Ch 2 Nclex - Health Care Delivery System

Question 1

1. A community center is presenting a nurse-led program on the Patient Protection and Affordable Care Act. Which statement made by a participant indicates a need for further teaching?
2. “My small company will now have to offer the 75 employees health insurance or pay a penalty.”
3. “As long as my son is a full-time student in college, I will be able to keep him on my health insurance until he is 26 years old.”
4. “I signed up for the state health insurance exchange before the designated deadline to make sure I had health insurance.”
5. “Since I have now been diagnosed with diabetes, my health insurance plan cannot charge me higher premiums.”

Answer 1

2

Question 2

2. Which activity performed by a nurse is related to maintaining competency in nursing practice?
3. Asking another nurse about how to change the settings on a medication pump
4. Regularly attending unit staff meetings
5. Participating as a member of the professional nursing council
6. Attending a review course in preparation for a certification examination

Answer 2

4

Question 3

3. A patient tells a nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse’s best explanation of a PPO?
4. This health plan is for people who cannot afford their own health insurance.
5. This health plan is operated by the government to provide health care to older adults.
6. This health plan gives you a list of physicians and hospitals from which you can choose.
7. This is a fee-for-service plan in which you can choose any physician or hospital.

Answer 3

3

Question 4

4. Which of the following are examples of a nurse participating in primary care activities? (Select all that apply.)
5. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester
6. Assessing the nutritional status of older adults who come to the community center for lunch
7. Working with patients in a cardiac rehabilitation program
8. Providing home wound care to a patient
9. Teaching a class to parents at the local grade school about the importance of immunizations

Answer 4

1,2,5

Question 5

5. Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system?
6. Patient safety
7. Evidence-based practice
8. Patient satisfaction
9. Maintenance of competency

Answer 5

1

Question 6

6. Which of the following statements is true regarding Magnet status recognition for a hospital?
7. Nursing is run by a Magnet manager who makes decisions for the nursing units.
8. Nurses in Magnet hospitals make all of the decisions on the clinical units.
9. Magnet is a term that is used to describe hospitals that are able to hire the nurses they need.
10. Magnet is a special designation for hospitals that achieve excellence in nursing practice.

Answer 6

4

Question 7

7. A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient29correctly. A change is needed quickly. What type of quality improvement method would be most appropriate?
8. PDSA
9. Six Sigma
10. Rapid-improvement event (RIE)
11. A randomized controlled trial

Answer 7

3

Question 8

8. Which of the following are characteristics of managed care systems? (Select all that apply.)
9. Provider receives a predetermined payment for each patient in the program.
10. Payment is based on a set fee for each service provided.
11. System includes a voluntary prescription drug program for an additional cost.
12. System tries to reduce costs while keeping patients healthy.
13. Focus of care is on prevention and early intervention.

Answer 8

1,4,5

Question 9

9. Which of the following nursing activities is provided in a secondary health care environment?
10. Conducting blood pressure screenings for older adults at the Senior Center
11. Teaching a clinic patient with chronic obstructive pulmonary disease purse-lipped breathing techniques
12. Changing the postoperative dressing for a patient on a medical-surgical unit
13. Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit

Answer 9

3,4

Question 10

10. A nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. Place the steps in the correct sequence for PDSA.
11. Bedside change of shift report is piloted on two medical-surgical units.
12. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change.
13. The nursing council develops a strategy for bedside change of shift report.
14. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units.

Answer 10

3,1,2,4

Question 11

11. The nursing staff is developing a quality program. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators (NDNQI) that the nurses can use to measure patient safety and quality for the unit? (Select all that apply.)
12. Use of physical restraints
13. Pain assessment, intervention, and reassessment
14. Patient satisfaction with food preparation
15. Registered nurse (RN) education and certification
16. Number of outpatient surgical cases per year

Answer 11

1,2,4

Question 12

12. A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care?
13. Patient will be able to walk 200 feet without shortness of breath.
14. Wound will heal without signs of infection.
15. Patient will express concerns related to return to home.
16. Patient will identify strategies to improve sleep habits.

Answer 12

1

Question 13

13. A nurse is presenting information to a management class of nursing students on the topic of financial reimbursement for achievement of established, measurable patient outcomes. The nurse is presenting information to the class on which topic?
14. Prospective payment system
15. Pay for performance
16. Capitation payment system
17. Managed care systems

Answer 13

2

Question 14

14. A nurse is using data collected from the unit to monitor the incidence of falls after the unit implemented a new fall protocol. The nurse is working in which area?
15. Quality improvement (QI)
16. Health care patient system
17. Nursing informatics
18. Computerized nursing network

Answer 14

1

Question 15

15. The nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. They decide to initiate a quality improvement project using the Plan-Do-Study-Act (PDSA) model. Which of the following is an example of “Do” from that model?
16. Implementing the new skin care protocol on all medicine units
17. Reviewing the data collected on patients cared for using the protocol
18. Reviewing the quality improvement reports on the six patients who developed ulcers over the last 3 months
19. Based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol

Answer 15

4