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Test Bank for Medical Surgical Nursing 5th Edition by Holly K. Stromberg Chapter 1-49 Newest Version 2023
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Test Bank For Medical Surgical Nursing 5th Edition By Holly K. Stromberg | Chapter 1-49 | COMPLETE GUIDE A+|Newest Version 2023

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  • October 7, 2024
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Test Bank for Medical Surgical Nursing 5th Edition by Holly K. Stromberg Chapter 1-49 Newest
Version 2023
Chapter 01: Caring for Medical Surgical Patients
Multiple Choice
1. What is the main function of the state nurse practice act (NPA)?
a. To test and license LPN/LVNs.
b. To define the scope of LPN/LVN practice.
c. To improve the quality of care provided by the LPN/LVN.
d. To limit the LPN/LVN employment placement.
ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary
purpose of the NPA of each state defines the scope of nursing practice in that state.

2. When the charge nurse instructs the new vocational nurse to initiate an intravenous infusion—
something not covered in her training—how should the vocational nurse react?
a. Ask a more experienced nurse to demonstrate the procedure.
b. Look up the procedure in the procedure manual.
c. Attempt to perform the procedure with supervision.
d. Inform the charge nurse of her lack of training in this procedure.
ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the
vocational nurse should seek further training to gain proficiency. Although the other options might be
helpful, they are not safe.

3. Which remark from the patient suggests that additional discharge education is necessary for the
vocational nurse to address?
a. “I have no idea of how this drug will affect me.”
b. “Do you know if my physician is coming back today?”
c. “Will my insurance pay for my stay?”
d. “Am I going to have to go to a nursing home?”
ANS: A
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
departments to which the nurse might refer the patient.
4. In most state NPAs, what role does the vocational nurse assume when acting as charge nurse in a
long-term care setting?
a. Working under direct supervision of an RN on the unit
b. Working with the RN in the building
c. Working under general supervision by the RN available on site or by phone
d. Working as an independent vocational nurse
ANS: C
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the
general supervision of an RN available on site or by phone
5. While informing a patient who belongs to a health maintenance organization (HMO), what key
information should the nurse provide?

, a. Seek the opinion of an alternate health care provider.
b. Obtain insurance approval for medical services prior to treatment.
c. Provide detailed documentation of all care received for his condition.
d. Wait at least 6 months to see a specialist.
ANS: B
Most HMOs require pre-procedure authorization for treatment. Patients are not required to seek a
second opinion, provided documentation of care, or wait a specific time period before visiting a
specialist.
6. A patient expresses confusion regarding the “deductible” owed to the hospital. How can the nurse
clarify what a deductible is?
a. An amount of money put aside for the payment of future medical bills
b. A one-time fee for service
c. An amount of money deducted from the bill by the insurance company
d. An annual amount of money the patient must pay out-of-pocket for medical care
ANS: D
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance
company assuming the cost. This practice improves the profit of the insurance company.

7. As the nurse contrasts the features of a health maintenance organization (HMO) with a preferred
provider organization (PPO), what details should be included about HMOs?
a. HMOs require a set fee of each member monthly.
b. HMOs allow the member to select his health care provider.
c. HMOs permit admission to any facility the member prefers.
d. HMOs offer unlimited diagnostic tests and treatments.
ANS: A
HMOs require a set fee from each member monthly (capitation). The patient will be treated by the
HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is
discouraged by the HMO.

8. If a patient inquires about what Medicare Part A includes, what would be the correct response?
a. Medicare Part A covers inpatient hospital costs.
b. Medicare Part A covers reimbursement to the physician.
c. Medicare Part A covers outpatient hospital services.
d. Medicare Part A covers ambulance transportation.
ANS: A
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive
care. Medicare Part B pays the physician, ambulance transport, and outpatient services.
9. What is the primary cost-containment element associated with diagnosis-related groups (DRGs)?
a. Hospitals focus only on the specific diagnosis.
b. Hospitals treat and discharge patients quickly.
c. Reduced cost drugs are ordered for specific diagnoses.
d. Diagnostic group classification streamlines care.
ANS: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s
diagnostic category regardless of the length of time in the hospital. If hospitals can treat and

, discharge patients before the allotted time, hospitals get to keep the excess payment; cost is
contained, and the patient is discharged sooner.
10. While evaluating a group of patients, which one is most likely to be eligible for Medicaid?
a. A 35-year-old unemployed single mother with diabetes
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term care
facility
c. An 80-year-old blind woman living in her own home who has inadequate private insurance
d. A 67-year-old stroke victim with Medicare Part A and an income from investments
ANS: A
Medicaid is a joint effort of federal and state governments geared primarily for low- income people
with no insurance.

11. What key area is emphasized by Healthy People 2020 as the main strategy for enhancing the health
of Americans in this decade?
a. Research funding
b. Health information distribution
c. Healthy lifestyle encouragement
d. Health improvement program designs
ANS: C
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
immunizations, healthy eating habits, and healthy weight.

12. Which term describes the type of care that encompasses interventions for all aspects of a patient’s
existence?
a. Focused care
b. General care
c. Directed care
d. Holistic care
ANS: D
Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of the
patient.

13. A patient angrily states, “My doctor was too busy giving instructions to listen to my questions!”
What is the most empathetic response?
a. “When people ignore me, I really get mad.”
b. “I’m sure that the doctor was rushed and unaware of your needs.”
c. “I’ll bet that made you feel very frustrated.”
d. “Take a deep breath and plan what you will say to him tomorrow.”
ANS: C
Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the emotion.
Belittling the patient’s feelings, showing sympathy, or defending the doctor makes the patient feel
devalued.

14. When clarifying the differences between therapeutic and social relationships, what crucial
information should the nurse share about therapeutic relationships?

, a. Therapeutic relationships lack formal boundaries.
b. Therapeutic relationships are goal directed.
c. Therapeutic relationships meet the needs of each person in the relationship.
d. Therapeutic relationships extend past the hospitalization period.
ANS: B
The therapeutic relationship is focused on the patient and is goal directed and designed to meet only
the needs of the patient and does not extend past the period of hospitalization.

15. A nurse in a long-term care facility is looking after a newly admitted 80-year-old patient with
depression. What approach should the nurse take?
a. Encourage the resident to engage in an activity.
b. Remind the resident of reasons to be positive.
c. Point out episodes of negative behavior.
d. Present a bright and cheerful behavior.
ANS: A
Activity and social interaction are helpful to depressed patients. Presenting a cheery approach and
pointing out negative behavior and reasons to be positive are not therapeutic at this stage of the
relationship.

16. A patient on antidepressants for three days expresses, “I still feel awful. I don’t believe anything can
help me.” What is the most effective response?
a. “I will tell the charge nurse how you are feeling.”
b. “You just need to be patient and give your medicine some time to work.”
c. “Look how much you have improved since you were admitted to the facility.”
d. “It must be frustrating to be going through this difficult time.”
ANS: D
This response is an empathetic response that allows for further exploration of the patient’s feelings.
The other responses will block communication with this patient.
17. An overweight male patient angrily discards his hospital gown, claiming, “This gown is too small
and shows my backside!” What is the most suitable response?
a. Remind patient of the need to wear the gown for convenience in care.
b. Confer with the patient for methods to acquire a larger gown.
c. Replace the torn gown with another.
d. Inform the charge nurse of the hostile behavior.
ANS: B
Allowing hostile patients to make reasonable requests defuses the anger and allows patients to vent
their feelings.

18. A patient tells the nurse, “You’re the only one who understands my pain. Can’t I have an extra dose
of pain medication?” How should the nurse reply?
a. Explain that dosage schedules are by physician’s orders.
b. Ignore the request.
c. Tell the patient that his behavior is manipulative.
d. Agree to give an extra dose of pain medication.
ANS: A

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