Chapter 06 My Nursing Test Banks

 

Kozier & Erbs Fundamentals of Nursing, 9/E
Chapter 06

Question 1

Type: MCSA

Healthy People 2010 has two primary goals. Which of the following is in alignment with one of the goals?

1. Providing free screening to schoolchildren

2. Opening a wellness clinic

3. Developing better insurance controls

4. Developing new pharmacological treatments

Correct Answer: 2

Rationale 1: Two primary goals of Healthy People 2010 are to (1) increase quality and years of healthy life; and (2) eliminate health disparities. Free screening to schoolchildren is already being done in most states

Rationale 2: Two primary goals of Healthy People 2010 are to (1) increase quality and years of healthy life; and (2) eliminate health disparities. Opening a wellness clinic focuses on bettering health, which would be in line with goal 1.

Rationale 3: Two primary goals of Healthy People 2010 are to (1) increase quality and years of healthy life; and (2) eliminate health disparities. Developing insurance control was a goal of health care reform during the Clinton administration.

Rationale 4: Ongoing development of pharmacological treatments is not a new initiative

Global Rationale: Page Reference: 100

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.

Question 2

Type: MCSA

A group of nurses are working to open a clinic that focuses on health promotion. Which of the following is an example of a health promotion activity?

1. Teaching biofeedback techniques for stress reduction

2. Providing immunization clinics

3. Evaluating regional industrial centers for environmental pollution

4. Teaching smoking cessation classes to adolescents

Correct Answer: 1

Rationale 1: Health promotion programs address nutrition, weight control, exercise, and stress reduction. Health promotion activities emphasize the role of clients in maintaining their own health and provide encouragement in maintaining the highest level of wellness they can achieve.

Rationale 2: Providing immunization clinics is an example of illness prevention, not health promotion.

Rationale 3: Evaluating industrial centers for pollutionis an example of illness prevention, not health promotion.

Rationale 4: Teaching smoking cessation classes is an example of illness prevention, not health promotion.

Global Rationale: Page Reference: 100

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter. 03 Identify the roles of various health care professionals.

Question 3

Type: MCSA

A client is in the end stages of cancer. By which type of service would this client best be served?

1. Rehabilitation

2. Health restoration

3. Acute care

4. Palliative care

Correct Answer: 4

Rationale 1: Rehabilitation is a process of restoring ill or injured people to optimum and functional levels of wellness, emphasizing the importance of assisting clients to function adequately in the physical, mental, social, economic, and vocational areas of their lives. That is not the service this client requires.

Rationale 2: Health restoration is service that helps bring ill or injured clients back to their former state of health. That is not the service this client requires.

Rationale 3: Acute care is the typical service provided in a hospital. That is not the service this client requires.

Rationale 4: Palliative care is service that provides comfort and treatment of symptoms. This type of care is for clients who cannot be returned to health. It may be conducted in many settings, including the home.

Global Rationale: Page Reference: 100

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 4

Type: MCSA

Several nurses are looking for an agency to sponsor a program that would meet the needs of a community group lacking in health promotion education. The nurses should seek help from which of the following?

1. State health department

2. Local health department

3. Local hospital

4. Federal government

Correct Answer: 2

Rationale 1: State health organizations are responsible for assisting the local health departments. This is not the agency to provide the assistance the nurses are looking for.

Rationale 2: The local health department has the responsibility for developing programs to meet the health needs of the people, providing the necessary staff and facilities to carry out those programs, evaluating their effectiveness, and monitoring changing needs.

Rationale 3: Local hospitals provide the majority of acute care services in a community. This is not the agency to provide the assistance the nurses are looking for.

Rationale 4: The U.S. Department of Health and Human Services is an agency at the federal level whose functions include conducting research and providing training in the health field, providing assistance to communities in planning and developing health facilities, and assisting states and local communities through financing and provision of trained personnel. This is not the agency to provide the assistance the nurses are looking for.

Global Rationale: Page Reference: 100

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 5

Type: MCSA

A nurse has begun working in a hospital that provides services in all specialty areas (medical, surgical, pediatrics, obstetrics). This hospital is classified as which of the following?

1. General hospital

2. Specialty hospital

3. Long-term care hospital

4. Short-term hospital

Correct Answer: 1

Rationale 1: Hospitals are classified by the services they provide as well as by their ownership. General hospitals admit clients requiring a variety of services such as medical, surgical, obstetric, pediatric, and psychiatric services.

Rationale 2: Hospitals are classified by the services they provide as well as by their ownership. Some hospitals offer only specialty services such as psychiatric or pediatric. This does not describe the facility in the stem.

Rationale 3: Hospitals are classified by the services they provide as well as by their ownership. Long-term care hospitals provide services for longer periods-sometimes years or for the remainder of the clients life. This does not describe the facility in the stem.

Rationale 4: Acute care (or short-term) hospitals provide assistance to clients whose illness and need for hospitalization are relatively short term, such as several days. This does not describe the facility in the stem.

Global Rationale: Page Reference: 102

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 6

Type: MCSA

A client is being discharged from an acute hospital following an extensive illness. The client continues to require IV antibiotics, is not able to complete ADLs (activities of daily living) without assistance, and has no family available to assist in the recovery phase. The nurse should make a recommendation for this client to:

1. Stay in the hospital until the client is fully capable of self-care.

2. Remain in the hospital until the antibiotic course is completed.

3. Be discharged to an extended care facility.

4. Go to a nursing home.

Correct Answer: 3

Rationale 1: An acute care hospital stay is no longer required since the needs of the client could be met in another facility.

Rationale 2: The antibiotic therapy and custodial care can be provided in a more suitable facility.

Rationale 3: Extended care facilities provide care for clients who require rehabilitation and custodial care after discharge from an acute care hospital. Since this client still receives antibiotic therapy and requires some custodial care, this type of facility can provide the best care until the client is ready for discharge home.

Rationale 4: The client may require a nursing home or long-term care facility at some point, but it is too early in the recovery to make this decision.

Global Rationale: Page Reference: 102-103

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 7

Type: MCSA

An elderly client has no family in the same community, lives alone in a small house, and is having greater difficulty with mobility due to advanced osteoarthritis. Cognitively, this client is alert, is able to manage her own business matters, and does her own cooking, but does not enjoy cooking for one. The home health nurse who visits has noticed that the client is losing weight and does not have as much energy or interest in activities as on previous visits. The nurse should recommend that the client:

1. See a psychiatrist since the client appears depressed.

2. Check out joint replacement options for the osteoarthritis.

3. Start thinking about long-term care.

4. Consider moving to an assisted living facility.

Correct Answer: 4

Rationale 1: Diagnosing depression is outside the scope of nursing practice, and other interventions can be implemented before this action should be considered nor does it meet the clients immediate needs.

Rationale 2: Joint replacement may or may not be an option, but it would not be the nurses responsibility to recommend this nor does it meet the clients immediate needs.

Rationale 3: This client does not show any indications of requiring long-term care at this point.

Rationale 4: Assisted living facilities offer meals, laundry services, nursing care, transportation, and social activities to residents who are able to live relatively independently. They are intended to meet the needs of people who are unable to remain at home but do not require hospital or nursing home care. The client in this scenario has some physical limitations, but could benefit from socialization and interaction with peers as well as have staff available who provide limited care and health promotion activities.

Global Rationale: Page Reference: 103

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 8

Type: MCSA

The spouse of a client diagnosed with Stage I/II Alzheimers disease must continue to work full-time. The spouse tells the occupational health nurse that the client has started to wander outside the house, forgets to turn off the stove after preparing food, and tries to drive the car if the client finds the keys. The nurse should recommend which of the following?

1. Long-term care placement for the client

2. That the spouse should consider early retirement

3. Placing the client in an adult day-care environment

4. Considering increasing the clients medications to slow the progress of the disease

Correct Answer: 3

Rationale 1: Placing a client from an independent home situation to long-term care would be more detrimental than a gradual progression of care.

Rationale 2: Telling the spouse to consider early retirement is neither therapeutic nor realistic.

Rationale 3: Day-care centers provide care and nutrition for adults who cannot be left at home alone but do not need to be in an institution. These centers often provide care involving socializing, exercise programs, and stimulation. Some provide counseling and physical therapy. Nurses who are employed in day-care centers may provide medications, treatment, and counseling.

Rationale 4: Increasing medications is a decision that needs to be made by the clients primary caregiver, not the nurse nor does it address the spouses concerns regarding care.

Global Rationale: Page Reference: 103-104

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 9

Type: MCSA

A client has just been referred to hospice care, and the spouse asks the hospice nurse why the client needs the change in services. The response by the nurse is:

1. So we can see if theres any way to improve your spouses life.

2. There is no need for acute care any longer.

3. Its best for your spouse to be cared for at home.

4. Hospice care is cheaper than acute care.

Correct Answer: 1

Rationale 1: The central concept of the hospice movement is not saving life but improving or maintaining the quality of life until death. Hospice care provides a variety of services given to the terminally ill, their families, and support persons. The place of care varies, but includes home, hospital, or skilled nursing facilities..

Rationale 2: Acute care may be warranted as the clients condition changes.

Rationale 3: The place of hospice care varies, but includes home, hospital, or skilled nursing facilities.

Rationale 4: Hospice care may well be cheaper, but this is not the main reason for referral to hospice services.

Global Rationale: Page Reference: 104

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 10

Type: MCSA

A client has been recovering after an injury that left him partially paralyzed. The client is a young adult and intent on living independently, as before the injury. The best referral for this client would be to which of the following?

1. Paramedical technologist

2. Physical therapist

3. Occupational therapist

4. Case manager

Correct Answer: 3

Rationale 1: The term paramedical technologist includes laboratory technologists, radiological technologists, and nuclear medicine technologists. This title is given to those professionals having some connection with medicine. This referral would not meet the clients needs regarding independent living.

Rationale 2: A physical therapist helps clients regain physical strength and mobility. In this case, the client would probably also see a physical therapist, but not for the focus on independent living.

Rationale 3: An occupational therapist assists clients with impaired function to gain the skills necessary for activities of daily living. The therapist teaches skills that are therapeutic but at the same time provide fulfillment. Helping a client with paralysis learn to use equipment or different methods of doing daily tasks will enable him to be as independent as possible.

Rationale 4: A case managers role is to ensure that clients receive fiscally sound, appropriate care in the best setting. Again, this client may well have a case manager to coordinate all the necessary care, but the question focuses on the return to independent living.

Global Rationale: Page Reference: 105

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 11

Type: MCSA

A nurse is interviewing a client at a clinic near a shelter for the homeless. Understanding the increased risk poor physical environment creates for this client, the nurse will focus on which of the following during the intake phase of the interview?

1. Lack of social support

2. Recent history of chills and body aches

3. Improper nutrition

4. Few personal resources

Correct Answer: 2

Rationale 1: Lack of social supportcontributes to health problems in general.

Rationale 2: Poor physical environment results in increased susceptibility to infections. The clients recent history of chills and body aches should alert the nurse that this client may have an infection.

Rationale 3: contributes to health problems in general.

Rationale 4: contributes to health problems in general.

Global Rationale: Page Reference: 108-109

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.
03 Identify the roles of various health care professionals.

Question 12

Type: MCSA

A nurse is working in a clinic whose emphasis is on cost control, customer satisfaction, health promotion, and preventive services. This represents which type of system?

1. Managed care

2. Case management

3. Differentiated practice

4. Patient-focused care

Correct Answer: 1

Rationale 1: Managed care describes a health care system whose goals are to provide cost-effective, quality care that focuses on decreased costs and improved outcomes for groups of clients.

Rationale 2: Case management describes a range of models for integrating health care services for individuals or groups. This is not the model described in the stem.

Rationale 3: Differentiated practice is a system in which the best possible use of nursing personnel is based on their educational preparation and resultant skill sets. This is not the model described in the stem..

Rationale 4: Patient-focused care is a delivery model that brings all services and care providers to the client. This is not the model described in the stem..

Global Rationale: Page Reference: 109

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe the factors that affect health care delivery.

Question 13

Type: MCSA

The manager of a small clinic has cross-trained the nurses to not only provide basic nursing care, but also perform ECG testing, phlebotomy, and some respiratory therapy interventions. This clinic is an example of which delivery model?

1. Managed care

2. Case management

3. Patient-focused care

4. Critical pathways

Correct Answer: 3

Rationale 1: Managed care focuses on cost-effective, quality care which results in decreased costs and improved outcomes. This is not the model described in the stem..

Rationale 2: Case management is a way to integrate health care services for individuals or groups and involves multidisciplinary teams that assume collaborative responsibility for planning, assessing needs, and coordinating, implementing, and evaluating care. This is not the model described in the stem..

Rationale 3: Patient-focused care is a delivery model that brings all services and care providers to the client. Activities provided by auxiliary personnel (physical therapy, respiratory therapy, ECG testing, and phlebotomy) are moved close to the client, thereby decreasing the number of personnel involved and the number of steps to get the work done.

Rationale 4: Critical pathways are used to track the clients progress in case management. This is not the model described in the stem..

Global Rationale: Page Reference: 110

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 02 Describe the functions and purposes of the health care agencies outlined in this chapter.

Question 14

Type: MCSA

A new graduate nurse is looking for employment and is hoping to find a facility that utilizes nursing personnel based on their educational preparation and skill set. Which of the following systems implements this practice?

1. Patient-focused care

2. Shared governance

3. Differentiated practice

4. Managed care

Correct Answer: 3

Rationale 1: Patient-focused care is a delivery model that brings all services and care providers to the client. This is not the model described in the stem.

Rationale 2: Shared governance is an organizational model in which nursing staff are cooperative with administrative personnel in making, implementing, and evaluating client care policies. This is not the model described in the stem.

Rationale 3: Differentiated practice is a system in which the best possible use of nursing personnel is based on their educational preparation and resultant skill sets. This model consists of specific job descriptions for nurses according to their education or training.

Rationale 4: Managed care focuses on cost containment, consumer satisfaction, health promotion, and preventive services. This is not the model described in the stem.

Global Rationale: Page Reference: 110

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 03 Identify the roles of various health care professionals.

Question 15

Type: MCSA

A nurse has just moved from a facility that utilized differentiated practice. Which of the following delivery systems would most resemble this system?

1. Case method

2. Shared governance

3. Functional method

4. Team nursing

Correct Answer: 4

Rationale 1: Case method is a client-centered model where one nurse is assigned to and responsible for the comprehensive care of a group of clients during a shift. In this method a client has consistent contact with one nurse during a shift, but may have different nurses on other shifts. This is not the model described in the stem.

Rationale 2: Shared governance is an organizational model in which nursing staff are cooperative with administrative personnel in making, implementing, and evaluating client care policies. This is not the model described in the stem.

Rationale 3: The functional nursing method focuses on the jobs to be completed. It is a task-oriented approach in which personnel with less preparation than the professional nurse perform less complex care requirements. This is not the model described in the stem.

Rationale 4: Team nursing is the delivery of individualized nursing care to clients by a team led by a professional nurse. The nursing team consists of registered nurses, licensed practical nurses, and unlicensed assistive personnel. The registered nurse retains responsibility and authority for client care but delegates appropriate tasks to the other team members. This enables nurses to progress and assume roles and responsibilities appropriate for their level of experience, capability, and educationmuch like the differentiated practice system.

Global Rationale: Page Reference: 110

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 03 Identify the roles of various health care professionals.

Question 16

Type: MCSA

A seasoned RN is especially competent in knowledge of the computerized charting system in a facility and is able to assume the team leader role on a regular basis. These two characteristics are the basis of which system?

1. Primary nursing

2. Team nursing

3. Differentiated practice

4. Case method

Correct Answer: 1

Rationale 1: Primary nursing is a system in which one nurse is responsible for total care of a number of clients, 24 hours a day, 7 days a week. It is a method of providing comprehensive, individualized, and consistent care. Primary nursing uses the nurses technical knowledge and management skills in assessing and prioritizing each clients needs, implementing the plan of care, and evaluating its effectiveness.

Rationale 2: Team nursing is the delivery of individualized nursing care to clients by a team led by a professional nurse and consisting of RNs, LPNs, and UAPs. This is not the model described in the stem.

Rationale 3: Differentiated practice is a system in which the best possible use of nursing personnel is based on their education preparation and resultant skill sets. This is not the model described in the stem..

Rationale 4: Case method is also referred to as total care, in which one nurse is assigned to and is responsible for the comprehensive care of a group of clients during an 8- or 12-hour shift. This is not the model described in the stem.

Global Rationale: Page Reference: 110

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 03 Identify the roles of various health care professionals.

Question 17

Type: MCSA

A client who is at least 65 years of age is asking the nurse how he will afford his hospitalization, which has now been extended, involving extremely expensive drugs. The best response by the nurse is:

1. Dont worry. Im sure everything will work out OK.

2. You need to focus on recovering, not worrying about finances.

3. Much of your care will be covered by Medicare.

4. Ill have someone from the business office come and talk to you about your bill.

Correct Answer: 3

Rationale 1: Ignoring the clients concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the clients concerns.

Rationale 2: Ignoring the clients concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the clients concerns.

Rationale 3: The Medicare amendment to the Social Security Act provided a national and state health insurance program for older adults. By the mid-1970s, virtually everyone over 65 years of age was protected by hospital insurance under Part A. In 1988, Congress expanded Medicare to include extremely expensive hospital care, catastrophic care, and expensive drugs.

Rationale 4: Giving the concern to the business office is merely passing the buck. Nurses should have some knowledge about the payment sources of their clients, especially those who have automatic coverage with Medicare because of their age.

Global Rationale: Page Reference: 111

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 05 Describe frameworks for the delivery of nursing care.

Question 18

Type: MCSA

A clinic in a rural area depends primarily on the services of a nurse practitioner. The legislation that allows this opportunity is which of the following?

1. Medicare

2. Medicaid

3. Rural Health Clinics Act

4. National Health Planning and Resources Development Act

Correct Answer: 3

Rationale 1: Medicare provides insurance coverage for people over age 65. This is not the legislation described in the stem.

Rationale 2: Medicaid provides service to people who require financial assistance for health care. This is not the legislation described in the stem.

Rationale 3: In 1978, the Rural Health Clinics Act provided for the development of health care in medically underserved rural areas. This act opened the door for nurse practitioners to provide primary care.

Rationale 4: The National Health Planning and Resources Development Act established health systems agencies throughout the United States for the development of health care in medically underserved rural areas. This is not the legislation described in the stem.

Global Rationale: Page Reference: 104

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 05 Describe frameworks for the delivery of nursing care.

Question 19

Type: MCSA

Principles recommended by the Institute of Medicine to address the problem of insurance coverage include which of the following?

1. Health coverage should be for everyone.

2. Families and individuals should have coverage they can afford.

3. Coverage should be provided by private companies.

4. Health coverage should be ongoing and uninterrupted.

5. Hospitals should be financed through taxation.

Correct Answer: 2

Rationale 1: Between 2001 and 2004, the Institute of Medicine issued six research reports identifying the scope of the problem of the underinsured in America. They recommended principles for addressing this problem with health coverage should be for everyone being one of them

Rationale 2: Between 2001 and 2004, the Institute of Medicine issued six research reports identifying the scope of the problem of the underinsured in America. They recommended principles for addressing this problemwith individuals and families need to have coverage they can afford being one of them

Rationale 3: Between 2001 and 2004, the Institute of Medicine issued six research reports identifying the scope of the problem of the underinsured in America. They recommended principles for addressing this problembut coverage should be provided by private companies is not aong them.

Rationale 4: Between 2001 and 2004, the Institute of Medicine issued research reports identifying the scope of the problem of the underinsured in America. They recommended five principles for addressing this problemwith health coverage should be ongoing/uninterruptiblebeing among them.

Rationale 5: The Canada Health Act in 1984 provided financing for hospitals through taxation.

Global Rationale: Page Reference: 112

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 05 Describe frameworks for the delivery of nursing care.

Question 20

Type: MCSA

A client has just been enrolled (through her employer) in an HMO. The clients previous experience with health care coverage through her employer was with a PPO. The client asks the occupational health nurse to explain the difference. The best response by the nurse is which of the following?

1. Youll have good health care benefits, so dont worry.

2. Both the HMO and PPO are covered by your employer so its really not your concern.

3. Your PPO offered you a choice in your health care provider as well as services. Now, you will choose a primary care provider who will evaluate your health and will coordinate all of your care.

4. You really should be happy about the HMO. Youll pay little, if any, out-of-pocket expense.

Correct Answer: 3

Rationale 1: Telling the client not to worry does not address the clients question, which is to explain the difference.

Rationale 2: Telling the client not to worry does not address the clients question, which is to explain the difference.

Rationale 3: HMO plans emphasize wellness, and members choose a primary care provider who evaluates their health status and coordinates their care. Clients are limited in their ability to select health care providers and services, but available services are at minimal and predetermined cost to the client. PPOs consist of a group of physicians that provide an insurance company or employer with health services at a discounted rate. One advantage of the PPO is that it provides clients with a choice of health care providers and services.

Rationale 4: Even though telling the client that she will have little out-of-pocket expense may be truthful, it doesnt answer the question.

Global Rationale: Page Reference: 113

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 05 Describe frameworks for the delivery of nursing care.

Question 21

Type: MCMA

Which of the following factors have an effect on health care delivery?

Standard Text: Select all that apply.

1. Increased use of complementary and alternative medicine.

2. More knowledgeable consumers.

3. Increase in the number of elderly.

4. Decrease in chronic disease.

5. Technological advances.

6. Economics.

Correct Answer: 2,3,5,6

Rationale 1: Though there is an increase in complementary and alternative medicine use, this does not affect how health care is delivered.

Rationale 2: With the improved availability of health-related information, consumers are more knowledgeable, and play an active in their health care.

Rationale 3: People over age 85 are projected to be the fastest-growing population in the United States.

Rationale 4: Chronic illness is prevalent in this group.

Rationale 5: Technology related to health care is rapidly increasing, and includes improved diagnostic procedures and equipment that permits early recognition of diseases.

Rationale 6: Inflation increases all costs, and paying for healthcare services is becoming a greater problem.

Global Rationale: Page Reference: 106-109

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 04 Describe the factors that affect health care delivery.

Question 22

Type: MCMA

Which of the following factors are related to cost increases?

Standard Text: Select all that apply.

1. Health care of the older adult.

2. Number of uninsured population.

3. Changes in birth rate over last 20 years.

4. Cost of prescription drugs.

5. State of inflation.

6. Amount of diagnosed chronic illnesses.

Correct Answer: 1,2,4,5,6

Rationale 1: The total population is growing, especially the older adult segment that tends to have greater healthcare needs compared to younger persons.

Rationale 2: The uninsured numbers are on the rise: 17% of persons under age 65.

Rationale 3: Birth rates have dropped in the last 20 years, and so do not have a major impact on healthcare costs.

Rationale 4: The cost of prescription drugs is increasing, and represents 19% of total healthcare expenditures in the United States.

Rationale 5: Inflation increases all costs.

Rationale 6: The total population is growing, especially the older adult segment that tends to have diagnosed chronic illnesses.

Global Rationale: Page Reference: 106-109

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 04 Describe the factors that affect health care delivery.

Question 23

Type: MCMA

In order to comply with the U.S. Department of Health and Human Services most current healthcare goals as stated in Healthy People 2020, the nurse will:

Standard Text: Select all that apply.

1. Plan a depression screening for senior citizens who regularly have lunch at the senior center.

2. Attend an educational in-service on the use of a new automated blood pressure monitor.

3. Advocate for psychiatric health care for those with no private insurance coverage.

4. Organize a park cleanup day to assure that the communitys children have a safe place to play.

5. Counsel older clients regarding programs available to assist them to live in their homes independently.

Correct Answer: 1,3,4,5

Rationale 1: The federal governments funded Healthy People 2020 has as one of its primary goals promoting health and quality life across the life span.

Rationale 2: This intervention is not directed towards the federal governments primary health goals as stated in Healthy People 2020.

Rationale 3: The federal governments funded Healthy People 2020 has among its primary goals achieving health equity and eliminating health disparities.

Rationale 4: The federal governments funded Healthy People 2020 has as one of its primary goals creating healthy environments for everyone.

Rationale 5: The federal governments funded Healthy People 2020 has as one of its primary goals increasing quality and years of healthy life.

Global Rationale: Page Reference: 100

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.

Question 24

Type: MCMA

The nurse recognizes that a federally funded program is likely providing healthcare coverage for the:

Standard Text: Select all that apply.

1. 35-year-old self-employed house painter.

2. 72-year-old retired schoolteacher.

3. 52-year-old nurse who runs the family farm.

4. 29-year-old mentally challenged sheltered workshop employee.

5. 40-year-old factory worker.

Correct Answer: 2,4

Rationale 1: This patient would be on a private insurance plan like Blue Cross and Blue Shield.

Rationale 2: This patient would be on a federally funded insurance plan like Medicare.

Rationale 3: This patient would be on a private insurance plan like Blue Cross and Blue Shield.

Rationale 4: This patient would be on a federally funded insurance plan like Medicaid.

Rationale 5: This patient would be on a prepaid group plan: a health maintenance organization (HMO).

Global Rationale: Page Reference: 111

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 05 Describe frameworks for the delivery of nursing care.

Kozier & Erbs Fundamentals of Nursing, 9/E Test Bank

Copyright 2012 by Pearson Education, Inc.

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