Management of Care RN
A 72-year-old man who had a stroke is being transferred from a medical unit to a rehabilitation center. The nurse case manager is assisting in the process. The nurse knows that the goals of case management include which of the following? Select all that apply. 1. Improving the coordination of care 2. Increasing referrals to local organizations 3. Reducing the fragmentation of care 4. Discharging clients quickly
1) CORRECT: One of the primary goals of case management is to improve the coordination of care. (3) CORRECT: One of the primary goals of case management is to reduce fragmentation of care.
Which activity represents secondary prevention? 1. A home health care nurse visits a patient's home to change a wound dressing. 2. A 50-year-old woman with no history of disease attends the local health fair and has her blood pressure checked. 3. The school nurse provides a program to freshman on healthy eating. 4. The patient attends cardiac rehab sessions weekly.
1. A home health care nurse visits a patient's home to change a wound dressing.
The health care provider prescribes these actions for a client who was admitted with acute substernal chest pain. Which actions are appropriate to delegate to an experienced LPN/ LVN who is working with you in the ED? (Select all that apply.) 1. Attaching cardiac monitor leads 2. Giving heparin 5000 units IV push 3. Administering morphine sulfate 4 mg IV 4. Obtaining a 12-lead electrocardiogram (ECG) 5. Asking the client about pertinent medical history 6. Having the client chew and swallow aspirin 162 mg
1. Attaching cardiac monitor leads 4. Obtaining a 12-lead electrocardiogram (ECG) 6. Having the client chew and swallow aspirin 162 mg
A nurse is planning care for a child diagnosed with gender dysphoria. Which of the following nursing diagnoses could potentially document this client's problems? (SATA) 1. Low self-esteem R/T rejection by peers 2. Self-care deficit R/T isolative behaviors 3. Disturbed personal identity R/T parenting patterns 4. Impaired social interactions R/T socially unacceptable behaviors 5. Activity intolerance R/T fatigue
1. Low self-esteem R/T rejection by peers 3. Disturbed personal identity R/T parenting patterns 4. Impaired social interactions R/T socially unacceptable behaviors
The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior? 1. Reflecting cultural value 2. An acceptance of treatment 3. Client agreement to the required procedures 4. Client understanding of the preoperative procedures
1. Reflecting cultural value
The nurse is participating at a health fair at the local mall giving influenza vaccinations to senior citizens. What level of prevention is the nurse practicing? 1. Primary Prevention 2. Secondary Prevention 3. Tertiary Prevention 4. Quaternary Prevention
1. primary
A client with diabetes mellitus is admitted to the hospital for eye surgery. Which task can be delegated to the unlicensed assistive personnel (UAP)? 1.Orient the client to the hospital surroundings. 2.Instruct the client on how to apply the eye drops. 3.Listen to the client express his frustration or loss. 4.Review hand washing and hygiene practices with the client.
1.Orient the client to the hospital surroundings.
The registered nurse (RN) directs the licensed practical nurse (LPN) to assist with the care of a client who has a sacral ulcer. Which is the most appropriate activity for the RN to delegate to the LPN? 1.Place the client in a side-lying position. 2.Initiate wound care protocol for standardized ulcer care. 3.Meet with the wound specialist to identify measures to improve healing. 4.Determine which treatments would best meet the healing needs of the client.
1.Place the client in a side-lying position.
A nurse is counseling a client diagnosed with gender dysphoria. What criteria would differentiate this disorder from a transvestic disorder? 1. Clients diagnosed with transvestic disorder are dissatisfied with their gender, whereas clients diagnosed with gender dysphoria are not. 2. Clients diagnosed with gender dysphoria are dissatisfied with their gender, whereas clients diagnosed with transvestic disorder are not. 3. Clients diagnosed with gender dysphoria avoid all forms of sexual intercourse, whereas clients diagnosed with transvestic disorder do not. 4. Clients diagnosed with transvestic disorder avoid all forms of sexual
2. Clients diagnosed with gender dysphoria are dissatisfied with their gender, whereas clients diagnosed with transvestic disorder are not.
A nurse is teaching a postoperative patient deep breathing and coughing exercises. Which method of instruction is most appropriate in this situation? 1. Explanation 2. Demonstration 3. Video presentation 4. Brochure with pictures
2. Demonstration
A nurse is assessing a patient's readiness to learn about smoking cessation. Which patient factor does the nurse consider is most important when determining if a teaching program is needed by the patient? 1. Previous experience 2. Perceived need 3. Expectations 4. Flexibility
2. Perceived need
A nurse could best refer an unemployed 42-year-old renal failure patient who has lost his job-related private insurance to which health care plan for his medical care? 1. Medicare 2. Medicaid 3. Public health facility 4. Community-based outpatient clinic
2. medicaid
Which tasks should the registered nurse (RN) delegate to the licensed practical nurse (LPN)? Select all that apply. 1.Assessment 2.Urinary catheterization 3.Endotracheal suctioning 4.Intramuscular medication administration 5.Subcutaneous medication administration 6.Intravenous push medication administration
2.Urinary catheterization 3.Endotracheal suctioning 4.Intramuscular medication administration 5.Subcutaneous medication administration
A nurse is planning to teach the patient how to self-administer a colostomy irrigation. Place the following actions that the nurse should employ in the order in which they should be implemented. 1. Identify the patient's readiness to learn. 2. Involve the patient in learning activities. 3. Identify the patient's motivation to learn. 4. Repeat essential concepts to reinforce learning. 5. Evaluate the patient's learning versus desired outcomes.
3, 1, 2, 4, 5
Which of the following teaching-learning concepts that moves from one extreme to the other is basic to all teaching plans? 1. Cognitive to the affective domain 2. Formal to the informal 3. Simple to the complex 4. Broad to the specific
3. Simple to the complex
A 66-year-old hospitalized patient is anxious about how the physician will be paid now that the patient is on Medicare Part A and Part B, instead of his previous privately funded insurance plan. The nurse explains that the physician will be paid by: 1. the previously private funded insurance. 2. Medicare Part A. 3. Medicare Part B. 4. the patient or his family.
3. medicare part B
A 76-year-old man, hospitalized for treatment following a stroke, asks the nurse how long he can expect Medicare to cover his treatment. The nurse's most informative response is: 1. "Your Part B will cover your hospital care as long as is necessary." 2. "Your care provider will determine how long your Medicare coverage will be in effect." 3. "You are allowed 50 days of inpatient care annually." 4. "You can receive skilled care for up to 100 days."
4. "You can recieve skilled care for up to 100 days."
A nurse is to provide nutritional counseling for an older adult. What should the nurse do first? 1. Plan educational sessions in the late afternoon 2. Speak louder when talking 3. Provide large-print books 4. Assess for readiness
4. Assess for readiness
A nurse is designing a teaching-learning program for a patient who is to be discharged from the hospital. After developing a nurse-patient relationship, which should the nurse do next? 1. Identify the patient's locus of control. 2. Use a variety of teaching methods appropriate for the patient. 3. Formulate an achievable, measurable, and realistic patient goal. 4. Assess the patient's current understanding of the content to be taught.
4. Assess the patient's current understanding of the content to be taught.
Which is the priority nursing action? 1. Find out the previous addresses of the patient. 2. Involve a chaplain in the plan of care. 3. Be able to speak a foreign language. 4. Explain procedures with knowledge of cultural preferences.
4. Explain procedures with knowledge of cultural preferences.
A school nurse working at a middle school recognizes that several students identify as LGBTQ. Which of the following should the school nurse keep in mind when assessing these students? 1. Later onset of puberty 2. Greater popularity among student peers 3. Earlier sexual activity 4. Greater risk of suicide
4. Greater risk of suicide
Health care benefits supported by both federal and state funding are exemplified in: 1. cost-containment prospective funding. 2. DHHS Social Security benefits for dentures. 3. CDC surveillance of persons at risk for AIDS. 4. Medicaid provision for skilled care in the home.
4. Medicaid provision for skilled care in the home.
Nurses agree to be advocates for their patients. The practice of advocacy calls for the nurse to which of the following? A. Assess the patient's perspective and explain it when necessary. B. Apply the law to the patient's clinical condition. C. Seek out the nursing supervisor to resolve conflict. D. Document all clinical changes in the medical record every 2 hours.
A. Assess the patient's perspective and explain it when necessary.
The state public health agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored eldercare programs. The public health core function applied is: A. Assurance. B. Policy development. C. Primary prevention. D. Public transportation.
A. Assurance
The state public health agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored eldercare programs. The public health core function applied is: A. Assurance. B. Policy development. C. Primary prevention. D. Public transportation.
A. Assurance.
Which activities does the sexual assault nurse examiner (SANE) perform? Select all that apply. A. Collect forensic evidence B. Conduct detailed physical examinations C. Testify in a court of law as an expert witness D. Objectively care for sexual assault victims and perpetrators E. Identify a victim's future medical needs and associated costs
A. Collect forensic evidence B. Conduct detailed physical examinations C. Testify in a court of law as an expert witness D. Objectively care for sexual assault victims and perpetrators
The first action by nurses who are seeking to provide culturally sensitive care to patients who are LGBTQIA is to: A. Gain an understanding of their own beliefs and attitudes about members of this group B. Seek information about the health risks in this population C. Attempt to learn about what it means to be LGBTQIA D. Involve themselves in advocacy groups to assist members of the group
A. Gain an understanding of their own beliefs and attitudes about members of this group
Which of the following actions is required of the nurse practicing advocacy? Select all that apply. A. Speak up for patient care issues even when others may disagree B. Contribute money towards patient healthcare costs because the patient is unable to pay C. Assess the patients point of view and be able to articulate it D. Document all clinical changes in the patients medical record in a timely and legible manner E. Become an active member of professional nursing organizations
A. Speak up for patient care issues even when others may disagree C. Assess the patients point of view and be able to articulate it D. Document all clinical changes in the patients medical record in a timely and legible manner
Which patients reflect examples of cases where the forensic nurse should be involved? Select all that apply. A. Victim of suspected homicide B. College student reporting rape C. Older adult with signs of abuse D. Patient who has sued for malpractice E. Victim of assault while committing a robbery
A. Victim of suspected homicide B. College student reporting rape C. Older adult with signs of abuse E. Victim of assault while committing a robbery
For a nurse to develop a therapeutic attitude toward the treatment of alcohol, tobacco, and other drug (ATOD) problems in the community, the nurse must realize drug addiction can be successfully treated, anyone may develop drug dependence, and: A. any drug can be abused. B. illegal drugs are the category of abused drugs. C. prescription drugs rarely cause dependence. D. over-the-counter (OTC) drugs are "good drugs."
A. any drug can be abused.
Which health care service represents the primary level of prevention? A. immunizations B. breast self examination C. home care for high risk pregnancies D. blood pressure screening
A. immunizations
The nurse desires to improve competency when caring for families within the LGBTQ community. Which first step should the nurse take to improve this competency? A) Learn the relevant language B) Evaluate personal background, beliefs, and biases C) Build cultural and personal knowledge D) Understand the unique disparities of the population
B) Evaluate personal background, beliefs, and biases
Which of the following is the best example of a situation where a nurse could demonstrate workforce advocacy? A. A client wishes to become an organ donor in spite of family opposition. B. A client feels pressured by a health care provider into agreeing to a specific medical procedure. C. A nurse witnessing a patient signing a formed consent at their own will
B. A client feels pressured by a health care provider into agreeing to a specific medical procedure.
Which are requirements to become a certified legal nurse consultant (LNC)? Select all that apply. A. Bachelor degree or higher B. Five years of nursing experience C. Current unrestricted nursing license D. 2000 hours of legal nurse consulting experience E. Passing the American Legal Nurse Consultant Certification Board exam
B. Five years of nursing experience C. Current unrestricted nursing license D. 2000 hours of legal nurse consulting experience E. Passing the American Legal Nurse Consultant Certification Board exam
Methadone maintenance for heroin addiction is a harm reduction strategy because it reduces deviant behavior and introduces addicted persons to the health care system. What is a disadvantage to the use of Methadone? A. Methadone is inexpensive. B. Methadone carries a risk of overdose. C. Methadone prevents relapse. D. Methadone is long acting and effective orally.
B. Methadone carries a risk of overdose.
A nurse is working on a pediatric unit where a 15-year-old male patient has confided to the nurse that he is uncomfortable sharing with his parents that he believes he is probably gay. On reflexing on this situation, the nurse considers that the young man has expressed a concern about his (select all that apply): A. Gender identity B. Sexual orientation C. Attraction to members of the same sex D. View of himself as a female
B. Sexual orientation C. Attraction to members of the same sex
Which are examples of transient evidence? Select all that apply. A. Blood samples B. The smell of alcohol C. Swelling of the wrists D. Upper arm tenderness E. Photographs of lacerations
B. The smell of alcohol C. Swelling of the wrists D. Upper arm tenderness
The harm reduction approach to substance abuse focuses on health promotion and disease prevention. A primary prevention strategy that can be used by the nurse to address substance abuse under this approach is to: A. assess for recreational drug use. B. destroy the myth of good drugs versus bad drugs. C. encourage children to "just say no." D. refer to an addiction treatment program.
B. destroy the myth of good drugs versus bad drugs.
Motivational Interviewing techniques are most effective during which 2 stages of change? A) action and relapse B) relapse and maintenance C) precontemplative and comtemplative D) precontemplative and action
C) precontemplative and comtemplative
You're making the patient assignments for the next shift. On your unit there are three LPNs, two RNs, and two nursing assistants. Which patients will you assign to the LPNs? Select all that apply:* A. A 68 year-old male patient who is expected to be discharged home with IV antibiotic therapy. B. A 25 year-old female patient newly admitted with diabetic ketoacidosis. C. A 75 year-old male patient with dementia who has an ileostomy and scheduled tube feedings. D. A 65 year-old female patient who has an order to remove the Foley catheter.
C. A 75 year-old male patient with dementia who has an ileostomy and scheduled tube feedings. D. A 65 year-old female patient who has an order to remove the Foley catheter.
When going to the hospital, which forms should patients be encouraged to bring with them in case end-of-life care becomes an ethical or legal issue? A. Euthanasia B. Organ donor card C. Advance directives D. Do not resuscitate (DNR)
C. Advance directives
A culturally competent nurse leads a staff development workshop for nurses on the car of patients who are LGBTQIA. What statement by the nurse conveys the most accurate information about the acronym LGBTQIA? A. It is a term that describes an organization in support of the gay people B. It is an umbrella term for individuals who are antigay C. It is an umbrella term that reflects both gender identity and sexual orientation identities D. It is a term that refers only to males who are gay
C. It is an umbrella term that reflects both gender identity and sexual orientation identities
The 1989 changes to Medicaid required states to provide care for children younger than 6 years and to pregnant women under 133% of the poverty level. These changes also ensured adequate access to qualified providers by: A. adding coverage for the medically indigent. B. reimbursing early periodic screening, diagnosis, and treatment (EPSDT) for those younger than 21 years. C. reimbursing pediatric and family nurse practitioners. D. reimbursing skilled and intermediate nurs
C. reimbursing pediatric and family nurse practitioners.
A useful way to distinguish between Medicare Part A and Medicare Part B is to recognize that: (select all that apply)Select all that apply. A.Part A covers outpatient hospital care. B.Part B covers limited skilled nursing care. C.Part A is hospital insurance. D.Part B is noninstitutional care insurance. E.Part B is a voluntary supplemental program.
C.Part A is hospital insurance. D.Part B is noninstitutional care insurance. E.Part B is a voluntary supplemental program.
How will the nurse describe the focus of forensic nursing? A. "Forensic nurses investigate why perpetrators commit crimes involving violence." B. "Forensic nurses assist only in adult cases of abuse, injury, and homicide, not on juvenile cases." C. "Forensic nurses concentrate on learning the role of medical coroner in order to replace that role." D. "Forensic nurses apply legal processes and investigation of injury related to violence and accidents."
D. "Forensic nurses apply legal processes and investigation of injury related to violence and accidents."
The forensic nurse is teaching on the current state and future of forensic nursing and asks participants to share what they have learned. Which reply requires further education? A. "Forensic nursing is a specialty that is expected to grow." B. "Violent crime is a burden to communities medically and economically." C. "Healthcare professionals have an obligation to screen for violence and abuse." D. "There has been a sharp increase in violent crime tracked by the U.S. Department of Justice." of Justice."
D. "There has been a sharp increase in violent crime tracked by the U.S. Department of Justice." of Justice."
When developing strategies to decrease health care disparities, the nurse working in a clinic located in a neighborhood with many Vietnamese individuals will include A.improving public transportation B. obtaining low-cost medications C. updating equipment and supplies for the clinic D. educating staff about Vietnamese health beliefs.
D. educating staff about Vietnamese health beliefs.
The Patient Protected and Affordable Care Act: A) Works to protect millions of people from losing or being denied health insurance coverage B) Allows millions of people better access to primary and preventive services C) Is sometimes referred to as Obamacare D) Allows children to be on their parent's insurance until the age of 26 E) All of the above
E) All of the above
A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the public health core function of: a) assessment b) assurance c) policy development d) research
a) assessment
Which of the following clients over 65 meets criteria for medicare reimbursement for home health nursing? a. A client who has questions about medications b. Needs help with ADLs c. Complex dressing change d. Ambulating to bathroom
a. A client who has questions about medications
What are the five "rights" of case management? a. Care, time, provider, setting, price b. Patient, medication, route, time, documentation c. Place, setting, patient, plan, outcomes d. Disease process, time, place, beneficence, advocate
a. Care, time, provider, setting, price
A nurse working in a long-term care facility is admitting an 85-year-old resident of Hispanic descent diagnosed with Alzheimer disease. What should this nurse take into consideration when caring for the resident? (Select all that apply.) a. Cultural background has an important role in determining the residents status b. The resident will be culturally sensitive to caregivers c. Home remedies may have value even if harmful d. The resident will have a strong sense of trust for health care workers e. Communication should involve gesturing whenever possible
a. Cultural background has an important role in determining the residents status c. Home remedies may have value even if harmful
A nurse who works for a hospital in employee health notes that several nurses from one unit have missed work after contracting a communicable disease from a patient. Which of the following best describes the host factor? a. Each sick nurse b. The communicable disease c. The hospital d. The patient
a. Each sick nurse
Affordable care act is important as the initiative helped...? a. expand medicaid and children's health insurance program b. provide free health care c. better health care for all d. its cool
a. Expand medicaid and children's health insurance program
Which of the following describes how occupational health nursing differs from other nursing specialties? (Select all that apply.) a. It is autonomous, because the occupational nurse works independently. b. The major focus is on the environment. c. Nurses focus on health promotion and disease prevention. d. Nursing care is given in the community.
a. It is autonomous, because the occupational nurse works independently. b. The major focus is on the environment.
The nursing case manager, who refers a 67-year-old patient to a skilled nursing facility for rehabilitative care, knows that it will be billed under which component of Medicare? a. Medicare Part A. b. Medicare Part B. c. Medicare Part D. d. Medigap.
a. Medicare Part A.
As the nurse manager in a public health department, you are implementing a plan to reduce the incidence of infection with human immunodeficiency virus (HIV) in the community. Which nursing action will you delegate to health assistants working for the agency? a. Supplying injection drug users with sterile injection equipment such as needles and syringes b. Interviewing patients about behaviors that indicate a need for annual HIV testing c. Teaching high-risk community members about the use of condoms in preventing HIV infection d. Assessing the community to determine which population groups to target for education
a. Supplying injection drug users with sterile injection equipment such as needles and syringes
An employee in a laboratory drops a flask, resulting in a chemical splash into the employee's eyes, which in turn results in burns to the eyes. Which of the following would be considered the agent? a. The chemical b. The employee c. The flask d. The laboratory
a. The chemical
To treat an infected foot, a patient with Medicare Part A is prescribed a two-week course of IV antibiotics, wound care, and physical therapy for mobility training. The nursing case manager recommends discharge to: a. a skilled nursing facility. b. an acute care hospital. c. an acute rehabilitation facility. d. home health services.
a. a skilled nursing facility.
The nursing case manager is concerned about the increase in the number of falls requiring hospitalization among older members of the local population. In order to identify those people at greater risk of readmission, the nurse: a. administers the Short Form 36 questionnaire at a community health fair. b. interviews individual patients with their families present. c. requires in-home evaluations by physical and occupational therapists. d. reviews the patients' daily nutrition diaries and medication lists.
a. administers the Short Form 36 questionnaire at a community health fair.
The nursing case manager reviews information about the number of patients with asthma who have received care by a specialist, those who have not, and the number of emergency department visits and inpatient hospitalizations for both groups. When comparing the data to develop interventions, the nurse engages in: a. aggregate data analysis. b. benchmarking. c. collaboration. d. integrated data solutions.
a. aggregate data analysis
A patient who is homeless has been admitted to the hospital with multiple health care problems. The nursing case manager, physician, social worker, and clinical dietician work together to care for the patient. This interprofessional interaction is referred to as: a. collaboration. b. consultation. c. continuity. d. coordination.
a. collaboration.
Which type of authorization is generated when services are rendered? a. Concurrent. b. Prospective. c. Retrospective. d. Subauthorization.
a. concurrent
A patient with hypertension resides in a homeless shelter 30 minutes from the patient's primary clinic. The patient's physician recommends checking blood pressure three times per week to determine efficacy of the patient's antihypertensive medications. The nursing case manager: a. contacts a clinic more accessible to the patient for follow-up. b. has the patient purchase a blood pressure machine to self-monitor. c. informs the patient that he or she has to provide his or her own transportation. d. instructs the patient to use a blood pressure machine at a local store.
a. contacts a clinic more accessible to the patient for follow-up.
Managing clinical outcomes, studying variance trends, and evaluating actions taken to correct deviations from critical pathways are components of: a. performance improvement. b. risk management. c. the nursing process. d. utilization review.
a. performance improvement
Nurses perform health promotion activities at a primary, secondary, or tertiary level. Which nursing actions are considered tertiary health promotion? Select all that apply. a. A nurse runs an immunization clinic in the inner city. b. A nurse teaches a patient with an amputation how to care for the residual limb. c. A nurse provides range-of-motion exercises for a paralyzed patient. d. A nurse teaches parents of toddlers how to childproof their homes. e. A school nurse provides screening for scoliosis for the students. f. A nurse teaches new parents how to choose and use an infant car seat.
b. A nurse teaches a patient with an amputation how to care for the residual limb. c. A nurse provides range-of-motion exercises for a paralyzed patient.
The nursing case manager meets with a 15-year-old patient with type 1 diabetes, who has a recent A1C of 8%. The patient reports smoking two to three cigarettes per day, denies using alcohol, and states, "I hate having diabetes; I just want to be like my friends." Which referral will benefit this patient's immediate needs? a. A smoking cessation group for adolescents. b. A support group for adolescents with diabetes. c. An education session about insulin, aimed at adolescents. d. Family counseling.
b. A support group for adolescents with diabetes.
the school nurse is held to which standards? a. OSHA b. ANA and state laws governing school mandates c. Scope and Standards of Home Health Nursing Practice developed by the ANA d. International Parish Nurse Resource Center (IPNRC)/Advocate Health Care resources
b. ANA and state laws governing school mandates
Which primary resource guides the nursing case manager's practice? a. American Case Management Association Member Code of Conduct. b. Case Management Society of America's Standards of Practice. c. Nursing: Scope and Standards of Practice. d. Nursing's Social Policy Statement: The Essence of the Profession.
b. Case Management Society of America's Standards of Practice.
Upon discharge from the hospital following total knee replacement surgery, a patient covered by Medicare with limited financial means will require six weeks of IV antibiotic therapy. The patient wants to go home. During the assessment, the nursing case manager discovers the patient lives alone, has no support at home, and lacks the dexterity to perform the infusion. What is the nurse's next step? a. Collaborate with the insurance company to allow the patient to stay six weeks. b. Explain to the patient about the barriers to going home and discuss other options. c. Make a home infusion referral because this is what the patient has requested. d. Order occupational therapy dexterity training for self-administration.
b. Explain to the patient about the barriers to going home and discuss other options.
Which right is a provision in the American Hospital Association's Patients' Bill of Rights? a. Competent patients must be informed about advance directives and be able to accept or refuse treatment. b. Patients must have access to an interpreter or translation services to effectively communicate concerns and discuss the treatment plan, provide consent, and receive discharge information. c. Patients must receive a timely response following a request of care and appropriate, professional care as ordered by a physician. d. Patients must receive any necessary examination and treatment during any emergency or when female patients are in labor, dependent on their ability to pay.
b. Patients must have access to an interpreter or translation services to effectively communicate concerns and discuss the treatment plan, provide consent, and receive discharge information.
Which of the following are the primary reasons that employers have increasingly focused on ensuring a healthy and safe environment for workers? (Select all that apply.) a. To fulfill their ethical and moral responsibility b. To avoid the cost of liability suits, workers' compensation, etc. c. To maintain good public relations d. To meet legislated standards and avoid significant penalties for noncompliance
b. To avoid the cost of liability suits, workers' compensation, etc. d. To meet legislated standards and avoid significant penalties for noncompliance
Which of the following best describes the mission of OSHA? a. To create an inspection system to avoid preventable loss of life b. To ensure safe and healthful working conditions c. To establish rules for employee safety d. To share factory illness and injury rates with the public
b. To ensure safe and healthful working conditions
When using a utilization tool to perform a concurrent review, the nursing case manager recognizes that: a. discharge is required whenever the tool so indicates. b. exceptions exist because utilization tools reflect only average circumstances. c. patients have a right to set length of stay without incurring nonreimbursable costs. d. the use of utilization tools guarantees payment for services.
b. exceptions exist because utilization tools reflect only average circumstances.
A 15-year-old single mother has a three-month-old infant. If the infant needs to be hospitalized for a non emergent illness, the consent for admission and treatment must be signed by the: a. infant's grandparent. b. infant's mother. c. mother's attorney. d. mother's legal guardian.
b. infant's mother.
A culturally diverse patient refuses to participate in a group because of the presence of a person who "can put spells on." The nurse recognizes a priority need to explore this patient's: a. Economic status b. Home environment c. Health-illness beliefs d. Educational background
c. Health-illness beliefs
A nurse is planning to incorporate a culturally sensitive focus in her nursing care. Which of these underlying principles concerning cultural heritage will be included? a. A group is formed from among individuals who share similar ancestral origins. b. A condition of belonging to a group is that all members share a unique heritage. c. Learned patterns of behavior and thinking are shared by members of a cultural group. d. The classification of humans into cultural groups is generally based on physical characteristics.
c. Learned patterns of behavior and thinking are shared by members of a cultural group.
To include a cultural focus in patient care planning, which belief about faith will the nurse incorporate? Faith is a: a. Belief of body and mind b. Manner of expressing spirituality c. Use of spiritual resources without empiric proof d. Search for the sacred, transcendent, or universal
c. Use of spiritual resources without empiric proof
To avoid hospital readmission, a patient requires services at a specialty clinic. Because the services are not covered under the patient's healthcare plan, the nursing case manager intercedes with the patient's insurance company. In this situation, the nurse is acting in the role of: a. broker. b. consultant. c. negotiator. d. provider.
c. negotiator
An occupational health nurse is removing a foreign body from a patient's eye. Which of the following levels of prevention is being implemented? a. Injury prevention b. Primary prevention c. Secondary prevention d. Tertiary prevention
c. secondary prevention
The occupational health nurse continually reminds employees to wear their safety goggles and ear plugs. Which of the following levels of prevention is being implemented? a. Both secondary and tertiary prevention b. Primary prevention c. Secondary prevention d. Tertiary prevention
c. secondary prevention
The nursing case manager receives a referral to provide case management services for an adolescent mother who was recently diagnosed with HIV. Which statement indicates that the patient understands her illness? a. "I can never have sex again, so I guess I will always be a single parent." b. "I will wear gloves when I'm caring for my baby because I could infect my baby with AIDS." c. "My CD4 count is 200 and my T cells are less than 14%. I need to stay at these levels by eating and sleeping well and staying healthy." d. "My CD4 count is 800 and my T cells are greater than 14%. I need to stay at these levels by eating and sleeping well and staying healthy."
d. "My CD4 count is 800 and my T cells are greater than 14%. I need to stay at these levels by eating and sleeping well and staying healthy."
A nurse is caring for patients of diverse cultures in a community health care facility. Which characteristics of cultural diversity that exist in the United States should the nurse consider when planning culturally competent care? Select all that apply. a. The United States has become less inclusive of same-sex couples. b. Cultural diversity is limited to people of varying cultures and races. c. Cultural diversity is separate and distinct from health and illness. d. People may be members of multiple cultural groups at one time. e. Culture guides what is acceptable behavior for people in a specific group. f. Cultural practices may evolve over time but mainly remain constant.
d. People may be members of multiple cultural groups at one time. e. Culture guides what is acceptable behavior for people in a specific group. f. Cultural practices may evolve over time but mainly remain constant.
An occupational health nurse sees the various injuries and diseases that persons can acquire from employment. Which of the following recommendations would the nurse most likely provide about safety in the workplace? a. Find employment in physical labor; at least your body will be in good condition. b. Professional positions are the safest choice for employment. c. White collar positions provide the least risk for injury. d. There is no "safe" occupation or profession.
d. There is no "safe" occupation or profession.
In synthesizing data for a disease management program, the nursing case manager uses which source of data triangulation to validate a conclusion? a. Cost, containment, and length of stay. b. Method, cause, and reaction. c. Reason, rationale, and resolution. d. Time, space, and person.
d. Time, space, and person.
Medication errors, orders for unnecessary tests, and omission of standard tests or procedures are classified as which type of variance? a. Community. b. Operational. c. Patient. d. Practitioner.
d. practitioner
Ideally, nursing case management planning identifies goals that are: a. anticipated, acceptable, and appropriate. b. challenging and timely. c. patient focused and cost effective. d. realistic, measurable, and specific.
d. realistic, measurable, and specific.
To cover the cost of durable medical equipment, a patient who is enrolled in Medicare is required to: a. appeal for coverage. b. request coverage. c. seek supplemental insurance. d. share in the cost.
d. share in the cost.
A doctor wants to order a brand-name fibromyalgia medication that is not covered by a patient's insurance provider. As the patient has failed multiple agents prior to this prescription, the nursing case manager: a. advises the doctor that the medication is not covered and suggests revisiting some medications that were ordered before. b. directs the patient to the website of the drug company's patient assistance program for alternative medications. c. negotiates the self-pay cost for the brand-name medication with the pharmacy. d. submits the request for prior authorization to the insurance company with accompanying medical justification.
d. submits the request for prior authorization to the insurance company with accompanying medical justification.
When developing a program offering for patients who are newly diagnosed with diabetes, the nursing case manager demonstrates an understanding of learning styles by: a. administering a pre- and post-test assessment. b. allowing attendees time to voice their opinions. c. providing a snack with a low glycemic index. d. utilizing a variety of educational materials.
d. utilizing a variety of educational materials.
Which ethical principle is grounded in truth? a. Autonomy. b. Beneficence. c. Fairness. d. Veracity.
d. veracity
A pediatric patient who is ventilator-dependent and has a gastrostomy button is scheduled to be discharged to home with visits from a home health nurse. Prior to discharge, the nursing case manager's most critical action is to: a. assess the patient's long-term home care needs. b. procure the required home medical equipment. c. secure funding sources for home health care. d. verify that the patient is being discharged to a safe environment.
d. verify that the patient is being discharged to a safe environment.
A nurse working in a primary care facility assesses patients who are experiencing various levels of health and illness. Which statements define these two concepts? Select all that apply. a. Health and illness are the same for all people. b. Health and illness are individually defined by each person. c. People with acute illnesses are actually healthy. d. People with chronic illnesses have poor health beliefs. e. Health is more than the absence of illness. f. Illness is the response of a person to a disease.
e. Health is more than the absence of illness. f. Illness is the response of a person to a disease.
