Introduction to Medical-Surgical Nursing 6th Edition Linton Test Bank
Chapter 01: The Health Care System
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
- An 89-year-old man, who was recently discharged from a rehabilitation hospital because of an
- Placement in a day care center from 8 AM to 5 PM daily
- Placement in a long-term psychiatric facility
- Placement in a high-security nursing home
- Admission to a general hospital for evaluation
inability to concentrate and frequent memory lapses, cannot be left alone while his family works. What options should the discharge planning team suggest that will satisfy safety concerns and give the greatest quality of life to the patient?
ANS: A
Day care centers provide supervision, safety, nutritious meals, and socialization while the caregiving family works.
DIF: Cognitive Level: Application REF: p. 7 OBJ: 5 TOP: Day Care Centers KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk
- A 66-year-old hospitalized patient is anxious about how the physician will be paid now that he
- Previous privately funded
is on Medicare Parts A and B, instead of his previous privately funded insurance plan. Who should the nurse explain is the payor to the physician on this plan?
N ins R ura I nce G plan B.C M
- Medicare Part A U
- Medicare Part B
- Patient or patient’s family
ANS: C
Part A pays skilled care facilities. Part B pays for physician’s services. The previously held insurance is no longer available because of the patient’s age. The family or patient is not responsible because Part B is in effect.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4 TOP: Health Care Funding KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- What health care plan is the best referral for an unemployed 42-year-old patient with renal
- Medicare
- Medicaid
- Public health facility
- Community-based outpatient clinic
failure who has lost his job-related private insurance?
ANS: B
Medicaid is available to needy low-income persons younger than 65 years of age who have a permanent disability. Medicare is for persons 65 years and older. Public health services are involved with prevention more often than with chronic care. 1 / 4
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4 TOP: Health Care Funding KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- A patient with terminal lung cancer with extensive metastasis is requesting a hospice transfer.
- The patient requests and agrees to the guidelines of hospice care without requiring
- The physician confirms that the patient has 6 months or less of life remaining and
- Proof confirms that the family can no longer care for the patient at home.
- The patient’s specific diagnosis is included on a list of accepted diseases that
What criteria are included as requirements for this transfer?
a physician’s order.
has provided a written order for hospice care.
qualifies the patient for hospice care.
ANS: B
The four criteria for transfer to hospice care are (1) diagnosis of any terminal illness, (2) prognosis of less than 6 months of life, (3) informed consent of patient, and (4) written physician’s order.
DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 5 TOP: Hospice Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
- A patient admitted yesterday with a diagnosis-related group (DRG) diagnosis of abdominal
- Effective laboratory response
- Medicare guidelines limiNtinU
- Cost containment related to a DRG diagnosis
- Patient who should not have been admitted in the first place
pain of an unknown cause is being discharged this afternoon because all diagnostic test results have been negative. What does this scenario exemplify?
gRhS osIpiN taGl T staBy.C O M
ANS: C
Cost containment is a means by which the cost of hospitalization time is reduced when the need for acute hospital care is no longer necessary.
DIF: Cognitive Level: Comprehension REF: p. 11-12 OBJ: 6 TOP: Cost Containment per DRGs KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- A nurse is discussing discharge to a transitional subacute facility with a 72-year-old patient
- It will be limited to 25 days.
- It will be limited to 50 days.
- It will be limited to 75 days.
- It is totally unlimited.
diagnosed with diabetes and bilateral leg amputation. What should the nurse inform the patient regarding the stay in the new facility?
ANS: D
Medicare limitations are waived for patients who have undergone amputations.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 4 TOP: Stay in a Skilled Care Facility KEY: Nursing Process Step: Planning 2 / 4
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- A patient is applying for Medicaid. What does the receipt of benefits require?
- Following a supervised health maintenance plan
- Enrolling in the Medicare-Preferred Drug Plan
- Qualifying for the food stamp program
- Having an annual income of less than $10,000
ANS: B
The Medicare-Preferred Drug Plan is a condition of Medicaid eligibility. Nonenrollment may cause the loss of all health care benefits.
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 4 TOP: Medicare-Preferred Drug Plan KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
- Which is true concerning proprietary agencies?
- They are organized to be nonprofit operations.
- They are organized to make a profit on their operation.
- Any profit they make is immediately used to purchase better equipment and
- They must participate in Medicare.
services.
ANS: B
These agencies are usually owned by large corporations and established for the purpose of making a profit. Although most such agencies do participate in Medicare, it is not required.
DIF: Cognitive Level: Compr N ehen R sion I
G RE B
F:
.C
- 6
M
OBJ: 6
TOP: Proprietary Agencies
MSC: NCLEX: N/A
U S N KTEY: NuOrsing Process Step: N/A
- Which patient should the nurse recognize as eligible for a referral to Medicaid?
- Military automobile mechanic with severe asthma
- Pregnant unmarried young woman employed at a discount retail store for 3 years
- College student on scholarship who works part-time at the college library and who
- Unemployed young mother on welfare who needs diabetic medication for one of
needs medication for arthritis
her children
ANS: D
Medicaid covers medication and health care services for welfare recipients for child health and long-term care.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4 TOP: Medicaid Services Eligibility KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
- Why was the Balanced Budget Act of 1997 the cause of closures of many proprietary home
- It specified that all care be given by registered nurses (RNs).
- It listed specific diagnoses that could qualify a patient for home health care.
- It limited the amount of money that could be spent on a patient. 3 / 4
health care agencies?
- It increased the criteria for patient eligibility for home care.
ANS: C
The Balanced Budget Act of 1997 placed a limit on the amount of money that could be spent on a patient’s home health care regardless of diagnosis or needs.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 6 TOP: Balanced Budget Act of 1997 KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- Who is considered the forerunner of modern public health nursing in the United States?
- Vincent DePaul
- William Rathbone
- Florence Nightingale
- Lillian Wald
ANS: D
Lillian Wald is recognized as the forerunner of modern public health nursing.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 1 TOP: Leaders and Founders of Public Health Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- What is true about voluntary health care agencies?
- They are supported by tax dollars.
- They are governed by boards made up of community members.
- They receive no fee for services.
- They use volunteers as he
N alth R ca I re p G rovi B de .rs C .M
ANS: B
U S N T O
Voluntary agencies are governed by boards made up of community members and are supported by a variety of sources. They are not supported by tax dollars.
DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: 5 TOP: Voluntary Agencies KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
- A client who is hospitalized for treatment after a stroke asks the nurse how long Medicare can
- “Your Part B will cover your hospital care as long as is necessary.”
- “Your health care provider will determine how long your Medicare coverage will
- “You are allowed 50 days of inpatient care annually.”
- “You can receive skilled care for up to 100 days.”
be expected to cover his treatment. What is the nurse’s most informative response?
be in effect.”
ANS: D
Persons hospitalized for skilled nursing care receive 100 days of Medicare coverage.
DIF: Cognitive Level: Application REF: p. 11 OBJ: 4 TOP: Skilled Care Limitation KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
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