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BUNDLE: NUR 410 NCLEX Med-Surg Exams Package, All Questions Answered & Rated, A+ Guide
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NUR 410 Med-Surg Final Exam Questions & Answers
NUR 410 Med-Surg Final Exam Questions & Answers-Which IV solution should the nurse anticipate administering to a client who sustained severe burns? A. D5... [Show More] W (5% dextrose in water) B. Lactated Ringers solution C. D5 1/2 normal saline with 20 mEq of potassium chloride. D. Hespan - B. Lactated Ringers solution The nurse on the burn unit provides care for a client with a new autograft on the left elbow. Which actions does the nurse take to improve skin graft outcomes? (select all that apply) A. Conduct range of motion exercises daily. B. Maintain gauze dressing over autograft for 3-5 days. C. Assist with incentive spirometry hourly while awake. D. Increase ambulation to tolerance. E. Immobilize the left arm. - B & E The nurse assesses a newly admitted client following a burn injury. Which assessment findings cause the nurse to suspect inhalation injury? (Select all that apply) Facial burns Singed nasal hair Hemoptysis Heart rate 112 beats/min Audible Stridor - Audible stridor Facial burns Singed nasal hair A client admitted to the emergency room with burns covering 45% of the total body surface area (TBSA) requires aggressive fluid resuscitation. What is the anticipated duration for fluid resuscitation intervention? . 12 hours B. 24 hours C. 48 hours D. 72 hours - B. 24 hours The clinic nurse instructs a client with partial-thickness burns of the thighs on how to clean and dress the wounds. At the next visit, the nurse notes the wounds are dirty and not covered by dressings. What actions does the nurse take? A. Inform the client the health care provider will not treat someone who is noncompliant. B. Review the dressing change, using the teach-back method. C. Ask the client why she is not following the instructions. D. Describe the physiology of burn healing and infection processes. - B. Review the dressing change, using the teach-back method. The triage nurse assesses a client with burns on the right arm and leg. The client is crying with pain, the burnt skin is red, and large wet blisters are present. Which depth of injury does the nurse suspect? A. Full thickness burn B. Superficial partial thickness burn C. Superficial burn D. Deep partial thickness burn - B. Superficial partial thickness burn What pain medication should the nurse administer to a client with a 35% TBSA burn? A. Morphine IVP B. Fentanyl patch C. Ketorolac IVP D. Morphine IM - A. Morphine IVP While collecting a medical history on a client who experienced a severe burn, which statement by the client's husband requires intervention? A. "She takes medication for menopause." B. "I think it has been at least 15 years since her last tetanus shot". C. "She smokes 1.5 packs of cigarettes a day." D. "She found out she has COPD about 2 years ago." - B. "I think it has been at least 15 years since her last tetanus shot". A client has burns covering the anterior torso, anterior arms (bilateral), and anterior legs (bilateral). What percentage of the total body surface area (BSA) does the nurse estimate is affected? (Record your answer rounding to the nearest whole number.) 27 % 45 % 54 % 72 % - 45 % A client sustains major burns on the anterior thorax, head, and bilateral upper extremities following a house fire. What is the initial A. Restore hemodynamic stability. B. Maintain patent airway. C. Prevent infection. D. Initiate intravascular resuscitation. - B. Maintain patent airway. During Fluid Resuscitation, how much fluid should be administered in the first 8 hrs? And then the next 16 hrs? - Half of the fluid is given in the first 8hrs. The remaining is given in the next 16 hrs. Care for graft site - elevate and immobilize the graft site keep free from pressure avoid weight bearing activities use cotton tip to removed exudate monitor for signs of infection avoid softeners/hard detergents protect from sun light use splints as prescribed How long must compression dressing be worn each day? and for what purpose? - 23 out of 24 hours. Saves mobility and prevents scarring Important concepts for burns - -Cardiac monitoring -Infection Control -Shock (sepsis) A client is brought to the emergency department with 35% TBSA burns. Which actions should the nurse implement for this client? A. Administer oxygen as required. B. Apply a cooling blanket on the client. C. Assess airway for patency. D. Elevate extremities if no fractures are present. E. Administer IVF resuscitation. F. Administer IM pain medication as needed - A, C, D, E Which client should the nurse see first? A. The client with burns to the chest and neck while grilling. B. The client with a burn to her left hand and arm from spilling boiling water. C. The client with a full-thickness burn to the leg from riding his motorcycle. D. The client with a chemical burn to his left leg. - A. The client with burns to the chest and neck while grilling. Review the client's information below and identify the intervention to implement first. Vital Signs Temperature 97.6 orally Heart Rate: 114 Respiratory Rate: 24 Blood Pressure 98/54 Oxygen Saturation 94 on venturi mask Assessment Serous exudate from the wound Lungs clear to auscultation but diminished Urine output 20 ml for the past hours Pain rating a 5 out of 10 A. Administer prescribed antibiotics. B. Increase the IVF per order. C. Encourage the use of the incentive spirometer. D. Administer the PRN pain medication. - B. Increase the IVF per oder. An adult client was burned in a car fire. The client sustained a circumferential burn to the right arm, the anterior torso, and half of the anterior face. What percent of the body was burned using the rule of nines? A. 15.75% B. 27% C. 29.25% D. 31.5% - C. 29.25% Which is the most serious complication for which the nurse must monitor a client with kidney failure? A. Platelet dysfunction B. Hyperkalemia C. Weight loss D. Anemia - B. Hyperkalemia A client who has been receiving hemodialysis for several years is to receive a kidney transplant. What should the nurse say in the client's preoperative teaching plan? Select all that apply. A. The kidney may not function immediately B. Precautions are needed to prevent infection C. A urinary catheter will be in place postoperatively D. The atrioventricular fistula will be used for drawing blood specimens preoperatively E. Immunosuppressive medications will be given a week before surgery - A. The kidney may not function immediately B. Precautions are needed to prevent infection C. A urinary catheter will be in place postoperatively A nurse is caring for a client with chronic kidney failure. What should the nurse teach the client to limit the intake of to help control uremia associated with end stage renal disease (ESRD)? A. Sodium B. Fluid C. Protein D. Potassium - C. Protein A nurse is caring for a client who had a kidney transplant. Which test is most important for determining whether a client's newly transplanted kidney is working effectively? A. Renal scan B. White blood cell (WBC) count C. 24-hour urine output D. Serum creatinine - D. Serum creatinine A client who is to begin continuous ambulatory peritoneal dialysis asks the nurse what this entails. What information should the nurse include when answering the client's question? A. Constant contact is maintained between the dialysate and the peritoneal membrane B. Peritoneal dialysis is performed in an ambulatory clinic C. About a quarter of a liter of dialysate is maintained in the peritoneal cavity D. Hemodialysis and peritoneal dialysis will be done together. - A. Constant contact is maintained between the dialysate and the peritoneal membrane A client develops kidney damage as a result of a transfusion reaction. What is the most significant clinical response that the nurse should assess when determining kidney damage? A. Glycosuria B. Acute flank pain C. Hematuria D. Decreased urinary output - D. Decreased urinary output The nurse would clarify which provider prescription for the client with acute kidney injury in the oliguric phase? A. Normal saline 125 ml/hr continuous intravenous infusion B. Furosemide 40 mg by mouth daily C. Place on a 1500 mg per day sodium restriction D. Decrease protein dietary intake - A. Normal saline 125 ml/hr continuous intravenous infusion [Show Less]
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NCLEX Style Questions Burns, Med Surg-Burns NCLEX Exam Questions & Answers (All Answers Explained!)
NCLEX Style Questions Burns, Med Surg - Burns NCLEX Exam Questions & Answers (All Answers Explained!)-When assessing a patient who spilled hot oil on the r... [Show More] ight leg and foot, the nurse notes that the skin is dry, pale, hard skin. The patient states that the burn is not painful. What term would the nurse use to document the burn depth? a. First-degree skin destruction b. Full-thickness skin destruction c. Deep partial-thickness skin destruction d. Superficial partial-thickness skin destruction - ANS: B With full-thickness skin destruction, the appearance is pale and dry or leathery and the area is painless because of the associated nerve destruction. Erythema, swelling, and blisters point to a deep partial-thickness burn. With superficial partial-thickness burns, the area is red, but no blisters are present. First-degree burns exhibit erythema, blanching, and pain On admission to the burn unit, a patient with an approximate 25% total body surface area (TBSA) burn has the following initial laboratory results: Hct 58%, Hgb 18.2 mg/dL (172 g/L), serum K+ 4.9 mEq/L (4.8 mmol/L), and serum Na+ 135 mEq/L (135 mmol/L). Which action will the nurse anticipate taking now? a. Monitor urine output every 4 hours. b. Continue to monitor the laboratory results. c. Increase the rate of the ordered IV solution. d. Type and crossmatch for a blood transfusion. - ANS: C The patient's laboratory data show hemoconcentration, which may lead to a decrease in blood flow to the microcirculation unless fluid intake is increased. Because the hematocrit and hemoglobin are elevated, a transfusion is inappropriate, although transfusions may be needed after the emergent phase once the patient's fluid balance has been restored. On admission to a burn unit, the urine output would be monitored more often than every 4 hours; likely every1 hour. A patient is admitted to the burn unit with burns to the head, face, and hands. Initially, wheezes are heard, but an hour later, the lung sounds are decreased and no wheezes are audible. What is the best action for the nurse to take? a. Encourage the patient to cough and auscultate the lungs again. b. Notify the health care provider and prepare for endotracheal intubation. c. Document the results and continue to monitor the patient's respiratory rate. d. Reposition the patient in high-Fowler's position and reassess breath sounds. - ANS: B The patient's history and clinical manifestations suggest airway edema and the health care provider should be notified immediately, so that intubation can be done rapidly. Placing the patient in a more upright position or having the patient cough will not address the problem of airway edema. Continuing to monitor is inappropriate because immediate action should occur A patient with severe burns has crystalloid fluid replacement ordered using the Parkland formula. The initial volume of fluid to be administered in the first 24 hours is 30,000 mL. The initial rate of administration is 1875 mL/hr. After the first 8 hours, what rate should the nurse infuse the IV fluids? a. 350 mL/hour b. 523 mL/hour c. 938 mL/hour d. 1250 mL/hour - ANS: C Half of the fluid replacement using the Parkland formula is administered in the first 8 hours and the other half over the next 16 hours. In this case, the patient should receive half of the initial rate, or 938 mL/hr. During the emergent phase of burn care, which assessment will be most useful in determining whether the patient is receiving adequate fluid infusion? a. Check skin turgor. b. Monitor daily weight. c. Assess mucous membranes. d. Measure hourly urine output. - ANS: D When fluid intake is adequate, the urine output will be at least 0.5 to 1 mL/kg/hour. The patient's weight is not useful in this situation because of the effects of third spacing and evaporative fluid loss. Mucous membrane assessment and skin turgor also may be used, but they are not as adequate in determining that fluid infusions are maintaining adequate perfusion. A patient has just been admitted with a 40% total body surface area (TBSA) burn injury. To maintain adequate nutrition, the nurse should plan to take which action? a. Insert a feeding tube and initiate enteral feedings. b. Infuse total parenteral nutrition via a central catheter. c. Encourage an oral intake of at least 5000 kcal per day. d. Administer multiple vitamins and minerals in the IV solution. - ANS: A Enteral feedings can usually be initiated during the emergent phase at low rates and increased over 24 to 48 hours to the goal rate. During the emergent phase, the patient will be unable to eat enough calories to meet nutritional needs and may have a paralytic ileus that prevents adequate nutrient absorption. Vitamins and minerals may be administered during the emergent phase, but these will not assist in meeting the patient's caloric needs. Parenteral nutrition increases the infection risk, does not help preserve gastrointestinal function, and is not routinely used in burn patients. While the patient's full-thickness burn wounds to the face are exposed, what is the best nursing action to prevent cross contamination? a. Use sterile gloves when removing old dressings. b. Wear gowns, caps, masks, and gloves during all care of the patient. c. Administer IV antibiotics to prevent bacterial colonization of wounds. d. Turn the room temperature up to at least 70° F (20° C) during dressing changes. - ANS: B Use of gowns, caps, masks, and gloves during all patient care will decrease the possibility of wound contamination for a patient whose burns are not covered. When removing contaminated dressings and washing the dirty wound, use nonsterile, disposable gloves. The room temperature should be kept at approximately 85° F for patients with open burn wounds to prevent shivering. Systemic antibiotics are not well absorbed into deep burns because of the lack of circulation. A nurse is caring for a patient who has burns of the ears, head, neck, and right arm and hand. The nurse should place the patient in which position? a. Place the right arm and hand flexed in a position of comfort. b. Elevate the right arm and hand on pillows and extend the fingers. c. Assist the patient to a supine position with a small pillow under the head. d. Position the patient in a side-lying position with rolled towel under the neck. - ANS: B The right hand and arm should be elevated to reduce swelling and the fingers extended to avoid flexion contractures (even though this position may not be comfortable for the patient). The patient with burns of the ears should not use a pillow for the head because this will put pressure on the ears, and the pillow may stick to the ears. Patients with neck burns should not use a pillow because the head should be maintained in an extended position in order to avoid contractures. A patient with circumferential burns of both legs develops a decrease in dorsalis pedis pulse strength and numbness in the toes. Which action should the nurse take? a. Notify the health care provider. b. Monitor the pulses every 2 hours. c. Elevate both legs above heart level with pillows. d. Encourage the patient to flex and extend the toes on both feet. - ANS: A The decrease in pulse in a patient with circumferential burns indicates decreased circulation to the legs and the need for an escharotomy. Monitoring the pulses is not an adequate response to the decrease in circulation. Elevating the legs or increasing toe movement will not improve the patient's circulation Esomeprazole (Nexium) is prescribed for a patient who incurred extensive burn injuries 5 days ago. Which nursing assessment would best evaluate the effectiveness of the medication? a. Bowel sounds b. Stool frequency c. Abdominal distention d. Stools for occult blood - ANS: D H2 blockers and proton pump inhibitors are given to prevent Curling's ulcer in the patient who has suffered burn injuries. Proton pump inhibitors usually do not affect bowel sounds, stool frequency, or appetite The nurse is reviewing the medication administration record (MAR) on a patient with partial-thickness burns. Which medication is best for the nurse to administer before scheduled wound debridement? a. Ketorolac (Toradol) b. Lorazepam (Ativan) c. Gabapentin (Neurontin) d. Hydromorphone (Dilaudid) - ANS: D Opioid pain medications are the best choice for pain control. The other medications are used as adjuvants to enhance the effects of opioids. A young adult patient who is in the rehabilitation phase after having deep partial-thickness face and neck burns has a nursing diagnosis of disturbed body image. Which statement by the patient indicates that the problem is resolving? a. "I'm glad the scars are only temporary." b. "I will avoid using a pillow, so my neck will be OK." c. "I bet my boyfriend won't even want to look at me anymore." d. "Do you think dark beige makeup foundation would cover this scar on my cheek?" - ANS: D The willingness to use strategies to enhance appearance is an indication that the disturbed body image is resolving. Expressing feelings about the scars indicates a willingness to discuss appearance, but not resolution of the problem. Because deep partial-thickness burns leave permanent scars, a statement that the scars are temporary indicates denial rather than resolution of the problem. Avoiding using a pillow will help prevent contractures, but it does not address the problem of disturbed body image The nurse caring for a patient admitted with burns over 30% of the body surface assesses that urine output has dramatically increased. Which action by the nurse would best ensure adequate kidney function? a. Continue to monitor the urine output. b. Monitor for increased white blood cells (WBCs). c. Assess that blisters and edema have subsided. d. Prepare the patient for discharge from the burn unit. - ANS: A The patient's urine output indicates that the patient is entering the acute phase of the burn injury and moving on from the emergent stage. At the end of the emergent phase, capillary permeability normalizes and the patient begins to diurese large amounts of urine with a low specific gravity. Although this may occur at about 48 hours, it may be longer in some patients. Blisters and edema begin to resolve, but this process requires more time. White blood cells may increase or decrease, based on the patient's immune status and any infectious processes. The WBC count does not indicate kidney function. The patient will likely remain in the burn unit during the acute stage of burn injury A patient with burns covering 40% total body surface area (TBSA) is in the acute phase of burn treatment. Which snack would be best for the nurse to offer to this patient? a. Bananas b. Orange gelatin c. Vanilla milkshake d. Whole grain bagel - ANS: C A patient with a burn injury needs high protein and calorie food intake, and the milkshake is the highest in these nutrients. The other choices are not as nutrient-dense as the milkshake. Gelatin is likely high in sugar. The bagel is a good carbohydrate choice, but low in protein. Bananas are a good source of potassium, but are not high in protein and calories. A patient has just arrived in the emergency department after an electrical burn from exposure to a high-voltage current. What is the priority nursing assessment? a. Oral temperature b. Peripheral pulses c. Extremity movement d. Pupil reaction to light - ANS: C All patients with electrical burns should be considered at risk for cervical spine injury, and assessments of extremity movement will provide baseline data. The other assessment data are also necessary but not as essential as determining the cervical spine status An employee spills industrial acids on both arms and legs at work. What is the priority action that the occupational health nurse at the facility should take? a. Remove nonadherent clothing and watch. b. Apply an alkaline solution to the affected area. c. Place cool compresses on the area of exposure. d. Cover the affected area with dry, sterile dressings. - ANS: A With chemical burns, the initial action is to remove the chemical from contact with the skin as quickly as possible. Remove nonadherent clothing, shoes, watches, jewelry, glasses, or contact lenses (if face was exposed). Flush chemical from wound and surrounding area with copious amounts of saline solution or water. Covering the affected area or placing cool compresses on the area will leave the chemical in contact with the skin. Application of an alkaline solution is not recommended. A patient who has burns on the arms, legs, and chest from a house fire has become agitated and restless 8 hours after being admitted to the hospital. Which action should the nurse take first? a. Stay at the bedside and reassure the patient. b. Administer the ordered morphine sulfate IV. c. Assess orientation and level of consciousness. d. Use pulse oximetry to check the oxygen saturation. - ANS: D Agitation in a patient who may have suffered inhalation injury might indicate hypoxia, and this should be assessed by the nurse first. Administration of morphine may be indicated if the nurse determines that the agitation is caused by pain. Assessing level of consciousness and orientation is also appropriate but not as essential as determining whether the patient is hypoxemic. Reassurance is not helpful to reduce agitation in a hypoxemic patient A patient arrives in the emergency department with facial and chest burns caused by a house fire. Which action should the nurse take first? a. Auscultate the patient's lung sounds. b. Determine the extent and depth of the burns. c. Infuse the ordered lactated Ringer's solution. d. Administer the ordered hydromorphone (Dilaudid). - ANS: A A patient with facial and chest burns is at risk for inhalation injury, and assessment of airway and breathing is the priority. The other actions will be completed after airway management is assured. A patient with extensive electrical burn injuries is admitted to the emergency department. Which prescribed intervention should the nurse implement first? a. Assess oral temperature. b. Check a potassium level. c. Place on cardiac monitor. d. Assess for pain at contact points. - ANS: C After an electrical burn, the patient is at risk for fatal dysrhythmias and should be placed on a cardiac monitor. Assessing the oral temperature is not as important as assessing for cardiac dysrhythmias. Checking the potassium level is important. However, it will take time before the laboratory results are back. The first intervention is to place the patient on a cardiac monitor and assess for dysrhythmias, so that they can be treated if occurring. A decreased or increased potassium level will alert the nurse to the possibility of dysrhythmias. The cardiac monitor will alert the nurse immediately of any dysrhythmias. Assessing for pain is important, but the patient can endure pain until the cardiac monitor is attached. Cardiac dysrhythmias can be lethal. Eight hours after a thermal burn covering 50% of a patient's total body surface area (TBSA) the nurse assesses the patient. Which information would be a priority to communicate to the health care provider? a. Blood pressure is 95/48 per arterial line. b. Serous exudate is leaking from the burns. c. Cardiac monitor shows a pulse rate of 108. d. Urine output is 20 mL per hour for the past 2 hours. - ANS: D The urine output should be at least 0.5 to 1.0 mL/kg/hr during the emergent phase, when the patient is at great risk for hypovolemic shock. The nurse should notify the health care provider because a higher IV fluid rate is needed. BP during the emergent phase should be greater than 90 systolic, and the pulse rate should be less than 120. Serous exudate from the burns is expected during the emergent phase [Show Less]
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NUR 410 NCLEX Final Comprehensive Exam Questions with Answers (With Explained Rationales)
NUR 410 NCLEX Final Comprehensive Exam Questions with Answers (With Explained Rationales)-The nurse who was responsible for organizing relief efforts for s... [Show More] oldiers during the U.S. Civil War and who was the founder of the American Red Cross was A. Clara Barton. B. Sojourner Truth. C. Mary Breckenridge. - A. Clara Barton Clara Barton was responsible for organizing relief efforts during the U.S. Civil War. In 1882, she successfully persuaded Congress to ratify the Treaty of Geneva, which allowed the Red Cross to perform humanitarian efforts in times of peace. Lavinia Dock was a writer and political activist. Sojourner Truth was an advocate for abolishing slavery and supporting women's rights. Mary Breckenridge developed nursing in rural Kentucky in the 1920s, establishing the Frontier Nursing Service. Which act, established in the 1940s, provided grants to states for the purpose of new construction of health care institutions? A. The Health Amendments Act B. The Hill-Burton Act C. The Tax Equity and Fiscal Responsibility Act D. The McCarren-Ferguson Act - B. The Hill-Burton Act The Hill-Burton Act of 1946 provided grants to states for the construction of new hospitals, targeting low income and rural areas. The McCarren-Ferguson Act gave states the right to regulate health insurance plans. The Health Amendments Act authorizes funds for registered nurse education in administration, supervision, or teaching. The Tax Equity and Fiscal Responsibility Act established the prospective payment system for Which is the correct process a bill must take before final approval by the president? a. A bill must go through discussion by the Supreme Court and then be submitted for final approval by the president. b. A bill must succeed through the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. c. A bill must be approved by the House and Senate and then go before a committee before being submitted for final approval by the president. d. A bill must succeed through one of the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. - D. A bill must succeed through the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. a. A bill must go through discussion by the Supreme Court and then be submitted for final approval by the president. b. A bill must succeed through the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. 1. The bill must succeed through both legislative bodies, the House of Representatives and the Senate. The Supreme Court is not involved in creating legislation. A bill goes before a committee before going to either legislative body. c. A bill must be approved by the House and Senate and then go before a committee before being submitted for final approval by the president. d. A bill must succeed through one of the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. Decisions on public policy are made by which part of the federal government? 1. Legislative, executive, or judicial branches of the government 2. Only the executive branch (president, governor, mayor) 3. Supreme Court 4. House of Representatives and Senate - 1. Legislative, executive, or judicial branches of the government Public policy refers to decisions made by legislative, executive, or judicial branches at the local, state, or federal levels of government. A statement of a decision regarding a goal in health care and a plan for achieving that goal is called A. nursing policy. B. fiscal policy. C. social policy. D. health policy. - D. health policy Health policy is a statement of a decision regarding a goal in health care and a plan for achieving that goal. Nursing policy specifies nursing leadership that influences and shapes health policy and nursing practice. Fiscal policy is related to finance. Social policy is policy associated with individuals and communities. Groups such as professional organizations, nonprofit health care organizations, and corporations that sponsor health care are/is called A. the public sector. B. the private sector. C. stakeholders. D. field experts. - the private sector. The private sector includes employers, professional organizations (e.g., American Hospital Association), nonprofit health care organizations (e.g., American Heart Association), and for-profit corporations that deliver, insure, or fund health care services outside government control. The public sector is concerned with providing government services. A stakeholder is one who can affect or be affected by the actions of an organization as a whole. An expert is one who has extensive knowledge or skill in a particular field. The Health Resources and Services Administration (HRSA) assists nursing workforce development by A. establishing schools of nursing. B. supporting organizations with a political agenda for health care. C. providing federal funds to promote health care reform. providing grants to provide for education and recruitment. - providing grants to provide for education and recruitment. The nursing workforce development programs administered by the HRSA through Title VIII provide federal support for nurses' workforce development. The HRSA does not establish nursing schools but provides federal funding for nursing education at the undergraduate and graduate levels and favors institutions that educate nurses for practice in rural and medically underserved communities. The other options do not assist nursing workforce development. A person who acts as a representative for another person or organization before the legislature is called a(n) A. advocate. B. policy maker. C. lobbyist. D. field expert. - C. lobbyist A lobbyist is a person, who voluntarily or for a fee, represents him- or herself, or another individual, organization, or entity for the purpose of influencing policy or legislation. An advocate is a person who supports a cause or policy. A policy maker is one who creates policies. An expert is one who has extensive knowledge or skill in a particular field. Political action committees (PAC) are formed by professional organizations, business, or labor groups for the purpose of A. attracting candidates who are sympathetic to particular health care issues. B. lobbying legislation about health policies. C. being an advocate for health care reform. D. providing financing to professional organizations. - attracting candidates who are sympathetic to particular health care issues. PACs are nonpartisan entities that promote the election of candidates believed to be sympathetic to their interests. The purpose of specific PACs could be to promote certain health care issues or health care reform or to obtain financing for certain professional organizations. Nurses' involvement in policy can be achieved by (Select all that apply.) A. conducting and supporting health policy research. B. avoiding discussions that involve health policy that may be controversial. C. working with health care professionals to influence change in the quality of health care. D. writing letters to educate legislators about health care issues. E. monitoring the quality ratings of health care organizations and suggesting changes that would improve care. - A. conducting and supporting health policy research. C. working with health care professionals to influence change in the quality of health care. D. writing letters to educate legislators about health care issues. E. monitoring the quality ratings of health care organizations and suggesting changes that would improve care. Nurses can support and use nursing research that demonstrates positive clinical and economic outcomes. This would serve to validate the importance of nursing within the health system. External strategies that nurses can use to influence private health policy include participation in discussion regarding quality and managed care. Nurses should work cooperatively with other health professions to influence managed care organizations to improve quality of care. Nurses should monitor the quality ratings of health care organizations and suggest changes that would improve care. Writing letters to legislators is a direct way to communicate opinions and concerns. Avoiding controversial discussions on health policy, however, will not foster positive changes. Which prospective payment method determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare? A. Current procedural terminology codes B. Actuarial classifications C. Diagnosis-related groups D. Medigap insurance - C. Diagnosis-related groups For determination of the prospective amount, Medicare depended on the diagnosis-related groups to calculate the reimbursement. Physician services are coded according to current procedural terminology codes. Actuarial classifications ensured that adequate premiums were charged by private health insurers for the projected health care needs of those enrolled. Medigap insurance is a privately purchased individual or group health insurance plan designed to supplement Medicare coverage. Access to health care is determined by the circumstances of the individual that obstruct the means to obtain desired health care. Which is not a barrier to health care access? A. Preexisting conditions B. Nonparticipating physician C. Inability to communicate D. Personal avoidance of a health problem - D. Personal avoidance of a health problem Any condition that prevents an individual from seeking desired health care presents a barrier. Chosen avoidance is not a barrier. In a managed care organization, physicians are responsible for the approval or referral of some services. In this position, they are referred to as A. enforcers. B. gatekeepers. C. carriers. D. distributors. - B. gatekeepers Some services may only be accessed on approval or referral from physicians who are called gatekeepers (the primary care providers). The other options do not pertain to the referral or approval of services by a physician. The early Blue Cross and Blue Shield plan was an example of a/an A. health maintenance organization. B. prospective payment plan. C. indemnity plan. D. cafeteria plan. - a demand for complex and advanced services The early Blue Cross and Blue Shield plan was an example of an indemnity plan. This plan paid all of the costs of covered services provided to the enrollee. The enrollee enjoyed free choice of provider and services. Indemnity plans preserved the enrollee's right of choice and allowed the person to manage his or her own health care. A health maintenance organization is a managed care plan that acts as an insurer and sometimes a provider for a fixed prepaid premium. Prospective payment is payment for health care providers based on the disease or injury that is treated. Cafeteria plans are customizable health care plans. A major cause for the rise in health care costs is A. an increase in the specialization of physicians. B. a decrease in nonprofit hospitals. C. a shortage in the number of primary care physicians. D. a demand for complex and advanced services. - D. a demand for complex and advanced services. The spiraling health care costs, starting from the mid-1960s and persisting into the twenty-first century, were fueled by the presence of very rapid technological advances, society's sense of entitlement to these therapies, a guaranteed payer, and the prevailing medical orientation toward curative measures. The number of physicians or hospitals is not a primary contributor to rising health care costs. [Show Less]
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