Medical-Surgical Nurse Exam Practice Questions

1. A Hispanic patient is admitted to a hospital unit where a nurse is to obtain the patient's admission history, but the patient speaks very little English. What should the nurse do?

A. Ask the patient's 12-year old son, who is fluent in English, to interpret.
B. Use sign language and pictures to supplement questions
C. Arrange for an interpreter.
D. Ask the patient's wife, who speaks fair English, to answer the questions for the patient.

2. The Health Insurance Portability and Accountability Act (HIPAA) regulates:

A. The transfer of patients from one facility to another.
B. The rights of the individual related to privacy of health information.
C. Medical trials.
D. Workplace safety.

3. The nurse is teaching a 45-year old woman with a colostomy to perform a colostomy irrigation. The nurse has prepared written directions and a video, but the patient ignores them. Instead, the patient picks up the equipment and looks at each part, trying to figure it out. The patient's learning style is probably:

A. Auditory.
B. Visual.
C. Kinesthetic.
D. Mixed.

4. A retrospective attempt to determine the cause of an event is:

A. Root cause analysis.
B. External benchmarking.
C. Internal trending.
D. Tracer methodology.

5. All departments in a healthcare institution should strive toward:

A. Autonomy.
B. A common vision of care.
C. Increased budget allotment.
D. A spirit of competition.

Medical-Surgical Nurse Exam Answer Key

1. C. The nurse should arrange for an interpreter. Children should never be used as interpreters as they lack sufficient vocabulary and understanding about health matters and may not interpret correctly. The use of a child interpreter may also be awkward or embarrassing, depending upon the topic being addressed. Other adult family members, such as the wife, should not be asked to answer questions for the patient unless the patient is unable to answer questions because of health condition because they may not understand medical terms and may not interpret correctly. Additionally, the patient may have kept information from the family.

2. A. The Health Insurance Portability and Accountability Act (HIPAA) addresses the rights of the individual related to privacy of health information. Health care workers must not release any information or documentation about a patient's condition or treatment without consent. The individual has the right to determine who may be given access to information considered "protected health information" (PHI). This includes all "individually identifiable health information" such as health history, condition, treatments in any form, and any related documentation. Personal information can be shared with a spouse, legal guardians, and those with durable power of attorney only if: 1) the patient agrees (or at least does not object), or 2) when it is professionally determined to be in the patient's "best interest" for certain specific and essential information to be provided (i.e., "directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient's care or payment for health care").

3. C. Kinesthetic learners learn best by handling, doing, and practicing. Thus, they should be allowed to handle supplies and equipment with minimal directions. They benefit most from demonstrating their understanding by performing the procedure. Visual learners learn best by seeing and reading, and thus benefit most from written directions, videos, diagrams, pictures, and demonstrations. Auditory learners learn best by listening and talking, so procedures should be thoroughly explained during any demonstrations. Auditory learners also benefit from audiotapes and extra time for questions.

4. A. Root cause analysis (RCA) is a retrospective attempt to determine the cause of an event, such as a death or other sentinel event. RCA involves interviews, observations, and review of medical records. External benchmarking monitors data from outside an institution, such as national rates of infections, and compares them to internal data. Internal trending compares internal rates of one area or population with another. Tracer methodology looks at the continuum of care a patient receives from admission to post-discharge, using a selected patient's medical record as a guide.

5. B. All departments in a healthcare institution should strive toward a common vision of care. This begins with the organization working collaboratively to create a team approach to serving the patient/family. Achieving a common vision requires inclusion of all levels of staff (both nursing and non-nursing) in consensus building through discussions, in-services, and team meetings. It also includes facilitation that values creativity, a vision statement that incorporates a common vision, and the recognition that a common vision is an organic concept that evolves over time and requires re-evaluation and periodic change.