COMPREHENSIVE PRACTICE EXAM: DEWIT'S
MEDICAL-SURGICAL NURSING, 4TH
EDITION QUESTIONS AND ANSWERS
WITH RATIONALES/ GRADED A+/2026
UPDATE /100%CORRECT
Unit I: Medical-Surgical Nursing Settings
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. To define the scope of LPN/LVN practice.
Rationale: While the NPA contributes to quality care, its primary legal purpose is to define the scope of
nursing practice and protect the public. It sets the legal boundaries for what an LPN/LVN can do in that
state .
2. The charge nurse asks a new LPN to start an IV, a skill not taught in her educational program. What is
the most appropriate response?
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. Inform the charge nurse of her lack of training in this procedure.
Rationale: The LPN must practice within the scope of their education and competence. It is the nurse's
responsibility to inform the charge nurse of a lack of training to ensure patient safety .
,3. A patient statement indicates a need for further discharge teaching that the LPN should address?
a. "I have no idea 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. "I have no idea how this drug will affect me."
Rationale: Lack of knowledge about medications is a direct patient education issue that falls within the
LPN's scope of practice. The other questions are more appropriately directed to the physician, case
manager, or social worker .
4. According to most state NPAs, an LPN acting as charge nurse in a long-term care facility acts in what
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 an RN available on site or by phone.
d. Working as an independent vocational nurse.
Answer: c. Working under general supervision by an RN available on site or by phone.
Rationale: LPNs in long-term care often function as charge nurses but must have an RN available for
supervision, even if that RN is not physically present on the unit at all times .
5. 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
Answer: d. Holistic care
Rationale: Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of
the patient, treating the whole person .
6. The main cost-containment component of diagnosis-related groups (DRGs) is that:
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. Hospitals treat and discharge patients quickly.
Rationale: DRGs provide a flat fee for a patient's diagnosis. If the hospital discharges the patient before
the allotted time, they retain the surplus, incentivizing shorter, efficient stays .
, 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 costs.
Rationale: Medicare Part A is hospital insurance, covering inpatient stays, skilled nursing facility care,
and some home health care. Part B covers physician services and outpatient care .
Unit II: Medical-Surgical Patient Care Problems
8. A patient is to receive 1000 mL of IV fluids over 8 hours. The drop factor is 15 gtt/mL. What is the flow
rate in gtt/min?
a. 21 gtt/min
b. 31 gtt/min
c. 41 gtt/min
d. 51 gtt/min
Answer: b. 31 gtt/min
Rationale: The formula is (Total Volume (mL) / Total Time (min)) x Drop Factor.
1000 mL / 480 min = 2.083 mL/min. 2.083 mL/min x 15 gtt/mL = 31.25 gtt/min.
9. A patient in the preoperative area tells the nurse, "I'm so scared I won't wake up from the surgery."
What is the most therapeutic response?
a. "Don't worry, modern anesthesia is very safe."
b. "You should focus on the positive outcome of your surgery."
c. "It sounds like you are feeling very frightened about the anesthesia."
d. "Would you like to talk to the anesthesiologist again?"
Answer: c. "It sounds like you are feeling very frightened about the anesthesia."
Rationale: This response uses therapeutic communication by acknowledging the patient's feelings
(reflecting) and encouraging them to elaborate. It validates the emotion without dismissing it .
10. The nurse is assessing a patient on the first postoperative day following abdominal surgery. Which
finding should be reported to the charge nurse immediately?
a. Temperature of 99.2°F (37.3°C)
b. Pain score of 6 out of 10
c. Urine output of 40 mL in the last hour
d. Wound edges that are slightly reddened
MEDICAL-SURGICAL NURSING, 4TH
EDITION QUESTIONS AND ANSWERS
WITH RATIONALES/ GRADED A+/2026
UPDATE /100%CORRECT
Unit I: Medical-Surgical Nursing Settings
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. To define the scope of LPN/LVN practice.
Rationale: While the NPA contributes to quality care, its primary legal purpose is to define the scope of
nursing practice and protect the public. It sets the legal boundaries for what an LPN/LVN can do in that
state .
2. The charge nurse asks a new LPN to start an IV, a skill not taught in her educational program. What is
the most appropriate response?
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. Inform the charge nurse of her lack of training in this procedure.
Rationale: The LPN must practice within the scope of their education and competence. It is the nurse's
responsibility to inform the charge nurse of a lack of training to ensure patient safety .
,3. A patient statement indicates a need for further discharge teaching that the LPN should address?
a. "I have no idea 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. "I have no idea how this drug will affect me."
Rationale: Lack of knowledge about medications is a direct patient education issue that falls within the
LPN's scope of practice. The other questions are more appropriately directed to the physician, case
manager, or social worker .
4. According to most state NPAs, an LPN acting as charge nurse in a long-term care facility acts in what
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 an RN available on site or by phone.
d. Working as an independent vocational nurse.
Answer: c. Working under general supervision by an RN available on site or by phone.
Rationale: LPNs in long-term care often function as charge nurses but must have an RN available for
supervision, even if that RN is not physically present on the unit at all times .
5. 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
Answer: d. Holistic care
Rationale: Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of
the patient, treating the whole person .
6. The main cost-containment component of diagnosis-related groups (DRGs) is that:
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. Hospitals treat and discharge patients quickly.
Rationale: DRGs provide a flat fee for a patient's diagnosis. If the hospital discharges the patient before
the allotted time, they retain the surplus, incentivizing shorter, efficient stays .
, 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 costs.
Rationale: Medicare Part A is hospital insurance, covering inpatient stays, skilled nursing facility care,
and some home health care. Part B covers physician services and outpatient care .
Unit II: Medical-Surgical Patient Care Problems
8. A patient is to receive 1000 mL of IV fluids over 8 hours. The drop factor is 15 gtt/mL. What is the flow
rate in gtt/min?
a. 21 gtt/min
b. 31 gtt/min
c. 41 gtt/min
d. 51 gtt/min
Answer: b. 31 gtt/min
Rationale: The formula is (Total Volume (mL) / Total Time (min)) x Drop Factor.
1000 mL / 480 min = 2.083 mL/min. 2.083 mL/min x 15 gtt/mL = 31.25 gtt/min.
9. A patient in the preoperative area tells the nurse, "I'm so scared I won't wake up from the surgery."
What is the most therapeutic response?
a. "Don't worry, modern anesthesia is very safe."
b. "You should focus on the positive outcome of your surgery."
c. "It sounds like you are feeling very frightened about the anesthesia."
d. "Would you like to talk to the anesthesiologist again?"
Answer: c. "It sounds like you are feeling very frightened about the anesthesia."
Rationale: This response uses therapeutic communication by acknowledging the patient's feelings
(reflecting) and encouraging them to elaborate. It validates the emotion without dismissing it .
10. The nurse is assessing a patient on the first postoperative day following abdominal surgery. Which
finding should be reported to the charge nurse immediately?
a. Temperature of 99.2°F (37.3°C)
b. Pain score of 6 out of 10
c. Urine output of 40 mL in the last hour
d. Wound edges that are slightly reddened
