Black & Hawks: Medical-Surgical Nursing: Clinical Management for Positive
Outcomes, 7th Edition
Chapter 8: Acute Health Care
MULTIPLE CHOICE
1. The prepayment plan developed in 1929 is
a. Blue Cross Health Insurance.
b. Medicare Insurance.
c. Medicaid Insurance.
d. Health Maintenance Organization.
ANS: a
The 1929 Blue Cross Plan offered a form of prepayment insurance.
DIF: Cognitive Level: Knowledge REF: Text Reference: 147
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
2. A hospital staff nurse is collaborating with a nurse case manager in planning the care
of a client with a below-the-knee amputation. The primary role of the case manager is
a. coordination of care for the client.
b. client education on specialized care.
c. education of the staff nurse.
d. direct care of the client’s medical problems.
ANS: a
Case managers are nurses who coordinate the care of a group of clients, monitor the
implementation of interdisciplinary care plans, and maintain communication with third-party
payers and referral sources.
DIF: Cognitive Level: Application REF: Text Reference: 151
TOP: Nursing Process Step: Intervention
MSC: NCLEX: Heath Promotion and Maintenance
3. A newly licensed registered nurse (RN) seeking work in a voluntary health agency
would choose a
a. Veterans Administration (VA) hospital.
b. state university hospital.
c. church-affiliated hospital.
d. proprietary hospital.
ANS: c
Voluntary agencies are not-for-profit, tax-exempt organizations designed to meet health care
needs of the public.
DIF: Cognitive Level: Comprehension REF: Text Reference: 148
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Chapter 8: Acute Health Care 2
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
4. The nurse explains that when a client experiences chest pain with electrocardiographic
changes during an appointment with the primary care physician, the physician orders
hospital admission for cardiac monitoring. This type of admission is a(n)
a. emergency admission.
b. scheduled admission.
c. direct admission.
d. elective admission.
ANS: c
A direct admission is the process followed when a client is determined to need hospital or
nursing care while in a physician’s office.
DIF: Cognitive Level: Comprehension REF: Text Reference: 148, Box 8-1;
TOP: Nursing Process Step: Intervention
MSC: NCLEX: Heath Promotion and Maintenance
5. A client for whom the nurse would provide subacute care is the
a. 76-year-old needing rehabilitation after cardiac surgery.
b. 38-year-old following cesarean birth.
c. 40-year-old recovering from kidney stone removal.
d. 60-year-old receiving a regulated regimen of antihypertensive medication.
ANS: a
Post-acute care areas are designed for clients who are out of the fragile phase of their illness and
need routine monitoring and rehabilitation.
DIF: Cognitive Level: Analysis REF: Text Reference: 150
TOP: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity
6. While administering an antibiotic to a client with an infection, the nurse explains the
importance of completing the full course of antibiotic therapy. This is an example of
a. giving advice.
b. formal education.
c. informal education.
d. setting an example.
ANS: c
Informal education continues throughout the course of nursing care in the form of directions and
explanations. Formal education is a formal presentation.
DIF: Cognitive Level: Application REF: Text Reference: 150
TOP: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity
7. When unit staffing includes unlicensed assistive personnel, the nurse is aware that
a. unlicensed assistive personnel do not have clinical duties on a client care unit.
b. unlicensed assistive personnel have formal training and are able to function
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Chapter 8: Acute Health Care 3
independently.
c. the licensed personnel are accountable for the tasks delegated to the unlicensed
personnel.
d. delegating tasks to unlicensed assistive personnel is not in the scope of RN
practice.
ANS: c
Nurses remain accountable for client outcomes whether or not the specific tasks are performed
by nurses of nurse extenders.
DIF: Cognitive Level: Comprehension REF: Text Reference: 152
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
8. When a nurse is able to work effectively in more than one care area (e.g., general
medical-surgical and cardiac care unit), the nurse is said to be
a. cross-trained.
b. skill mixed.
c. nursing intense.
d. flexible assigned.
ANS: a
In an attempt the make the most effective use of available personnel, nurses may be cross-trained
to work skillfully in two or more specialty care areas.
DIF: Cognitive Level: Application REF: Text Reference: 153
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
9. An applicant was denied employment with a health care agency because she is a
recovering alcoholic. This action by the agency violates the
a. Occupational Safety and Health Act.
b. Americans with Disabilities Act.
c. Age Discrimination and Employment Act.
d. Civil Rights Act.
ANS: b
In 1990 the Americans with Disabilities Act was passed to eliminate discrimination against
persons with physical or mental disabilities.
DIF: Cognitive Level: Application REF: Text Reference: 155
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
10. A planned program of loss prevention and liability control best defines
a. quality assurance.
b. risk management.
c. clinical pathway.
d. client satisfaction.
ANS: b
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Chapter 8: Acute Health Care 4
Risk management is a planned program of loss prevention to identify and analyze risks in an
effort to reduce accidents and injuries.
DIF: Cognitive Level: Application REF: Text Reference: 157
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
11. A 34-year-old client injured in an automobile accident is now stable but permanently
ventilator-dependent. The client is to be transferred to post–acute care services, and
the nurse manager recommends a
a. transitional unit.
b. general medical-surgical unit.
c. rehabilitation unit.
d. long-term care unit.
ANS: d
Long-term care is the option for a client who is stable and has little recovery potential. Long-
term care units are more cost-effective when acute care is not longer needed.
DIF: Cognitive Level: Analysis REF: Text Reference: 150
TOP: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity
12. The nurse who is delegating care to unlicensed assistive personnel should keep in
mind that most of these workers have an educational background consisting of
a. on-the-job experience.
b. completion of high school.
c. less than 1 year of college.
d. more than 1 year of college.
ANS: a
Other than on-the-job experience, unlicensed assistive personnel have very little formal training.
DIF: Cognitive Level: Knowledge REF: Text Reference: 152
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
13. The examination of the ratio of RNs to vocational nurses and unlicensed assistive
personnel to create the best level of quality of care is the
a. work design.
b. skill mix.
c. work schedule.
d. risk management.
ANS: b
Skill mix is the study of the licensed/unlicensed personnel ratio to attain a cost-effective but
quality-assured level of care.
DIF: Cognitive Level: Comprehension REF: Text Reference: 152
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
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Chapter 8: Acute Health Care 5
14. Using an nursing intensity classification system, the nurse manager assesses that the
client requiring the greatest amount of care is the
a. 24-year-old with a 3-day-old fractured femur in Russell’s traction.
b. 37-year-old in isolation for hepatitis who is vomiting.
c. 42-year-old 1 day after a craniotomy.
d. 76-year-old 4 days after a cerebrovascular accident (CVA) who is comatose.
ANS: c
The craniotomy client will need high-level assessment and highly technological procedures. The
other clients, although ill, have common care problems that require no more than routine care
investment.
DIF: Cognitive Level: Analysis REF: Text Reference: 154, Table 8-1;
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A
15. The nurse assigned to a client is doing a grooming assessment as part of a care
intensity rating system. The client is unable to do much for himself, and the nurse
assigns the rating of
a. Category 1.
b. Category 2.
c. Category 3.
d. Category 4.
ANS: c
Clients who are unable to do much for themselves in terms of grooming are placed in Category
3.
DIF: Cognitive Level: Analysis REF: Text Reference: 185, Table 8-1;
TOP: Nursing Process Step: Assessment
MSC: NCLEX: Heath Promotion and Maintenance
Elsevier items and derived items 2005 by Elsevier Inc.
