FUNDAMENTALS OF NURSING,10th and 11TH EDITION POTTER WITH ... - $40.45 Add To Cart
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Fundamentals of Nursing 10th Edition Potter Perry Test Bank WITH ALL CHAPTERS INCLUDED MULTIPLE CHOICE 1. Contemporary nursing practice is ba... [Show More] sed on knowledge generated through nursing theories. Florence Nightingales theory introduced the concept that nursing care focuses on: 1 Psychological needs 2 A maximal level of wellness 3 Health maintenance and restoration 4 Interpersonal interactions with the client ANS: 3 Florence Nightingale believed the role of the nurse was to put the clients body in the best state in order to remain free of disease or to recover from disease. Although Florence Nightingale may have addressed meeting the psychological needs of her clients, it is not the focus of her theory. The goal of Nightingales theory is to facilitate the bodys reparative processes by manipulating the clients environment. Florence Nightingale thought the human body had reparative properties of its own if it was cared for in a way to recover from disease. Her theory did not focus on achieving a maximal level of wellness. Florence Nightingale believed the nurse was in charge of the clients health. Although she interacted with her clients by reading to them, her theory of nursing care did not focus upon interpersonal interactions. DIF: A REF: 2 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 2. Nursing education programs in the United States may seek voluntary accreditation by the appropriate accrediting commission council of the: 1 National League for Nursing 2 American Nurses Association 3 Congress for Nursing Practice 4 International Council of Nurses ANS: 1 The National League for Nursing (NLN) is the professional nursing organization concerned with nursing education. The NLN provides accreditation to nursing programs that seek and meet the NLN accreditation requirements. The American Nurses Association (ANA) is concerned with the nursing profession and issues affecting health care, including standards of care. The Congress for Nursing Practice is the part of the ANA concerned with determining the legal aspects of nursing practice, the public recognition of the importance of nursing, and the impact of trends in health care on nursing practice. The International Council of Nurses (ICN) is concerned about issues of health care and the nursing profession, including the provision of an international power base for nurses. DIF: A REF: 8 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 3. The minimum educational requirement for a nurse practitioner is: 1 Diploma in nursing 2 Masters in nursing 3 Doctorate in nursing 4 Baccalaureate in nursing ANS: 2 A masters degree is nursing is required to become a nurse practitioner. Diploma programs in nursing require 3 years of education after which the graduate may become a registered nurse, but not a nurse practitioner. Doctoral programs focus on the application of research findings to clinical practice. The doctoral degree is beyond the masters degree. The baccalaureate degree program generally requires 4 years of study in a college or university, after which the graduate may become a registered nurse, not a nurse practitioner. DIF: A REF: 8 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 4. A group that lobbies at the state and federal level for advancement of nursings role, economic interest, and health care is the: 1 State Board of Nursing 2 American Nurses Association 3 American Hospital Association 4 National Student Nurses Association ANS: 2 The American Nurses Association (ANA) hires lobbyists at the state and federal level to promote the advancement of health care and the economic and general welfare of nurses. State Boards of Nursing primarily focus on licensure of nurses within their own state. The American Hospital Association does not focus on nurses economic issues and the advancement of the role of nurses. The National Student Nurses Association focuses on issues of importance for nursing students. DIF: A REF: 8 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 5. A nurse moves from Seattle to Boston and begins working in a hospital. The most important factor for the nurse to consider when moving to another state is the: 1 Massachusetts Nurse Practice Act 2 Standard for nursing practice in Boston 3 Clinical ladder of mobility in the new hospital 4 Requirement for continuing education units (CEU) in Massachusetts ANS: 1 Although most states have similar practice acts, each individual state has its own Nurse Practice Act that regulates the licensure and practice of nursing within that state. Knowledge of the Nurse Practice Act is necessary to provide safe and legal nursing care. Standards of nursing practice are not specific to a city, but rather to the profession itself. Although the clinical ladder of mobility may be of interest in regard to professional advancement, it is not the most important factor when practicing nursing in another state. Knowledge of the Nurse Practice Act in order to provide safe and legal nursing care is of higher importance. Regardless of where a nurse practices, the nurse should strive to remain current. DIF: C REF: 8 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 6. A nurse is caring for a client who has chronic renal failure. The nurse states, We will do everything possible to return you to the optimum level of self-care possible. In coordinating an approach to best meet the needs of this client, the nurse is fulfilling the role of: 1 Manager 2 Educator 3 Counselor 4 Communicator ANS: 1 The nurse, in caring for this client, will coordinate the activities of other members of the health care team. This client may require the assistance of a nursing assistant to provide personal care until the client is less fatigued. A nutritionist may be necessary for diet evaluation, planning, and teaching. A nurse may provide education on the dialysis therapy and perform the skill necessary until the client is able to do so independently. The nurse may include patient teaching in the clients care, but more is required to meet the needs of this client. The nurse is not performing in the role of counselor. Clear communication will be necessary for the client to understand self-care measures regarding dialysis. The role of communicator does not, however, entirely meet the clients physical needs at this time. DIF: A REF: 10 OBJ: Comprehension TOP: Nursing Process: Planning MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 7. Nurses have the opportunity to work in a wide variety of health care agencies around the world. The practice setting where the majority of nurses continue to work is: 1 Acute care 2 Home care 3 Long-term care 4 Ambulatory care ANS: 1 Most nurses provide direct client care in the hospital setting. Although opportunities for providing patient care in the clients home are increasing, the majority of nurses are not employed in this setting. The majority of nurses do not work in nursing homes or extended care settings. Significantly fewer nurses work in an ambulatory care setting. DIF: A REF: 10 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 8. A client is receiving Dilantin to prevent seizure activity. To which allied health care professional should the nurse refer this client in order to minimize the challenges this condition creates? 1 Physical therapist 2 Physicians assistant 3 Respiratory therapist 4 Occupational therapist ANS: 4 An occupational therapist is a person who provides assessment and intervention to ameliorate physical and psychological deficits that interfere with the performance of activities and tasks of living, including ones employment. A physical therapist is responsible for the patients musculoskeletal system. A physical therapist may use exercises as an intervention to improve a clients mobility. A respiratory therapist provides treatment to preserve or improve pulmonary function. A physicians assistant performs tasks usually done by physicians and works under the direction of a supervising physician. DIF: C OBJ: Analysis TOP: Nursing Process: Planning MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 9. The Goldmark Report concluded that: 1 Nursing roles and responsibilities required clarification 2 A theory-based curriculum was necessary for accreditation 3 Nursing education programs must be affiliated with universities 4 Increased financial support should be provided for nursing education ANS: 4 In 1923 the Goldmark Report identified the need for increased financial support to university- based schools of nursing. The National Commission on Nursing and Nursing Education Report of 1965 recommended that nursing roles and responsibilities be clarified in relation to other health care professionals. In 1975 the National League for Nursing required theory-based curriculum for accreditation. The Brown Report of 1948 concluded that all nursing education programs should be affiliated with universities and should have their own budgets. DIF: A REF: 3 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 10. In 1893 Lillian Wald and Mary Brewster made significant contributions to the nursing profession through their work involving the: 1 Henry Street Settlement in New York 2 First training school in Toronto, Canada 3 Training school at Johns Hopkins in Baltimore 4 Development of the American Journal of Nursing ANS: 1 In 1893 Lillian Wald and Mary Brewster opened the Henry Street Settlement, which was the first community health service for the poor. The first nurses training school in Canada was founded in St. Catherines, Ontario, in 1874. In 1894 Isabel Hampton Robb was the first superintendent of the Johns Hopkins Training School in Baltimore, Maryland. Isabel Hampton Robb was one of the original founders of the American Journal of Nursing. DIF: A REF: 3 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 11. To obtain a certification in a specialty area, the nurse will have to complete: 1 A request for state approval 2 A graduate degree in nursing 3 An examination and the minimum practice requirements 4 A general examination given to all nurses seeking certification ANS: 3 Set minimum practice requirements are based on the certification the nurse is seeking. After passing the initial examination, the nurse maintains certification by ongoing continuing education and clinical or administrative practice. Individual states do not grant certification by request. Certification in a specialty area requires passing the examination for certification in that area and meeting minimum practice requirements. A masters degree in nursing is not required for certification in a specialty area. A specialized examination is given according to the specific area of nursing practice in which certification is being sought. DIF: A REF: 9 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 12. In the ANA Standards of Professional Performance, which one of the following is a specific measurement criterion for The nurses decisions and actions on behalf of clients are determined in an ethical manner? 1 Acts as client advocate 2 Participates in the collection of client data 3 Seeks experiences to maintain clinical skills 4 Consults with appropriate health care providers ANS: 1 As a client advocate, the nurse protects the clients human and legal rights and provides assistance in asserting those rights if the need arises. Performing in the role of patient advocate fulfills a measurement criterion for the professional performance standard of ethics. Participating in data collection is a measurement criterion for the professional performance standard of quality of practice. The nurse who seeks experiences to maintain clinical skills is fulfilling a measurement criterion for the professional performance standard of education. Consulting with health care providers is a measurement criterion for the professional performance standard of collaboration. 13. In looking at the nineteenth century, the growth of professional nursing was stimulated by: 1 The Civil War 2 Federal legislation 3 Florence Nightingale 4 The womens suffrage movement ANS: 1 The Civil War stimulated the growth of nursing in the United States. Nurses were in demand to tend to the soldiers of the battlefield. Throughout history, nurses and their professional organizations have lobbied for health care legislation to meet the needs of clients. However, legislation was not responsible for the growth of nursing in the nineteenth century. Although Florence Nightingale had great impact on the practice of nursing, she was not the cause for the growth of nursing in the United States during the nineteenth century. The womens movement has encouraged nurses to seek greater autonomy and responsibility in providing care, and has caused female clients to seek more control of their health and lives. The womens movement was not responsible for the growth of nursing in the nineteenth century. DIF: A REF: 3 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 14. Which of the following educational activities is an example of in-service education? 1 A workshop given at a nursing convention on malpractice 2 A program on new cardiac medications provided at a local hospital 3 Credit courses in communication offered at the community college 4 Noncredit courses on nursing issues available through the internet ANS: 2 An in-service education program is instruction or training provided by a health care agency or institution for its employees. A workshop at a nursing convention is an example of a continuing education program. Credit courses at a college are examples of continuing education that could possibly by applied toward furthering ones degree. Noncredit courses offered via the internet are an example of a continuing education program. 15. Nurses need to be aware of current trends in the health care delivery system in order to respond in educational preparation and practice. A major trend that is influencing nursing practice today is: 1 Decreased client acuity 2 Increased hospital stays 3 Decreased emphasis on health promotion 4 Increased incidence of chronic disease processes ANS: 4 In recent decades, there is a higher incidence of chronic, long-term illness. With shortened hospital stays, client acuity has increased, not decreased. Hospital stays have decreased, not increased. Lengths of stay have shortened with a trend toward home care, and health promotion and illness prevention. With increased public awareness and rising health care costs, greater emphasis has been placed on health promotion and illness prevention. DIF: A REF: 4 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 16. The nurse assists the client in a health promotion activity that also reduces the cost of health care delivery when: 1 Administering medication 2 Treating a diabetic foot ulcer 3 Obtaining an operative consent 4 Discussing exercise and nutrition ANS: 4 The nurse may educate the client in such areas as exercise, nutrition, and healthy lifestyles to assist the client in health promotion and illness prevention. By administering medication, the nurse is assisting to restore a person to health or maintain ones health. A nurse who treats a foot ulcer is assisting a client to restore their health, rather than promoting healthy behaviors. Obtaining an operative consent pertains to legal aspects of care and is not considered a health promotion activity. DIF: A REF: 5 OBJ: Comprehension TOP: Nursing Process: Planning 17. The nurse is best able to provide quality care that benefits both client and family by: 1 Incorporating caring into the practice 2 Making the client the center of the practice 3 Integrating the science and art of nursing into the practice 4 Being knowledgeable of the institutions standards of practice ANS: 3 Nursing is an art and a science. As a professional nurse you will learn to deliver care artfully with compassion, caring, and a respect for each clients dignity and personhood. As a science, nursing is based on a body of knowledge that is continually changing with new discoveries and innovations. When you integrate the science and art of nursing into your practice, the quality of care you provide to your clients is at a level of excellence that benefits clients and their families. Caring is one part of the art of nursing. While the client is the focus of nursing practice, this focus is not the main contributor to quality care. Standards of care provide guidelines for the delivery of client care. Awareness of the standards does not guarantee quality care. DIF: C REF: 2 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 18. Which of the following statements best reflects Nightingales nursing philosophy on health maintenance and restoration? 1 Did all the clients eat a good breakfast? 2 What is the client rating his pain level after his medication? 3 Have any clients developed a nosocomial infection last month? 4 Is anyone interested in volunteering to mentor our new graduates? ANS: 3 Florence Nightingale studied and implemented methods to improve battlefield sanitation, which ultimately reduced illness, infection, and mortality (Cohen, 1984). Today nurses are active in determining the best practices for skin care management, pain control, nutritional management, and care of older adults. Infection control and its impact on disease prevention was a major outcome of her contributions to nursing. Awareness of the connection between hospital-acquired infections (nosocomial) and nursing practice is the best example of her nursing philosophy. Nutritional management and its impact on client health, while important does not reflect the best option offered. Pain management while a vital client concern does not represent the best option offered While volunteering is certainly reflected in Nightingales practice it is not the best option offered. DIF: C REF: 2-3 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance/Disease Prevention 19. The twentieth century is recognized for which of the following nursing concepts? 1 Code of Nursing Ethics 2 Hospital-based nursing care 3 Specialized nursing textbooks were adopted. 4 Formalized university-based nursing education ANS: 4 In the early twentieth century a movement toward a scientific, research-based defined body of nursing knowledge and practice was evolving. Nurses began to assume expanded and advanced practice roles. Mary Adelaide Nutting was instrumental in the affiliation of nursing education with universities. In 1990 the American Nurses Association established the Center for Ethics and Human Rights. Nursing in hospitals expanded in the late nineteenth century. Isabel Hampton Robb helped found the Nurses Associated Alumnae of the United States and Canada in 1896. This organization became the American Nurses Association (ANA) in 1911. She authored many nursing textbooks, including Nursing: Its Principles and Practice for Hospital and Private Use (1894), Nursing Ethics (1900), and Educational Standards for Nurses (1907), and was one of the original founders of theAmerican Journal of Nursing (AJN). DIF: A REF: 4 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment 20. The best example of the impact of the womens movement on health care is: 1 Improvement in breast cancer survival rates 2 Insurance coverage for well-woman check-ups 3 Women subjects to be included in all appropriate health research projects 4 A single, teenage mother receiving Women, Infants, and Children (WIC) benefits ANS: 3 The womens movement brought about many changes in society as women increasingly demanded economic, political, occupational, and educational equality. As a result, there is greater sensitivity to the health care needs of women and the role of women in health care research. There are emerging health care specialties dealing with the needs of women. These new specialties expand from the traditional obstetrical specialty and address issues ranging from well- womens examinations, to oncological subspecialties, to the management of menopause. Because of the prior lack of female subjects in biomedical research, the federal government now requires studies to routinely include women in research, unless specific exception criteria are met. For example, research focusing on management of prostatic cancer is an exception. Improved survival rates for female-oriented cancers is evident because of emphasis being placed on research. While important, increased insurance coverage is not the best option available because this action would be directly driven by research findings. While important, increased federal funding for female-oriented benefits does not represent the best option available because this action would be directly driven by research findings. DIF: C REF: 4 OBJ: Analysis TOP: Nursing Process: Comprehension MSC: NCLEX test plan designation: Health Promotion and Maintenance 21. The human rights movement most directly impacts nursing practice because: 1 Nurses act as advocates for all clients 2 Clients require someone to focus on their needs 3 Caring for clients is the focus of nursing practice 4 Everyone deserves to be treated fairly and with respect ANS: 1 Client advocacy is a nursing responsibility. The human rights movement changed the way society views the rights of all of its members, including minorities, clients with terminal illness, pregnant women, and older adults. Many groups have special health care needs, and nursing responds by respecting the human rights of all clients and their right to quality care. Nurses advocate the rights of all clients. Clients do require someone to focus on their needs; advocacy is a responsibility of the nurse but the concept of the nurse as an advocate was established well before the human rights movement. Caring for clients is the focus of nursing practice, but caring physically and emotionally for a client as a nursing responsibility was established well before the human rights movement. Everyone deserves to be treated fairly and with respect. The realization of that truth was impacted by the human rights movement; however, this option does not directly relate to nursing. DIF: C REF: 4-5 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care 22. Nurses are caring for clients from a variety of cultures primarily as a result of: 1 Increased ease of travel and mobility 2 Political unrest in many foreign countries 3 Increased incidence of contagious diseases 4 Poor health care in underdeveloped countries ANS: 1 Because the worlds population is more mobile, both immigration and travel have shown an increase over the last decades. Nursing practice will require the management and delivery of care for clients from many different cultures. Although immigration to this country has been impacted by political strife in other countries, it is not the primary factor in an increasingly culturally diverse client population. Increased incidence of contagious diseases has little impact on the cultural diversity of the client population. Although poor health care services may contribute to some influx of foreign clients, it is not the primary factor in an increasingly culturally diverse client population. DIF: C REF: 5 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity 23. Risk for injury during client transfer is minimized most effectively by: 1 Implementation of lift teams 2 Yearly personnel training sessions 3 Using mechanical lifts when possible 4 Use of evidence-based techniques ANS: 4 Injuries to both caregiver and client occur during client transfer. The caregiver is at risk for musculoskeletal injuries. The client is at risk for falls as well as musculoskeletal injuries. There is a shift from ineffective, injury-prone client transfer techniques to evidence-based practices for safe client handling. The implementation of a lift team is directly supported by evidence-based research (EBR). Yearly training sessions are important but the specific training is determined first by EBR. The use of mechanical lifts is directly supported by evidence-based research (EBR). DIF: C REF: 6 OBJ: Analysis TOP: Nursing Process: Planning MSC: NCLEX test plan designation: Safe, Effective Care Environment/Accident Prevention MULTIPLE RESPONSE 1. Which of the following activities reflect the nurses role in health promotion and wellness? (Select all that apply.) 1 Screening the local homeless population for head lice 2 Monitoring blood pressures at a community health fair 3 Organizing a foot race to benefit national cancer research 4 Consulting a teenage mother on breast-feeding techniques 5 Providing literature on smoking cessation to client families 6 Presenting a nursing workshop on the care of diabetic ulcers ANS: 1, 2, 4, 5 Nursing responds to this greater concern for health promotion by providing programs in the community such as health fairs and wellness programs; educational programs for specific diseases; and client and family teaching activities in hospitals, clinics, primary care facilities, and other health care settings. While admirable, organizing a benefit for cancer research is not an activity directed towards health promotion and wellness but rather towards research that will benefit the population as a whole rather than specific individuals. Presenting a workshop on a specific nursing intervention is not an activity directed toward health promotion and wellness but rather towards professional development of the nurses. DIF: A REF: 5 OBJ: Comprehension TOP: Nursing Process: Planning MSC: NCLEX test plan designation: Health Promotion and Maintenance/Programs 2. Changes in recent population demographics that have impacted the delivery of nursing care include the following: (Select all that apply.) 1 Increased birth rates 2 Increased life expectancy 3 Decreasing rural population 4 Expanding urban settlement 5 Advances in medical modalities 6 Availability of free public education ANS: 2, 3, 4 Demographic changes affect the population. Changes influencing health care in recent decades include the population shift from rural areas to urban centers; the increased life span; the higher incidence of chronic, long-term illness; and the increased incidence of diseases such as alcoholism and lung cancer. Nursing responds to such changes by exploring new methods to provide care, by changing educational emphases, and by establishing practice standards. Recent birth rates have declined. Advances in medical modalities and availability of free public education do not reflect changes in population demographics but rather health care advances and social services. MULTIPLE CHOICE 1. Regulatory interventions were initiated to reduce the rise in health care costs. These interventions include: 1 Prospective payment systems 2 State limits on health care fees 3 Federal guidelines for treatment 4 Court review of insurance coverage ANS: 1 As a means to reduce health care costs, in 1983 Congress established the prospective payment system in which hospitals are reimbursed a set dollar amount for each diagnosis-related group, regardless of the length of stay or use of services in the hospital. State limits on health care fees have not been used nationwide to reduce health care costs. Federal guidelines for treatment have not been used to reduce the cost of health care. Rather, the focus has been on financial reimbursement. Court review of insurance coverage has not been a primary intervention to lower health care costs. DIF: A REF: 16 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 2. Levels of prevention are used by the nurse to provide a framework or guide for nursing interventions. Focus is based on the clients needs and the care or service that is provided. An example of a true health promotion service is a(n): 1 Aerobic dance class 2 Immunization clinic 3 Diabetic support group 4 Smoking cessation clinic ANS: 1 Examples of health promotion activities include exercise classes, prenatal care, well-baby care, nutrition counseling, and family planning. An immunization clinic is an example of an illness prevention service. A diabetic support group may be an example of a rehabilitation service to adapt to a change in lifestyle. A smoking cessation clinic may be a part of rehabilitation or offered as an illness prevention service. DIF: A REF: 19 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 3. There are many types of health care delivery agencies. An example of a secondary level care agency is a: 1 School 2 Nursing home 3 Drug rehabilitation center 4 State-owned psychiatric hospital ANS: 4 A state-owned psychiatric hospital is an example of the secondary level of care in which clients who present with signs and symptoms of disease are diagnosed and treated. A school is an example of preventive or primary care. A nursing home is an example of continuing care. A drug rehabilitation center is an example of restorative care. DIF: A REF: 20 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 4. Which of the following fits within the occupational safety and health categories? 1 Noise exposure 2 Firearms safety 3 Swimming lessons 4 Motorcycle helmets ANS: 1 Exposure to environmental hazards within the workplace, such as noise exposure, is one aspect of occupational safety and health. Firearms do not fit within the occupational safety and health category. Swimming lessons do no fit within the occupational safety and health category. Motorcycle helmets do not fit within the occupational safety and health category. DIF: A REF: 20 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 5. A contractual agreement between a hospital and a corporation to pay the health care expenses of the corporations employees is an example of a(n): 1 PPO 2 HMO 3 Private insurance 4 Third-party payment ANS: 1 A preferred provider organization (PPO) is characterized by a contractual agreement between a set of providers (e.g., hospitals, physicians, or clinics) and a purchaser (e.g., the corporations insurance plan). Comprehensive health services are provided at a discount to the companies under contract. Enrollees are limited to a list of preferred hospitals, physicians, and providers. An enrollee pays more out-of-pocket expenses for using a provider not on the list. A Medicare HMO is the same as a managed care organization (all care provided by a primary care physician) but designed to cover costs of senior citizens. Private insurance is the traditional fee-for-service plan where payment is computed after services are provided based on the number of services used. Third-party payment is when an entity (other than the client or health care provider) reimburses health care expenses. Third-party payers include insurance companies, governmental agencies, and employers. DIF: A REF: 18 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 6. The Medicaid insurance program is best described as: 1 Acute care hospital insurance for the older adult population 2 A funded health care program for older and disabled persons 3 A state-regulated health care program for persons of low income 4 A fee-for-service insurance plan that supports preventive health care ANS: 3 Medicaid is a federally funded, state-operated program of medical assistance to people with low incomes. Individual states determine eligibility and benefits. This option describes Medicare. This option describes Medicare Part A. This option does not describe Medicaid. DIF: A REF: 18 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 7. Quality health care is an innovative approach to delivering health care. The major factor for its success is that it: 1 Focuses on the nursing process 2 Uses outcomes to manage client care 3 Is used exclusively in the acute care setting 4 Allows a high degree of flexibility delivering the care ANS: 2 Health care providers are defining and measuring quality in terms of outcomes. An outcome is a measure of what actually does or does not happen as a result of a process of care. The focus in quality health care is on the outcome, not the process. Quality health care is not used exclusively in the acute care setting. It may be used in various health care settings. Because quality health care is based on achieving outcomes, it does not allow a high degree of flexibility for the nurse in delivering care. DIF: A REF: 27 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 8. Case management is one strategy for coordinating health care services. What best describes this caregiving approach? 1 Continuity of care is the primary concern. 2 This focus of care may be more expensive. 3 The physician is the coordinator of client care. 4 It is designed to provide minimal to moderate levels of care. ANS: 1 With the case management model of care, the case manager coordinates the efforts of all disciplines to achieve the most efficient and appropriate plan of care. Continuity of care is of primary importance. If the efforts of all disciplines are well managed, repetition or delays may be avoided with a resultant shortened hospital stay. Therefore this focus of care may not be more expensive. The physician may or may not be the coordinator of client care. The case manager typically is a nurse or social worker. Case management is not entirely based on the level of care required. DIF: A REF: 21 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care/ Case Management 9. The payment mechanism that Medicare uses within its health care financing is: 1 Capitation 2 Fixed payments 3 Direct contracting 4 Prospective payment ANS: 2 Inpatient hospital services for Medicare clients are reimbursed a set amount for each DRG, regardless of the clients length of stay or use of services in the hospital. Capitation is the payment mechanism in which providers receive a fixed amount per enrollee of a health care plan. The payment mechanism that Medicare uses is not direct contracting. Medicare is not based on fixed payments, but rather on a set dollar amount according to the DRG. DIF: A REF: 27 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 10. A student nurse visiting a nurse-managed clinic should expect to see which of the following services offered? 1 Physical therapy 2 Same-day surgery 3 Family support services 4 Ongoing psychiatric therapy ANS: 3 Nurse-managed clinics focus on health promotion and health education, disease prevention, chronic disease management, and support for self-care and caregivers. Physical therapy is not typically offered in a nurse-managed clinic. Same-day surgery is not offered in a nurse-managed clinic. Psychiatric therapy is not offered in a nurse-managed clinic. DIF: A REF: 21 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 11. A disabled client requiring restorative care should be referred to a(n): 1 Nursing home 2 Subacute care unit 3 Home health care agency 4 Ambulatory health center ANS: 3 A home health care agency provides health services to individuals and families in their home to promote, maintain, or restore health, or to maximize the level of independence while minimizing the effects of disability and illness. A nursing home is a long-term care setting in which clients receive 24-hour intermediate and custodial care. A subacute care unit is not the best referral for restorative care. An ambulatory health center is not the best referral for restorative care. DIF: A REF: 16 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care 12. Which of the following is an appropriate referral for an older client who requires some assistance with daily activities within a partially protective environment? 1 Respite care 2 Extended care 3 Assisted living 4 Rehabilitative care ANS: 3 The appropriate response is assisted living. A group of residents live together, each resident having his or her own room, yet sharing dining and social activity areas. Respite care is a service that provides short-term relief for persons providing home care to the ill or disabled. An extended care facility provides intermediate medical, nursing, or custodial care for clients recovering from acute or chronic illness or disabilities. [Show Less]
Fundamentals of Nursing, 11th Edition Potter WITH ALL CHAPTERS INCLUDED Chapter 01: Nursing Today Potter: Fundamentals of Nursing, 11th Edit... [Show More] ion MULTIPLE CHOICE 1. Which nurse most likely kept records on sanitation techniques and the effects on health? a. Florence Nightingale b. Mary Nutting c. Clara Barton d. Lillian Wald ANS: A Nightingale was the first practicing nurse epidemiologist. Her statistical analyses connected poor sanitation with cholera and dysentery. Mary Nutting, Clara Barton, and Lillian Wald came after Nightingale, each contributing to the nursing profession in her own way. Mary Nutting was instrumental in moving nursing education into universities. Clara Barton founded the American Red Cross. Lillian Wald helped open the Henry Street Settlement. DIF:Understand (comprehension) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Evaluation MSC: Health Promotion and Maintenance 2. The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of nursing practice is the nurse following? a. Assessment b. Diagnosis c. Planning d. Implementation ANS: C In planning, the registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. During assessment, the registered nurse collects comprehensive data pertinent to the patient’s health and/or the situation. In diagnosis, the registered nurse analyzes the assessment data to determine the diagnoses or issues. During implementation, the registered nurse implements (carries out) the identified plan. DIF:Understand (comprehension) OBJ:Discuss the development of professional nursing roles. TOP: Planning MSC: Management of Care 3. An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor? a. Novice b. Proficient c. Competent d. Advanced beginner ANS: A A beginning nursing student or any nurse entering a situation in which there is no previous level of experience (e.g., an experienced operating room nurse chooses to now practice in home health) is an example of a novice nurse. A proficient nurse perceives a patient’s clinical situation as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from multiple previous experiences to a situation. A competent nurse understands the organization and specific care required by the type of patients (e.g., surgical, oncology, or orthopedic patients). This nurse is a competent practitioner who is able to anticipate nursing care and establish long-range goals. A nurse who has had some level of experience with the situation is an advanced beginner. This experience may only be observational in nature, but the nurse is able to identify meaningful aspects or principles of nursing care. DIF:Apply (application) OBJ:Discuss the development of professional nursing roles. TOP: Evaluation MSC: Management of Care 4. A nurse assesses a patient’s fluid status and decides that the patient needs to drink more fluids. The nurse then encourages the patient to drink more fluids. Which concept is the nurse demonstrating? a. Licensure b. Autonomy c. Certification d. Accountability ANS: B Autonomy is an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders. To obtain licensure in the United States, the RN candidate must pass the NCLEX-RN. Beyond the NCLEX-RN, the nurse may choose to work toward certification in a specific area of nursing practice. Accountability means that you are responsible, professionally and legally, for the type and quality of nursing care provided. DIF:Apply (application) OBJ:Discuss the roles and career opportunities for nurses. TOP: Implementation MSC: Management of Care 5. A nurse prepares the budget and policies for an intensive care unit. Which role is the nurse implementing? a. Educator b. Manager c. Advocate d. Caregiver ANS: B A manager coordinates the activities of members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or facility. As an educator, you explain concepts and facts about health, describe the reason for routine care activities, demonstrate procedures such as self-care activities, reinforce learning or patient behavior, and evaluate the patient’s progress in learning. As a patient advocate, you protect your patient’s human and legal rights and provide assistance in asserting these rights if the need arises. As a caregiver, you help patients maintain and regain health, manage disease and symptoms, and attain a maximal level function and independence through the healing process. DIF:Apply (application) OBJ:Discuss the roles and career opportunities for nurses. TOP: Implementation MSC: Management of Care 6. The nurse has been working in the clinical setting for several years as an advanced practice nurse. However, the nurse has a strong desire to pursue research and theory development. To fulfill this desire, which program should the nurse attend? a. Doctor of Nursing Science degree (DNSc) b. Doctor of Philosophy degree (PhD) c. Doctor of Nursing Practice degree (DNP) d. Doctor in the Science of Nursing degree (DSN) ANS: B Some doctoral programs prepare nurses for more rigorous research and theory development and award the research-oriented Doctor of Philosophy (PhD) in nursing. Professional doctoral programs in nursing (DSN or DNSc) prepare graduates to apply research findings to clinical nursing. The DNP is a practice doctorate that prepares advanced practice nurses such as nurse practitioners. DIF:Understand (comprehension) OBJ:Compare and contrast the educational programs available for professional registered nurse (RN) education. TOP: Teaching/Learning MSC: Management of Care 7. A nurse attends a workshop on current nursing issues provided by the American Nurses Association. Which type of education did the nurse receive? a. Graduate education b. Inservice education c. Continuing education d. Registered nurse education ANS: C Continuing education involves formal, organized educational programs offered by universities, hospitals, state nurses associations, professional nursing organizations, and educational and health care institutions. After obtaining a baccalaureate degree in nursing, you can pursue graduate education leading to a master’s or doctoral degree in any number of graduate fields, including nursing. Inservice education programs are instruction or training provided by a health care facility or institution. Registered nurse education is the education preparation for an individual intending to be an RN. DIF:Apply (application) OBJ:Compare and contrast the educational programs available for professional registered nurse (RN) education. TOP: Teaching/Learning MSC: Management of Care 8. A nurse identifies gaps between local and best practices. Which Quality and Safety Education for Nurses (QSEN) competency is the nurse demonstrating? a. Safety b. Patient-centered care c. Quality improvement d. Teamwork and collaboration ANS: C Quality improvement identifies gaps between local and best practices. Safety minimizes risk of harm to patients and providers through both system effectiveness and individual performance. Patient-centered care recognizes the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs. Teamwork and collaboration allows effective functioning within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making. DIF:Understand (comprehension) OBJ:Discuss the roles and career opportunities for nurses. TOP: Evaluation MSC: Management of Care 9. A nurse has compassion fatigue. What is the nurse experiencing? a. Lateral violence and intrapersonal conflict b. Burnout and secondary traumatic stress c. Short-term grief and single stressor d. Physical and mental exhaustion ANS: B Compassion fatigue is a term used to describe a state of burnout and secondary traumatic stress. Compassion fatigue may contribute to what is described as lateral violence (nurse-nurse interactions, not intrapersonal). Frequent, intense, or prolonged exposure to grief and loss places nurses at risk for developing compassion fatigue. Stressors, not a single stressor, contribute to compassion fatigue. Physical and mental exhaustion describes burnout only. DIF:Understand (comprehension) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Assessment MSC: Health Promotion and Maintenance 10. A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse, ―I have no idea what is going to happen. I couldn’t ask any questions.‖ The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying? a. Manager b. Patient educator c. Patient advocate d. Clinical nurse specialist ANS: C As a patient advocate, the nurse protects the patient’s human and legal rights, including the right of the patient to understand procedures before signing permits. Although nurses can be educators, it is the responsibility of the surgeon to provide education for the patient in preparation for surgery, and it is the nurse’s responsibility to notify the health care provider if the patient is not properly educated. Managers coordinate the activities of members of the nursing staff in delivering nursing care, and clinical nurse specialists are experts in a specialized area of nursing practice in a variety of settings. DIF:Apply (application) OBJ:Discuss the roles and career opportunities for nurses. TOP: Evaluation MSC: Management of Care 11. The patient requires routine gynecological services after giving birth to her son, and while seeing the nurse-midwife, the patient asks for a referral to a pediatrician for the newborn. Which action should the nurse-midwife take initially? a. Provide the referral as requested. b. Offer to provide the newborn care. c. Refer the patient to the supervising provider. d. Tell the patient that is not allowed to make referrals. ANS: B The practice of nurse-midwifery involves providing independent care for women during normal pregnancy, labor, and delivery, as well as care for the newborn. After being apprised of the midwifery role, if the patient insists on seeing a pediatrician, the nurse-midwife should provide the referral. The supervising provider is an obstetric provider, not a pediatrician. A nurse-midwife can make referrals. DIF:Analyze (analysis) OBJ:Discuss the roles and career opportunities for nurses. TOP: Implementation MSC: Management of Care 12. The nurse has a goal of becoming a certified registered nurse anesthetist (CRNA). Which activity is appropriate for a CRNA? a. Manages gynecological services such as PAP smears. b. Works under the guidance of an anesthesiologist. c. Obtains a PhD degree in anesthesiology. d. Coordinates acute medical conditions. ANS: B Nurse anesthetists provide surgical anesthesia under the guidance and supervision of an anesthesiologist, who is a physician (health care provider) with advanced knowledge of surgical anesthesia. Nurse practitioners, not CRNAs, manage self-limiting acute and chronic stable medical conditions; certified nurse-midwives provide gynecological services such as routine Papanicolaou (Pap) smears. The CRNA is an RN with an advanced education in a nurse anesthesia accredited program. A PhD is not a requirement. DIF:Understand (comprehension) OBJ:Discuss the roles and career opportunities for nurses. TOP: Implementation MSC: Management of Care 13. A nurse teaches a group of nursing students about nurse practice acts. Which information is most important to include in the teaching session about nurse practice acts? a. Protects the nurse. b. Protects the public. c. Protects the provider. d. Protects the hospital. ANS: B The nurse practice acts regulate the scope of nursing practice and protect public health, safety, and welfare. They do not protect the nurse, provider, or hospital. DIF:Understand (comprehension) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Teaching/Learning MSC: Management of Care 14. A bill has been submitted to the State House of Representatives that is designed to reduce the cost of health care by increasing the patient-to-nurse ratio from a maximum of 2:1 in intensive care units to 3:1. What should the nurse realize? a. Legislation is politics beyond the nurse’s control. b. National programs have no bearing on state politics. c. The individual nurse can influence legislative decisions. d. Focusing on nursing care provides the best patient benefit. ANS: C Nurses can influence policy decisions at all governmental levels. One way is to get involved by participating in local and national efforts. This effort is critical in exerting nurses’ influence early in the political process. Legislation is not beyond the nurse’s control. National program can have bearing on state politics. The question is focusing on legislation and health care costs, not nursing care. DIF:Analyze (analysis) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Evaluation MSC: Management of Care 15. A nurse is using a guide that provides principles of right and wrong to provide care to patients. Which guide is the nurse using? a. Code of ethics b. Standards of practice c. Standards of professional performance d. Quality and safety education for nurses ANS: A The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care to your patients. The standards of practice describe a competent level of nursing care. The ANA Standards of Professional Performance describe a competent level of behavior in the professional role. Quality and safety education for nurses addresses the challenge to prepare nurses with the competencies needed to continuously improve the quality of care in their work environments. DIF:Understand (comprehension) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Implementation MSC: Management of Care 16. A graduate of a baccalaureate degree program plans to start working as a registered nurse (RN) in the emergency department. Which action must the nurse take first? a. Obtain certification for an emergency nurse. b. Pass the National Council Licensure Examination. c. Take a course on genomics to provide competent emergency care. d. Complete the Hospital Consumer Assessment of Healthcare Providers Systems. ANS: B Currently, in the United States, the most common way to become a registered nurse (RN) is through completion of an associate degree or baccalaureate degree program. Graduates of both programs are eligible to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become registered nurses in the state in which they will practice. Certification can be obtained after passing the NCLEX and working for the specified amount of time. Genomics is a newer term that describes the study of all the genes in a person and interactions of these genes with one another and with that person’s environment. Consumers can also access Hospital Consumer Assessment of Healthcare Providers Systems (HCAHPS) to obtain information about patients’ perspectives on hospital care. DIF:Remember (knowledge) OBJ:Compare and contrast the educational programs available for professional registered nurse (RN) education. TOP: Implementation MSC: Management of Care 17. While providing care to a patient, the nurse is responsible, both professionally and legally, for the appropriateness and proper execution of the care. Which concept does this describe? a. Autonomy b. Accountability c. Patient advocacy d. Patient education ANS: B Accountability means that the nurse is responsible, professionally and legally, for the type and quality of nursing care provided. Autonomy is an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders. As a patient advocate, the nurse protects the patient’s human and legal rights and provides assistance in asserting these rights if the need arises. As an educator, the nurse explains concepts and facts about health, describes the reasons for routine care activities, demonstrates procedures such as self-care activities, reinforces learning or patient behavior, and evaluates the patient’s progress in learning. DIF:Remember (knowledge) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Evaluation MSC: Management of Care 18. A nurse is teaching the staff about Benner’s levels of proficiency. In which order should the nurse place the levels from beginning level to ending level? 1. Expert 2. Novice 3. Proficient 4. Competent 5. Advanced beginner a. 2, 4, 5, 1, 3 b. 2, 5, 4, 3, 1 c. 4, 2, 5, 3, 1 d. 4, 5, 2, 1, 3 ANS: B Benner’s levels of proficiency are as follows: novice, advanced beginner, competent, proficient, and expert. DIF:Understand (comprehension) OBJ:Discuss the development of professional nursing roles. TOP: Teaching/Learning MSC: Management of Care MULTIPLE RESPONSE 1. A nurse is preparing a teaching session about contemporary influences on nursing. Which examples should the nurse include? (Select all that apply.) a. Human rights b. Affordable Care Act c. Demographic changes d. Medically underserved e. Decreasing health care costs ANS: A, B, C, D Multiple external forces affect nursing, including the need for nurses’ self-care, Affordable Care Act (ACA) and rising (not decreasing) health care costs, demographic changes of the population, human rights, and increasing numbers of medically underserved. DIF:Understand (comprehension) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Teaching/Learning MSC: Management of Care 2. After licensure, the nurse wants to stay current in knowledge and skills. Which programs are the most common ways nurses can do this? (Select all that apply.) a. Master’s degree b. Inservice education c. Doctoral preparation d. Continuing education e. National Council Licensure Examination retakes ANS: B, D Continuing education programs help nurses maintain current nursing skills, gain new knowledge and theory, and obtain new skills reflecting the changes in the health care delivery system. Inservice education programs are provided by a health care facility to increase the knowledge, skills, and competencies of nurses employed by the institution. Both can help the nurse stay current. Master’s degree programs are valuable for those in the role of nurse educator, nurse administrator, or advanced practice nurse. Professional doctoral programs in nursing (DSN or DNSc) prepare graduates to apply research findings to clinical nursing. National Council Licensure Examination retakes are not to keep current; this test is taken to enter RN practice. DIF:Understand (comprehension) OBJ:Compare and contrast the educational programs available for professional registered nurse (RN) education. TOP: Teaching/Learning MSC: Management of Care 3. A nurse wants to become an advanced practice registered nurse. Which options should the nurse consider? (Select all that apply.) a. Patient advocate b. Nurse administrator c. Certified nurse-midwife d. Clinical nurse specialist e. Certified nurse practitioner ANS: C, D, E Although all nurses should function as patient advocates, ―advanced practice nurse‖ is an umbrella term for an advanced clinical nurse such as a certified nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, or certified nurse-midwife. A nurse administrator is not an example of advanced practice. DIF:Understand (comprehension) OBJ:Discuss the roles and career opportunities for nurses. TOP: Teaching/Learning MSC: Management of Care 4. The nurse manager from the oncology unit has had two callouts; the orthopedic unit has had multiple discharges and probably will have to cancel one or two of its nurses. The orthopedic unit has agreed to ―float‖ two of its nurses to the oncology unit if oncology can ―float‖ a nursing assistant to the orthopedic unit to help with obtaining vital signs. Which concepts does this situation entail? (Select all that apply.) a. Autonomy b. Informatics c. Accountability d. Political activism e. Teamwork and collaboration ANS: A, C, E Staffing is an independent nursing intervention and is an example of autonomy. Along with increased autonomy comes accountability or responsibility for outcomes of an action. When nurses work together, this is teamwork and collaboration. Informatics is the use of information and technology to communicate, manage knowledge, mitigate error, and support decision making. Political activism usually involves more than day-to-day activities such as unit staffing. DIF:Analyze (analysis) OBJ:Discuss the influence of social, historical, political, and economic changes on nursing practices. TOP: Evaluation MSC: Management of Care Chapter 02: Health Care Delivery System Potter: Fundamentals of Nursing, 11th Edition MULTIPLE CHOICE 1. The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning care for this patient? a. Capitation provides the hospital with a means of recovering variable charges. b. The hospital will be paid for the full cost of the patient’s hospitalization. c. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost. d. Medicare will pay the national average for the patient’s condition. ANS: C In 1983, Congress established the prospective payment system (PPS), which grouped inpatient hospital services for Medicare patients into diagnosis-related groups (DRGs), each of which provides a fixed reimbursement amount based on assigned DRG, regardless of a patient’s length of stay or use of services. Capitation means that providers receive a fixed amount per patient or enrollee of a health care plan. DRG reimbursement is based on case severity, rural/urban/regional costs, and teaching costs, not national averages. DIF:Understand (comprehension) OBJ:Explain the concept of ―pay for value,‖ used to reward hospitals financially. TOP: Planning MSC: Management of Care 2. A nurse is teaching the staff about integrated health care systems. Which model of care should the nurse include in the teaching about seam-less care delivery? a. Affordable Care Act b. Hospital Value–Based Purchasing c. Bundled Payments for Care Improvements d. The patient-centered medical home model ANS: D Basically, two types of integrated health care systems are found: an organizational structure that follows economic imperatives (such as combining financing with all providers, from hospitals, clinics, and physicians to home care and long-term care facilities) and a structure that supports an organized care delivery approach (coordinating care activities and services into seamless functioning). The patient-centered medical home model is an example of an integrated health care system that strengthens the physician-patient relationship with coordinated, goal-oriented, individualized care. All the other options are more related to the financial accessibility of health care. DIF:Understand (comprehension) OBJ:Explain the concept of ―pay for value,‖ used to reward hospitals financially. TOP: Teaching/Learning MSC: Management of Care 3. A nurse is teaching a family about health care plans. Which information from the nurse indicates a correct understanding of the Affordable Care Act? a. A family can choose whether to have health insurance with no consequences. b. Primary care physician payments from Medicaid services can equal Medicare. c. Adult children up to age 26 are allowed coverage on the parent’s plan. d. Quality hospital outcome scores are tied directly to patient satisfaction. ANS: C The Affordable Care Act ties payment to organizations offering Medicare Advantage plans to the quality ratings of the coverage they offer. If hospitals perform poorly in quality scores, they receive lower payments for services. Quality outcome measures include patient satisfaction, more effective management of care by reducing complications and readmissions and improving care coordination. All individuals are required to have some form of health insurance by 2014 or pay a penalty through the tax code. Primary care physician payments for Medicaid services increased to equal Medicare payments. Implementation of insurance regulations prevents private insurance companies from denying insurance coverage for any reason and from charging higher premiums based on health status and gender. DIF:Remember (knowledge) OBJ:Explain the concept of ―pay for value,‖ used to reward hospitals financially. TOP: Teaching/Learning MSC: Management of Care 4. A nurse is caring for a patient in the hospital. When should the nurse begin discharge planning? a. When the patient is ready. b. Close to the time of discharge. c. Upon admission to the hospital. d. After an order is written/prescribed. ANS: C Discharge planning begins the moment a patient is admitted to a health care facility. When the patient is ready may be too late. Close to the time of discharge and after an order is written/prescribed are too late to help the transition of patient care from the hospital to home or other care facility. DIF:Remember (knowledge) OBJ:Discuss the role of nurses in various health care settings. TOP: Planning MSC: Management of Care 5. The nurse is applying for a position with a home care organization that specializes in spinal cord injury. In which type of health care facility does the nurse want to work? a. Secondary acute b. Continuing c. Restorative d. Tertiary ANS: C Patients recovering from an acute or chronic illness or disability often require additional services (restorative care) to return to their previous level of function or reach a new level of function limited by their illness or disability. Restorative care includes cardiovascular and pulmonary rehabilitation, sports medicine, spinal cord injury programs, and home care. Secondary acute care involves emergency care, acute medical-surgical care, and radiological procedures. Continuing care involves assisted living, psychiatric care, and older-adult day care. Tertiary care includes intensive care and subacute care. DIF:Understand (comprehension) OBJ:Discuss the role of nurses in various health care settings. TOP: Implementation MSC: Management of Care [Show Less]
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