rationale 2: The rehabilitation center focuses on restoring the client to the previous level of functioning or to as optimum a level as possible. Caring for the acutely ill or curing a person of a disease is generally the domain of the acute care facility. Stabilization of condition is also conducted in acute care facilities. Rationale 3: The rehabilitation center focuses on restoring the client to the previous level of functioning or to as optimum a level as possible. Caring for the acutely ill or curing a person of a disease is generally the domain of the acute care facility. Stabilization of condition is also conducted in acute care facilities. Rationale 4: The rehabilitation center focuses on restoring the client to the previous level of functioning or to as optimum a level as possible. Caring for the acutely ill or curing a person of a disease is generally the domain of the acute care facility. Stabilization of condition is also conducted in acute care facilities. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Describe the functions and purposes of the healthcare agencies outlined in this chapter. Question 14 Type: MCSA The nurse caring for a client whose condition is rapidly deteriorating is unable to reach the primary care provider. The nurse next would attempt to notify which of the following? 1. The physician's assistant 2. The secondary care provider 3. The hospitalist 4. The Emergency Department physician Correct Answer: 3 Rationale 1: A hospitalist is a physician hired to care for any inpatient client requiring immediate attention. If a hospital employs this type of physician, many primary care physicians will turn their client over to the hospitalist while the client is in the hospital. In the event of an emergency, or if the primary physician cannot be reached, the Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. hospitalist would temporarily act as the client's physician to provide emergency care. The physician's assistant would not be able to function independently in this situation. A secondary care provider is the hospital, not a specific person. In the past, if a client physician could not be reached, the Emergency Department physician would assist in the care of the client. However, the ED physician's first responsibility is to the clients in the ED, and she might not be available to deliver care. Rationale 2: A hospitalist is a physician hired to care for any inpatient client requiring immediate attention. If a hospital employs this type of physician, many primary care physicians will turn their client over to the hospitalist while the client is in the hospital. In the event of an emergency, or if the primary physician cannot be reached, the hospitalist would temporarily act as the client's physician to provide emergency care. The physician's assistant would not be able to function independently in this situation. A secondary care provider is the hospital, not a specific person. In the past, if a client physician could not be reached, the Emergency Department physician would assist in the care of the client. However, the ED physician's first responsibility is to the clients in the ED, and she might not be available to deliver care. Rationale 3: A hospitalist is a physician hired to care for any inpatient client requiring immediate attention. If a hospital employs this type of physician, many primary care physicians will turn their client over to the hospitalist while the client is in the hospital. In the event of an emergency, or if the primary physician cannot be reached, the hospitalist would temporarily act as the client's physician to provide emergency care. The physician's assistant would not be able to function independently in this situation. A secondary care provider is the hospital, not a specific person. In the past, if a client physician could not be reached, the Emergency Department physician would assist in the care of the client. However, the ED physician's first responsibility is to the clients in the ED, and she might not be available to deliver care. Rationale 4: A hospitalist is a physician hired to care for any inpatient client requiring immediate attention. If a hospital employs this type of physician, many primary care physicians will turn their client over to the hospitalist while the client is in the hospital. In the event of an emergency, or if the primary physician cannot be reached, the hospitalist would temporarily act as the client's physician to provide emergency care. The physician's assistant would not be able to function independently in this situation. A secondary care provider is the hospital, not a specific person. In the past, if a client physician could not be reached, the Emergency Department physician would assist in the care of the client. However, the ED physician's first responsibility is to the clients in the ED, and she might not be available to deliver care. Global Rationale: Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Identify the roles of various healthcare professionals. Question 15 Type: MCMA Which of the following activities would a nurse perform when providing health promotion? Select all that apply. Standard Text: Select all that apply. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 1. Provide flu shots. 2. Teach proper nutrition. 3. Assist clients with weight control and exercise programs. 4. Help clients identify risk factors for illness. 5. Assist with routine screening exams. Correct Answer: 2,3,5 Rationale 1: Health-promotion activities are those that assist the client to maintain wellness and achieve a healthy lifestyle. Flu shots and identification of risk factors are preventive interventions. Rationale 2: Health-promotion activities are those that assist the client to maintain wellness and achieve a healthy lifestyle. Flu shots and identification of risk factors are preventive interventions. Rationale 3: Health-promotion activities are those that assist the client to maintain wellness and achieve a healthy lifestyle. Flu shots and identification of risk factors are preventive interventions. Rationale 4: Health-promotion activities are those that assist the client to maintain wellness and achieve a healthy lifestyle. Flu shots and identification of risk factors are preventive interventions. Rationale 5: Health-promotion activities are those that assist the client to maintain wellness and achieve a healthy lifestyle. Flu shots and identification of risk factors are preventive interventions. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: !NP>Intervention Learning Outcome: Differentiate primary, secondary, and tertiary healthcare delivery services. Question 16 Type: MCMA Which of the following does the nurse define as a secondary care service? Select all that apply. Standard Text: Select all that apply. 1. The Emergency Department treats victims of a house fire. 2. The hospice nurse gives care to a client in the home. 3. The rehabilitation hospital teaches a client to walk again. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 4. The hospital provides care for a client with pneumonia. 5. The nursing home provides long-term care for the disabled. Correct Answer: 1,4 Rationale 1: Secondary care settings, such as a hospital, provide acute and emergency care to clients. Tertiary care facilities provide long-term, rehabilitative, and palliative care for the dying. Rationale 2: Secondary care settings, such as a hospital, provide acute and emergency care to clients. Tertiary care facilities provide long-term, rehabilitative, and palliative care for the dying. Rationale 3: Secondary care settings, such as a hospital, provide acute and emergency care to clients. Tertiary care facilities provide long-term, rehabilitative, and palliative care for the dying. Rationale 4: Secondary care settings, such as a hospital, provide acute and emergency care to clients. Tertiary care facilities provide long-term, rehabilitative, and palliative care for the dying. Rationale 5: Secondary care settings, such as a hospital, provide acute and emergency care to clients. Tertiary care facilities provide long-term, rehabilitative, and palliative care for the dying. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Differentiate primary, secondary, and tertiary healthcare delivery services. Question 17 Type: MCMA Primary health care services include which of the following: Standard Text: Select all that apply. 1. Exercise promotion programs 2. Stress reduction 3. HIV testing 4. Mammograms 5. Immunizations Correct Answer: 1,2,5 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 1: Health promotion and illness prevention are the focus of primary healthcare settings. Rationale 2: Stress reduction is a form of health promotion and illness prevention. Rationale 3: HIV testing is part of secondary healthcare services and is part of diagnosis and treatment. Rationale 4: Mammograms are a function of disease diagnosis and therefore found in the secondary healthcare services. Rationale 5: Immunizations are a form of illness prevention. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 18 Type: MCSA Nurses in tertiary healthcare settings emphasize: 1. The important role clients play in maintaining their own health 2. Diagnosis and treatment of illness 3. The importance of assisting clients to regain previous capabilities 4. Walk-in screening services 5. Correct Answer: 3 Rationale 1: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Rationale 2: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Rationale 3: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Rationale 4: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 19 Type: MCMA The outpatient healthcare setting cares for which type of client? Standard Text: Select all that apply. 1. Seriously ill 2. Those requiring routine health screening 3. One who requires laboratory or radiologic services 4. Elder requiring supervision 5. Restorative care Correct Answer: 2,3,4 Rationale 1: The sreiously ill client is generally cared for at an inpatient setting. Rationale 2: Routine health screening is a function of the outpatient setting, such as a physicians office. Rationale 3: The client who requires laboratory or radiologic services can obtain these services on an outpatient basis in a freestanding clinic or ambulatory care center. Rationale 4: The elder requiring supervision during the day can access an adult daycare setting . Rationale 5: Restorative care is generally provided at an inpatient setting. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Question 20 Type: MCSA The home health setting allows the nurse to: 1. Function independently 2. To set own schedule and priorities 3. Feel free to question advice 4. Have more responsibility for care of client 5. Correct Answer: 1 Rationale 1: The home health setting allows the nurse to function more independently. Rationale 2: The family sets their own schedule and priorities. Rationale 3: The family may feel free to question advice. Rationale 4: The family will have more responsibility for care of client. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: Question 21 Type: MCMA Nurses who work in an inpatient setting may care for clients Standard Text: Select all that apply. 1. For a long period of time 2. Who are acutely ill Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 3. For less than 24 hours 4. Who need rehabilitation 5. Who require early detection Correct Answer: 1,2,4 Rationale 1: The nurse who works in an inpatient setting may care for clients from over 24 hours to many years. Rationale 2: The nurse may care for acutely ill clients at an acute care hospital. Rationale 3: The client in the outpatient setting is cared for by nurses for 24 hours or less. Rationale 4: Nurses who work in long term care will see patients who require rehabilitation and restoration. Rationale 5: Early detection and treatment is usually seen in outpatient settings. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: Question 22 Type: MCMA Community based (outpatient) facilities can provide which of the following services: Standard Text: Select all that apply. 1. Adult day care 2. Client education 3. Respite care 4. Coronary care services 5. Custodial care Correct Answer: 1,2,3 Rationale 1: Adult day care, or elder care, can be arranged for socializing, stimulation, and exercise programs. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 2: Client education needs can be met in an outpatient facility as well as in the home. Rationale 3: Respite care for caregivers provides temporary care in a daycare setting, or is delivered in homes. Rationale 4: Acute coronary care services are provided in an inpatient acute care setting. Rationale 5: Custodial care is generally provided in an inpatient longterm care facility. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 23 Type: MCMA Nurses who work at rehabilitation centers may see a variety of clients based on the facility’s specialty. Possible client populations include: Standard Text: Select all that apply. 1. Hospice clients 2. Chemical addiction 3. Psychiatric 4. Spinal cord injury 5. Acute infection Correct Answer: 2,3,4 Rationale 1: Hospice clients are terminally ill and the goal of care is to maintain the quality of life until death. Rationale 2: Alcohol and drug treatment centers help free clients of dependence and assist them in reentering the community. Rationale 3: Psychiatric rehabilitation centers assist clients in reaching maximum function and returning to the community. Rationale 4: Spinal cord injury clients are often found at physical rehabilitation centers where they are assisted in regaining purpose, function and dignity. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 5: Clients with an acute infection are generally treated in the community or in the acute care setting (hospital). Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 24 Type: MCSA 1. 2. 3. 4. 5. Correct Answer: Rationale 1: Rationale 2: Rationale 3: Rationale 4: Rationale 5: Global Rationale: Cognitive Level: Client Need: Client Need Sub: Nursing/Integrated Concepts: Learning Outcome: Question 25 Type: MCMA Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. The American Hospital Association bill of rights states that clients have the right to: Standard Text: Select all that apply. 1. Free health care 2. Considerate and respectful care 3. Confidentiality of all records and communications regarding care 4. Right to refuse care 5. Right to refuse to participate in research studies Correct Answer: 2,3,4,5 Rationale 1: The AHA bill does not state that the client is entitled to free healthcare. Rationale 2: The client has the right to considerate and respectful care. Rationale 3: The client has the right by the AHA bill and HIPAA to have all communications kept confidential except when necessary for care or payment. Rationale 4: The client has the right to refuse care or procedures. Rationale 5: The client has the right to refuse to participate in health care research. Global Rationale: Cognitive Level: Understanding Client Need: Psychosocial Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 26 Type: MCSA 1. 2. 3. 4. 5. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Correct Answer: Rationale 1: Rationale 2: Rationale 3: Rationale 4: Rationale 5: Global Rationale: Cognitive Level: Client Need: Client Need Sub: Nursing/Integrated Concepts: Learning Outcome: Question 27 Type: MCSA The healthcare team consists of personnel whose goal is to 1. Work well together 2. Keep healthcare costs down 3. Restore clients’ health and promote wellness 4. Make sure the client does what each provider prescribes 5. Correct Answer: 3 Rationale 1: While this is expected, it is not the final goal of the team. Rationale 2: While this is helpful it is not the final goal of the team. Rationale 3: The mutual goal of team members is to restore clients’ health and promote wellness . Rationale 4: Rationale 5: Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 28 Type: MCMA The nurse identifies the role of the case manager as being: Standard Text: Select all that apply. 1. To ensure cost effective appropriate care 2. Always filled by a social worker 3. Often filled by a family member 4. Considered an alternative care provider 5. Filled by the team member who is most involved in client’s care Correct Answer: 1,5 Rationale 1: Ensuring fiscally sound healthcare in the best setting is the role of the case manager. Rationale 2: The role of the case manager can be filled by a nurse, social worker, OT, PT. Rationale 3: The role of the case manager is filled by a member of the healthcare team. Rationale 4: The role of case manager is not an that of an alternative care provider. Rationale 5: The team member most involved with the client’s care will be able to understand care needs most completely. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 29 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Type: MCSA Nurses work with many types of healthcare providers, including which of the following alternative care providers? 1. Massage therapist 2. Chaplain 3. Dentist 4. Unlicensed assistive personnel 5. Correct Answer: 1 Rationale 1: The massage therapist is often seen as an alternative provider, whose services can be used in conjunction with traditional providers. Rationale 2: The chaplain or other spiritual support person is often seen as the member of the healthcare team who attends to the spiritual needs of the client. Rationale 3: Dental care is a traditional role, and involves preventive measures to maintain healthy oral structures. Rationale 4: UAP are healthcare staff who assume aspects of client care, such as feeding, and bathing, that do not require nursing judgment. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 30 Type: MCSA Nurses who are graduating in the next few years will find which of the following populations among to be the majority of the adult population they will be caring for? 1. The frail elderly Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 2. Adults over 65 years of age 3. Homeless populations 4. The working poor 5. Correct Answer: 2 Rationale 1: The frail elderly, those over age 85, will constitute 9.6 million people by 2030. Rationale 2: The number of adults over age 65 will be nearly 56 million by 2020. Rationale 3: The homeless population will not be the largest client population cared for. Rationale 4: The working poor will not be the largest population cared for. Rationale 5: Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 31 Type: MCMA A homeless client is being admitted to the acute medical-surgical unit in a hospital. The nurse predicts which of the following as health risks for this client? Standard Text: Select all that apply. 1. Improper nutrition 2. Lack of social support 3. Sleep needs usually met 4. Increased susceptibility to infection 5. Poor personal hygiene Correct Answer: 1,2,4,5 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 1: Homeless clients often have a deficiency in one or more nutrients. Rationale 2: Many homeless clients are disaffiliated from family and friends. Rationale 3: Homeless individuals often have inadequate sleep and rest due to lack of housing. Rationale 4: Homeless clients’ poor physical environments often result in increased susceptibility to infections. Rationale 5: Homeless clients often have poor access to facilities for personal hygiene. Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 32 Type: MCMA The nurse practicing in a gynecologist’s office will deal which of the following women’s health issues? Standard Text: Select all that apply. 1. Sexually transmitted infections 2. Abuse 3. Issues on aging 4. Immunizations 5. Lack of insurance for preventive care Correct Answer: 1,2,3 Rationale 1: Treatment of STIs is an area of treatment focus in women’s health. Rationale 2: Domestic abuse is a healthcare concern that is a research and treatment focus in women’s health. Rationale 3: With the growing number of adults over 65, issues on aging will become more important in women’s health. Rationale 4: Immunizations are not a specifically female health issue. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 5: With the passing of the Affordable Care Act, preventive care services are exempt from co-payments and deductibles. Global Rationale: Cognitive Level: Client Need: Client Need Sub: Nursing/Integrated Concepts: Learning Outcome: Question 33 Type: MCMA Which of the following factors can affect client access to healthcare negatively? Standard Text: Select all that apply. 1. Geography 2. Homelessness 3. Having insurance 4. Living in the New England states 5. Low income Correct Answer: 1,2,5 Rationale 1: Rural communities may not have a hospital, or physician within 100 miles. Rationale 2: Homeless individuals often have minimal access to healthcare due to lack of insurance, and access to facilities. Rationale 3: Having insurance usually increases access to healthcare. Rationale 4: The New England states have more physicians and nurses per capita than the south. Rationale 5: Low income is associated with less access to healthcare, even with some government assistance. Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Learning Outcome: Question 34 Type: MCMA Managed care systems are characterized by: Standard Text: Select all that apply. 1. Cost containment 2. Patient driven access 3. Health promotion 4. Preventive care 5. Customer satisfaction Correct Answer: 1,3,4,5 Rationale 1: Managed care systems strive to provide cost-effective care. Rationale 2: Care of a client is managed by providers and the agency. Rationale 3: Health promotion is an area that managed care systems focus on. Rationale 4: Preventive care services are emphasized by managed care systems; preventing illness costs less than treating illness. Rationale 5: Customer satisfaction and improved outcomes for groups of clients are goals of managed care systems. Global Rationale: Cognitive Level: Remembering Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 35 Type: MCSA The case manager may use clinical pathways for 1. Care of a client Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 2. Client teaching 3. Client satisfaction 4. Planning care and anticipating problems 5. Correct Answer: 4 Rationale 1: Clinical pathways provide an expected path of client needs, but are not used in this manner by the case manager. Rationale 2: Case managers generally do not provide client teaching. Rationale 3: Case managers do not use clinical pathways to assess client satisfaction. Rationale 4: The case manager may use clinical pathways for planning care and anticipating potential problems in the progression of a client’s recovery. Rationale 5: Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 36 Type: MCSA Facilities are using which model of care less and less? 1. Client focused care 2. Functional method 3. Team nursing 4. Primary nursing 5. Correct Answer: 4 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 1: Cross-training of employees is integral to the managed care system. Rationale 2: The functional approach to nursing is economical and efficient. Rationale 3: Team nursing is experiencing a resurgence with the advent of managed care. Rationale 4: With today’s nursing shortage and the high cost of health care, this model of nursing care is being replaced. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 37 Type: MCSA Which of the following models of care focuses on the RN as primary caregiver? 1. Case method 2. Client focused care 3. Team nursing 4. Functional method 5. Correct Answer: 1 Rationale 1: The case method assigns one nurse for the comprehensive care of a group of clients. Rationale 2: The client focused model cross-trains individuals to provide many elements of care. Rationale 3: Team nursing is the delivery of individualized nursing care to clients by a nursing team of RNs, LPNs/LVNs and nurse’s aides. Rationale 4: The functional method is a task oriented approach to care where care is assigned by the head nurse to personnel with less preparation than a professional nurse. Rationale 5: Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 38 Type: MCMA Nurses in an HMO setting focus on which aspects of care? Standard Text: Select all that apply. 1. Health promotion 2. Illness prevention 3. Disabilities 4. Geriatrics 5. DRGs Correct Answer: 1,2 Rationale 1: The better the health of the person, the fewer services used, the greater the profit for the agency. Rationale 2: The health maintenance organization strives to prevent illness to maximize the agency’s profit. Rationale 3: The focus for nurses in the HMO is not on disabilities. Rationale 4: Nurses’ focus in the HMO setting is not on geriatrics specifically. Rationale 5: DRGs are a component of the prospective payment system passed by the U.S. Congress in 1983. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 39 Type: MCSA Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Which of the following payment sources has no element of government payment? 1. Medicare 2. Medicaid 3. Supplemental Security Income 4. Group plans 5. Correct Answer: 4 Rationale 1: Medicare is a national and state health insurance program. Rationale 2: Medicaid is a federal public assistance program. Rationale 3: People who are blind may be eligible for special payment through federal payments. Rationale 4: The group plan is paid for by the client and or the employer. Rationale 5: Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 40 Type: MCMA Third party reimbursement refers to payment by: Standard Text: Select all that apply. 1. A health insurance plan 2. The client 3. Medicare 4. Medicaid Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 5. Blue Shield Correct Answer: 1,3,4,5 Rationale 1: Third party reimbursement is payment for services rendered to a person by an entity other than the one who received the service. Rationale 2: The client does not pay for services when there is third party reimbursement. Rationale 3: Medicare is a third-party reimbursement entity. Rationale 4: Medicaid is a federal third-party reimbursement entity. Rationale 5: Blue Shield is a private third party reimbursement entity. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 41 Type: MCSA The nursing is reviewing prenatal care guidelines with a group of pregnant teenagers. This is an example of: 1. Primary care 2. Secondary care 3. Tertiary care 4. Inpatient care 5. Correct Answer: 1 Rationale 1: Primary care includes preventive care and health education. Rationale 2: Secondary care includes emergency and acute care. Rationale 3: Tertiary care includes long-term care. Rationale 4: The information does not support an answer of in-patient care; there is no mention of setting. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 42 Type: MCSA The employment setting in which the nurse is most likely to provide custodial care is: 1. Hospital 2. Extended-care facility 3. Hospice 4. Crisis center 5. Correct Answer: 2 Rationale 1: The hospital provides restorative care. Rationale 2: Custodial care is usually provided in an extended care facility. Rationale 3: Hospice serves clients who are terminally ill. Rationale 4: Crisis centers provide direct counseling. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 43 Type: MCSA Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. The nurse who provides in home education and care is most likely working in which setting? 1. Hospice 2. Assisted living center 3. Ambulatory care center 4. Home healthcare agency 5. Correct Answer: 4 Rationale 1: Hospce services include maintaining the quality of life until death. Rationale 2: Services in the assisted living center include meals, laundry, and nursing care. Rationale 3: Services at the ambulatory care center generally include diagnostic and treatment facilities. Rationale 4: Home healthcare agencies generally provide in home education and care. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 44 Type: MCSA The nurse is describing the services provided by unlicensed assistive personnel as including: 1. Developing and coordinating care 2. Treatment of uncomplicated illness 3. Aspects of client care that do not require nursing judgment 4. Monitoring effects of medication on clients 5. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Correct Answer: 3 Rationale 1: Developing and coordinating care, and assessing client health status are functions of the nurse. Rationale 2: Screening, diagnosis and treatment of uncomplicated illness and injury are functions of a nurse practitioner. Rationale 3: Unlicensed assistive personnel are responsible for aspects of client care that do not require nursing judgment. Rationale 4: Pharmacists are responsible for monitoring and evaluating the actions and effects of medications on clients. Rationale 5: Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 45 Type: MCMA Primary healthcare services include which of the following: Standard Text: Select all that apply. 1. Exercise-promotion programs 2. Stress reduction 3. HIV testing 4. Mammograms 5. Immunizations Correct Answer: 1,2,5 Rationale 1: Health promotion and illness prevention are the focus of primary healthcare settings. Rationale 2: Stress reduction is a form of health promotion and illness prevention. Rationale 3: HIV testing is part of secondary healthcare services, and is part of diagnosis and treatment. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 4: Mammograms are a function of disease diagnosis, and therefore categorized as secondary healthcare services. Rationale 5: Immunizations are a form of illness prevention. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 46 Type: MCSA Nurses in tertiary healthcare settings emphasize: 1. The important role clients play in maintaining their own health. 2. Diagnosis and treatment of illness. 3. The importance of assisting clients to regain previous capabilities. 4. Walk-in screening services. Correct Answer: 3 Rationale 1: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Rationale 2: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Rationale 3: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Rationale 4: The tertiary healthcare setting emphasizes the restoration of ill or injured people to optimum and functional levels of wellness. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Question 47 Type: MCMA The outpatient healthcare setting cares for which type of client? Standard Text: Select all that apply. 1. Seriously ill 2. Those requiring routine health screening 3. One who requires laboratory or radiologic services 4. Elder requiring supervision 5. Those requiring restorative care Correct Answer: 2,3,4 Rationale 1: The seriously ill client is generally cared for at an inpatient setting. Rationale 2: Routine health screening is a function of the outpatient setting, such as a physician’s office. Rationale 3: The client who requires laboratory or radiologic services can obtain these services on an outpatient basis in a freestanding clinic or ambulatory care center. Rationale 4: The elder requiring supervision during the day can access an adult daycare setting. Rationale 5: Restorative care is generally provided at an inpatient setting. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: Question 48 Type: MCSA The home health setting allows the nurse to: 1. Function independently. 2. Set his own schedule and priorities. 3. Feel free to question advice. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 4. Have more responsibility for care of the client. Correct Answer: 1 Rationale 1: The home health setting allows the nurse to function more independently. Rationale 2: The family set their own schedule and priorities. Rationale 3: The family may feel free to question advice. Rationale 4: The family will have more responsibility for care of client. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: Question 49 Type: MCMA Nurses who work in an inpatient setting might care for clients: Standard Text: Select all that apply. 1. For a long period of time. 2. Who are acutely ill. 3. For less than 24 hours. 4. Who need rehabilitation. 5. Who require early detection. Correct Answer: 1,2,4 Rationale 1: The nurse who works in an inpatient setting might care for clients from over 24 hours to many years. Rationale 2: The nurse might care for acutely ill clients at an acute care hospital. Rationale 3: The client in the outpatient setting is cared for by nurses for 24 hours or less. Rationale 4: Nurses who work in long-term care will see patients who require rehabilitation and restoration. Rationale 5: Early detection and treatment are usually seen in outpatient settings. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: Question 50 Type: MCMA Community-based (outpatient) facilities can provide which of the following services? Standard Text: Select all that apply. 1. Adult day care 2. Client education 3. Respite care 4. Coronary care services 5. Custodial care Correct Answer: 1,2,3 Rationale 1: Adult day care, or elder care, can be arranged for socializing, stimulation, and exercise programs. Rationale 2: Client education needs can be met in an outpatient facility as well as in the home. Rationale 3: Respite care for caregivers provides temporary care in a daycare setting, or is delivered in homes. Rationale 4: Acute coronary care services are provided in an inpatient acute care setting. Rationale 5: Custodial care is generally provided in an inpatient long-term care facility. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 51 Type: MCMA Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Nurses who work at rehabilitation centers might see a variety of clients based on the facility’s specialty. Possible client populations include: Standard Text: Select all that apply. 1. Hospice clients. 2. Clients with chemical addiction. 3. Psychiatric clients. 4. Clients with spinal cord injury. 5. Clients with acute infection. Correct Answer: 2,3,4 Rationale 1: Hospice clients are terminally ill, and the goal of care is to maintain the quality of life until death. Rationale 2: Alcohol and drug treatment centers help free clients of dependence and assist them in re-entering the community. Rationale 3: Psychiatric rehabilitation centers assist clients in reaching maximum function and returning to the community. Rationale 4: Spinal cord injury clients are often found at physical rehabilitation centers, where they are assisted in regaining purpose, function, and dignity. Rationale 5: Clients with an acute infection are generally treated in the community or in the acute care setting (hospital). Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 52 Type: MCMA The American Hospital Association bill of rights states that clients have the right to: Standard Text: Select all that apply. 1. Free health care. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 2. Considerate and respectful care. 3. Confidentiality of all records and communications regarding care. 4. Refuse care. 5. Refuse to participate in research studies. Correct Answer: 2,3,4,5 Rationale 1: The AHA bill does not state that the client is entitled to free health care. Rationale 2: The client has the right to considerate and respectful care. Rationale 3: The client has the right by the AHA bill and HIPAA to have all communications kept confidential except when necessary for care or payment. Rationale 4: The client has the right to refuse care or procedures. Rationale 5: The client has the right to refuse to participate in healthcare research. Global Rationale: Cognitive Level: Understanding Client Need: Psychosocial Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 53 Type: MCSA The healthcare team consists of personnel whose goal is to: 1. Work well together. 2. Keep healthcare costs down. 3. Restore clients’ health and promote wellness. 4. Make sure the client does what each provider prescribes. Correct Answer: 3 Rationale 1: While this is expected, it is not the final goal of the team. Rationale 2: While this is helpful, it is not the final goal of the team. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 3: The mutual goal of team members is to restore clients’ health and promote wellness. Rationale 4: While this is expected, it is not the final goal of the team. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 54 Type: MCMA The nurse identifies the role of the case manager as being: Standard Text: Select all that apply. 1. To ensure cost-effective, appropriate care. 2. Always filled by a social worker. 3. Often filled by a family member. 4. An alternative care provider. 5. Filled by the team member who is most involved in client’s care. Correct Answer: 1,5 Rationale 1: Ensuring fiscally sound health care in the best setting is the role of the case manager. Rationale 2: The role of the case manager can be filled by a nurse, social worker, OT, or PT. Rationale 3: The role of the case manager is filled by a member of the healthcare team. Rationale 4: The role of case manager is not that of an alternative care provider. Rationale 5: The team member most involved with the client’s care will be able to understand care needs most completely. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Learning Outcome: Question 55 Type: MCSA Nurses work with many types of healthcare providers, including which of the following alternative care providers? 1. Massage therapist 2. Chaplain 3. Dentist 4. Unlicensed assistive personnel Correct Answer: 1 Rationale 1: The massage therapist is often seen as an alternative provider, whose services can be used in conjunction with traditional providers. Rationale 2: The chaplain or other spiritual support person is often seen as the member of the healthcare team who attends to the spiritual needs of the client. Rationale 3: Dental care is a traditional role, and involves preventive measures to maintain healthy oral structures. Rationale 4: UAP are healthcare staff who assume aspects of client care, such as feeding, and bathing, that do not require nursing judgment. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 56 Type: MCSA Nurses who are graduating in the next few years will find which of the following populations among to be the majority of the adult population they will be caring for? 1. The frail elderly 2. Adults over 65 years of age 3. Homeless populations Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 4. The working poor Correct Answer: 2 Rationale 1: The frail elderly, those over age 85, will number 9.6 million people by 2030. Rationale 2: The number of adults over age 65 will be nearly 56 million by 2020. Rationale 3: The homeless population will not be the largest client population cared for. Rationale 4: The working poor will not be the largest population cared for. Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 57 Type: MCMA A homeless client is being admitted to the acute medical–surgical unit in a hospital. The nurse predicts which of the following as health risks for this client? Standard Text: Select all that apply. 1. Improper nutrition 2. Lack of social support 3. Sleep needs usually met 4. Increased susceptibility to infection 5. Poor personal hygiene Correct Answer: 1,2,4,5 Rationale 1: Homeless clients often have a deficiency in one or more nutrients. Rationale 2: Many homeless clients are disaffiliated from family and friends. Rationale 3: Homeless individuals often have inadequate sleep and rest due to lack of housing. Rationale 4: Homeless clients’ poor physical environments often result in increased susceptibility to infections. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 5: Homeless clients often have poor access to facilities for personal hygiene. Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 58 Type: MCMA The nurse practicing in a gynecologist’s office will deal which of the following women’s health issues? Standard Text: Select all that apply. 1. Sexually transmitted infections 2. Abuse 3. Issues related to aging 4. Immunizations 5. Lack of insurance for preventive care Correct Answer: 1,2,3 Rationale 1: Treatment of STIs is an area of treatment focus in women’s health. Rationale 2: Domestic abuse is a healthcare concern that is a research and treatment focus in women’s health. Rationale 3: With the growing number of adults over 65, issues on aging will become more important in women’s health. Rationale 4: Immunizations are not a specifically female health issue. Rationale 5: With the passing of the Affordable Care Act, preventive care services are exempt from co-payments and deductibles. Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Question 59 Type: MCMA Which of the following factors can affect client access to health care negatively? Standard Text: Select all that apply. 1. Geography 2. Homelessness 3. Having insurance 4. Living in the New England states 5. Low income Correct Answer: 1,2,5 Rationale 1: Rural communities might not have a hospital, or a physician within 100 miles. Rationale 2: Homeless individuals often have minimal access to health care due to lack of insurance and access to facilities. Rationale 3: Having insurance usually increases access to health care. Rationale 4: The New England states have more physicians and nurses per capita than does the South. Rationale 5: Low income is associated with less access to health care, even with some government assistance. Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 60 Type: MCMA Managed care systems are characterized by: Standard Text: Select all that apply. 1. Cost containment. 2. Patient-driven access. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 3. Health promotion. 4. Preventive care. 5. Customer satisfaction. Correct Answer: 1,3,4,5 Rationale 1: Managed care systems strive to provide cost-effective care. Rationale 2: Care of a client is managed by providers and the agency. Rationale 3: Health promotion is an area on which managed care systems focus. Rationale 4: Preventive care services are emphasized by managed care systems; preventing illness costs less than does treating illness. Rationale 5: Customer satisfaction and improved outcomes for groups of clients are goals of managed care systems. Global Rationale: Cognitive Level: Remembering Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 61 Type: MCSA The case manager may use clinical pathways for: 1. Care of a client. 2. Client teaching. 3. Client satisfaction. 4. Planning care and anticipating problems. Correct Answer: 4 Rationale 1: Clinical pathways provide an expected path of client needs, but are not used in this manner by the case manager. Rationale 2: Case managers generally do not provide client teaching. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 3: Case managers do not use clinical pathways to assess client satisfaction. Rationale 4: The case manager may use clinical pathways for planning care and anticipating potential problems in the progression of a client’s recovery. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 62 Type: MCSA Facilities are using which model of care less and less? 1. Client-focused care 2. Functional method 3. Team nursing 4. Primary nursing Correct Answer: 4 Rationale 1: Cross-training of employees is integral to the managed care system. Rationale 2: The functional approach to nursing is economical and efficient. Rationale 3: Team nursing is experiencing a resurgence with the advent of managed care. Rationale 4: With today’s nursing shortage and the high cost of health care, this model of nursing care is being replaced. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 63 Type: MCSA Which of the following models of care focuses on the RN as primary caregiver? Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. 1. Case method 2. Client-focused care 3. Team nursing 4. Functional method Correct Answer: 1 Rationale 1: The case method assigns one nurse the comprehensive care of a group of clients. Rationale 2: The client-focused model cross-trains individuals to provide many elements of care. Rationale 3: Team nursing is the delivery of individualized nursing care to clients by a nursing team of RNs, LPNs/LVNs, and nurse’s aides. Rationale 4: The functional method is a task-oriented approach to care where care is assigned by the head nurse to personnel with less preparation than a professional nurse would have. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 64 Type: MCMA Nurses in an HMO setting focus on which aspects of care? Standard Text: Select all that apply. 1. Health promotion 2. Illness prevention 3. Disabilities 4. Geriatrics 5. DRGs Correct Answer: 1,2 Rationale 1: The better the health of the person, the fewer services used, and the greater the profit for the agency. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 2: The health maintenance organization strives to prevent illness to maximize the agency’s profit. Rationale 3: The focus for nurses in the HMO is not on disabilities. Rationale 4: Nurses’ focus in the HMO setting is not on geriatrics specifically. Rationale 5: DRGs are a component of the prospective payment system passed by the U.S. Congress in 1983. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 65 Type: MCSA Which of the following payment sources has no element of government payment? 1. Medicare 2. Medicaid 3. Supplemental Security Income 4. Group plans Correct Answer: 4 Rationale 1: Medicare is a national and state health insurance program. Rationale 2: Medicaid is a federal public assistance program. Rationale 3: People who are blind might be eligible for special payment through federal payments. Rationale 4: The group plan is paid for by the client and or the employer. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 66 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Type: MCMA Third-party reimbursement refers to payment by: Standard Text: Select all that apply. 1. A health insurance plan. 2. The client. 3. Medicare. 4. Medicaid. 5. Blue Shield. Correct Answer: 1,3,4,5 Rationale 1: Third-party reimbursement is payment for services rendered to a person by an entity other than the one who received the service. Rationale 2: The client does not pay for services when there is third-party reimbursement. Rationale 3: Medicare is a third-party reimbursement entity. Rationale 4: Medicaid is a federal third-party reimbursement entity. Rationale 5: Blue Shield is a private third-party reimbursement entity. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: Question 67 Type: MCSA The nursing is reviewing prenatal care guidelines with a group of pregnant teenagers. This is an example of: 1. Primary care. 2. Secondary care. 3. Tertiary care. 4. Inpatient care. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Correct Answer: 1 Rationale 1: Primary care includes preventive care and health education. Rationale 2: Secondary care includes emergency and acute care. Rationale 3: Tertiary care includes long-term care. Rationale 4: The information does not support an answer of inpatient care; there is no mention of setting. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 68 Type: MCSA The employment setting in which the nurse is most likely to provide custodial care is the: 1. Hospital. 2. Extended-care facility. 3. Hospice. 4. Crisis center. Correct Answer: 2 Rationale 1: The hospital provides restorative care. Rationale 2: Custodial care is usually provided in an extended care facility. Rationale 3: Hospice serves clients who are terminally ill. Rationale 4: Crisis centers provide direct counseling. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Question 69 Type: MCSA The nurse who provides in-home education and care is most likely working in which setting? 1. Hospice 2. Assisted living center 3. Ambulatory care center 4. Home healthcare agency Correct Answer: 4 Rationale 1: Hospice services include maintaining the quality of life until death. Rationale 2: Services in the assisted living center include meals, laundry, and nursing care. Rationale 3: Services at the ambulatory care center generally include diagnostic and treatment facilities. Rationale 4: Home healthcare agencies generally provide in-home education and care. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Question 70 Type: MCSA The nurse describes the services provided by unlicensed assistive personnel as including: 1. Developing and coordinating care. 2. Treatment of uncomplicated illness. 3. Aspects of client care that do not require nursing judgment. 4. Monitoring effects of medication on clients. Correct Answer: 3 Rationale 1: Developing and coordinating care and assessing client health status are functions of the nurse. Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc. Rationale 2: Screening, diagnosis, and treatment of uncomplicated illness and injury are functions of a nurse practitioner. Rationale 3: Unlicensed assistive personnel are responsible for aspects of client care that do not require nursing judgment. Rationale 4: Pharmacists are responsible for monitoring and evaluating the actions and effects of medications on clients. Global Rationale: Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Copyright 2012 by Pearson Education, Inc.