TEST BANK
deWit's Medical-Surgical Nursing,
Concepts and Practice, 4th Edition
(Stromberg, 2023) Chapters 1 - 49
Medical-Surgical Nursing, Concepts and Practice
,TABLE OF CONTENTS
Medical-Surgical Nursing, Concepts and Practice
,Medical-Surgical Nursing, Concepts and Practice
,Chapter 01: Caring for Medical-Surgical Patients
DeWit: Medical-Surgical Nursing: Concepts & 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
ANSWER: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, theprimary
purpose of the NPA of each 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
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.
ANSWER: 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.
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 address?
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?‖
ANSWER: A
Lack of knowledge at discharge about medication effects and side effects is a concern thatshould
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.
Medical-Surgical Nursing, Concepts and Practice
,DIF: Cognitive Level: Application REF: p. 2 OBJ: 1
TOP: Teaching KEY: Nursing Process Step: Implementation
Medical-Surgical Nursing, Concepts and Practice
, 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
ANSWER: C
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts withthe
general supervision of an RN 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
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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. Contact the insurance company for coverage details as services may be limited.
c. Provide detailed documentation of all care received for his condition.
d. Wait at least 6 months to see a specialist.
ANSWER: B
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups
of patients for a set capitation fee and by limiting services. Patients are not required toseek a
second opinion, provide documentation of care, or wait a specific time period before visiting a
specialist.
DIF: Cognitive Level: Application REF: p. 9 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
ANSWER: 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.
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?
Medical-Surgical Nursing, Concepts and Practice
,a. Medicare Part A covers inpatient hospital costs.
b. Medicare Part A covers reimbursement to the physician.
Medical-Surgical Nursing, Concepts and Practice
, c. Medicare Part A covers outpatient hospital services.
d. Medicare Part A covers ambulance transportation.
ANSWER: 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.
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.
ANSWER: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s
diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
discharge patients before the allotted time, hospitals get to keep the excess 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
ANSWER: A
Medicaid is a joint effort of federal and state governments geared primarily for low-incomepeople
with no insurance.
DIF: Cognitive Level: Application REF: p. 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance—Medicaid
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through
which to improve the health of Americans in the second decade of the century?
a. Research funding
Medical-Surgical Nursing, Concepts and Practice
,b. Health information distribution
Medical-Surgical Nursing, Concepts and Practice
, c. Healthy lifestyle encouragement
d. Health improvement program designs
ANSWER: C
Healthy People 2020 focuses on expanding ongoing programs to include support and information
to reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and toincrease effective
immunizations, healthy eating habits, and healthy weight.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7
TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
11. 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 addresses the physiologic, psychological, social, cultural, and spiritual needs ofthe
patient.
DIF: Cognitive Level: Comprehension REF: p. 9 OBJ: 8
TOP: Holistic Care KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
12. A patient furiously says, ―My doctor was so busy giving me instructions that he didn’t hear
what I was trying to ask him!‖ Which response is most empathetic?
a. ―When people ignore me, I really get mad.‖
b. ―I’m sure that the doctor was rushed and unaware of your needs.‖
c. ―That sounds really frustrating.‖
d. ―Take a deep breath and plan what you will say to him tomorrow.‖
ANSWER: C
Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the
emotion. Belittling the patient’s feelings, showing sympathy, or defending the doctor makesthe
patient feel devalued.
DIF: Cognitive Level: Analysis REF: p. 10 OBJ: 10
TOP: Nurse-Patient Relationship KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
13. The nurse is explaining differences in a therapeutic relationship and a social relationship to a
patient. Which information about therapeutic relationships is most important for the nurse to
include in the explanation?
a. Therapeutic relationships lack formal boundaries.
b. Therapeutic relationships are goal directed.
c. Therapeutic relationships meet the needs of each person in the relationship.
d. Therapeutic relationships extend past the hospitalization period.
Medical-Surgical Nursing, Concepts and Practice
