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Test Bank Med Surg Nursing

John Marsh
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Medical Surgical Test Bank Primary Concepts Of

Test Bank for Medical Surgical Nursing

All Quiz Answers Chapter Wise

Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice

Chapter 02: Community-Based Nursing Practice

Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing Process

Chapter 04: Health Education and Promotion

Chapter 05: Adult Health and Nutritional Assessment

Chapter 06: Individual and Family Homeostasis, Stress, and Adaptation

Chapter 07: Overview of Transcultural Nursing

Chapter 08: Overview of Genetics and Genomics in Nursing

Chapter 09: Chronic Illness and Disability

Chapter 10: Principles and Practices of Rehabilitation

Chapter 11: Health Care of the Older Adult

Chapter 12: Pain Management

Chapter 13: Fluid and Electrolytes: Balance and Disturbance

Chapter 14: Shock and Multiple Organ Dysfunction Syndrome

Chapter 15: Management of Patients with Oncologic Disorders

Chapter 16: End-of-Life Care

Chapter 17: Preoperative Nursing Management

Chapter 18: Intraoperative Nursing Management

Chapter 19: Postoperative Nursing Management

Chapter 20: Assessment of Respiratory Function

Chapter 21: Respiratory Care Modalities

Chapter 22: Management of Patients With Upper Respiratory Tract Disorders

Chapter 23: Management of Patients with Chest and Lower Respiratory Tract Disorders

Chapter 24: Management of Patients With Chronic Pulmonary Disease

Chapter 25: Assessment of Cardiovascular Function

Chapter 26: Management of Patients With Dysrhythmias and Conduction Problems

Chapter 27: Management of Patients With Coronary Vascular Disorders

Chapter 28: Management of Patients With Structural, Infectious, and Inflammatory Cardiac Disorders

Chapter 29: Management of Patients With Complications from Heart Disease

Chapter 30: Assessment and Management of Patients With Vascular Disorders and Problems of Peripheral Circulation

Chapter 31: Assessment and Management of Patients With Hypertension

Chapter 32: Assessment of Hematologic Function and Treatment Modalities

Chapter 33: Management of Patients With Nonmalignant Hematologic Disorders

Chapter 34: Management of Patients With Hematologic Neoplasms

Chapter 35: Assessment of Immune Function

Chapter 36: Management of Patients With Immune Deficiency Disorders

Chapter 37: Assessment and Management of Patients With Allergic Disorders

Chapter 38: Assessment and Management of Patients With Rheumatic Disorders

Chapter 39: Assessment of Musculoskeletal Function

Chapter 40: Musculoskeletal Care Modalities

Chapter 41: Management of Patients With Musculoskeletal Disorders

Chapter 42: Management of Patients With Musculoskeletal Trauma

Chapter 43: Assessment of Digestive and Gastrointestinal Function

Chapter 44: Digestive and Gastrointestinal Treatment Modalities

Chapter 45: Management of Patients with Oral and Esophageal Disorders

Chapter 46: Management of Patients with Gastric and Duodenal Disorders

Chapter 47: Management of Patients With Intestinal and Rectal Disorders

Chapter 48: Assessment and Management of Patients with Obesity

Chapter 49: Assessment and Management of Patients with Hepatic Disorders

Chapter 50: Assessment and Management of Patients with Biliary Disorders

Chapter 51: Assessment and Management of Patients with Diabetes

Chapter 52: Assessment and Management of Patients with Endocrine Disorders

Chapter 53: Assessment of Kidney and Urinary Function

Chapter 54: Management of Patients with Kidney Disorders

Chapter 55: Management of Patients with Urinary Disorders

Chapter 56: Assessment and Management of Patients With Female Physiologic Processes

Chapter 57: Management of Patients with Female Reproductive Disorders

Chapter 58: Assessment and Management of Patients with Breast Disorders

Chapter 59: Assessment and Management of Patients With Male Reproductive Disorders

Chapter 60: Assessment of Integumentary Function

Chapter 61: Managements of Patients with Dermatologic Problems

Chapter 62: Managements of Patients with Burn Injury

Chapter 63: Assessment and Management of Patients with Eye and Vision Disorders

Chapter 64: Assessment and Management of Patients with Hearing and Balance Disorders

Chapter 65: Assessment of Neurologic Function

Chapter 66: Management of Patients with Neurologic Dysfunction

Chapter 67: Management of Patients with Cerebrovascular Disorders

Chapter 68: Management of Patients with Neurologic Trauma

Chapter 69: Management of Patients with Neurologic Infections, Autoimmune Disorders, and Neuropathies

Chapter 70: Management of Patients With Oncologic or Degenerative Neurologic Disorders

Chapter 71: Management of Patients With Infectious Diseases

Chapter 72: Emergency Nursing

Chapter 73: Terrorism, Mass Casualty, and Disaster Nursing

Nursing Test Bank

Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice Questions

1. The public health nurse is presenting a health promotion class to a group of new mothers. How should
the nurse best define health?
A) Health is being disease free.
B) Health is having fulfillment in all domains of life.
C) Health is having psychological and physiological harmony.
D) Health is being connected in body, mind, and spirit.

2. A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What is
one characteristic the nurse would cite as necessary to possess to be an effective nurse?
A) Sensitivity to cultural differences
B) Team-focused approach to problem-solving
C) Strict adherence to routine
D) Ability to face criticism

3. With increases in longevity, people have had to become more knowledgeable about their health and the
professional health care that they receive. One outcome of this phenomenon is the development of
organized self-care education programs. Which of the following do these programs prioritize?

A) Adequate prenatal care
B) Government advocacy and lobbying
C) Judicious use of online communities
D) Management of illness

4. The home health nurse is assisting a patient and his family in planning the patients return to work after
surgery and the development of postsurgical complications. The nurse is preparing a plan of care that
addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the
patients need for self-fulfillment relate?
A) Physiologic
B) Transcendence
C) Love and belonging
D) Self-actualization

5. The view that health and illness are not static states but that they exist on a continuum is central to
professional health care systems. When planning care, this view aids the nurse in appreciating which of
the following?
A) Care should focus primarily on the treatment of disease.
B) A persons state of health is ever-changing.
C) A person can transition from health to illness rapidly.
D) Care should focus on the patients compliance with interventions.

6. A group of nursing students are participating in a community health clinic. When providing care in this
context, what should the students teach participants about disease prevention?
A) It is best achieved through attending self-help groups.
B) It is best achieved by reducing psychological stress.
C) It is best achieved by being an active participant in the community.
D) It is best achieved by exhibiting behaviors that promote health.

7. A nurse on a medical-surgical unit has asked to represent the unit on the hospitals quality committee.
When describing quality improvement programs to nursing colleagues and members of other health
disciplines, what characteristic should the nurse cite?
A) These programs establish consequences for health care professionals actions.
B) These programs focus on the processes used to provide care.
C) These programs identify specific incidents related to quality.
D) These programs seek to justify health care costs and systems.

8. Nurses in acute care settings must work with other health care team members to maintain quality care
while facing pressures to care for patients who are hospitalized for shorter periods of time than in the
past. To ensure positive health outcomes when patients return to their homes, what action should the
nurse prioritize?
A) Promotion of health literacy during hospitalization
B) Close communication with insurers
C) Thorough and evidence-based discharge planning
D) Participation in continuing education initiatives

9. You are admitting a patient to your medical unit after the patient has been transferred from the
emergency department. What is your priority nursing action at this time?
A) Identifying the immediate needs of the patient
B) Checking the admitting physicians orders
C) Obtaining a baseline set of vital signs
D) Allowing the family to be with the patient

10. A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing
assessments and interventions with the aid of a pathway, the nurse should prioritize what goal?
A) Helping the patient to achieve specific outcomes
B) Balancing risks and benefits of interventions
C) Documenting the patients response to therapy
D) Staying accountable to the interdisciplinary team

11. Staff nurses in an ICU setting have noticed that their patients required lower and fewer doses of
analgesia when noise levels on the unit were consciously reduced. They informed an advanced practice
RN of this and asked the APRN to quantify the effects of noise on the pain levels of hospitalized
patients. How does this demonstrate a role of the APRN?
A) Involving patients in their care while hospitalized
B) Contributing to the scientific basis of nursing practice
C) Critiquing the quality of patient care
D) Explaining medical studies to patients and RNs

12. Nurses now have the option to practice in a variety of settings and one of the fastest growing venues of
practice for the nurse in todays health care environment is home health care. What is the main basis for the growth in this health care setting?
A) Chronic nursing shortage
B) Western focus on treatment of disease
C) Nurses preferences for day shifts instead of evening or night shifts
D) Discharge of patients who are more critically ill

13. Nurses have different educational backgrounds and function under many titles in their practice setting. If
a nurse practicing in an oncology clinic had the goal of improving patient outcomes and nursing care by
influencing the patient, the nurse, and the health care system, what would most accurately describe this
nurses title?
A) Nursing care expert
B) Clinical nurse specialist
C) Nurse manager
D) Staff nurse

14. Nursing continues to recognize and participate in collaboration with other health care disciplines to meet
the complex needs of the patient. Which of the following is the best example of a collaborative practice
A) The nurse and the physician jointly making clinical decisions.
B) The nurse accompanying the physician on rounds.
C) The nurse making a referral on behalf of the patient.
D) The nurse attending an appointment with the patient.

15. A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of
needs, what dimension of care should the nurse consider primary in importance when caring for a dying
A) Spiritual
B) Social
C) Physiologic
D) Emotional

16. A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within
this framework of understanding, what would be the nurses first priority?
A) Allowing the family to see a newly admitted patient
B) Ambulating the patient in the hallway
C) Administering pain medication
D) Teaching the patient to self-administer insulin safely

17. A medical-surgical nurse is aware of the scope of practice as defined in the state where the nurse
provides care. This nurses compliance with the nurse practice act demonstrates adherence to which of
the following?
A) National Council of Nursings guidelines for care
B) National League for Nursings Code of Conduct
C) American Nurses Associations Social Policy Statement
D) Department of Health and Human Services White Paper on Nursing

18. Nursing is, by necessity, a flexible profession. It has adapted to meet both the expectations and the
changing health needs of our aging population. What is one factor that has impacted the need for
certified nurse practitioners (CNPs)?
A) The increased need for primary care providers
B) The need to improve patient diagnostic services
C) The push to drive institutional excellence
D) The need to decrease the number of medical errors

19. A nurse is providing care for a patient who is postoperative day one following a bowel resection for the
treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency of quality
A) By liaising with the members of the interdisciplinary care team
B) By critically appraising the outcomes of care that is provided
C) By integrating the patients preferences into the plan of care
D) By documenting care in the electronic health record in a timely fashion

20. Professional nursing expands and grows because of factors driven by the changing needs of health care
consumers. Which of the following is a factor that nurses should reflect in the planning and provision of
health care?
A) Decreased access to health care information by individuals
B) Gradual increases in the cultural unity of the American population
C) Increasing mean and median age of the American population
D) Decreasing consumer expectations related to health care outcomes

21. A public health nurse has been commissioned to draft a health promotion program that meets the health
care needs and expectations of the community. Which of the following focuses is most likely to
influence the nurses choice of interventions?
A) Management of chronic conditions and disability
B) Increasing need for self-care among a younger population
C) A shifting focus to disease management
D) An increasing focus on acute conditions and rehabilitation

22. A community health nurse has witnessed significant shifts in patterns of disease over the course of a
four-decade career. Which of the following focuses most clearly demonstrates the changing pattern of
disease in the United States?
A) Type 1 diabetes management
B) Treatment of community-acquired pneumonia
C) Rehabilitation from traumatic brain injuries
D) Management of acute Staphylococcus aureus infections

23. The ANA has identified several phenomena toward which the focus of nursing care should be directed,
and a nurse is planning care that reflects these priorities. Which of the nurses actions best demonstrates
these priorities?
A) Encouraging the patients dependence on caregivers
B) Fostering the patients ability to make choices
C) Teaching the patient about nurses roles in the health care system
D) Assessing the patients adherence to treatment

24. The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all levels of
health care. Which of the following activities are considered integral to the CNP role? Select all that
A) Educating patients and family members
B) Coordinating care with other disciplines
C) Using direct provision of interventions
D) Educating registered nurses and practical nurses
E) Coordinating payment plans for patients

25. The ANA has identified central characteristics of nursing practice that are applicable across the wide
variety of contexts in which nurses practice. A nurse can best demonstrate these principles by
performing which of the following actions?
A) Teaching the public about the role of nursing
B) Taking action to control the costs of health care
C) Ensuring that all of his or her actions exemplify caring
D) Making sure to carry adequate liability insurance

26. A nurse has accepted a position as a clinical nurse leader (CNL), a new role that has been launched
within the past decade. In this role, the nurse should prioritize which of the following activities?
A) Acting as a spokesperson for the nursing profession
B) Generating and disseminating new nursing knowledge
C) Diagnosing and treating health problems that have a predictable course
D) Helping patients to navigate the health care system

27. Our world is connected by a sophisticated communication system that makes much health information
instantly accessible, no matter where the patient is being treated. This instant access to health
information has impacted health care delivery strategies, including the delivery of nursing care. What is
one way the delivery of health care has been impacted by this phenomenon?
A) Brisk changes as well as swift obsolescence
B) Rapid change that is nearly permanent
C) Limitations on the settings where care can be provided
D) Increased need for social acceptance

28. With the changing population of health care consumers, it has become necessary for nurses to work
more closely with other nurses, as when acute care nurses collaborate with public health and home
health nurses. What nursing function has increased in importance because of this phenomenon?
A) Prescribing medication
B) Performing discharge planning
C) Promoting family involvement
D) Forming collegial relationships

29. A nurse has integrated the principles of evidence-based practice into care. EBP has the potential to help
the nurse achieve what goal?
A) Increasing career satisfaction
B) Obtaining federal grant money
C) Ensuring high quality patient care
D) Enhancing the publics esteem for nursing

30. A case manager has been hired at a rural hospital that has a combined medical-surgical unit. When
defining this new role, which of the following outcomes should be prioritized by the hospitals
A) Decreased need for physician services
B) Improved patient and family education
C) Increased adherence to the principles of EBP
D) Increased coordination of health services

31. A hospitals current quality improvement program has integrated the principles of the Institute for
Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the
campaign goals of reducing preventable harm and death?
A) By adhering to EBP guidelines
B) By reducing nurse-to-patient ratios and increasing accountability
C) By having researchers from outside the facility evaluate care
D) By involving patients and families in their care planning

32. Over the past several decades, nursing roles have changed and expanded in many ways. Which of the
following factors has provided the strongest impetus for this change?
A) The need to decrease the cost of health care
B) The need to improve the quality of nursing education
C) The need to increase the number of nursing jobs available
D) The need to increase the public perception of nursing

33. Advanced practice nursing roles have grown in number and in visibility in recent years. What
characteristic sets these nurses apart from the registered nurse?
A) Collaboration with other health care providers
B) Education that goes beyond that of the RN
C) Advanced documentation skills
D) Ability to provide care in the surgical context

34. CNPs are educated as specialists in areas such as family care, pediatrics, or geriatrics. In most states,
what right do CNPs have that RNs do not possess?
A) Perform health interventions independently
B) Make referrals to members of other health disciplines
C) Prescribe medications
D) Perform surgery independently

35. A team of community health nurses are planning to draft a proposal for a program that will increase the
communitys alignment with the principles contained in the Healthy People 2020report. Which of the
following activities would best demonstrate the priorities identified in this report?
A) Addressing determinants of health such as clean environments and safety in the community
B) Lobbying for increased funding to the county hospital where many residents receive primary care
C) Collaborating with health professionals in neighboring communities to pool resources and increase
D) Creating clinical placements where nursing students and members of other health disciplines can
gain experience in a community setting

36. A nurse is aware that an increasing emphasis is being placed on health, health promotion, wellness, and
self-care. Which of the following activities would best demonstrate the principles of health promotion?

A) A discharge planning initiative between acute care and community care nurses
B) Collaboration between several schools of nursing in an urban area
C) Creation of a smoking prevention program undertaken in a middle school
D) Establishment of a website where patients can check emergency department wait-times

37. A group of nursing students are learning about recent changes in the pattern of disease in the United
States. Which of the following statements best describes these current changes?
A) Infectious diseases continue to decrease in incidence and prevalence.
B) Chronic illnesses are becoming increasingly resistant to treatment.
C) Most acute, infectious diseases have been eradicated.
D) Most, but not all, communicable diseases are declining.

38. The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) are evaluating a
large, university medical center according to core measures. Evaluators should perform this evaluation
in what way?
A) By auditing the medical centers electronic health records
B) By performing focus groups and interviews with care providers from numerous disciplines
C) By performing statistical analysis of patient satisfaction surveys
D) By comparing the centers patient outcomes to best practice indicators

39. Leadership of a medical unit have been instructed to integrate the principles of the Quality and Safety
Education for Nurses (QSEN) competency of quality improvement. What action should the units leaders
A) Provide access to online journals and Web-based clinical resources for nursing staff.
B) Use flow charts to document the processes of care that are used on the unit.
C) Enforce continuing education requirements for all care providers.
D) Reduce the use of chemical and physical restraints on the unit.

40. The IOM Report Health Professions Education: A Bridge to Quality issued a number of challenges to
the educational programs that teach nurses and members of other health professions. According to this
report, what activity should educational institutions prioritize?
A) More clearly delineate each professions scope of practice during education
B) Move toward developing a single health curriculum that can be adapted for any health profession
C) Include interdisciplinary core competencies into curricula
D) Elicit input from patients and families into health care

Chapter 02: Community-Based Nursing Practice

1. A community health nurse has scheduled a hypertension clinic in a local shopping mall in which
shoppers have the opportunity to have their blood pressure measured and learn about hypertension. This
nursing activity would be an example of which type of prevention activity?
A) Tertiary prevention
B) Secondary prevention
C) Primary prevention
D) Disease prevention

2. The nursing instructor is preparing a group of students for their home care rotation. In preparation, the
group discusses the patients that they are most likely to care for in the home. Which of the following
groups are the most common recipients of home care services?
A) Mentally ill patients
B) Patients receiving rehabilitation after surgery
C) Terminally ill and palliative patients
D) Elderly patients

3. A recent nursing graduate has been surprised at the sharp contrast between some patients lifestyles in
their homes and the nurses own practices and beliefs. To work therapeutically with the patient, what must the nurse do?
A) Request another assignment if there is dissonance with the patients lifestyle.
B) Ask the patient to come to the agency to receive treatment, if possible.
C) Resolve to convey respect for the patients beliefs and choices.
D) Try to adapt the patients home to the norms of a hospital environment.

4. Infection control is a high priority in every setting where nursing care is provided. When performing a
home visit, how should the nurse best implement the principles of infection control?
A) Perform hand hygiene before and after giving direct patient care.
B) Remove the patients wound dressings from the home promptly.
C) Disinfect the patients syringes prior to disposal.
D) Establish a sterile field in the patients home before providing care.

5. An adult patient is ready to be discharged from the hospital after undergoing a transmetatarsal
amputation. When should your patients discharge planning begin?

A) The day prior to discharge
B) The day of estimated discharge
C) The day that the patient is admitted
D) Once the nursing care plan has been finalized

6. A home health nurse is preparing to make the initial visit to a new patients home. When planning
educational interventions, what information should the nurse provide to the patient and his or her
A) Available community resources to meet their needs
B) Information on other patients in the area with similar health care needs
C) The nurses contact information and credentials
D) Dates and times of all scheduled home care visits

7. The home health nurse receives a referral from the hospital for a patient who needs a home visit for
wound care. After obtaining the referral, what would be the first action the nurse should take?
A) Have community services make contact with the patient.
B) Obtain a physicians order for the visit.
C) Call the patient to obtain permission to visit.
D) Arrange for a home health aide to initially visit the patient.

8. At the beginning of a day that will involve several home visits, the nurse has ensured that the health care
agency has a copy of her daily schedule. What is the rationale for the nurses action?
A) It allows the agency to keep track for payment to the nurse.
B) It supports safety precautions for the nurse when making a home care visit.
C) It allows for greater flexibility for the nurse and his or her colleagues for changes in assignments.
D) It allows the patient to cancel appointments with minimal inconvenience.

9. There are specific legal guidelines and regulations for the documentation related to home care. When
providing care for a patient who is a Medicaid recipient, what is most important for the nurse to
A) The medical diagnosis and the supplies needed to care for the patient
B) A summary of the patients income tax paid during the previous year
C) The specific quality of nursing care that is needed
D) The patients homebound status and the specific need for skilled nursing care

10. Your patient has had a total knee replacement and will need to walk with a two-wheeled walker for 6
weeks. He is being discharged home with a referral for home health care. What will the home care nurse
need to assess during the initial nursing assessment in the home?
A) Assistance of neighbors
B) Qualification for Medicare and Medicaid
C) Costs related to the visits
D) Characteristics of the home environment

11. A nurse who has an advanced degree in primary care for a pediatric population is employed in a health
clinic. In what role is this nurse functioning?
A) Nurse practitioner
B) Case coordinator
C) Clinical nurse specialist
D) Clinic supervisor

12. A nurse is based in an automotive assembly plant and works with the plants employees in the areas of
health promotion and basic primary care. What nursing role is this nurse performing?
A) Occupational health nurse
B) Community nurse specialist
C) Nurse clinician
D) Public health nurse

13. A school nurse has been working closely with a student who has cystic fibrosis. The nurse is aware that
children with health problems are at major risk for what problem?
A) Mental health disorders
B) Gradual reduction in intelligence
C) Psychological stress due to a desire to overachieve
D) Underachievement in school

14. A community health nurse is aware that restoration of health often depends on appropriate interventions
performed early in the course of a disease. Which patient is most likely to seek health care late in the
course of his or her disease process and deteriorate more quickly than other patients?
A) A patient who has been homeless for an extended period of time
B) A patient who recently immigrated to the United States
C) A patient who is 88 years old and who has enjoyed relatively good health
D) A teenage boy

15. A recent nursing school graduate has chosen to pursue a community nursing position because of
increasing opportunities for nurses in community settings. What changes in the health care system have
created an increased need for nurses to practice in community-based settings? Select all that apply.
A) Tighter insurance regulations
B) Younger population
C) Increased rural population
D) Changes in federal legislation
E) Decreasing hospital revenues

16. A nursing student has taught a colleague that nursing practice is not limited to hospital settings,
explaining that nurses are now working in ambulatory health clinics, hospice settings, and homeless
shelters and clinics. What factor has most influenced this increased diversity in practice settings for nurses?
A) Population shift to more rural areas
B) Shift of health care delivery into the community
C) Advent of primary care clinics
D) Increased use of rehabilitation hospitals

17. A nurse is collaborating with a team of community nurses to identify the vision and mission for
community care. What is the central focus of community-based nursing?
A) Increased health literacy in the community
B) Distributing ownership for the health of the community
C) Promoting and maintaining the health of individuals and families
D) Identifying links between lifestyle and health

18. You are the community-based nurse who performs the role of case manager for a small town about 60
miles from a major health care center. When planning care in your community, what is the most
important variable in community-based nursing that you should integrate into your planning?

A) Eligibility requirements for services
B) Community resources available to patients
C) Transportation costs to the medical center
D) Possible charges for any services provided

19. An urban, community-based nurse is looking for community resources for a patient who has complex
rehabilitation needs coupled with several comorbid, chronic health conditions. Where is the best place
for the nurse to search for appropriate resources?
A) A hospital directory
B) The hospital intranet
C) A community directory
D) The nurses own personal network

20. You are a community-based care manager in a medium-sized community that does not have an up-todate resource directory available. As a result, you have been given the task of beginning to compile such
a directory. What would be important to include in this directory? Select all that apply.
A) Links to online health sciences journals
B) Lists of social service workers in the community
C) Eligibility requirements for services
D) Lists of the most commonly used resources
E) Costs associated with services

21. You are assessing a new patient and his home environment following the patients referral for
community-based care. Which of the following is the most important responsibility that you, as a
community-based nurse, have at this initial visit?
A) Encourage the patient and his family to become more involved in their community.
B) Encourage the patient and his family to delegate someone to contact community resources.
C) Encourage the patient and his family to focus primarily on online supports.
D) Encourage the patient and his family to connect with appropriate community resources.

22. A nurse is comparing some of the similarities and differences between the care that is provided in
community- and hospital-based settings. What type of care is provided in both of these settings?
A) Dieticians
B) Ambulatory health care
C) Occupational health care
D) Hospice care

23. A community-based case manager is sending a community nurse to perform an initial home assessment
of a newly referred patient. To ensure safety, the case manager must make the nurse aware of which of
the following?
A) The potential for at-risk working environments
B) Self-defense strategies
C) Locations of emergency services in the area
D) Standard precautions for infection control

24. A home health nurse is making a visit to a new patient who is receiving home care following a
mastectomy. During the visit, the patients husband arrives home in an intoxicated state and speaks to
both you and the patient in an abusive manner. What is your best response?
A) Ignore the husband and focus on the patient.
B) Return to your agency and notify your supervisor.
C) Call the police from your cell phone.
D) Remove the patient from the home immediately.

25. The community-health nurse has received a referral for a new patient who resides in a high-crime area.
What is the most important request that the nurse should make of the agency to best ensure safety?
A) An early morning or late afternoon appointment
B) An assigned parking space in the neighborhood
C) A colleague to accompany the nurse on the visit
D) Someone to wait in the car while the nurse makes the visit

26. A home health nurse has been assigned to the care of an 82 year-old woman who has been discharged
home following hip replacement surgery. At what level of care is this nurse most likely practicing?
A) Preventative care
B) Primary prevention
C) Secondary prevention
D) Tertiary prevention

27. You are admitting two new patients to your local home health care service. These patients live within
two blocks of each other and both homes are in a high-crime area. What action best protects your
personal safety?
A) Drive a car that is hard to break into.
B) Keep your satchel close to you at all times.
C) Do not leave anything in the car that might be stolen.
D) Do not wear expensive jewelry.

28. In two days you are scheduled to discharge a patient home after left hip replacement. You have initiated
a home health referral and you have met with a team of people who have been involved with this
patients discharge planning. Knowing that the patient lives alone, who would be appropriate people to be
on the discharge planning team? Select all that apply.
A) Home health nurse
B) Physical therapist
C) Pharmacy technician
D) Social worker
E) Meal-on-Wheels provider

29. A home health nurse is conducting a home visit to a patient who receives wound care twice weekly for a
diabetic foot ulcer. While performing the dressing change, the nurse realizes that she forgot to bring the
adhesive gauze specified in the wound care regimen. What is the nurses best action?
A) Phone a colleague to bring the required supplies as soon as possible.
B) Improvise, if possible, using sterile gauze and adhesive tape.
C) Leave the wound open to air and teach the patient about infection control.
D) Schedule a return visit for the following day.

30. Discharge planning is an integral part of community-health nursing and home health. Which of the
following is prioritized in the discharge-planning process?
A) Identifying the patients specific needs
B) Making a social services referral
C) Getting physical therapy involved in care
D) Notifying the pharmacy of the discharge date

31. Within the public health system there has been an increased demand for medical, nursing, and social
services. The nurse should recognize what phenomenon as the basis for this increased demand?
A) Increased use of complementary and alternative therapies
B) The growing number of older adults in the United States
C) The rise in income disparity in the United States
D) Increasing profit potential for home health services

32. Nursing care is provided in an increasingly diverse variety of settings. Despite the variety in settings,
some characteristics of professional nursing practice are required in any and every setting. These
characteristics include which of the following?
A) Advanced education
B) Certification in a chosen specialty
C) Cultural competence
D) Independent practice

33. Medicare is a federal program that finances many Americans home health care expenses. The Medicare
program facilitates what aspect of home health care?
A) Providing care without the oversight of a physician
B) Writing necessary medication orders for the patient
C) Ordering physical, occupational, and speech therapy if needed
D) Managing and evaluating patient care for seriously ill patients

34. You are a school nurse who will work with an incoming kindergarten student who has a diagnosis of
cerebral palsy. Why would you make a home visit before school starts?
A) To provide anticipatory guidance to the family
B) To assess the safety of the childs assistive devices
C) To arrange for a teaching aide to work with the child
D) To provide follow-up care after the childs clinic visit

35. A home health nurse has been working for several months with a male patient who is receiving
rehabilitative services. The nurse is aware that maintaining the patients confidentiality is a priority. How
can the nurse best protect the patients right to confidentiality?
A) Avoid bringing the patients medical record to the home.
B) Discuss the patients condition and care only when he is alone in the home.
C) Keep the patients medical record secured at all times.
D) Ask the patient to avoid discussing his home care with friends and neighbors.

36. A home health nurse has completed a visit to a patient and has immediately begun to document the visit.
Accurate documentation that is correctly formatted is necessary for which of the following reasons?
A) Accurate documentation guarantees that the nurse will not be legally liable for unexpected
B) Accurate documentation ensures that the agency is correctly reimbursed for the visit.
C) Accurate documentation allows the patient to gauge his or her progress over time.
D) Accurate documentation facilitates safe delegation of care to unlicensed caregivers.

37. A home health nurse is collaborating with a hospice nurse in order to transfer the care of a woman who
has a diagnosis of lung cancer. To qualify for hospice care, the patient must meet what criterion?
A) The patient must be medically inappropriate for hospital care.
B) The patient must be in the final six months of his or her life.
C) The patients family must demonstrate that they are unable to provide care.
D) The patient must have a diagnosis that is associated with high morbidity and mortality.

38. A home health nurse has completed a scheduled home visit to a patient with a chronic sacral ulcer. The
nurse is now evaluating and documenting the need for future visits and the frequency of those visits.
What question can the nurse use when attempting to determine this need?
A) How does the patient describe his coping style?
B) When was the patient first diagnosed with this wound?
C) Is the patients family willing to participate in care?
D) Is the patient willing to create a plan of care?

39. A home health nurse is conducting an assessment of a patient who may qualify for Medicare.
Consequently, the nurse is utilizing the Outcome and Assessment Instrument Set (OASIS). When
performing an assessment using this instrument, the nurse should assess which of the following domains
of the patients current status?
A) Psychiatric status
B) Spiritual state
C) Compliance with care
D) Functional status

40. A community health nurse in a large, urban setting is participating in a pilot project that will involve the
establishment of a community hub. On what population should the nurse focus?
A) Postsurgical patients
B) Individuals with vulnerable health
C) Community leaders
D) Individuals motivated to participate in health education



Test Bank Med Surg Nursing

Test Bank Med Surg Nursing


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