Comm. Nursing Exam 2 (EAQs)

A client who is addicted to opioids undergoes emergency surgery. During the postoperative period, the health care provider decreases the previously prescribed methadone dosage. For which clinical manifestations will the nurse monitor the client?

Agitation and attempts to escape from the hospital Rationale: When the methadone dosage is reduced, a craving for opioids may occur, anxiety will increase, and the client will become agitated and may try to leave the hospital to secure drugs.

Medicaid Facts

-Financial support for low-income families is given by Medicaid only -Services provided during pregnancy are covered by Medicaid ONLY

Which psychosocial clues would be explored to confirm substance abuse in an adolescent?

-Increased school absenteeism -Changes in interpersonal relationships

Which scenario would contribute to health disparities?

An English-speaking nurse conducts the admission interview of a Puerto Rican immigrant with limited knowledge of English.

Which statement best describes the nurse's role as a caregiver?

Help the client maintain and regain health, manage disease and symptoms, and attain a maximal level of function and independence through the healing process.

A 2½-year-old child is admitted for treatment of injuries supposedly sustained in a fall down a flight of stairs. Which statements are more likely to come from a parent who engages in child abuse?

-"Trial and error is a way for kids to learn about accidents and dangers." -"Every time I turn around the kid is falling over something." -"This child is adventurous and doesn't understand about getting hurt." -"The kid didn't have a problem using the stairs without my help before this." -"Little kids are always on the go, and I just can't keep running after him."

Which response would the nurse use when a parent, suspected of child abuse, gives information that contradicts the information given by the child.

"Tell me again how your child fell down the stairs."

The nurse is caring for a child admitted with suspicious injuries. Which question would the nurse ask to obtain further information about possible child abuse?

"What happens when you do something wrong?" Rationale: This provides information about punishment and physical and/or verbal abuse that may be taking place

Which clients would be eligible for Medicare coverage?

-A 67-year-old man with pneumonia -A 75-year-old woman with end-stage renal failure -A 40-year-old physically handicapped man Rationale: Medicare is a federal health insurance program that provides health care coverage for all people who are 65 years of age and older, people who are permanently disabled, and individuals with end-stage renal disease

Which are the similarities between Medicare and Medicaid

1)Older clients are assisted through both programs 2)Medicare and Medicaid pay for home care services

List in priority order the outcome criteria for a client who is a polysubstance abuser.

1)Verbalizes that a substance abuse problem exists 2)Discusses effect of drug use on self and others 3)Expresses negative feelings about the current life situation 4)Explores the relationship of substance use and current problems

Which statement best describes the nurse's role as a manager?

Establishing an environment for collaborative client-centered care to provide safe, quality care with positive client outcomes.

Which component of cultural competence is being demonstrated when the nurse motivates the immigrant to accept differences in the way a pregnant women is cared for in her current residence?

Culture desire Rationale: The nurse is using cultural desire as a part of cultural competence. This component is related to motivation and commitment toward the care of an individual.

Which nursing action during a psychosocial assessment of a transgender client may contribute to health disparities?

Insisting on using the name listed on the client's driver's license

Which statement accurately describes a health care policy as it relates to health care economics

It provides overarching goals and helps in setting priorities and values for the distribution of health resources

Medicare Part C

Medicare advantage plans

Which health care provider would be the best choice to help a homeless client receive needed medication for a communicable disease?

Navigator

When the nurse is developing educational programs for parents of younger school-age children to promote safety, which information would the nurse include that would be appropriate for this age group?

Use a helmet. Rationale: School-age children are at highest risk for injury because of sports and activities. Head injuries are a significant cause of death, especially those that result from bicycle and scooter use.

Which initial outcome criterion would be appropriate for a client who is a polysubstance abuser and is mandated to seek drug and alcohol counseling?

Verbalizes that a substance abuse problem exists

The public health nurse is developing a program geared toward primary prevention of domestic violence. Which information would the nurse include in the program for those at high risk?

-Coping Skills -Social Support -Stress Reduction Rationale: Primary prevention of domestic violence would include programs that prevent abuse from occurring.

While interviewing the parents of an injured child who is brought to the emergency department, the nurse begins to suspect child abuse. Which parental behaviors might support this conclusion?

-Focusing on the child's role in sustaining the injury -Changing the story of how the child sustained the injury -Giving an explanation of how the injury occurred that is not consistent with the injury

The nurse is advised to join a community health center that mainly caters to Latino clients. Which skills would the nurse develop to help reduce health disparities?

-Learning to speak basic medical Spanish -Learning about the health literacy rate of the community -Incorporating the health beliefs of the community in any nursing care plans -Learning about and respecting unique beliefs and values prevalent among the group

A client with an opioid addiction has been taking 40 mg/day of methadone. She is now in the prenatal clinic and is 3 months' pregnant. Which plan of care would the prenatal nurse anticipate?

Continue the prescribed methadone to prevent withdrawal symptoms. Rationale: Methadone and buprenorphine are the recommended treatment options for pregnant women with opioid addiction

Which group benefits from Medicare

People who are 65 years or older

Which organization assists in establishing policies related to Medicare and Medicaid payment for meaningful use of electronic health records (EHRs)?

Center for Medicare and Medicaid Services (CMS) Rationale: CMS rules specify how health care facilities and providers make meaningful use of the EHRs and technologies to receive payment from Medicare and Medicaid.

Which statement best describes the nurse's role as an educator?

Explaining concepts and facts about health, describing reasons for routine care activities, demonstrating procedures such as self-injections, reinforcing learning or client behavior, and evaluating the client's progress in learning.

Medicare Part D

Outpatient prescription drug coverage

A client whose medical expenses are covered under Medicare is hospitalized. Which component of Medicare can be claimed?

Part A

The nurse is working in a hospital that receives most of its payment from Medicare and Medicaid services. In the annual assessment of The Joint Commission, the hospital had not met all the standards set forth in the Centers of Medicare and Medicaid Services. Which action would the nurse expect to be taken?

The Joint Commission would conduct an unannounced follow-up survey in the hospital. Rationale: Before any action is taken, The Joint Commission performs an unannounced follow-up assessment. The hospital accreditation may be lost if the hospital fails to meet the standards during the follow-up survey.

Which definition of battery would the nurse include in teaching a group of parents about child abuse?

The application of force to another person without lawful justification

A client is concerned about not receiving treatment as a result of a Medicare policy change. Which response by the nurse leader is accurate?

The change will not affect your treatment

Which nurse statement reflects positive cultural sensitivity to help reduce potential health disparities?

"Which type of food do you usually eat at home?"

What is the public health organization definition of relative homelessness?

People who have a physical shelter but do not meet the standards of health and safety.

What is the public health organization definition of absolute homelessness?

People who have no physical shelter

Which statement by the mother supports a suspicion of child abuse for a 3-year-old girl admitted to the hospital with many poorly explained injuries?

-"I have no problems with any of my other children."

The nurse manager is teaching the nursing team about funds allocated to health departments for personal health services by local, state, and federal governments. Which statements made by a member of the team would indicate effective learning?

-"The funds provide care for newborns." -"The funds provide care for clients with tuberculosis." -"The funds provide care for children with birth defects." Rationale: The funds provided by the local, state, and federal governments for the personal health services include care for newborns, care for clients with communicable diseases, and care for children with birth defects.

Which clients are ideal candidates for interpreter service to prevent contributing health disparities?

-A non-English-speaking client in the emergency department -A Spanish-speaking client ready to be discharged from the facility -An Indian American who does not speak the language used at the facility

A 20-year-old carpenter with a history of substance abuse falls from a roof and sustains fractures of the right femur and left tibia. Which intervention is the most important?

-Assessing for amount and time of last substance use Rationale: Nurses would base their treatment of withdrawal symptoms on the time and amount of last use

Which parental behaviors support a suspicion of child abuse?

-Exhibiting difficulty in showing concern for their child -Procrastinating in obtaining treatment for their child's injuries

Medicare Facts

-Medicare sometimes does not cover the full cost of certain services provided to the members. -Medicare is a health insurance program; the payment for this program is deducted from the individual's monthly Social Security check.

Which trigger would the nurse instruct a client to avoid to decrease the incidence of asthma attacks?

-Mold -Cold air -Pet dander -Air pollution -Cigarette smoke

The nurse's advocate role for a victim of intimate partner violence (IPV) would include which important components?

-Planning for future safety -Validating the experiences -Promoting access to community services

Which agencies have the power to implement Medicare and Medicaid reimbursement?

-The Joint Commission (TJC) -National Committee for Quality Assurance (NCQA) -Community Health Accreditation Program (CHAP) -Accreditation Commission for Health Care (ACHC)

Which instructions would the nurse provide to a group of parents with small children to promote safety and prevent injury?

-Turn pot handles away from edges. -Install smoke detectors in the house. -Lock medication away in a safe place. -Place child safety latches on cabinets. -Verify water temperature before baths.

When compared with their non-Hispanic white counterparts, which factors contribute to the health disparities among the older adult Hispanic population?

-Value differences -Language barrier -Lack of health care facility -Inadequate health insurance

Which physical or behavioral signs of substance abuse would a nurse observe for in the adolescent population?

-Worrying about being addicted -Experiencing an overdose or withdrawal symptoms -Manifesting bizarre behavior or confusion

What are the stages of the policy process (Correct Order)

1)Agenda Setting 2)Policy Formulation 3)Policy Adoption 4)Policy Implementation 5)Policy Evaluation

Which statements best describe a health policy

1)It involves goal-directed decision-making 2)It involves governments or other authorized entities 3)It includes actions, nonactions, decisions, and guidance

The nurse notes that a client is refusing a vital lifesaving surgery because of financial constraints. The client's insurance has lapsed and the health care facility's policies do not allow surgeries to be performed free of cost. Which would the nurse do first to deal with the situation?

Collect information relevant to the issue from multiple sources. Rationale: The nurse identifies the situation to be an ethical dilemma. When resolving the ethical dilemma, the nurse would first gather all relevant information related to the situation from multiple sources, such as the client, the family, and the institution

Medicare Part A

Covers hospital insurance

Medicare Part B

Covers supplemental medical insurance

Which action performed by the nurse is in accordance with the rules of the Centers for Medicare and Medicaid Services (CMS)?

Enters symptoms and treatment provided to the client in the electronic health record (EHR) Rationale: The nurse would enter symptoms, treatments, and outcomes in the EHR because doing so helps claim insurance.

When suspicion of child abuse is confirmed, which intervention is the priority?

Protecting the total well-being of the child

Which statement best describes the nurse's role as an advocate?

Protects the client's human and legal rights and helps assert these rights

Which is the professional nurse's legal responsibility regarding child abuse?

Report any suspected abuse to local law enforcement authorities.

The nurse in an emergency department is assessing a young child with a head injury. The child is accompanied by a parent. Which observation would prompt the nurse to assess the child for abuse?

The child has received care for injuries twice earlier. Rationale: Frequent emergency visits for injuries should prompt the nurse to further investigate the case

A community health care nurse is conducting a survey about homeless children in the community. Which finding helps the nurse distinguish absolute homelessness from relative homelessness?

The children do not have a physical shelter and may sleep outdoors or in vehicles.

A client who does not understand English requires an interpreter. Which action by the student nurse may exacerbate health disparities?

The student talks only to the interpreter about the client. Rationale: The nurse would talk to the client about the client's condition and care and not to the interpreter.

Which represents a significant shift in U.S. health policy in recent years

There is a focus on better managing clients with multiple chronic conditions

Which definition of assault would the nurse include in teaching a group of parents about child abuse?

Threat to do bodily harm to another person

The nurse is planning personal protective equipment for a client who is homeless and who is hospitalized for alcohol withdrawal. The nurse recalls that this population is at risk for which condition

Tuberculosis