Medical Surgical Nurse Practice Test

1.Using the average cost of a problem and the cost of intervention to demonstrate savings is: A.A cost-benefit analysis B.An efficacy study C.A product evaluation D.A cost-effective analysis 2.In Erikson's psychosocial model of development, which stage is typical of those entering young adulthood? A.Identify vs role confusion B.Initiative vs guilt C.Ego integrity vs despair D.Intimacy vs isolation 3.A 30-year old patient has been diagnosed with advanced ovarian cancer. The patient says, "This is all my fault." Which of Kbler-Ross's five stages of grief is the patient probably experiencing? A.Denial B.Anger C.Depression D.Acceptance 4.A 68-year old man with mild COPD refuses to exercise because he tires easily. He spends most of every day sitting in a chair watching television. What is the most appropriate nursing diagnosis? A.Ineffective health maintenance B.Impaired physical mobility C.Risk for disuse syndrome D.Activity intolerance 5.Measuring the effectiveness of an intervention rather than the monetary savings is:

A.A cost-benefit analysis. B.An efficacy study. C.A product evaluation. D.A cost-effective analysis.

Medical Surgical Nurse Answers and Explanations

1.A. A cost-benefit analysis uses average cost of a problem (such as wound infections) and the average cost of intervention to demonstrate savings. For example, if a surgical unit averaged 10 surgical site infections annually at an additional average cost of $27,000 each, the total annual cost would be $270,000. If the total cost for interventions, (new staff person, benefits, education, and software) totals $92,000, and the goal is to reduce infections by 50% (0.5 X $270,000 for a total projected savings of $135,000), cost benefit is demonstrated by subtracting the proposed savings from the intervention costs ($135,000 - $92,000) for a savings of $43,000 annually. 2.D. Erickson's psychosocial development model focuses on conflicts at each stage of the lifespan and the virtue that results from finding balance in the conflict. The first 5 stages refer to infancy and childhood and the last 3 stages to adulthood: Intimacy vs isolation (Young adulthood): Love/intimacy or lack of close relationships. Generativity vs stagnation (Middle age): Caring and achievements or stagnation. Ego integrity vs despair (Older adulthood): Acceptance and wisdom or failure to accept changes of

aging/despair. 3.B. The patient is experiencing the stage of anger. People grieve individually and may not go through all stages, but most go through at least 2 stages. KblerRoss's 5 stages of grief include: Denial: Refusal to believe, confused, stunned, detached. Anger: Directed inward (self-blame) or outward. Bargaining: If - then thinking. ("If I go to church, then I will heal.") Depression: Sad, withdrawn. Acceptance: Resolution. 4.C. The most appropriate nursing diagnosis for a person who is able to exercise but remains sedentary is risk of disuse syndrome because the patient is putting himself at risk for the development of circulatory impairment and muscle atrophy. Failure to exercise may also exacerbate his condition. While his health maintenance may be ineffective, it is directly due to of his lack of activity. He does not have impaired physical mobility or activity intolerance that precludes exercise. 5.D. A cost-effective analysis measures the effectiveness of an intervention rather than the monetary savings. For example, annually 2 million nosocomial infections result in 90,000 deaths and an estimated $6.7 billion in additional health costs. From that perspective, decreasing infections should reduce costs, but there are human savings in suffering as well, and it can be difficult to place a dollar value on that. If each infection adds about 12 days to hospitalization, then a reduction of 5 infections (5 X 12 = 60) would result in a cost-effective

savings of 60 fewer patient infection days.