Study Guide for Fundamentals of Nursing The Art and Science of Nursing Care

living environment as well as the healthcare pro-

vided. Provide direct care, supervise others, serve

as an administrator, and teach.

3.With the trend toward discharging patients earlier,

hospitals more often focus on the acute care needs

of the patient. Along with this focus has come a

proliferation of services offered by the hospital

aimed at the outpatient.

4. a.Surgical procedures
   b.Diagnostic tests
   c. Medications
   d.Physical therapy
   e.Counseling
   f. Health education
   5.DRGs: Diagnosis-related groups: This plan pays the
   hospital a predetermined, fixed amount defined by
   the medical diagnosis or specific procedure rather
   than by the actual cost of hospitalization and care.
   DRGs were implemented by the federal government
   in an effort to control rising healthcare costs. If the
   cost of hospitalization is greater than that assigned,
   the hospital must absorb the additional cost. How-
   ever, if cost is less than that assigned, the hospital
   makes a profit.
   6.When patients come in contact with many different
   healthcare providers (e.g., registered nurses, licensed
   practical nurses, nursing assistants, nurse specialists,
   physical therapists, dietitians, and students) and are
   frequently seen by other physician specialists called
   in on consultation or to do surgery, the patient may
   become confused about care and treatment. This
   fragmentation of care may result in the loss of con-
   tinuity of care, resulting in conflicting plans of care,
   too much or too little medication, and higher
   healthcare costs.
   REFLECTIVE PRACTICE USING CRITICAL
   THINKING SKILLS
   Sample Answers
   1.What nursing interventions might the nurse
   employ to assist Ms. Ritchie with her caregiver
   duties?
   The nurse can provide Ms. Ritchie with information
   about how to access respite care and make referrals
   for her. However, since Medicaid and most
   insurance providers do not cover the costs of respite
   care, the nurse should also check community services
   that may provide respite care for free. Ms. Ritchie’s
   husband may qualify for hospice care, and the nurse
   can arrange for this service.
   2.What would be a successful outcome for this patient?
   Ms. Ritchie vocalizes the benefits of respite care and
   hospice care programs and states that she will sign
   up for any services available to her.
   3.What intellectual, technical, interpersonal, and/or
   ethical/legal competencies are most likely to bring
   about the desired outcome?
   Intellectual: knowledge of the various types of
   healthcare services and settings available to meet
   the needs of families caring for dying patients

Technical: ability to provide technical assistance to

meet the needs of families of patients on hospice

Interpersonal: ability to work with different

available resources to ensure everyone’s access to

safe, quality healthcare

Ethical/Legal: knowledge of ethical and legal princi-

ples related to patients with terminal illnesses

4.What resources might be helpful for Ms. Ritchie?

Respite care, hospice services, community services

CHAPTER 9

PRACTICING FOR NCLEX

MULTIPLE CHOICE QUESTIONS

1.c 2.a 3.d 4.a 5.b

6.c

ALTERNATE-FORMAT QUESTIONS

Multiple Response Questions

1.a, c, e

2.b, c, f

3.c, d, e, f

4.b, e, f

5.a, d, f

DEVELOPING YOUR KNOWLEDGE BASE

FILL-IN-THE-BLANKS

1.Community-based

2.Health Insurance Portability and Accountability Act

(HIPAA)

3.Against medical advice (AMA)

4.Discharge planning

CORRECT THE FALSE STATEMENTS

1.False—nurse

2.False—Continuity of care

3.True

4.True

5.False—patient’s name, ID number, and physician

6.False—decreasing

7.False—is indicated

8.True

9.False—remains at the hospital

10.False—physician’s order

SHORT ANSWER

1.Sample answers:

a.With patient’s permission, check with relatives,

neighbors, or fellow church or club members who

could help; if necessary, check with social agencies.

b.Describe the procedure to the patient in detail so

he/she will know what to expect.

c. Check the patient’s insurance status, Medicare,

or Medicaid; see if procedures are covered and

what amount the patient will be responsible for.

Refer to the appropriate agencies if necessary.

d.With patient’s permission, check with family; if

necessary, check into home healthcare possibili-

ties, hospice, or extended-care facilities.

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