Test Bank for Dewits Medical Surgical Nursing Concepts and Practice 5th
Edition Stromberg Chapter 1-49 Newest Version 2026
,Chapter 01: Caring for Medical-Surgical Patients
x x x x x
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
x x x x x x x
MULTIPLE CHOICE x
1. Which statement accurately describes the primary purpose of the state nurse
x x x x x x x x x x
practice act (NPA)?
x x x
a. To test and license LPN/LVNs
x x x x
b. To define the scope of LPN/LVN practice
x x x x x x
c. To improve the quality of care provided by the LPN/LVN
x x x x x x x x x
d. To limit the LPN/LVN employment placement
x x x x x
ANS: B x
While improving quality of care provided by the LPN/LVN may be a result
x x x x x x x x x x x x
of the NPA, the primarypurpose of the NPA of each state defines the
x x x x x x x x x x x x x
scope of nursing practice in that state.
x x x x x x x
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 x x x x x
TOP: NPA
x KEY: Nursing Process Step: Implementation
x x x x x
xMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the
x x x x x x x x x x x x x x x x
vocational nurse has not been taught during her educational program. How should the vocational
x x x x x x x x x x x x x x
nurse respond?
x x
a. Ask a more experienced nurse to demonstrate the procedure.
x x x x x x x x
b. Look up the procedure in the procedure manual.
x x x x x x x
c. Attempt to perform the procedure with supervision. x x x x x x
d. Inform the charge nurse of her lack of training in this procedure.
x x x x x x x x x x x
ANS: D x
The charge nurse should be informed of the lack of training to perform the procedure, and the
x x x x x x x x x x x x x x x x
vocational nurse should seek further training to gain proficiency. Although the other options might be
x x x x x x x x x x x x x x x
helpful, they are not safe.
x x x x x
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 x x x x x
TOP: Providing Safe Care
x x KEY: Nursing Process Step: N/A x x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
x x x x x x x x x x x x x
should address?
x x
a. "I have no idea of how this drug will affect me."
x x x x x x x x x x
b. "Do you know if my physician is coming back today?"
x x x x x x x x x
c. "Will my insurance pay for my stay?" x x x x x x
d. "Am I going to have to go to a nursing home?"
x x x x x x x x x x
ANS: A x
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
x x x x x x x x x x x x x x x x
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
x x x x x x x x x x x x x x x x
departments to which the nurse might refer the patient.
x x x x x x x x x
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 x x x x x
TOP: Teaching
x KEY: Nursing Process Step: Implementation
x x x x x
xMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care
x x x x x x x x x x x x x x x
facility acts in which capacity?
x x x x x
a. Working under direct supervision of an RN on the unit x x x x x x x x x
b. Working with the RN in the building x x x x x x
c. Working under general supervision by the RN available on site or by phone
x x x x x x x x x x x x
d. Working as an independent vocational nurse x x x x x
ANS: C x
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the
x x x x x x x x x x x x x x x x x
general supervision of an RN available on site or by phone.
x x x x x x x x x x x
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 x x x x x
TOP: Charge Nurse/Manager
x x KEY: Nursing Process Step: N/A x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
x x x x x x x x x x x x x x x x
information should the nurse include?
x x x x x
a. Seek the opinion of an alternate health care provider.
x x x x x x x x
b. Contact the insurance company for coverage details as services may be limited.
x x x x x x x x x x x
c. Provide detailed documentation of all care received for his condition.
x x x x x x x x x
d. Wait at least 6 months to see a specialist.
x x x x x x x x
ANS: B x
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups
x x x x x x x x x x x x x x x x
of patients for a set capitation fee and by limiting services. Patients are not required to seek a
x x x x x x x x x x x x x x x x x x
second opinion, provide documentation of care, or wait a specific time period before visiting a
x x x x x x x x x x x x x x x
specialist.
x
DIF: Cognitive Level: Application
x x REF: p. 9 OBJ: 9 x x x x x x
TOP: Charge Nurse/Manager
x KEY: Nursing Process Step: Implementation
x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
x x x x x x x x x x x x x x x x x
Which statement accurately explains a deductible?
x x x x x x
a. An amount of money put aside for the payment of future medical bills
x x x x x x x x x x x x
b. A one-time fee for service
x x x x
c. An amount of money deducted from the bill by the insurance company
x x x x x x x x x x x
d. An annual amount of money the patient must pay out-of-pocket for medical care
x x x x x x x x x x x x
ANS: D x
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance
x x x x x x x x x x x x x x
company assuming the cost. This practice improves the profit of the insurance company.
x x x x x x x x x x x x x
DIF: Cognitive Level: Comprehension
x x REF: p. 7 OBJ: 9 x x x x x x x x
TOP: Health Care Financing
x KEY: Nursing Process Step: Implementation
x x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
7. A patient asks the nurse what Medicare Part A covers. Which response is correct?
x x x x x x x x x x x x x
a. Medicare Part A covers inpatient hospital costs. x x x x x x
b. Medicare Part A covers reimbursement to the physician. x x x x x x x
c. Medicare Part A covers outpatient hospital services. x x x x x x
d. Medicare Part A covers ambulance transportation. x x x x x
ANS: A x
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
x x x x x x x x x x x x x
Medicare Part B pays the physician, ambulance transport, and outpatient services.
x x x x x x x x x x x
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 x x x x x x
OBJ: 9 x TOP: Government-Sponsored Health Insurance x x x
KEY: Nursing Process Step: Implementation
x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
8. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
x x x x x x x x x
a. Hospitals focus only on the specific diagnosis. x x x x x x
b. Hospitals treat and discharge patients quickly. x x x x x
c. Reduced cost drugs are ordered for specific diagnoses.
x x x x x x x
d. Diagnostic group classification streamlines care. x x x x
ANS: B x
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
x x x x x x x x x x x x x x x x
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients
x x x x x x x x x x x x x x x x x
before the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is
x x x x x x x x x x x x x x x x x x
discharged sooner.
x x
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 x x x x x
TOP: Government-Sponsored Health Insurance
x x x x
KEY: Nursing Process Step: Implementation
x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
9. The nurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
x x x x x x x x x x x x x x x
a. A 35-year-old unemployed single mother with diabetes
x x x x x x
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
x x x x x x x x x x x x x
care facility
x x
c. An 80-year-old blind woman living in her own home who has inadequate private
x x x x x x x x x x x x
insurance
x
d. A 67-year-old stroke victim with Medicare Part A and an income from investments
x x x x x x x x x x x x
ANS: A x
Medicaid is a joint effort of federal and state governments geared primarily for low-income people
x x x x x x x x x x x x x x
with no insurance.
x x x
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 x x x x x x
OBJ: 9 x TOP: Government-Sponsored Health Insurance—Medicaid x x x
KEY: Nursing Process Step: Assessment
x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
x x x x x x x x x x x x x x x x
improve the health of Americans in the second decade of the century?
x x x x x x x x x x x x
a. Research funding x
b. Health information distribution x x
c. Healthy lifestyle encouragement x x
d. Health improvement program designs x x x
ANS: C x
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
x x x x x x x x x x x x x
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
x x x x x x x x x x x x
immunizations, healthy eating habits, and healthy weight.
x x x x x x x
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 x x x x x x
TOP: Healthy People 2020
x KEY: Nursing Process Step: Implementation
x x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
Edition Stromberg Chapter 1-49 Newest Version 2026
,Chapter 01: Caring for Medical-Surgical Patients
x x x x x
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
x x x x x x x
MULTIPLE CHOICE x
1. Which statement accurately describes the primary purpose of the state nurse
x x x x x x x x x x
practice act (NPA)?
x x x
a. To test and license LPN/LVNs
x x x x
b. To define the scope of LPN/LVN practice
x x x x x x
c. To improve the quality of care provided by the LPN/LVN
x x x x x x x x x
d. To limit the LPN/LVN employment placement
x x x x x
ANS: B x
While improving quality of care provided by the LPN/LVN may be a result
x x x x x x x x x x x x
of the NPA, the primarypurpose of the NPA of each state defines the
x x x x x x x x x x x x x
scope of nursing practice in that state.
x x x x x x x
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 x x x x x
TOP: NPA
x KEY: Nursing Process Step: Implementation
x x x x x
xMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the
x x x x x x x x x x x x x x x x
vocational nurse has not been taught during her educational program. How should the vocational
x x x x x x x x x x x x x x
nurse respond?
x x
a. Ask a more experienced nurse to demonstrate the procedure.
x x x x x x x x
b. Look up the procedure in the procedure manual.
x x x x x x x
c. Attempt to perform the procedure with supervision. x x x x x x
d. Inform the charge nurse of her lack of training in this procedure.
x x x x x x x x x x x
ANS: D x
The charge nurse should be informed of the lack of training to perform the procedure, and the
x x x x x x x x x x x x x x x x
vocational nurse should seek further training to gain proficiency. Although the other options might be
x x x x x x x x x x x x x x x
helpful, they are not safe.
x x x x x
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 x x x x x
TOP: Providing Safe Care
x x KEY: Nursing Process Step: N/A x x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
x x x x x x x x x x x x x
should address?
x x
a. "I have no idea of how this drug will affect me."
x x x x x x x x x x
b. "Do you know if my physician is coming back today?"
x x x x x x x x x
c. "Will my insurance pay for my stay?" x x x x x x
d. "Am I going to have to go to a nursing home?"
x x x x x x x x x x
ANS: A x
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
x x x x x x x x x x x x x x x x
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
x x x x x x x x x x x x x x x x
departments to which the nurse might refer the patient.
x x x x x x x x x
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 x x x x x
TOP: Teaching
x KEY: Nursing Process Step: Implementation
x x x x x
xMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care
x x x x x x x x x x x x x x x
facility acts in which capacity?
x x x x x
a. Working under direct supervision of an RN on the unit x x x x x x x x x
b. Working with the RN in the building x x x x x x
c. Working under general supervision by the RN available on site or by phone
x x x x x x x x x x x x
d. Working as an independent vocational nurse x x x x x
ANS: C x
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the
x x x x x x x x x x x x x x x x x
general supervision of an RN available on site or by phone.
x x x x x x x x x x x
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 x x x x x
TOP: Charge Nurse/Manager
x x KEY: Nursing Process Step: N/A x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
x x x x x x x x x x x x x x x x
information should the nurse include?
x x x x x
a. Seek the opinion of an alternate health care provider.
x x x x x x x x
b. Contact the insurance company for coverage details as services may be limited.
x x x x x x x x x x x
c. Provide detailed documentation of all care received for his condition.
x x x x x x x x x
d. Wait at least 6 months to see a specialist.
x x x x x x x x
ANS: B x
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups
x x x x x x x x x x x x x x x x
of patients for a set capitation fee and by limiting services. Patients are not required to seek a
x x x x x x x x x x x x x x x x x x
second opinion, provide documentation of care, or wait a specific time period before visiting a
x x x x x x x x x x x x x x x
specialist.
x
DIF: Cognitive Level: Application
x x REF: p. 9 OBJ: 9 x x x x x x
TOP: Charge Nurse/Manager
x KEY: Nursing Process Step: Implementation
x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
x x x x x x x x x x x x x x x x x
Which statement accurately explains a deductible?
x x x x x x
a. An amount of money put aside for the payment of future medical bills
x x x x x x x x x x x x
b. A one-time fee for service
x x x x
c. An amount of money deducted from the bill by the insurance company
x x x x x x x x x x x
d. An annual amount of money the patient must pay out-of-pocket for medical care
x x x x x x x x x x x x
ANS: D x
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance
x x x x x x x x x x x x x x
company assuming the cost. This practice improves the profit of the insurance company.
x x x x x x x x x x x x x
DIF: Cognitive Level: Comprehension
x x REF: p. 7 OBJ: 9 x x x x x x x x
TOP: Health Care Financing
x KEY: Nursing Process Step: Implementation
x x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
7. A patient asks the nurse what Medicare Part A covers. Which response is correct?
x x x x x x x x x x x x x
a. Medicare Part A covers inpatient hospital costs. x x x x x x
b. Medicare Part A covers reimbursement to the physician. x x x x x x x
c. Medicare Part A covers outpatient hospital services. x x x x x x
d. Medicare Part A covers ambulance transportation. x x x x x
ANS: A x
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
x x x x x x x x x x x x x
Medicare Part B pays the physician, ambulance transport, and outpatient services.
x x x x x x x x x x x
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 x x x x x x
OBJ: 9 x TOP: Government-Sponsored Health Insurance x x x
KEY: Nursing Process Step: Implementation
x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
8. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
x x x x x x x x x
a. Hospitals focus only on the specific diagnosis. x x x x x x
b. Hospitals treat and discharge patients quickly. x x x x x
c. Reduced cost drugs are ordered for specific diagnoses.
x x x x x x x
d. Diagnostic group classification streamlines care. x x x x
ANS: B x
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
x x x x x x x x x x x x x x x x
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients
x x x x x x x x x x x x x x x x x
before the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is
x x x x x x x x x x x x x x x x x x
discharged sooner.
x x
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 x x x x x
TOP: Government-Sponsored Health Insurance
x x x x
KEY: Nursing Process Step: Implementation
x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
9. The nurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
x x x x x x x x x x x x x x x
a. A 35-year-old unemployed single mother with diabetes
x x x x x x
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
x x x x x x x x x x x x x
care facility
x x
c. An 80-year-old blind woman living in her own home who has inadequate private
x x x x x x x x x x x x
insurance
x
d. A 67-year-old stroke victim with Medicare Part A and an income from investments
x x x x x x x x x x x x
ANS: A x
Medicaid is a joint effort of federal and state governments geared primarily for low-income people
x x x x x x x x x x x x x x
with no insurance.
x x x
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 x x x x x x
OBJ: 9 x TOP: Government-Sponsored Health Insurance—Medicaid x x x
KEY: Nursing Process Step: Assessment
x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
x x x x x x x x x x x x x x x x
improve the health of Americans in the second decade of the century?
x x x x x x x x x x x x
a. Research funding x
b. Health information distribution x x
c. Healthy lifestyle encouragement x x
d. Health improvement program designs x x x
ANS: C x
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
x x x x x x x x x x x x x
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
x x x x x x x x x x x x
immunizations, healthy eating habits, and healthy weight.
x x x x x x x
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 x x x x x x
TOP: Healthy People 2020
x KEY: Nursing Process Step: Implementation
x x x x x x
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
x x x x x x x x
