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Contemporary Medical-Surgical Nursing Test Bank
Contemporary Medical-Surgical Nursing Test Bank
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,Chapter 1--The Health Care System and Contemporary NursingMULTIPLE CHOICE
1. The nurse ensures that a client’s bedspace is neat and clean with the call light within easy reach. The
nurse is focusing on which nursing theorist who realized the importance of the environment for care?
1. Florence Nightingale
2. Sister Callista Roy
3. Dorothea Orem
4. Martha Rogers
ANS: 1
Florence Nightingale’s theory focused on the environment for care. Sister Callista Roy’s model is
based in systems theory and an individual’s ability to adapt. Dorothea Orem’s model is the self-care
deficit theory. Martha Roger’s model is the science of unitary human beings.
PTS: 1 DIF: Apply
REF: Emergence of Contemporary Nursing in the United States
2. The nurse is instructing a client on self-administration of insulin so that the client will not need a
health care provider to do this activity. The nurse is implementing which of the following aspects of
Virginia Henderson’s theory of nursing?
1. A caring relationship
2. Helping the client achieve independence from the nurse’s assistance as quickly as possible
3. Integration of objective and subjective data
4. Application of critical thinking
ANS: 2
Virginia Henderson’s theory of nursing is to help people achieve health or a peaceful death so that they
can be independent from the nurse’s assistance as quickly as possible. A caring relationship,
integration of objective and subjective data, and application of critical thinking are included in the
American Nurses Association’s essential features of professional nursing.
PTS: 1 DIF: Analyze
REF: Emergence of Contemporary Nursing in the United States
3. A client tells the nurse that he has an HMO for his health insurance. The nurse understands that the
purpose of this type of health plan is to:
1. ensure payment is made to Medicare for services rendered.
2. maximize the utilization of health care resources.
3. efficiently manage costs while providing quality care.
4. focus on the illness when providing care.
ANS: 3
Health maintenance organizations (HMOs) were created to efficiently manage health care costs while
providing quality care. An HMO is a type of managed care plan with the goal of providing wellness
care and not focusing on the illness during the provision of care. HMOs do not ensure payment is
made to Medicare for services rendered. HMOs also do not maximize the utilization of health care
resources but rather uses financial incentives to decrease care costs.
PTS: 1 DIF: Understand REF: Cost of Care
,4. A client tells the nurse that he does not have a primary care physician but rather makes an appointment
with a doctor who specializes in the area in which he is experiencing a problem. The nurse realizes this
client is at risk for which of the following?
1. Fragmented care
2. Overpayment of services
3. Inability to sustain health
4. Finding an appropriate general practitioner
ANS: 1
In the 1980s, the close and trusting relationship between an individual and the individual’s physician
waned and was replaced by acquaintances with specialists based upon particular health care problems.
These episodes of care cause fragmentation of care. The client who utilizes specialists is not at risk for
overpayment of services, the inability to sustain health, or finding an appropriate general practitioner.
PTS: 1 DIF: Analyze REF: Providers of Care
5. The nurse is attending a master’s degree program in efforts to be educationally prepared to serve as a
hospital leader. The nurse realizes that this educational preparation will:
1. hinder the nurse’s ability to work with physicians.
2. be viewed as not supporting the profession of nursing by other nurses.
3. ensure the nurse is biased towards clinicians’ interests.
4. prepare the nurse to serve as strong clinical support with the ability to integrate business
and caring.
ANS: 4
The nurse is attending an educational program to serve as a hospital leader. This education will prepare
the nurse to serve as strong clinical support with the ability to integrate business and caring. This
education will not hinder the nurse’s ability to work with physicians. This education will not be viewed
as unsupportive to the profession of nursing. The education will ensure that the nurse is not biased
towards clinicians’ interests.
PTS: 1 DIF: Analyze REF: Clinical Systems Leadership
6. A client tells the nurse that all hospitals care about is doing the minimum for a client regardless of the
outcome. Which of the following should the nurse respond to this client?
1. “It does feel like that sometimes.”
2. “Health insurance companies have caused this problem.”
3. “The doctors will get paid regardless of the clients’ outcomes.”
4. “There are quality programs in place to make sure clients receive the best quality of care
regardless of the cost.”
ANS: 4
In response to concerns about safety and quality of care voiced by clients and providers, total quality
management and continuous quality improvement programs were initiated. These programs ensure
society that cost management is not compromising safety or quality. This is what the nurse should
respond to the client. The other choices do not address the client’s concerns nor do they explain quality
management programs.
PTS: 1 DIF: Apply REF: Quality Measure Shift
7. The nurse is providing care at a time that is the most beneficial to the client. The nurse is implementing
which of the following Joint Commission Dimensions of Quality Performance?
1. Safety
2. Timeliness
3. Efficiency
, 4. Availability
ANS: 2
The dimension of timeliness means the degree in which interventions are provided at the most
beneficial time to the client. Safety means the degree in which the risk of an intervention and risk to
the environment are reduced for both client and health care provider. Efficiency means the degree in
which care has the desired effect with a minimum of effort, waste, or expense. Availability means the
degree in which appropriate interventions are available to meet the client’s needs.
PTS: 1 DIF: Analyze
REF: Box 1-1 Joint Commission Dimensions of Quality Performance
8. The nurse is providing care while adhering to safety as a Joint Commission Dimension of Quality
Performance. Which of the following did the nurse provide to the client?
1. Using a needleless device when providing intravenous medications
2. Keeping the siderails of the bed in the down position after providing a pain medication to a
client
3. Having the client sit in a wheelchair with the wheels in the unlocked position
4. Placing cloth towels over a spill in the room of an ambulatory client
ANS: 1
The dimension of safety means the degree in which the risk of an intervention and risk to the
environment are reduced for both client and health care provider. The nurse who uses a needleless
device when providing intravenous medications is adhering to this dimension. Keeping the siderails in
the down position is not a safe practice. Having a client sit in a wheelchair with the wheels unlocked is
not a safe practice. Placing cloth towels over a spill in the room of an ambulatory client is not a safe
practice.
PTS: 1 DIF: Analyze
REF: Box 1-1 Joint Commission Dimensions of Quality Performance
9. The nurse is planning and providing care while adhering to the American Nurses Association
definition of professional nursing. Which of the following does the nurse include when implementing
client care?
1. Follows the NANDA nursing diagnoses process
2. Integrates objective and subjective data
3. Respects cultural diversity of peers
4. Acknowledges the experience and training of physicians
ANS: 2
The American Nurses Association acknowledges six essential features of professional nursing. These
include: 1) a caring relationship, 2) attention to the full range of human health and illness experiences,
3) integrates objective and subjective data, 4) applies scientific knowledge and critical thinking, 5)
advances nursing knowledge through scholarly inquiry, and 6) promotes social justice. The nurse
integrating objective and subjective data is implementing one of the six essential features of
professional nursing. The other choices are not essential features of professional nursing.
PTS: 1 DIF: Analyze
REF: Emergence of Contemporary Nursing in the United States
10. The nurse has shifted her practice from an illness focus to a health focus. Which of the following has
this nurse implemented?
1. Standardized care plans
2. Critical pathways
3. Instructing a client on relaxation techniques to aid with sleep
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