TEST BANK
deWit's Medical-Surgical Nursing,
Concepts and Practice, 4th Edition
(Stromberg, 2023) Chapters 1 - 49
,TABLE OF CONTENTS
,
,Chapter 01: Caring for Medical-Surgical Patients
DeWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition
MULTIPLE CHOICE
1. Which statement accurately describes the primary purpose 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
ANSWER: 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.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3
TOP: NPA KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a
skill that the vocational nurse has not been taught during her educational program.
How should the vocational nurse respond?
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.
ANSWER: 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.
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1
TOP: Providing Safe Care KEY: Nursing Process Step:
N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
3. Which patient statement indicates a need for further discharge teaching that the
vocational nurse should 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?‖
ANSWER: 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.
,DIF: Cognitive Level: Application REF: p. 2 OBJ: 1
TOP: Teaching KEY: Nursing Process Step: Implementation
, MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-
term care facility acts in which capacity?
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
ANSWER: 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.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1
TOP: Charge Nurse/Manager KEY: Nursing Process Step:
N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
5. The nurse is educating a patient that is a member of a health maintenance
organization (HMO). Which information should the nurse include?
a. Seek the opinion of an alternate health care provider.
b. Contact the insurance company for coverage details as services may be
limited.
c. Provide detailed documentation of all care received for his condition.
d. Wait at least 6 months to see a specialist.
ANSWER: B
HMOs are a kind of managed care. This is accomplished by paying providers to care
for groups of patients for a set capitation fee and by limiting services. Patients are
not required to seek a second opinion, provide documentation of care, or wait a
specific time period before visiting a specialist.
DIF: Cognitive Level: Application REF: p. 9 OBJ: 9
TOP: Charge Nurse/Manager KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
6. The patient complains to the nurse that he is confused about his ―deductible‖ that
he owes the hospital. Which statement accurately explains a deductible?
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
ANSWER: 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.
DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 9
TOP: Health Care Financing KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
Care
7. A patient asks the nurse what Medicare Part A covers. Which response is correct?
,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.
ANSWER: 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.
DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4
OBJ: 9 TOP: Government-Sponsored Health
Insurance KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. Which is the main cost-containment component of 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.
ANSWER: 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.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9
TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. The nurse is assessing a group of patients. Which patient would most likely
qualify 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
ANSWER: A
Medicaid is a joint effort of federal and state governments geared primarily for low-
income people with no insurance.
DIF: Cognitive Level: Application REF: p. 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance—
Medicaid KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. Which area is the major focus of Healthy People 2020 and the primary mechanism
through which to improve the health of Americans in the second decade of the
century?
, a. Research funding
b. Health information distribution
