1. Which statement accurately describes the primary
purpose of the state Caregiver practice
act(NPA)?
a. To test and license LPN/LVNs.
b. To define the scope of LPN/LVN practice.
c. To improve the quality of care provided by the
LPN/LVN.
d. To limit the LPN/LVN employment placement.
CORRECT FEEDBACK: B
EXPLANATION :->>>While improving quality
of care provided by the LPN/LVN may be a result
of the NPA, theprimary
purpose of the NPA of each state defines the scope of nursing practice in that state.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
OBJ: 3 TOP: NPA KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. The charge Caregiver asks the new vocational Caregiver to start an intravenous infusion, a
skill that the vocational Caregiver has not been taught during her educational program. How
should the vocational Caregiver respond?
a. Ask a more experienced Caregiver to demonstrate the procedure.
b. Look up the procedure in the procedure manual.
c. Attempt to perform the procedure with supervision.
d. Inform the charge Caregiver of her lack of training in this procedure.
CORRECT FEEDBACK: D
EXPLANATION :->>>The charge Caregiver should be informed of the lack of training to
perform the procedure, and the vocational Caregiver should seek further training to gain
proficiency. Although the other options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application REF: 3
OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
3. Which client statement indicates a need for further discharge teaching that the vocational
Caregiver should address?
a. “I have no idea of how this drug will affect me.”
b. “Do you know if my physician is coming back today?”
c. “Will my insurance pay for my stay?”
d. “Am I going to have to go to a nursing home?”
CORRECT FEEDBACK: A
, EXPLANATION :->>>Lack of knowledge at discharge about medication effects and side
effects is a concern that should be addressed by the vocational Caregiver. The other concerns
in the options are the responsibility of other departments to which the Caregiver might refer
the client.
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
4. According to most state NPAs, the vocational Caregiver acting as charge Caregiver in a long-
term care facility acts in which capacity?
a. Working under direct supervision of an RN on the unit
b. Working with the RN in the building
c. Working under general supervision by the RN available on site or by phone
d. Working as an independent vocational Caregiver
CORRECT FEEDBACK: C
EXPLANATION :->>>The vocational Caregiver in the capacity of the charge Caregiver in a
long-term care facility acts with the general supervision of an RN available on site or by
phone.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
OBJ: 1 TOP: Charge Caregiver/Manager KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. The Caregiver is educating a client that is a member of a health maintenance
organization (HMO). Which information should the Caregiver include?
a. Seek the opinion of an alternate health care provider.
b. Obtain insurance approval for medical services prior to treatment.
c. Provide detailed documentation of all care received for his condition.
d. Wait at least 6 months to see a specialist.
CORRECT FEEDBACK: B
EXPLANATION :->>>Most HMOs require preprocedure authorization for treatment.
Clients are not required to seek a second opinion, provide documentation of care, or wait a
specific time period before visiting a specialist.
PTS: 1 DIF: Cognitive Level: Application REF: 9
OBJ: 9 TOP: Charge Caregiver/Manager
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The client complains to the Caregiver that he is confused about his “deductible” that he owes
the hospital. Which statement accurately explains a deductible?
a. An amount of money put aside for the payment of future medical bills
b. A one-time fee for service
c. An amount of money deducted from the bill by the insurance company
d. An annual amount of money the client must pay out-of-pocket for medical care
CORRECT FEEDBACK: D
EXPLANATION :->>>The deductible is the annual amount the insured must pay out-of-pocket prior
to the insurance company assuming the cost. This practice improves the profit of the insurance
company.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 7
OBJ: 9 TOP: Health Care Financing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
, 7. The Caregiver compares the characteristics of a health maintenance organization (HMO)
and a preferred provider organization (PPO). Which information should the Caregiver
include about HMOs?
a. HMOs require a set fee of each member monthly.
b. HMOs allow the member to select his health care provider.
c. HMOs permit admission to any facility the member prefers.
d. HMOs offer unlimited diagnostic tests and treatments.
CORRECT FEEDBACK: A
EXPLANATION :->>>HMOs require a set fee from each member monthly (capitation). The
client will be treated by the HMO staff in HMO-approved facilities. Excessive use of
diagnostic tests and treatments is discouraged by the HMO.
PTS: 1 DIF: Cognitive Level: Application REF: 9
OBJ: 9 TOP: Managed Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. A client asks the Caregiver what Medicare Part A covers. Which response is correct?
a. Medicare Part A covers inclient hospital costs.
b. Medicare Part A covers reimbursement to the physician.
c. Medicare Part A covers outclient hospital services.
d. Medicare Part A covers ambulance trCorrect Feedbackportation.
CORRECT FEEDBACK: A
EXPLANATION :->>>Medicare Part A covers inclient hospital expenses, drugs, x-
rays, laboratory work, and intensive care. Medicare Part B pays the physician,
ambulance trCorrect Feedbackport, and outclient services.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 7, Box 1-4
OBJ: 9 TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
a. Hospitals focus only on the specific diagnosis.
b. Hospitals treat and discharge clients quickly.
c. Reduced cost drugs are ordered for specific diagnoses.
d. Diagnostic group classification streamlines care.
CORRECT FEEDBACK: B
EXPLANATION :->>>DRGs are a prospective payment plan in which hospitals receive a
flat fee for each client’s diagnostic category regardless of the length of time in the hospital.
If hospitals can treat and discharge clients before the allotted time, hospitals get to keep the
excess payment; cost is contained, and the client is discharged sooner.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 8
OBJ: 9 TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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