MEDICAL SURGICAL NURSING DE WIT TEST BANK GRADED A
Chapter 01: Caring for Medical-Surgical Patients
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
1. 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 training to gain proficiency. Although the other
options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application 3
REF:
OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process
Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. 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 defines the scope of nursing practice in that state.
PTS: 1 DIF:
Cognitive Level: ComprehensionREF:
2
OBJ: 3 TOP: NPA KEY: Nursing Process Step:
Implementation
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.”
, MEDICAL SURGICAL NURSING DE WIT TEST BANK GRADED A
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 nurse. 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: REF: 2
Comprehension
OBJ: 1 TOP: Charge Nurse/Manager Nursi Process Step:
KEY ng N/A
:
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
, MEDICAL SURGICAL NURSING DE WIT TEST BANK GRADED A
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 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 documentation of care, or wait a specific time period before
visiting a specialist.
PTS: 1 DIF: Cognitive Level: 9
Application REF:
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 statement 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: REF: 7
Comprehension
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 organization (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.
, MEDICAL SURGICAL NURSING DE WIT TEST BANK GRADED A
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: 9
Application REF:
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: REF: 7, Box
Comprehension 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)?
Chapter 01: Caring for Medical-Surgical Patients
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
1. 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 training to gain proficiency. Although the other
options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application 3
REF:
OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process
Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. 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 defines the scope of nursing practice in that state.
PTS: 1 DIF:
Cognitive Level: ComprehensionREF:
2
OBJ: 3 TOP: NPA KEY: Nursing Process Step:
Implementation
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.”
, MEDICAL SURGICAL NURSING DE WIT TEST BANK GRADED A
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 nurse. 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: REF: 2
Comprehension
OBJ: 1 TOP: Charge Nurse/Manager Nursi Process Step:
KEY ng N/A
:
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
, MEDICAL SURGICAL NURSING DE WIT TEST BANK GRADED A
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 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 documentation of care, or wait a specific time period before
visiting a specialist.
PTS: 1 DIF: Cognitive Level: 9
Application REF:
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 statement 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: REF: 7
Comprehension
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 organization (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.
, MEDICAL SURGICAL NURSING DE WIT TEST BANK GRADED A
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: 9
Application REF:
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: REF: 7, Box
Comprehension 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)?
