MS 1-2

A client who has mental disabilities has recently lost his remaining parent and is unable to care for himself at home. What facility would best meet the needs of this client?

Intermediate care facility

In an effort to cut costs, hospitals have instituted many changes. Which of these cost-cutting factors is most likely to jeopardize the quality of care?

Using unlicensed assistive personnel

What statement by the nurse shows an understanding of the ultimate goal of Healthy People 2020?

"The ultimate goal is that they provide an overall action plan to improve health and quality of life."

The nurse informs the administrative assistant that a client is expected to come in for lab work. The administrative assistant inquires about why the nurse refers to the individual as a client. What is the best response by the nurse?

"Using the term client implies that they are an active partner in nursing care."

An LPN just received her license to practice and applied for a position at a skilled nursing care facility. While being interviewed, the LPN asks what her role will be at the facility. What is the best answer by the interviewer?

"You will be participating in the care of the clients."

A student nurse asks the nursing instructor, "What will my role as a nurse encompass after I graduate?" What is the best response by the nursing instructor?

"You will care for individuals and families and play a role in health education, illness prevention, and promotion."

A hospital unit has been using a functional nursing model for delivery of care for several years. The manager has been discussing with the staff the idea of a change to total care because functional nursing has some disadvantages to the clients. What disadvantage is the manager referring to?

It fragments care and is confusing for the clients.

The nurse is leading a cardiac rehabilitation support group. How can the nurse best demonstrate meeting the clients need holistically?

Lead an exercise, show a video about healthy lifestyle changes, and invite a spiritual leader to talk with the group.

A client is a member of a group insurance plan in which he pays a preset, fixed fee for healthcare services. What type of insurance plan does the nurse understand the client to have?

A health maintenance organization (HMO)

The charge nurse is making assignments for a group of clients on a medical unit. When reviewing the acuity of the clients, the charge nurse assigns the RN to the clients with higher acuity levels. Why would the charge nurse assign the RN to the clients with a higher acuity?

A higher acuity client requires a greater need for highly skilled care.

A client who is mentally disabled is working at an adult activity center. The client is unable to live independently, and the family member they are living with can no longer assist with supervised care. What option for living arrangements would be ideal for this person?

Boarding home

The nurse manager of a telemetry unit is considering changing from a team model of nursing to a primary nursing model. When considering this decision, what advantage does the manager understand the primary nursing model brings to nursing care?

Caregivers see to all their clients' needs, thus providing holistic and comprehensive care.

A client is admitted to an acute care facility after having a stroke. The client will require a variety of healthcare services throughout the hospital stay as well as coordination of care prior to discharge. What referral would be a priority for overseeing the client's care?

Case management

A client is brought into the emergency department by the rescue squad after involvement in a motorcycle accident with a severe spinal cord injury. What type of illness does the nurse view this event?

Catastrophic

Freestanding apartments are an example of which type of alternative healthcare setting?

Congregate housing

An older man has been sick for 3 weeks but will not seek medical help even though he is able to get to the doctor's office. The client does not know what his insurance will cover. The client has many medical bills from treatments not covered and does not want to be faced with more. Why is this client waiting to obtain medical treatment?

Cost

A client is unable to care for her needs and requires assistance with activities of daily living. The son calls the clinic and informs the nurse that he wants his mother to be able to remain in her home but must work and is unable to care for her 24 hours per day. What options can the nurse suggest for the care of his mother?

Employ private duty nurses to care for the parent.

The nurse is working for a physician who participates in an HMO and will be assisting with the billing. What type of information regarding capitation does the nurse need to understand?

Fees are not based on the number of services provided but rather are projected to the number of participants and expected services.

The LPN has been assigned to a medical floor and to do all of the dressing changes and other treatments. The RN will make the rounds with the physicians, transcribe orders, and administer all of the IV medications. Another LPN will administer medications. What type of nursing is this group providing?

Functional nursing

Veterans' hospitals are an example of which type of ownership?

Government-owned

A 17-year-old client is having protected sex one to two times a week in a monogamous relationship. What is the client participating in?

Health maintenance

What method for financing healthcare is based on the ability to keep clients healthy and out of the hospital through periodic screening, health education, and preventive services?

Health maintenance organization

The nurse is providing a program at the local YMCA about stress-reduction techniques combined with a 1-mile walk around the indoor track once a week. What does this type of program address for the community?

Health promotion

What does the nurse understand is the focus of healthcare when a client receives services from a health maintenance organization (HMO)?

Health promotion and maintenance

A client has end-stage chronic obstructive pulmonary disease (COPD) and is terminally ill. The family wants the client to spend her last days in a facility that will be able to keep the client comfortable and control her severe dyspnea. What facility will meet the needs of the client and family?

Hospice care

Which type of care is used for clients with terminal illness who have a life expectancy of less than 6 months?

Hospice care

A client undergoing a surgical procedure at the hospital died related to complications during the procedure. The nurse is required to collect data about the event so that a cause can be determined. What type of quality indicators would be used in this incident?

Inpatient QIs

The nurse is collecting data at the clinic from a new client who is being seen for an employee physical. The client informs the nurse that both parents have a history of high blood pressure and his father had a stroke at age 52 years. The nurse discusses diet and exercise programs that may benefit the client. What is the nurse displaying with this information?

Illness prevention

Which nursing theorist stated that clients are open systems in constant interaction with their environment?

Imogene King

A client arrives at the physician's clinic in order to receive care for a cough and fever. What type of healthcare institute classification is this client attending?

In-and-out care

Which type of length of stay includes emergency department visits?

In-and-out care

The Healthy People 2020 initiative targets the improvement of health for all. In addition to eliminating health disparities, what are the broad goals of this plan?

Increasing the quality and length of a healthy life

Which setting has been the traditional site for the nursing work force?

Inpatient units

A client who is receiving respiratory support with a tracheostomy and mechanical ventilation after a stroke is being discharged from the acute care facility. Family members state that they will not be able to care for the client at home to provide the care that is required. What type of care may this client be a candidate for after discharge?

Long-term acute care

A client informs the nurse that she is a single parent with four children and cannot afford to pay for medical insurance for her and her family. What coverage does the nurse understand this client and her family may be eligible for?

Medicaid

A 72-year-old client who is hospitalized will be going on anticoagulant therapy and will require home healthcare nurses to visit once weekly to draw blood for coagulation studies. What coverage does the client have that will cover this service?

Medicare Part A

A 65-year-old client is prescribed multiple medications for diabetes, hypertension, and angina and is going to the pharmacy to have the prescriptions filled. What coverage will the client use to assist with financial coverage of the medication?

Medicare Part D

The hospital is having a problem with healthcare-associated infections. A committee has been established to study the problem and make recommendations. The nurse working on the committee knows that this work addresses what?

National Patient Safety Goals

A religious organization is an example of this type of ownership?

Nonprofit agency

The nurse is aware of the various changes in the healthcare field. What important factor remains the same in this time of change?

Nurses must provide safe, high-quality, cost-effective care to individuals, families, and communities.

A client will be discharged from an acute care facility but will require home health services to assess the need for assistive devices to aid in activities of daily living and identify issues related to fine motor movements and muscle retraining after a stroke. What referral will home health services make?

Occupational therapy

The nurse is making a referral to physical therapy for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse understands that having physical therapy included in the care of the client includes

Part of the healthcare team

The nurse has been asked to assist in gathering data regarding the incidence of falls in the hospital as part of a project that is geared toward identifying avoidable contributing factors and their effects. What type of quality indicators (QI) is this considered?

Patient safety QI

Managed care organizations are insurers that carefully plan and closely supervise the distribution of healthcare services. What is one of the goals of managed care?

Preventing illness through screening and promotion of health activities

A client complaining of bloody urine has scheduled an appointment with a family practitioner. What type of care is the client receiving?

Primary

An RN has been assigned to care for three clients on the medical unit and will assume 24-hour accountability for those clients' care. When the nurse goes off duty, the plan of care will be continued by a secondary nurse. What type of nursing model is this considered?

Primary nursing

The nurse is assisting with the development of a program to administer flu shots to a group of senior citizens. What type of prevention does this program reflect?

Primary prevention

A client in an acute care facility is assigned a case manager to oversee and coordinate care. What important function does a case manager have?

Provide early, thorough discharge planning.

Which of the following describes the role of the nurse as defined by Florence Nightingale?

Putting the client in the best condition for nature to act upon him or her

A client experienced a stroke approximately 2 weeks previously and has residual left side hemiparesis. What facility would best meet the needs of this client in order to help regain independence with activities of daily living?

Rehabilitation care

A client is living in congregate housing and informs the nurse at the clinic that they do not like living there. When the nurse asks why they are unhappy with current living arrangements, the client states, "It is a nice place but I am unable to do anything because I hardly have money for my medicines or food." What is an issue related to congregate housing?

Residents may not have any other resources to purchase extra services or goods.

The client is referred from the physician to a cardiologist for a cardiac catheterization to determine if the client has coronary artery disease. What type of care does the nurse understand that this is?

Secondary care

The nurse working in the clinic has had several incidence of positive chlamydia cultures return in women with pelvic pain. The nurse understands that early diagnosis and treatment are essential measures in which to reduce contagion and limit the complications related to this infection. What type of prevention will the nurse use when these infections are treated?

Secondary prevention

An older adult client is being transferred to another facility in order to continue physical therapy after having a total right hip replacement. What type of facility will provide skilled nursing and rehabilitative care for this client who will go home after the rehabilitation?

Skilled nursing care

The LPN is part of a group of nurses that has an RN team leader as well as another LPN and two nursing assistants who will be providing care to a group of clients. What type of nursing method is this considered?

Team nursing

After hip surgery, a client is admitted to the rehabilitation hospital. What type of care is the client receiving?

Tertiary

Which of the following describes the goal of alternative care facilities?

The facility provides the least restrictive living arrangement.

A client with terminal cancer is being referred to hospice services to assist with care of the client and the family in the home environment. What type of care does the nurse determine this is?

Tertiary care

The LPN is caring for clients at the hospital's medical unit. What role does the LPN/LVN have in the care of clients on this unit?

The LPN/LVN may provide care to clients who have a well-defined, common problem.

A client is going to be in a subacute care unit for approximately 30 days. The client will require frequent assessments and periodic review of the client's progress. What role will the registered nurse have in the care of this client?

The RN will coordinate the client's care.

An LPN says to an RN, "I don't understand why I get paid less, yet we do the same thing here at work." What role does the RN have in the healthcare setting that the LPN does not?

The RN's role is more complex and involves management and coordination of all the care provided to a group of clients.

A client with chronic obstructive pulmonary disease visits a local long-term care facility once a week to lead a bingo game for the residents. How does the nurse determine that this client is achieving a high level of wellness?

The client is achieving a high quality of life within the limits of her illness.

Since losing his right leg years ago, the client and his wife have formed a community walking group to raise money for the homeless in his area. Which of these has contributed to him being viewed as "healthy"?

The client is experiencing high quality of life within the limits of the physical condition.

An HMO client obtained a second opinion regarding a diagnosis of colon cancer. There was no authorization obtained for this second opinion from the client or primary care provider. What is the consequence of this action?

The client will be responsible for the entire bill for the second opinion.

A client comes to the clinic with the complaint that he has been ill for several weeks but do not have insurance and have delayed care. What does the nurse understand about the overall healthcare reform goals that will address issues such as this client?

The goal of healthcare reform is to provide affordable healthcare to more citizens.

Home health nurses will be caring for a debilitated client in the home. The client will be discharged from an acute care facility to the care of family members. The client will require twice daily wound care for a large sacral decubitus ulcer. What will be the goal of the home health nurses in the care of this client?

To encourage family members to develop self-care skills and perform dressing changes

The RN is assuming all of the care for a small group of clients, and an LPN is assigned to another group of clients with a lower acuity. What type of nursing is this considered?

Total care

A nurse has applied for a position in the hospital emergency department and is told that the facility only hires RNs and unlicensed assistive personnel (UAPs) in the emergency department. What concern does the nurse have with the practice of hiring UAPs in place of LPNs?

UAPs are performing some of the duties that practical nurses typically provide and may jeopardize the quality of care.