Chapter 2 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 2  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
The nurse is a member of a committee that is studying the frequency of medication errors. Other committee members include a health care provider, pharmacist, pharmacy technician, and nurse manager. The nurse is most likely participating in which specific type of quality process?
1. Total quality management
2. Continuous quality improvement
3. Quality improvement
4. Quality assurance
Correct Answer: 2
Rationale 1: Total quality management is a way to ensure customer satisfaction by involving all employees in the improvement of the quality of every product or service.
Rationale 2: Continuous quality improvement is the process of improving a system by using multidisciplinary teams to analyze the system, collect measurements, and propose changes.
Rationale 3: Quality improvement programs are large programs that focus on accountability to the payer and consumer.
Rationale 4: Quality assurance refers to an organization’s efforts to provide services that follow professional standards and guarantee or ensure quality of care.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2-1

Question 2
Type: MCSA
At the end of a scheduled work shift, the nurse asks each of his patients if there was anything he could have done to make their day more comfortable. The nurse is most likely participating in which process?
1. Quality improvement
2. Self-assessment
3. Continuous quality improvement study
4. Departmental assessment
Correct Answer: 1
Rationale 1: At the level of the individual nurse and patient, the quality improvement process is an appraisal of how the nurse performed in taking care of the patients.
Rationale 2: Self-assessment is not the best description of this activity.
Rationale 3: A continuous quality improvement study is conducted by a multidisciplinary team to analyze a system, collect data, and propose changes.
Rationale 4: There is no evidence to suggest a departmental assessment.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2-1

Question 3
Type: MCSA
The hospital benefits manager describes a health care program in which the nurse employee will pay a certain amount of money each month for comprehensive health services. The nurse will have a primary physician who will direct care within a specific network of providers. The nurse’s heath care must be provided by these in-network physicians. The nurse will have which type of health care?
1. Health maintenance organization (HMO)
2. Traditional insurance service plan
3. Independent practice association (IPA) coverage
4. Preferred provider organization (PPO)
Correct Answer: 1
Rationale 1: An HMO is a group health agency that provides basic and supplemental health treatment with a fee being set without regard to the amount or kind of service provided.
Rationale 2: Traditional insurance service plans contract with providers to accept payment based on a fee schedule. The insured may have some restrictions on providers, and the provider is paid directly by the plan.
Rationale 3: An IPA is a group of health care providers who join together to offer services to managed care organizations; the fees are collected and distributed according to fee-for-service arrangements. The physicians remain independent contractors.
Rationale 4: In a PPO, a network of physicians provide care. For a higher deductible, the insured can contract to be able to see providers outside the network.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2-2

Question 4
Type: MCSA
A patient tells the nurse that her primary care provider wants her to see a specialist, but the specialist is out of the network and her deductible will be higher. The nurse realizes the patient is a member of which type of health care organization?
1. Medicare
2. Health maintenance organization (HMO)
3. Independent practice association (IPA)
4. Preferred provider organization (PPO)
Correct Answer: 4
Rationale 1: Medicare is the national health insurance program that covers people 65 years of age or older, some people under 65 with disabilities, and people with end-stage renal disease.
Rationale 2: HMOs deliver comprehensive care for fixed prepaid fees or capitation; they typically restrict access to a specific network of providers.
Rationale 3: An IPA is a type of health care provider business structure in which physicians contract with an HMO to provide services but remain independent contractors with separate practices. This business model does not match the described scenario.
Rationale 4: PPOs provide reimbursement for covered care to non-network providers but at a different rate, and the patient may have to pay a higher deductible.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2-2

Question 5
Type: MCSA
A 46-year-old patient, unemployed and diagnosed with kidney disease, tells the nurse that he is having difficulty with his medical bills. What should the nurse do to help this patient?
1. Work with the pharmacist to determine which medications the patient can discontinue and still maintain an acceptable level of health.
2. Suggest the patient take prescribed medications every other day to make the prescription last longer.
3. Ask social services to discuss Medicare as a health care coverage option.
4. Assure the patient that the nurse will ask the health care provider if the patient can be quickly discharged to home.
Correct Answer: 3
Rationale 1: Encouraging the patient to discontinue medications is not an acceptable nursing practice.
Rationale 2: The nurse should not suggest that the patient skip doses. This practice would not constitute good care.
Rationale 3: The nurse should find out from social services whether the patient is eligible for Medicare coverage. Medicare is the national health insurance program that covers people 65 years or older, some people under age 65 with disabilities, and people with end-stage renal disease.
Rationale 4: The patient should remain hospitalized as long as necessary to receive essential care.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2-2