Medical-Surgical Nursing: Concepts & Practice, 3rd Edition (deWit)

MULTIPLE CHOICE 1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs. b. To define the scope of LPN/LVN practice. c. To improve the quality of care provided by the LPN/LVN. d. To limit the LPN/LVN employment placement. ANS: B While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each state defines the scope of nursing practice in that state. PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 OBJ: 3 TOP: NPA KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational nurse has not been taught during her educational program. How should the vocational nurse respond? a. Ask a more experienced nurse to demonstrate the procedure. b. Look up the procedure in the procedure manual. c. Attempt to perform the procedure with supervision. d. Inform the charge nurse of her lack of training in this procedure. ANS: D The charge nurse should be informed of the lack of training to perform the procedure, and the vocational nurse should seek further training to gain proficiency. Although the other options might be helpful, they are not safe. PTS: 1 DIF: Cognitive Level: Application REF: 3 OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 3. Which patient statement indicates a need for further discharge teaching that the vocational nurse should address? a. “I have no idea of how this drug will affect me.” b. “Do you know if my physician is coming back today?” c. “Will my insurance pay for my stay?” d. “Am I going to have to go to a nursing home?” ANS: A Lack of knowledge at discharge about medication effects and side effects is a concern that should be addressed by the vocational nurse. The other concerns in the options are the responsibility of other departments to which the nurse might refer the patient. PTS: 1 DIF: Cognitive Level: Application REF: 2 OBJ: 1 TOP: Teaching KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts in which capacity? a. Working under direct supervision of an RN on the unit b. Working with the RN in the building c. Working under general supervision by the RN available on site or by phone d. Working as an independent vocational nurse ANS: C The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general supervision of an RN available on site or by phone. PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 OBJ: 1 TOP: Charge Nurse/Manager KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which information should the nurse include? a. Seek the opinion of an alternate health care provider. b. Obtain insurance approval for medical services prior to treatment. c. Provide detailed documentation of all care received for his condition. d. Wait at least 6 months to see a specialist. ANS: B Most HMOs require preprocedure authorization for treatment. Patients are not required to seek a second opinion, provide documentation of care, or wait a specific time period before visiting a specialist. PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 9 TOP: Charge Nurse/Manager KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 6. The patient complains to the nurse that he is confused about his “deductible” that he owes the hospital. Which statement accurately explains a deductible? a. An amount of money put aside for the payment of future medical bills b. A one-time fee for service c. An amount of money deducted from the bill by the insurance company d. An annual amount of money the patient must pay out-of-pocket for medical care ANS: D The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company assuming the cost. This practice improves the profit of the insurance company. PTS: 1 DIF: Cognitive Level: Comprehension REF: 7 OBJ: 9 TOP: Health Care Financing KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care