TEST BANK
,Chapter 01: Caring for Medical-Surgical Patients
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th 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
ANS: B
While improving quality of care provided by the LPN/LVN may be a result
of the NPA, the primarypurpose 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.
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.
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?"
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.
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
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.
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.
ANS: 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
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.
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.
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.
, 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 pis pthe pmain pcost-containment pcomponent pof pdiagnosis-related pgroups p(DRGs)?
a. Hospitals pfocus ponly pon pthe pspecific pdiagnosis.
b. Hospitals ptreat pand pdischarge ppatients pquickly.
c. Reduced pcost pdrugs pare pordered pfor pspecific pdiagnoses.
d. Diagnostic pgroup pclassification pstreamlines pcare.
ANS: pB
DRGs pare pa pprospective ppayment pplan pin pwhich phospitals preceive pa pflat pfee pfor peach ppatient's
pdiagnostic pcategory pregardless pof pthe plength pof ptime pin pthe phospital. pIf phospitals pcan ptreat
pand pdischarge ppatients pbefore pthe pallotted ptime, phospitals pget pto pkeep pthe pexcess ppayment;
pcost pis pcontained, pand pthe ppatient pis pdischarged psooner.
DIF: Cognitive pLevel: pComprehension REF: p p. p8 OBJ:
p9 pTOP: pGovernment-Sponsored pHealth pInsurance
KEY: pNursing pProcess pStep: pImplementation
MSC: pNCLEX: pSafe, pEffective pCare pEnvironment: pCoordinated pCare
9. The pnurse pis passessing pa pgroup pof ppatients. pWhich ppatient pwould pmost plikely pqualify pfor pMedicaid?
a. A p35-year-old punemployed psingle pmother pwith pdiabetes
b. A p70-year-old pMedicare precipient pwith pretirement pincome pwho pneeds pto pbe pin pa
plong-term pcare pfacility
c. An p80-year-old pblind pwoman pliving pin pher pown phome pwho phas pinadequate
pprivate pinsurance
d. A p67-year-old pstroke pvictim pwith pMedicare pPart pA pand pan pincome pfrom pinvestments
ANS: pA
Medicaid pis pa pjoint peffort pof pfederal pand pstate pgovernments pgeared pprimarily pfor plow-income
ppeople pwith pno pinsurance.
DIF: Cognitive pLevel: pApplication REF: pp. p8, pBox p1-5
OBJ: p 9 TOP: pGovernment-Sponsored pHealth pInsurance—
Medicaid pKEY: pNursing pProcess pStep: pAssessment
MSC: pNCLEX: pSafe, pEffective pCare pEnvironment: pCoordinated pCare
10. Which parea pis pthe pmajor pfocus pof pHealthy pPeople p2020 pand pthe pprimary pmechanism
pthrough pwhich pto pimprove pthe phealth pof pAmericans pin pthe psecond pdecade pof pthe pcentury?
a. Research pfunding
b. Health pinformation p distribution
c. Healthy plifestyle p encouragement
d. Health pimprovement p program pdesigns
ANS: pC
Healthy pPeople p2020 pfocuses pon pexpanding pongoing pprograms pto pinclude psupport pand
pinformation pto preduce pinfant pmortality, pcancer, pcardiovascular pdisease, pand pHIV/AIDS, pand pto
pincrease peffective pimmunizations, phealthy peating phabits, pand phealthy pweight.
DIF: Cognitive pLevel: pComprehension REF: p p p. p6 OBJ: p 7
TOP: p Healthy pPeople p2020 KEY: pNursing pProcess pStep:
pImplementation pMSC: pNCLEX: pSafe, pEffective pCare pEnvironment: pCoordinated
pCare
