MEDICAL .
SURGICALNUR .
SINGCONCEPTS
. .
ANDPRACTICE
. .
3THEDITIONDE
. .
WITTESTBAN . .
K
Med.C
,Chapter. 01:. Caring. for. Medical-Surgical. Patients
deWit:. Medical-Surgical. Nursing:. Concepts. &. Practice,. 3rd. 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.primary.purpose.of.the.NPA.of.each.state.d
efines.the.scope.of.nursing.practice.in.that.state.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 2
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.trai
ning.to.gain.proficiency..Although.the.other.options.might.be.helpful,.they.are.not.safe.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 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.nurs
e..The.other.concerns.in.the.options.are.the.responsibility.of.other.departments.to.which.the.nurse.might.refer.the.patient.
PTS: 1 DIF: Cognitive.Level:.Application. . REF: 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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 2
OBJ: 1 TOP: Charge.Nurse/Manager KEY: Nursing Process.Step:.N/A
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
Med.C
, 5. The.nurse.is.educating.a.patient.that.is.a.member.of.a.health.maintenance.organization.(HMO)..Which.information.shou
ld.the.nurse.include?
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.preprocedure.authorization.for.treatment..Patients.are.not.required.to.seek.a.second.opinion,.provide.documentat
ion.of.care,.or.wait.a.specific.time.period.before.visiting.a.specialist.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 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.state
ment.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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 7
OBJ: 9 TOP: Health.Care.Financing
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
7. The.nurse.compares.the.characteristics.of.a.health.maintenance.organization.(HMO).and.a.preferred.provider.org
anization.(PPO)..Which.information.should.the.nurse.include.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.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 9
OBJ: 9 TOP: Managed.Care
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
8. 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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 7,.Box.1-4
OBJ: 9 TOP: Government-Sponsored. Health. Insurance
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
9. Which.is.the.main.cost-containment.component.of.diagnosis-related.groups.(DRGs)?
Med.C
, 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;.co
st.is.contained,.and.the.patient.is.discharged.sooner.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 8
OBJ: 9 TOP: Government-Sponsored. Health. Insurance
KEY:. . Nursing.Process.Step:.Implementation
MSC:. . NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
10. 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
ANS: A
Medicaid.is.a.joint.effort.of.federal.and.state.governments.geared.primarily.for.low-income.people.with.no.insurance.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 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
11. Which.area.is.the.major.focus.of.Healthy.People.2020.and.the.primary.mechanism.through.which.to.improve.the.health.of.A
mericans.in.the.second.decade.of.the.century?
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,.c
ardiovascular.disease,.and.HIV/AIDS,.and.to.increase.effective.immunizations,.healthy.eating.habits,.and.healthy.weight.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 6
OBJ: 7 TOP: Healthy.People.2020
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
12. Which.term.explains.the.type.of.care.that.addresses.interventions.for.all.dimensions.of.a.patient’s.life?
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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 6
OBJ: 8 TOP: Holistic.Care
KEY: Nursing.Process.Step:.Planning
MSC: NCLEX:.Psychosocial.Integrity:.Coping.and.Adaptation
13. A.patient.furiously.says,.“My.doctor.was.so.busy.giving.me.instructions.that.he.didn’t.hear.what.I.was.trying.to.ask.him!”
.Which.response.is. most.empathetic?
a. “When.people.ignore.me,.I.really.get.mad.”
b. “I’m.sure.that.the.doctor.was.rushed.and.unaware.of.your.needs.”
Med.C
SURGICALNUR .
SINGCONCEPTS
. .
ANDPRACTICE
. .
3THEDITIONDE
. .
WITTESTBAN . .
K
Med.C
,Chapter. 01:. Caring. for. Medical-Surgical. Patients
deWit:. Medical-Surgical. Nursing:. Concepts. &. Practice,. 3rd. 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.primary.purpose.of.the.NPA.of.each.state.d
efines.the.scope.of.nursing.practice.in.that.state.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 2
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.trai
ning.to.gain.proficiency..Although.the.other.options.might.be.helpful,.they.are.not.safe.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 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.nurs
e..The.other.concerns.in.the.options.are.the.responsibility.of.other.departments.to.which.the.nurse.might.refer.the.patient.
PTS: 1 DIF: Cognitive.Level:.Application. . REF: 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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 2
OBJ: 1 TOP: Charge.Nurse/Manager KEY: Nursing Process.Step:.N/A
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
Med.C
, 5. The.nurse.is.educating.a.patient.that.is.a.member.of.a.health.maintenance.organization.(HMO)..Which.information.shou
ld.the.nurse.include?
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.preprocedure.authorization.for.treatment..Patients.are.not.required.to.seek.a.second.opinion,.provide.documentat
ion.of.care,.or.wait.a.specific.time.period.before.visiting.a.specialist.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 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.state
ment.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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 7
OBJ: 9 TOP: Health.Care.Financing
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
7. The.nurse.compares.the.characteristics.of.a.health.maintenance.organization.(HMO).and.a.preferred.provider.org
anization.(PPO)..Which.information.should.the.nurse.include.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.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 9
OBJ: 9 TOP: Managed.Care
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
8. 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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 7,.Box.1-4
OBJ: 9 TOP: Government-Sponsored. Health. Insurance
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
9. Which.is.the.main.cost-containment.component.of.diagnosis-related.groups.(DRGs)?
Med.C
, 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;.co
st.is.contained,.and.the.patient.is.discharged.sooner.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 8
OBJ: 9 TOP: Government-Sponsored. Health. Insurance
KEY:. . Nursing.Process.Step:.Implementation
MSC:. . NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
10. 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
ANS: A
Medicaid.is.a.joint.effort.of.federal.and.state.governments.geared.primarily.for.low-income.people.with.no.insurance.
PTS: 1 DIF: Cognitive.Level:.Application. REF: 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
11. Which.area.is.the.major.focus.of.Healthy.People.2020.and.the.primary.mechanism.through.which.to.improve.the.health.of.A
mericans.in.the.second.decade.of.the.century?
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,.c
ardiovascular.disease,.and.HIV/AIDS,.and.to.increase.effective.immunizations,.healthy.eating.habits,.and.healthy.weight.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 6
OBJ: 7 TOP: Healthy.People.2020
KEY: Nursing.Process.Step:.Implementation
MSC: NCLEX:.Safe,.Effective.Care.Environment:.Coordinated.Care
12. Which.term.explains.the.type.of.care.that.addresses.interventions.for.all.dimensions.of.a.patient’s.life?
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.
PTS: 1 DIF: Cognitive.Level:.Comprehension REF: 6
OBJ: 8 TOP: Holistic.Care
KEY: Nursing.Process.Step:.Planning
MSC: NCLEX:.Psychosocial.Integrity:.Coping.and.Adaptation
13. A.patient.furiously.says,.“My.doctor.was.so.busy.giving.me.instructions.that.he.didn’t.hear.what.I.was.trying.to.ask.him!”
.Which.response.is. most.empathetic?
a. “When.people.ignore.me,.I.really.get.mad.”
b. “I’m.sure.that.the.doctor.was.rushed.and.unaware.of.your.needs.”
Med.C
