Deck 2: Medical-Surgical Practice Settings

Question 1

What is an example of a description of community health nursing?

A) Visiting patients in their homes after hospital discharge to assess their personal health status
B) Asking a nursing assistant (NA)to identify the health services most needed in the patient's personal life
C) Meeting with residents of low-income housing to identify their health care needs
D) Developing a hospital-based home health care service

Answer 1

Meeting with residents of low-income housing to identify their health care needs

Question 2

A patient with multiple sclerosis must be fed, bathed, and dressed.How should the nurse assess this patient?

A) Disabled
B) Disadvantaged
C) Handicapped
D) Impaired

Answer 2

Impaired

Question 3

While a home health nurse is making the entry to a service assessment on a homebound patient, the spouse of the patient asks whether Medicare will cover the patient's ventilator therapy and insulin injections.What is the best response by the nurse?

A) "Yes, Medicare will cover both the ventilator therapy and the insulin injections."
B) "No, Medicare will not cover either of these ongoing therapies."
C) "Medicare will cover the ventilator therapy, but it does not cover the insulin injections."
D) "Medicare will cover the ongoing insulin therapy, but it does not cover a highly technical skill such as ventilator therapy."

Answer 3

"Medicare will cover the ventilator therapy, but it does not cover the insulin injections."

Question 4

The wife of a patient asks the nurse whether her husband would be considered for placement in a skilled nursing care facility when he is discharged from the general hospital.The patient is incontinent, has mild dementia but is able to ambulate with a walker, and must have help to eat and dress himself.What is the nurse's most appropriate response?

A) "Yes, your husband would qualify for a skilled care facility because of his inability to feed and dress himself."
B) "No, your husband's disabilities would not qualify him for a skilled facility."
C) "Yes, your husband qualifies for placement in a skilled care facility because of his dementia."
D) "Yes, anyone who is willing to pay can be placed in a skilled nursing facility."

Question 5

A computer programmer who lost both legs is being retained by his employer, who has made arrangements for a ramp and a special desk to accommodate the patient's wheelchair.What is the disability level of the computer programmer?

A) I
B) II
C) III
D) IV

Question 6

Based on guidelines from the Americans with Disability Act (ADA), which question is an appropriate choice for the director of nurses to ask a nurse with an artificial leg who is applying for a staff position in an extended care facility?

A) "How long have you had your prosthesis?"
B) "How many flights of stairs are you able to climb without assistance?"
C) "Are you able to lift a load of 45 lb?"
D) "Has your disability caused you to miss work?"

Question 7

Home health nurses have some different nursing activities than those of community health nurses.Which statement best describes the home health nurse's activities?

A) Conducting health education classes in a senior citizens' common residence building
B) Conducting blood pressure screening on a regular basis at a local mall
C) Visiting and assessing the home care and further teaching needs of a patient who has been recently discharged from the hospital
D) Acting as a nurse consultant to a chronic psychiatric section in a state institution

Question 8

A nurse reminds a resident in a long-term care facility that he has autonomy in many aspects of his institutionalization.What is an example of autonomy?

A) Selection of medication times
B) Availability of his own small electrical appliances
C) Smoking in the privacy of his own room
D) Application of advance directives

Question 9

A nurse explains that in 1990, the Americans with Disabilities Act (ADA)was passed.For which extended services for the disabled persons did this act provide?

A) Covering the costs for the rehabilitation of disabled World War I servicemen by providing job training
B) Extending protection to the disabled in the military sector, such as wheelchair ramps on military bases
C) Extending protection to the disabled in private areas, such as accessibility to public restaurant bathrooms and telephones
D) Affording disabled persons full access to all health care services

Question 10

A frail patient in a long-term care facility asks the nurse if a bath is to be given this morning.What is the best reply by the nurse to encourage independence and give the patient the most flexibility?

A) "Based on your room number, you get bathed on Monday, Wednesday, and Friday.Today is Tuesday."
B) "If you want to eat breakfast in the dining room with the others, you may sponge yourself off in your bathroom."
C) "When your daughter comes this evening, ask her if she can give you a bath."
D) "I will bring a basin of water for a sponge off for right now.After breakfast, we will talk about a bath schedule."

Question 11

A nurse has noted that a newly admitted resident to an extended care facility stays in her room, does not take active part in activities, and leaves the meal table after having eaten very little.The nurse should analyze this relocation response as

A) regression.
B) social withdrawal.
C) depersonalization.
D) passive aggressive.

Question 12

A client was admitted to a long-term residential care facility.On what should the admitting nurse tell the family the concepts of long-term care are based?

A) Amount of activities the resident can do for herself
B) Maintenance care with an emphasis on incontinence
C) Successful adaptation to the regulations of the home
D) Maintenance of as much function as possible

Question 13

A nurse clarifies to a new patient in a rehabilitation center what rehabilitation means.What statement made by the patient indicates a correct understanding?

A) "I will return to my previous level of functioning."
B) "I will be counseled into a new career."
C) "I will develop better coping skills to accept his disability."
D) "I will attain the greatest degree of independence possible."

Question 14

A nurse is making a list of the members of the rehabilitation team, so the different types of services available to patients may be taught to a group of families.Which lists should be used?

A) Physical therapist, nurse, family members, and personal physician
B) Occupational therapist, dietitian, nurse, and patient
C) Rehabilitation physician, laboratory technician, patient, and family
D) Vocational rehabilitation specialist, patient, and psychiatrist

Question 15

A partially paralyzed forklift operator is to be retrained by vocational rehabilitation services for less demanding office work.What law provides for this rehabilitation?

A) Vocational Rehabilitation Act of 1920
B) Social Security Act of 1935
C) Rehabilitation Act of 1973
D) Americans with Disabilities Act of 1990

Question 16

A nurse assesses a patient who needs to be reminded to take premeasured oral medications, wash, go to meals, and undress and come to bed at night, but coming and going as he pleases is considered safe for him.What facility placement would be most appropriate for this patient?

A) Skilled care
B) Intermediate care
C) Sheltered housing
D) Domiciliary care

Question 17

The home health care nurse performs all the following actions.Which is the only action that is reimbursable under Medicare payment rules?

A) Observing a spouse cleaning and changing a dressing
B) Taking a frail couple for a walk to provide exercise
C) Watching a patient measure out all medications
D) Teaching a patient to self-administer insulin

Question 18

A 58-year-old patient with diabetes is recuperating from a broken hip and is concerned about how to pay for rehabilitation.The nurse should inform this patient that funds for rehabilitation are available from which resource?

A) Vocational Rehabilitation Act of 1920
B) Rehabilitation Act of 1973
C) Disabled American Veterans Act of 1990
D) Title V, Health of Crippled Americans 1935

Question 19

Which law initially provided for rehabilitation of disabled Americans?

A) Vocational Rehabilitation Act of 1920
B) Social Security Act of 1935
C) Rehabilitation Act of 1973
D) Americans with Disabilities Act of 1990

Question 20

A nurse explains the level of disability to a patient who was injured in a construction accident that resulted in the loss of both his right arm and right leg.This loss has affected his quality of life and ability to return to previous employment.At what level should the client be classified as being disabled?

A) I
B) II
C) III
D) IV

Question 21

From what do most quality-of-care problems in home health care result? (Select all that apply.)

A) Patient's noncompliance
B) Family's reluctance to participate in the care
C) Inadequate documentation
D) Limited funding
E) Defective communication among care team members

Question 22

An 80-year-old man is newly admitted to a long-term care facility and suddenly becomes incontinent of urine at night.What nursing interventions should be used to help restore self-toileting? (Select all that apply.)

A) Waking the resident every 2 hours and escorting him to the bathroom
B) Leaving a night-light on
C) Discouraging the use of long-legged pajama bottoms
D) Placing a urinal at the bedside
E) Keeping the room uncluttered

Question 23

Prioritize the steps in solving an ethical dilemma.______ (Place the events in the appropriate sequence.Do not separate answers with a space or punctuation.Example: ABCD.)

A)Evaluate the outcome.
B)Plan an approach.
C)Visualize the consequences.
D)Take action.
E)Identify the problem.

Question 24

What should the home health nurse do when teaching a family member the skill of injecting insulin effectively? Prioritize these nursing interventions for this situation.______ (Place the events in the appropriate sequence.Do not separate answers with a space or punctuation.Example: ABCD.)

A)Offer instruction at an appropriate pace.
B)Write down the steps of the procedure.
C)Assess the level of knowledge of the family member.
D)Inquire about the preferred learning style.
E)Evaluate the family member's performance.

Question 25

The nurse clarifies that an impairment that creates a measurable diminished capacity to work is a(n)_______.

Question 26

The nursing care plan in a long-term care facility calls for the documentation of regressive behavior of a newly admitted 82-year-old resident who has had congestive heart failure and osteoarthritis.Of these behaviors observed by the nurse, which should be documented as regression? (Select all that apply.)

A) Talks nonstop to staff and other residents.
B) Wets and soils self several times a day.
C) Wakes in the middle of the night and is unable to return to sleep.
D) Wears the same clothes day after day.
E) Cries frequently for no apparent reason.