Question 1

A nurse is responsible for the care coordination of a client with multiple sclerosis who is being treated at a multiservice outpatient clinic.The nurse is informed by the occupational therapist that the client needs specialized assistive devices in order to prepare meals but does not have the money to purchase them.The client's insurance company has denied approval to cover the devices.Which is the appropriate action by the nurse?

Accepted Answer

A) Care coordination may involve advocating with the client's insurance company to cover the costs of a resource. Telling the occupational therapist or client to come up with other plans or resources is not an appropriate role for a care coordinator. The coordinator may try to find another source to cover the cost for necessary equipment.
B) Care coordination may involve advocating with the client's insurance company to cover the costs of a resource. Telling the occupational therapist or client to come up with other plans or resources is not an appropriate role for a care coordinator. The coordinator may try to find another source to cover the cost for necessary equipment.
C) Care coordination may involve advocating with the client's insurance company to cover the costs of a resource. Telling the occupational therapist or client to come up with other plans or resources is not an appropriate role for a care coordinator. The coordinator may try to find another source to cover the cost for necessary equipment.
D) Care coordination may involve advocating with the client's insurance company to cover the costs of a resource. Telling the occupational therapist or client to come up with other plans or resources is not an appropriate role for a care coordinator. The coordinator may try to find another source to cover the cost for necessary equipment.

Question 2

A nurse,who works in a clinic environment,places great emphasis on cost control,customer satisfaction,health promotion,and preventive services.The primary focus of this nurse is representative of which type of healthcare system?

Accepted Answer

A) Managed care describes a healthcare system whose goals are to provide cost-effective, quality care that focuses on decreased costs and improved outcomes for groups of clients. The case method of care is a client-centered model in which one nurse is assigned to care for a group of clients during an 8- to 12-hour shift. The functional method of care focuses on jobs to be completed and is task oriented. Client-focused care is a delivery model that brings all services and care providers to the client.
B) Managed care describes a healthcare system whose goals are to provide cost-effective, quality care that focuses on decreased costs and improved outcomes for groups of clients. The case method of care is a client-centered model in which one nurse is assigned to care for a group of clients during an 8- to 12-hour shift. The functional method of care focuses on jobs to be completed and is task oriented. Client-focused care is a delivery model that brings all services and care providers to the client.
C) Managed care describes a healthcare system whose goals are to provide cost-effective, quality care that focuses on decreased costs and improved outcomes for groups of clients. The case method of care is a client-centered model in which one nurse is assigned to care for a group of clients during an 8- to 12-hour shift. The functional method of care focuses on jobs to be completed and is task oriented. Client-focused care is a delivery model that brings all services and care providers to the client.
D) Managed care describes a healthcare system whose goals are to provide cost-effective, quality care that focuses on decreased costs and improved outcomes for groups of clients. The case method of care is a client-centered model in which one nurse is assigned to care for a group of clients during an 8- to 12-hour shift. The functional method of care focuses on jobs to be completed and is task oriented. Client-focused care is a delivery model that brings all services and care providers to the client.

Question 3

The nurse is caring for a preschool-age client who suffered brain damage following a car accident.The client has a tracheostomy,is ventilator-dependent,and will be discharged from the hospital into the family's care.The family wants to care for the child at home but does not have the resources for 24-hour care.Which action by the care manager is appropriate?

Accepted Answer

A) The referral process is a systematic problem-solving approach that helps clients to use resources that meet their healthcare needs. The process involves knowledge of community resources and an ability to solve problems, set priorities, coordinate, and collaborate. The family's wishes for post-hospital care should be respected if other possibilities exist, which, in this case, they do. The nurse would not be responsible for a fundraiser. Contacting local nurses would not be an efficient way to coordinate care for the client.
B) The referral process is a systematic problem-solving approach that helps clients to use resources that meet their healthcare needs. The process involves knowledge of community resources and an ability to solve problems, set priorities, coordinate, and collaborate. The family's wishes for post-hospital care should be respected if other possibilities exist, which, in this case, they do. The nurse would not be responsible for a fundraiser. Contacting local nurses would not be an efficient way to coordinate care for the client.
C) The referral process is a systematic problem-solving approach that helps clients to use resources that meet their healthcare needs. The process involves knowledge of community resources and an ability to solve problems, set priorities, coordinate, and collaborate. The family's wishes for post-hospital care should be respected if other possibilities exist, which, in this case, they do. The nurse would not be responsible for a fundraiser. Contacting local nurses would not be an efficient way to coordinate care for the client.
D) The referral process is a systematic problem-solving approach that helps clients to use resources that meet their healthcare needs. The process involves knowledge of community resources and an ability to solve problems, set priorities, coordinate, and collaborate. The family's wishes for post-hospital care should be respected if other possibilities exist, which, in this case, they do. The nurse would not be responsible for a fundraiser. Contacting local nurses would not be an efficient way to coordinate care for the client.

Question 4

An instructor is teaching the class about cost-conscious nursing practice.The instructor knows that the students understand this concept when the students make which statements? Select all that apply.

Accepted Answer

A) Nurses at all levels face significant pressures to become more cost conscious. This level of financial accountability is new to the nursing profession. Nurses must now compete with other departments within organizations for limited resources. Nurses can be more cost-conscious by carefully using supplies, by searching for more efficient ways to deliver nursing care, and by placing a new emphasis on health promotion and disease prevention. Taking short cuts can lead to mistakes and client care should never be compromised. It is true that there are insufficient healthcare workers to meet needs, but this does not contribute to cost-conscious nursing care.
B) Nurses at all levels face significant pressures to become more cost conscious. This level of financial accountability is new to the nursing profession. Nurses must now compete with other departments within organizations for limited resources. Nurses can be more cost-conscious by carefully using supplies, by searching for more efficient ways to deliver nursing care, and by placing a new emphasis on health promotion and disease prevention. Taking short cuts can lead to mistakes and client care should never be compromised. It is true that there are insufficient healthcare workers to meet needs, but this does not contribute to cost-conscious nursing care.
C) Nurses at all levels face significant pressures to become more cost conscious. This level of financial accountability is new to the nursing profession. Nurses must now compete with other departments within organizations for limited resources. Nurses can be more cost-conscious by carefully using supplies, by searching for more efficient ways to deliver nursing care, and by placing a new emphasis on health promotion and disease prevention. Taking short cuts can lead to mistakes and client care should never be compromised. It is true that there are insufficient healthcare workers to meet needs, but this does not contribute to cost-conscious nursing care.
D) Nurses at all levels face significant pressures to become more cost conscious. This level of financial accountability is new to the nursing profession. Nurses must now compete with other departments within organizations for limited resources. Nurses can be more cost-conscious by carefully using supplies, by searching for more efficient ways to deliver nursing care, and by placing a new emphasis on health promotion and disease prevention. Taking short cuts can lead to mistakes and client care should never be compromised. It is true that there are insufficient healthcare workers to meet needs, but this does not contribute to cost-conscious nursing care.
E) Nurses at all levels face significant pressures to become more cost conscious. This level of financial accountability is new to the nursing profession. Nurses must now compete with other departments within organizations for limited resources. Nurses can be more cost-conscious by carefully using supplies, by searching for more efficient ways to deliver nursing care, and by placing a new emphasis on health promotion and disease prevention. Taking short cuts can lead to mistakes and client care should never be compromised. It is true that there are insufficient healthcare workers to meet needs, but this does not contribute to cost-conscious nursing care.

Question 5

A nurse is applying for a job as a case manager for a managed care insurance organization.Which responsibility is associated with this role?

Accepted Answer

A) Insurance-based case management is a labor-intensive activity that is provided typically by telephone. Case management involves interdisciplinary teams that assume collaborative responsibility for planning and assessing needs. Case management involves coordinating, implementing, and evaluating care for groups of clients from preadmission through discharge or transfer and recuperation. Approving treatment decisions is not a case management role.
B) Insurance-based case management is a labor-intensive activity that is provided typically by telephone. Case management involves interdisciplinary teams that assume collaborative responsibility for planning and assessing needs. Case management involves coordinating, implementing, and evaluating care for groups of clients from preadmission through discharge or transfer and recuperation. Approving treatment decisions is not a case management role.
C) Insurance-based case management is a labor-intensive activity that is provided typically by telephone. Case management involves interdisciplinary teams that assume collaborative responsibility for planning and assessing needs. Case management involves coordinating, implementing, and evaluating care for groups of clients from preadmission through discharge or transfer and recuperation. Approving treatment decisions is not a case management role.
D) Insurance-based case management is a labor-intensive activity that is provided typically by telephone. Case management involves interdisciplinary teams that assume collaborative responsibility for planning and assessing needs. Case management involves coordinating, implementing, and evaluating care for groups of clients from preadmission through discharge or transfer and recuperation. Approving treatment decisions is not a case management role.

Question 6

A client who is experiencing an exacerbation of rheumatoid arthritis (RA)will be discharged after a week's stay in the hospital.The client tells the nurse,"I can't believe how much better I am feeling now." Which is the rationale for why the client is feeling better?

Accepted Answer

A) When coordinating care for clients, the nurse should consider the client's ability to tolerate activity and provide blocks of time for rest. Keeping the client busy would work against the client's best interests and not produce the desired results for overall healing. RA is a chronic disease from which the client will not recover. Although the client may appreciate the various levels of care, that appreciation would not account for how much better the client is feeling after the hospital stay.
B) When coordinating care for clients, the nurse should consider the client's ability to tolerate activity and provide blocks of time for rest. Keeping the client busy would work against the client's best interests and not produce the desired results for overall healing. RA is a chronic disease from which the client will not recover. Although the client may appreciate the various levels of care, that appreciation would not account for how much better the client is feeling after the hospital stay.
C) When coordinating care for clients, the nurse should consider the client's ability to tolerate activity and provide blocks of time for rest. Keeping the client busy would work against the client's best interests and not produce the desired results for overall healing. RA is a chronic disease from which the client will not recover. Although the client may appreciate the various levels of care, that appreciation would not account for how much better the client is feeling after the hospital stay.
D) When coordinating care for clients, the nurse should consider the client's ability to tolerate activity and provide blocks of time for rest. Keeping the client busy would work against the client's best interests and not produce the desired results for overall healing. RA is a chronic disease from which the client will not recover. Although the client may appreciate the various levels of care, that appreciation would not account for how much better the client is feeling after the hospital stay.

Question 7

A nurse is caring for a client who had a total hip replacement 14 days ago.The client is preparing for discharge in a few days.The nurse facilitates a care conference with the primary healthcare provider,occupational therapist,physical therapist,and the client and family to develop a plan of care for the client prior to discharge.Which roles are being demonstrated by this nurse? Select all that apply.

Accepted Answer

A) The nurse is solving problems and planning care for the client by coordinating and collaborating with the other health team members who will participate in client care. All members of the team may be experts, but the level of expertise is not the role the nurse is exhibiting. The nurse is not responsible for how the members of the health team perform their jobs as a team leader would be. The nurse is not acting as an authoritarian in this case; the nurse is planning care and coordination. Differentiated practice involves nursing care from all levels of education and is not illustrated in this scenario.
B) The nurse is solving problems and planning care for the client by coordinating and collaborating with the other health team members who will participate in client care. All members of the team may be experts, but the level of expertise is not the role the nurse is exhibiting. The nurse is not responsible for how the members of the health team perform their jobs as a team leader would be. The nurse is not acting as an authoritarian in this case; the nurse is planning care and coordination. Differentiated practice involves nursing care from all levels of education and is not illustrated in this scenario.
C) The nurse is solving problems and planning care for the client by coordinating and collaborating with the other health team members who will participate in client care. All members of the team may be experts, but the level of expertise is not the role the nurse is exhibiting. The nurse is not responsible for how the members of the health team perform their jobs as a team leader would be. The nurse is not acting as an authoritarian in this case; the nurse is planning care and coordination. Differentiated practice involves nursing care from all levels of education and is not illustrated in this scenario.
D) The nurse is solving problems and planning care for the client by coordinating and collaborating with the other health team members who will participate in client care. All members of the team may be experts, but the level of expertise is not the role the nurse is exhibiting. The nurse is not responsible for how the members of the health team perform their jobs as a team leader would be. The nurse is not acting as an authoritarian in this case; the nurse is planning care and coordination. Differentiated practice involves nursing care from all levels of education and is not illustrated in this scenario.
E) The nurse is solving problems and planning care for the client by coordinating and collaborating with the other health team members who will participate in client care. All members of the team may be experts, but the level of expertise is not the role the nurse is exhibiting. The nurse is not responsible for how the members of the health team perform their jobs as a team leader would be. The nurse is not acting as an authoritarian in this case; the nurse is planning care and coordination. Differentiated practice involves nursing care from all levels of education and is not illustrated in this scenario.

Question 8

A postoperative client is transferred to the medical-surgical unit from the intensive care unit (ICU).The client asks the assigned nurse why unlicensed assistive personnel (UAP)help with range-of-motion exercises.Which is the best response by the nurse?

Accepted Answer

A) An assignment of care is made to a qualified individual (the RN), who then may delegate parts of that care to a UAP. The nurse would not assign care to the UAP, but rather, delegate certain tasks to the UAP. Saying that the client does not need the nurse is not the best approach; it is better to explain that the client has improved to the point where the UAP can assist with certain tasks. The UAP may be delegated tasks by a nurse assigned to care for the client. The charge nurse does not make the assessment to delegate to the UAP; the RN assigned to the care of the client is the decision maker.
B) An assignment of care is made to a qualified individual (the RN), who then may delegate parts of that care to a UAP. The nurse would not assign care to the UAP, but rather, delegate certain tasks to the UAP. Saying that the client does not need the nurse is not the best approach; it is better to explain that the client has improved to the point where the UAP can assist with certain tasks. The UAP may be delegated tasks by a nurse assigned to care for the client. The charge nurse does not make the assessment to delegate to the UAP; the RN assigned to the care of the client is the decision maker.
C) An assignment of care is made to a qualified individual (the RN), who then may delegate parts of that care to a UAP. The nurse would not assign care to the UAP, but rather, delegate certain tasks to the UAP. Saying that the client does not need the nurse is not the best approach; it is better to explain that the client has improved to the point where the UAP can assist with certain tasks. The UAP may be delegated tasks by a nurse assigned to care for the client. The charge nurse does not make the assessment to delegate to the UAP; the RN assigned to the care of the client is the decision maker.
D) An assignment of care is made to a qualified individual (the RN), who then may delegate parts of that care to a UAP. The nurse would not assign care to the UAP, but rather, delegate certain tasks to the UAP. Saying that the client does not need the nurse is not the best approach; it is better to explain that the client has improved to the point where the UAP can assist with certain tasks. The UAP may be delegated tasks by a nurse assigned to care for the client. The charge nurse does not make the assessment to delegate to the UAP; the RN assigned to the care of the client is the decision maker.

Question 9

A nurse working in a large municipal hospital is appointed to a task force whose focus is addressing nursing shortages.Which factor should the task force consider?

Accepted Answer

A) One factor in nursing shortages is the increasing demand for nurses to work in new roles. Periods of acute shortage are often followed by periods of adequate availability of nurses. Hospitals often have cut nursing staff and replaced them with unlicensed assistive personnel (UAP) as a cost-containment measure. As a result of reductions in nursing staff, some nurses, feeling they can no longer provide quality health care, experience disillusionment and leave the profession.
B) One factor in nursing shortages is the increasing demand for nurses to work in new roles. Periods of acute shortage are often followed by periods of adequate availability of nurses. Hospitals often have cut nursing staff and replaced them with unlicensed assistive personnel (UAP) as a cost-containment measure. As a result of reductions in nursing staff, some nurses, feeling they can no longer provide quality health care, experience disillusionment and leave the profession.
C) One factor in nursing shortages is the increasing demand for nurses to work in new roles. Periods of acute shortage are often followed by periods of adequate availability of nurses. Hospitals often have cut nursing staff and replaced them with unlicensed assistive personnel (UAP) as a cost-containment measure. As a result of reductions in nursing staff, some nurses, feeling they can no longer provide quality health care, experience disillusionment and leave the profession.
D) One factor in nursing shortages is the increasing demand for nurses to work in new roles. Periods of acute shortage are often followed by periods of adequate availability of nurses. Hospitals often have cut nursing staff and replaced them with unlicensed assistive personnel (UAP) as a cost-containment measure. As a result of reductions in nursing staff, some nurses, feeling they can no longer provide quality health care, experience disillusionment and leave the profession.

Question 10

The nurse is helping in discharge planning for a diabetic client who needs extensive rehabilitation and is on a complicated medication schedule.The client and spouse currently live with their eldest son and the family is very involved in the client's care.The nurse would want to coordinate the client's care by including which priority individuals? Select all that apply.

Accepted Answer

A) Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and healthcare professionals the opportunity to plan care and set goals. Involving the client's spouse and children would be important in this situation because of the complexity of the client's situation. The physician, pharmacist, and social worker may also be included, but by their own decision, not necessarily by the nurse's invitation, as is the case with coordination.
B) Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and healthcare professionals the opportunity to plan care and set goals. Involving the client's spouse and children would be important in this situation because of the complexity of the client's situation. The physician, pharmacist, and social worker may also be included, but by their own decision, not necessarily by the nurse's invitation, as is the case with coordination.
C) Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and healthcare professionals the opportunity to plan care and set goals. Involving the client's spouse and children would be important in this situation because of the complexity of the client's situation. The physician, pharmacist, and social worker may also be included, but by their own decision, not necessarily by the nurse's invitation, as is the case with coordination.
D) Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and healthcare professionals the opportunity to plan care and set goals. Involving the client's spouse and children would be important in this situation because of the complexity of the client's situation. The physician, pharmacist, and social worker may also be included, but by their own decision, not necessarily by the nurse's invitation, as is the case with coordination.
E) Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and healthcare professionals the opportunity to plan care and set goals. Involving the client's spouse and children would be important in this situation because of the complexity of the client's situation. The physician, pharmacist, and social worker may also be included, but by their own decision, not necessarily by the nurse's invitation, as is the case with coordination.

Question 11

The nurse is caring for several medical-surgical clients.The nurse has delegated skin care of an incontinent client to new unlicensed assistive personnel (UAP)on the unit.Which action by the nurse will improve effectiveness of the client care provided?

Accepted Answer

A) The nurse would show the UAP the exact procedure the first time to avoid any confusion. The nurse would reassess the client's skin later rather than asking the UAP if the task was done. The nurse could possibly alarm the client by asking the client if care was appropriate. Closely observing the UAP defeats the purpose of delegation.
B) The nurse would show the UAP the exact procedure the first time to avoid any confusion. The nurse would reassess the client's skin later rather than asking the UAP if the task was done. The nurse could possibly alarm the client by asking the client if care was appropriate. Closely observing the UAP defeats the purpose of delegation.
C) The nurse would show the UAP the exact procedure the first time to avoid any confusion. The nurse would reassess the client's skin later rather than asking the UAP if the task was done. The nurse could possibly alarm the client by asking the client if care was appropriate. Closely observing the UAP defeats the purpose of delegation.
D) The nurse would show the UAP the exact procedure the first time to avoid any confusion. The nurse would reassess the client's skin later rather than asking the UAP if the task was done. The nurse could possibly alarm the client by asking the client if care was appropriate. Closely observing the UAP defeats the purpose of delegation.

Question 12

The nurse is appointed to a clinical-administrative task force studying critical staffing issues and care delivery models for the hospital.Which evidence on the effects of different staffing choices and care delivery models should the task force consider? Select all that apply.

Accepted Answer

A) Higher nurse-client ratios have been associated with shorter lengths of stay and fewer complications. A recent study depicted a significant reduction in the risk of mortality in surgical clients when the proportion of registered nurses was higher. There is little research on care delivery models since it is more difficult to compare outcomes because each unit may employ slight variations of the model. Research continues to prove that higher nursing ratios result in fewer adverse outcomes for clients.
B) Higher nurse-client ratios have been associated with shorter lengths of stay and fewer complications. A recent study depicted a significant reduction in the risk of mortality in surgical clients when the proportion of registered nurses was higher. There is little research on care delivery models since it is more difficult to compare outcomes because each unit may employ slight variations of the model. Research continues to prove that higher nursing ratios result in fewer adverse outcomes for clients.
C) Higher nurse-client ratios have been associated with shorter lengths of stay and fewer complications. A recent study depicted a significant reduction in the risk of mortality in surgical clients when the proportion of registered nurses was higher. There is little research on care delivery models since it is more difficult to compare outcomes because each unit may employ slight variations of the model. Research continues to prove that higher nursing ratios result in fewer adverse outcomes for clients.
D) Higher nurse-client ratios have been associated with shorter lengths of stay and fewer complications. A recent study depicted a significant reduction in the risk of mortality in surgical clients when the proportion of registered nurses was higher. There is little research on care delivery models since it is more difficult to compare outcomes because each unit may employ slight variations of the model. Research continues to prove that higher nursing ratios result in fewer adverse outcomes for clients.
E) Higher nurse-client ratios have been associated with shorter lengths of stay and fewer complications. A recent study depicted a significant reduction in the risk of mortality in surgical clients when the proportion of registered nurses was higher. There is little research on care delivery models since it is more difficult to compare outcomes because each unit may employ slight variations of the model. Research continues to prove that higher nursing ratios result in fewer adverse outcomes for clients.

Question 13

A nurse is completing discharge teaching for a client who is hospitalized for total hip replacement.The client asks the nurse why there is a case manager involved and expresses confusion about who is in charge.The client states,"I thought my doctor manages my care." Which is the best response by the nurse?

Accepted Answer

A) The case manager is responsible for assuring that all the client's healthcare needs are met in a cost-effective manner. The nurse may be a case manager; however, a staff nurse is not the most likely individual in the hospital setting to be the case manager. An agency usually has several case managers, who collaborate with nursing, the physician, and any other departments involved in the care of the client. A physician does not participate in care by being a case manager. Case managers coordinate disciplines of care for the client and do not delegate any care to other professionals.
B) The case manager is responsible for assuring that all the client's healthcare needs are met in a cost-effective manner. The nurse may be a case manager; however, a staff nurse is not the most likely individual in the hospital setting to be the case manager. An agency usually has several case managers, who collaborate with nursing, the physician, and any other departments involved in the care of the client. A physician does not participate in care by being a case manager. Case managers coordinate disciplines of care for the client and do not delegate any care to other professionals.
C) The case manager is responsible for assuring that all the client's healthcare needs are met in a cost-effective manner. The nurse may be a case manager; however, a staff nurse is not the most likely individual in the hospital setting to be the case manager. An agency usually has several case managers, who collaborate with nursing, the physician, and any other departments involved in the care of the client. A physician does not participate in care by being a case manager. Case managers coordinate disciplines of care for the client and do not delegate any care to other professionals.
D) The case manager is responsible for assuring that all the client's healthcare needs are met in a cost-effective manner. The nurse may be a case manager; however, a staff nurse is not the most likely individual in the hospital setting to be the case manager. An agency usually has several case managers, who collaborate with nursing, the physician, and any other departments involved in the care of the client. A physician does not participate in care by being a case manager. Case managers coordinate disciplines of care for the client and do not delegate any care to other professionals.

Question 14

The nurse is caring for an adult client from Canada who has come to the United States for a serious neurological surgery.The client tells the nurse,"I came to this country so that I would receive better care." Which is the most likely rationale for the client's statement?

Accepted Answer

A) Americans with health insurance have more of a choice about their health care than do other nations of the world. Canada, not the United States, has a universal healthcare system. Most other countries do not allow for competition in health care, but the United States does. Rationing is one reason why clients come to the United States; with rationing, an individual could wait months for needed surgery.
B) Americans with health insurance have more of a choice about their health care than do other nations of the world. Canada, not the United States, has a universal healthcare system. Most other countries do not allow for competition in health care, but the United States does. Rationing is one reason why clients come to the United States; with rationing, an individual could wait months for needed surgery.
C) Americans with health insurance have more of a choice about their health care than do other nations of the world. Canada, not the United States, has a universal healthcare system. Most other countries do not allow for competition in health care, but the United States does. Rationing is one reason why clients come to the United States; with rationing, an individual could wait months for needed surgery.
D) Americans with health insurance have more of a choice about their health care than do other nations of the world. Canada, not the United States, has a universal healthcare system. Most other countries do not allow for competition in health care, but the United States does. Rationing is one reason why clients come to the United States; with rationing, an individual could wait months for needed surgery.

Question 15

A client recovering from an emergency appendectomy is a citizen of France.The client asks the nurse to explain why the United States has chosen such a different healthcare reimbursement system from other Western countries.Which American value could the nurse mention to explain the system in this country?

Accepted Answer

A) The American system reflects ambivalence toward the role of government. In the United States, individual accountability is valued over equity. The U.S. system is based on market competition. In the United States, pluralism and choice are often valued over universality.
B) The American system reflects ambivalence toward the role of government. In the United States, individual accountability is valued over equity. The U.S. system is based on market competition. In the United States, pluralism and choice are often valued over universality.
C) The American system reflects ambivalence toward the role of government. In the United States, individual accountability is valued over equity. The U.S. system is based on market competition. In the United States, pluralism and choice are often valued over universality.
D) The American system reflects ambivalence toward the role of government. In the United States, individual accountability is valued over equity. The U.S. system is based on market competition. In the United States, pluralism and choice are often valued over universality.

Question 16

A veteran nurse is working on a large medical-surgical unit.The nurse is caring for a client with MRSA who requires frequent dressing changes.Which action by the nurse would help control the cost associated with this client's care?

Accepted Answer

A) When a client with MRSA is discharged, everything in the room is either discarded or terminally cleaned. By keeping needed supplies outside the room, the nurse is containing costs as the supplies will not have to be discarded on discharge. Stocking the room with supplies that may not be needed may increase costs of health care. Storing equipment in the appropriate room will not necessarily reduce costs. Wiping down the equipment at the end of the shift has no effect on cost.
B) When a client with MRSA is discharged, everything in the room is either discarded or terminally cleaned. By keeping needed supplies outside the room, the nurse is containing costs as the supplies will not have to be discarded on discharge. Stocking the room with supplies that may not be needed may increase costs of health care. Storing equipment in the appropriate room will not necessarily reduce costs. Wiping down the equipment at the end of the shift has no effect on cost.
C) When a client with MRSA is discharged, everything in the room is either discarded or terminally cleaned. By keeping needed supplies outside the room, the nurse is containing costs as the supplies will not have to be discarded on discharge. Stocking the room with supplies that may not be needed may increase costs of health care. Storing equipment in the appropriate room will not necessarily reduce costs. Wiping down the equipment at the end of the shift has no effect on cost.
D) When a client with MRSA is discharged, everything in the room is either discarded or terminally cleaned. By keeping needed supplies outside the room, the nurse is containing costs as the supplies will not have to be discarded on discharge. Stocking the room with supplies that may not be needed may increase costs of health care. Storing equipment in the appropriate room will not necessarily reduce costs. Wiping down the equipment at the end of the shift has no effect on cost.

Question 17

The nurse delegates vital signs and daily weights of assigned clients to the unlicensed assistive personnel (UAP)on duty.Which is the reason for the nurse to assess each client throughout the shift?

Accepted Answer

A) The nurse remains accountable for the care of clients during delegation to the UAP. The UAP may be untrustworthy, but the reason the nurse checks on the clients is because the accountability belongs to the nurse. The nurse could take a report from the UAP and report that to the next shift. The nurse transfers the authority for the delegated care to the UAP.
B) The nurse remains accountable for the care of clients during delegation to the UAP. The UAP may be untrustworthy, but the reason the nurse checks on the clients is because the accountability belongs to the nurse. The nurse could take a report from the UAP and report that to the next shift. The nurse transfers the authority for the delegated care to the UAP.
C) The nurse remains accountable for the care of clients during delegation to the UAP. The UAP may be untrustworthy, but the reason the nurse checks on the clients is because the accountability belongs to the nurse. The nurse could take a report from the UAP and report that to the next shift. The nurse transfers the authority for the delegated care to the UAP.
D) The nurse remains accountable for the care of clients during delegation to the UAP. The UAP may be untrustworthy, but the reason the nurse checks on the clients is because the accountability belongs to the nurse. The nurse could take a report from the UAP and report that to the next shift. The nurse transfers the authority for the delegated care to the UAP.

Question 18

The nurse is working on a medical-surgical unit that is short staffed due to a callout.The manager of the unit was unable to replace the nurse,so the extra clients were assigned to the remaining nurses.The manager was able to get the help of unlicensed assistive personnel (UAP)from the house pool to help on the unit.Which action by the nurses would ensure effective care for the client?

Accepted Answer

A) The nurses would delegate to the UAP tasks such as taking and recording vital signs, performing a.m. care, and ambulating clients to ensure that all clients receive appropriate care. UAPs are not assigned care, they are delegated tasks. The goal for the unit is to meet the needs of the clients; complaining to the manager will not accomplish this. Telling the clients their care will be sparse is inappropriate. UAPs can be very helpful because they are trained to complete tasks that the nurses would not have time to complete, thus accomplishing the goal of care for all clients on the unit. To alleviate clients' anxiety, the nurse may tell them that extra help is coming for the shift. Nurses delegate tasks directly to the UAPs rather than telling the manager what needs to be done.
B) The nurses would delegate to the UAP tasks such as taking and recording vital signs, performing a.m. care, and ambulating clients to ensure that all clients receive appropriate care. UAPs are not assigned care; they are delegated tasks. The goal for the unit is to meet the needs of the clients; complaining to the manager will not accomplish this. Telling the clients their care will be sparse is inappropriate. UAPs can be very helpful because they are trained to complete tasks that the nurses would not have time to complete, thus accomplishing the goal of care for all clients on the unit. To alleviate clients' anxiety, the nurse may tell them that extra help is coming for the shift. Nurses delegate tasks directly to the UAPs rather than telling the manager what needs to be done.
C) The nurses would delegate to the UAP tasks such as taking and recording vital signs, performing a.m. care, and ambulating clients to ensure that all clients receive appropriate care. UAPs are not assigned care; they are delegated tasks. The goal for the unit is to meet the needs of the clients; complaining to the manager will not accomplish this. Telling the clients their care will be sparse is inappropriate. UAPs can be very helpful because they are trained to complete tasks that the nurses would not have time to complete, thus accomplishing the goal of care for all clients on the unit. To alleviate clients' anxiety, the nurse may tell them that extra help is coming for the shift. Nurses delegate tasks directly to the UAPs rather than telling the manager what needs to be done.
D) The nurses would delegate to the UAP tasks such as taking and recording vital signs, performing a.m. care, and ambulating clients to ensure that all clients receive appropriate care. UAPs are not assigned care; they are delegated tasks. The goal for the unit is to meet the needs of the clients; complaining to the manager will not accomplish this. Telling the clients their care will be sparse is inappropriate. UAPs can be very helpful because they are trained to complete tasks that the nurses would not have time to complete, thus accomplishing the goal of care for all clients on the unit. To alleviate clients' anxiety, the nurse may tell them that extra help is coming for the shift. Nurses delegate tasks directly to the UAPs rather than telling the manager what needs to be done.

Question 19

An older adult client tells the nurse,"I am worried about how I will pay for my hospital bill." The client is being discharged,is being referred to home health care,and the new plan of care involves extremely expensive drugs.Which response by the nurse is appropriate?

Accepted Answer

A) The Medicare amendments to the Social Security Act and their subsequent expansions provide a national and state health insurance program that includes extremely expensive hospital care and prescription drug coverage for adults over the age of 65. Ignoring the client's concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the client's concerns. Passing the concern to the business office does not address the client's concerns. Nurses should have some knowledge about the payment sources of their clients, especially those who have automatic coverage with Medicare because of their age.
B) The Medicare amendments to the Social Security Act and their subsequent expansions provide a national and state health insurance program that includes extremely expensive hospital care and prescription drug coverage for adults over the age of 65. Ignoring the client's concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the client's concerns. Passing the concern to the business office does not address the client's concerns. Nurses should have some knowledge about the payment sources of their clients, especially those who have automatic coverage with Medicare because of their age.
C) The Medicare amendments to the Social Security Act and their subsequent expansions provide a national and state health insurance program that includes extremely expensive hospital care and prescription drug coverage for adults over the age of 65. Ignoring the client's concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the client's concerns. Passing the concern to the business office does not address the client's concerns. Nurses should have some knowledge about the payment sources of their clients, especially those who have automatic coverage with Medicare because of their age.
D) The Medicare amendments to the Social Security Act and their subsequent expansions provide a national and state health insurance program that includes extremely expensive hospital care and prescription drug coverage for adults over the age of 65. Ignoring the client's concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the client's concerns. Passing the concern to the business office does not address the client's concerns. Nurses should have some knowledge about the payment sources of their clients, especially those who have automatic coverage with Medicare because of their age.

Question 20

A nurse working in an outpatient OB-GYN clinic is asked to assume care coordination for the clinic's adolescent clients.Which skills will the nurse need to perform this work?

Accepted Answer

A) Critical thinking skills are crucial to the development of a well-coordinated care plan and its execution. Specific strategic analysis skills are not necessary for this role. Relaxation training skills and accounting skills are not a part of care coordination.
B) Critical thinking skills are crucial to the development of a well-coordinated care plan and its execution. Specific strategic analysis skills are not necessary for this role. Relaxation training skills and accounting skills are not a part of care coordination.
C) Critical thinking skills are crucial to the development of a well-coordinated care plan and its execution. Specific strategic analysis skills are not necessary for this role. Relaxation training skills and accounting skills are not a part of care coordination.
D) Critical thinking skills are crucial to the development of a well-coordinated care plan and its execution. Specific strategic analysis skills are not necessary for this role. Relaxation training skills and accounting skills are not a part of care coordination.

Quiz 39: Managing Care

A nurse,who works in a clinic environment,places great emphasis on cost control,customer satisfaction,health promotion,and preventive services.The primary focus of this nurse is representative of which type of healthcare system?

An instructor is teaching the class about cost-conscious nursing practice.The instructor knows that the students understand this concept when the students make which statements? Select all that apply.

A nurse is applying for a job as a case manager for a managed care insurance organization.Which responsibility is associated with this role?

A client who is experiencing an exacerbation of rheumatoid arthritis (RA) will be discharged after a week's stay in the hospital.The client tells the nurse,"I can't believe how much better I am feeling now." Which is the rationale for why the client is feeling better?

A postoperative client is transferred to the medical-surgical unit from the intensive care unit (ICU) .The client asks the assigned nurse why unlicensed assistive personnel (UAP) help with range-of-motion exercises.Which is the best response by the nurse?