Comprehensive Exam: Medical-Surgical
Nursing: Concepts and Practice, 6th Edition
BY Holly K. Stromberg ISBN: 9780443121029
Unit I: Medical-Surgical Nursing Settings
1. Which statement accurately describes the primary purpose of a state's nurse practice act (NPA)?
a) To test and license LPN/LVNs.
b) To define the scope of practice for LPN/LVNs.
c) To improve the quality of care provided by the LPN/LVN.
d) To limit the employment placement of LPN/LVNs.
Correct Answer: b) To define the scope of practice for LPN/LVNs.
Rationale: The primary purpose of each state's NPA is to define the scope of nursing practice and set the
legal parameters for that role within the state. While licensure (a) and quality improvement (c) may be
outcomes or related, they are not the primary legal purpose .
2. The charge nurse asks a new LPN/LVN to start an intravenous infusion, a skill the LPN/LVN was not
taught in their educational program. How should the LPN/LVN 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 their lack of training in this procedure.
Correct Answer: d) Inform the charge nurse of their lack of training in this procedure.
Rationale: The LPN/LVN must practice within their scope of education and training. The priority is to
inform the charge nurse of the lack of training to ensure patient safety. The other options do not
address the core issue of being uneducated on the skill .
3. A nurse is caring for a patient who is a member of a Health Maintenance Organization (HMO).
Which information should the nurse include when educating the patient about their insurance plan?
a) "You will need to seek a second opinion from a specialist outside the plan if you are unsatisfied."
b) "Your care must be coordinated through a primary care provider (PCP) who manages your referrals."
,c) "This plan will cover a large portion of your medical expenses after you pay a high deductible."
d) "You have the freedom to see any specialist without a referral, but your monthly premium is higher."
Correct Answer: b) "Your care must be coordinated through a primary care provider (PCP) who
manages your referrals."
Rationale: HMOs are known for requiring patients to choose a PCP who acts as a gatekeeper for all
healthcare services, including referrals to specialists. Options c and d describe features of high-
deductible health plans and PPOs, respectively .
4. 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.
Correct Answer: a) A 35-year-old unemployed single mother with diabetes.
Rationale: Medicaid is a joint federal and state program designed primarily for low-income individuals
and families, regardless of age. The other options describe individuals who are likely eligible for
Medicare (over 65 or disabled) but may not meet the low-income requirements for Medicaid .
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) Be prepared to pay out-of-pocket for all healthcare services.
c) Select a primary care physician to manage all healthcare needs.
d) Be prepared to have a longer hospital stay for a diagnosis-related group.
Correct Answer: c) Select a primary care physician to manage all healthcare needs.
Rationale: A key feature of an HMO is that the patient selects a primary care physician (PCP) who
manages their care and provides referrals to specialists. The other options are not characteristic of
HMOs .
6. 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.
Correct Answer: b) Hospitals treat and discharge patients quickly.
Rationale: DRGs are a prospective payment system. Hospitals receive a flat, pre-determined fee based
on the diagnosis. If the hospital discharges the patient before the allotted time, they keep the surplus,
creating a financial incentive for efficiency and shorter lengths of stay .
, Unit II: Medical-Surgical Patient Care Problems
7. 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
Correct Answer: d) Holistic care.
Rationale: Holistic care is a philosophy that addresses the interconnected physiological, psychological,
social, cultural, and spiritual needs of the patient, rather than just the physical disease .
8. The nurse is caring for a patient who has been on antidepressants for 3 days. The patient tearfully
says, "I still feel terrible. I don't think anything can help how I feel." Which response is best?
a) "I will tell the charge nurse how you are feeling."
b) "You just need to be patient and give your medicine some time to work."
c) "Look how much you have improved since you were admitted to the facility."
d) "It must be frustrating to be going through this difficult time."
Correct Answer: d) "It must be frustrating to be going through this difficult time."
Rationale: This response uses therapeutic communication by demonstrating empathy and validating the
patient's feelings, which encourages further expression. The other options are non-therapeutic, offering
false reassurance, giving advice, or dismissing the patient's feelings .
9. An overweight male patient rips off his hospital gown, throws it out the door, and shouts, "I'm not
wearing this stupid gown! It is too small, too short, and exposes my backside to the world!" Which
response is most appropriate?
a) Remind the patient of the need to wear the gown for convenience in care.
b) Confer with the patient for methods to acquire a larger gown.
c) Replace the torn gown with another.
d) Inform the charge nurse of the hostile behavior.
Correct Answer: b) Confer with the patient for methods to acquire a larger gown.
Rationale: Allowing a hostile patient to participate in finding a reasonable solution (like getting a larger
gown) can help defuse their anger and validates their feelings of dignity. It addresses the underlying
issue of embarrassment .
Unit III: Immune System & Unit IV: Respiratory System
Nursing: Concepts and Practice, 6th Edition
BY Holly K. Stromberg ISBN: 9780443121029
Unit I: Medical-Surgical Nursing Settings
1. Which statement accurately describes the primary purpose of a state's nurse practice act (NPA)?
a) To test and license LPN/LVNs.
b) To define the scope of practice for LPN/LVNs.
c) To improve the quality of care provided by the LPN/LVN.
d) To limit the employment placement of LPN/LVNs.
Correct Answer: b) To define the scope of practice for LPN/LVNs.
Rationale: The primary purpose of each state's NPA is to define the scope of nursing practice and set the
legal parameters for that role within the state. While licensure (a) and quality improvement (c) may be
outcomes or related, they are not the primary legal purpose .
2. The charge nurse asks a new LPN/LVN to start an intravenous infusion, a skill the LPN/LVN was not
taught in their educational program. How should the LPN/LVN 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 their lack of training in this procedure.
Correct Answer: d) Inform the charge nurse of their lack of training in this procedure.
Rationale: The LPN/LVN must practice within their scope of education and training. The priority is to
inform the charge nurse of the lack of training to ensure patient safety. The other options do not
address the core issue of being uneducated on the skill .
3. A nurse is caring for a patient who is a member of a Health Maintenance Organization (HMO).
Which information should the nurse include when educating the patient about their insurance plan?
a) "You will need to seek a second opinion from a specialist outside the plan if you are unsatisfied."
b) "Your care must be coordinated through a primary care provider (PCP) who manages your referrals."
,c) "This plan will cover a large portion of your medical expenses after you pay a high deductible."
d) "You have the freedom to see any specialist without a referral, but your monthly premium is higher."
Correct Answer: b) "Your care must be coordinated through a primary care provider (PCP) who
manages your referrals."
Rationale: HMOs are known for requiring patients to choose a PCP who acts as a gatekeeper for all
healthcare services, including referrals to specialists. Options c and d describe features of high-
deductible health plans and PPOs, respectively .
4. 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.
Correct Answer: a) A 35-year-old unemployed single mother with diabetes.
Rationale: Medicaid is a joint federal and state program designed primarily for low-income individuals
and families, regardless of age. The other options describe individuals who are likely eligible for
Medicare (over 65 or disabled) but may not meet the low-income requirements for Medicaid .
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) Be prepared to pay out-of-pocket for all healthcare services.
c) Select a primary care physician to manage all healthcare needs.
d) Be prepared to have a longer hospital stay for a diagnosis-related group.
Correct Answer: c) Select a primary care physician to manage all healthcare needs.
Rationale: A key feature of an HMO is that the patient selects a primary care physician (PCP) who
manages their care and provides referrals to specialists. The other options are not characteristic of
HMOs .
6. 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.
Correct Answer: b) Hospitals treat and discharge patients quickly.
Rationale: DRGs are a prospective payment system. Hospitals receive a flat, pre-determined fee based
on the diagnosis. If the hospital discharges the patient before the allotted time, they keep the surplus,
creating a financial incentive for efficiency and shorter lengths of stay .
, Unit II: Medical-Surgical Patient Care Problems
7. 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
Correct Answer: d) Holistic care.
Rationale: Holistic care is a philosophy that addresses the interconnected physiological, psychological,
social, cultural, and spiritual needs of the patient, rather than just the physical disease .
8. The nurse is caring for a patient who has been on antidepressants for 3 days. The patient tearfully
says, "I still feel terrible. I don't think anything can help how I feel." Which response is best?
a) "I will tell the charge nurse how you are feeling."
b) "You just need to be patient and give your medicine some time to work."
c) "Look how much you have improved since you were admitted to the facility."
d) "It must be frustrating to be going through this difficult time."
Correct Answer: d) "It must be frustrating to be going through this difficult time."
Rationale: This response uses therapeutic communication by demonstrating empathy and validating the
patient's feelings, which encourages further expression. The other options are non-therapeutic, offering
false reassurance, giving advice, or dismissing the patient's feelings .
9. An overweight male patient rips off his hospital gown, throws it out the door, and shouts, "I'm not
wearing this stupid gown! It is too small, too short, and exposes my backside to the world!" Which
response is most appropriate?
a) Remind the patient of the need to wear the gown for convenience in care.
b) Confer with the patient for methods to acquire a larger gown.
c) Replace the torn gown with another.
d) Inform the charge nurse of the hostile behavior.
Correct Answer: b) Confer with the patient for methods to acquire a larger gown.
Rationale: Allowing a hostile patient to participate in finding a reasonable solution (like getting a larger
gown) can help defuse their anger and validates their feelings of dignity. It addresses the underlying
issue of embarrassment .
Unit III: Immune System & Unit IV: Respiratory System
