Chapter 01: Caring for Medical-Surgical Patients
Stromberg: deWit’s Medical-Surgical Nursing: Concepts and Practice, 4th 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 pu
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 vocatio
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 vocation
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
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 ad
nurse. The other concerns in the options are the responsibility of other departments to which the nurse
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
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 gener
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
, 6. The patient complains to the nurse that he is confused about his “deductible” that he owes the hospital.
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
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.
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 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.
ANS: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s diagnostic
length of time in the hospital. If hospitals can treat and discharge patients before the allotted time, hosp
payment; cost is contained, and the patient is discharged sooner.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9
TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. 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 wit
DIF: Cognitive Level: Application REF: p. 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance—Medicaid
KEY: Nursing Process Step: Assessment
Stromberg: deWit’s Medical-Surgical Nursing: Concepts and Practice, 4th 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 pu
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 vocatio
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 vocation
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
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 ad
nurse. The other concerns in the options are the responsibility of other departments to which the nurse
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
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 gener
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
, 6. The patient complains to the nurse that he is confused about his “deductible” that he owes the hospital.
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
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.
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 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.
ANS: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s diagnostic
length of time in the hospital. If hospitals can treat and discharge patients before the allotted time, hosp
payment; cost is contained, and the patient is discharged sooner.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9
TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. 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 wit
DIF: Cognitive Level: Application REF: p. 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance—Medicaid
KEY: Nursing Process Step: Assessment
