TEST BANK for Medical-Surgical Nursing: Concepts & Practice 3rd Edition by Susan C. deWit | ISBN 9780323243780 | Complete Questions & Answers | All Chapters Covered | Latest 2025/2026 Updated Guide | A+ Resource

Test Bank For:
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Medical Surgical Nursing: Concepts & Practice
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3rd Edition By Dewit (Chapter 1-48)
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,Chapter01: Caringfor Medical-Surgical Patients
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deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
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v MULTIPLE CHOICE v




1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)?
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a. To test and license LPN/LVNs.
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b. To define the scope of LPN/LVN practice.
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c. To improve the quality of care provided by the LPN/LVN.
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d. To limit the LPN/LVN employment placement.
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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
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defines the scope of nursing practice in that state.
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PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 v v



OBJ: 3 TOP: NPA KEY: Nursing Process Step: Implementation v v v




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational nurse has not been
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taught during her educational program. How should the vocational nurse respond?
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a. Ask a more experienced nurse to demonstrate the procedure.
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b. Look up the procedure in the procedure manual. v v v v v v v




c. Attempt to perform the procedure with supervision. v v v v v v




d. Inform the charge nurse of her lack of training in this procedure. v v v v v v v v v v v




ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational nurse should seek further
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training to gain proficiency. Although the other options might be helpful, they are not safe.
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PTS: 1 DIF: Cognitive Level: Application REF: v v v 3
OBJ: 1 TOP: Providing Safe Care KEY: v v Nursing Process Step: N/A v v v




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




3. Which patient statement indicates a need for further discharge teaching that the vocational nurse should address?
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a. “I have no idea of how this drug will affect me.”
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b. “Do you know if my physician is coming back today?”
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c. “Will my insurance pay for my stay?” v v v v v v




d. “Am I going to have to go to a nursing home?”
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ANS: A
Lack of knowledge at discharge about medication effects and side effects is a concern that should be addressed by the vocational nurse.
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The other concerns in the options are the responsibility of other departments to which the nurse might refer the patient.
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PTS: 1 DIF: Cognitive Level: Application REF: 2 v v v v



OBJ: 1 TOP: Teaching KEY: Nursing Process Step: Implementation v v v v




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts in which v v v v v v v v v v v v v v v v v v v




capacity?
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a. Working under direct supervision of an RN on the unit v v v v v v v v v




b. Working with the RN in the building v v v v v v




c. Working under general supervision by the RN available on site or by phone v v v v v v v v v v v v




d. Working as an independent vocational nurse v v v v v




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
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on site or by phone.
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PTS: 1 DIF: Cognitive Level: Comprehension v v REF: 2
OBJ: 1 TOP: Charge Nurse/Manager KEY: v Nursing Process Step: N/A v v v




MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v

,5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which information
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should the nurse include?
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a. Seek the opinion of an alternate health care provider.
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b. Obtain insurance approval for medical services prior to treatment.
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c. Provide detailed documentation of all care received for his condition.
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d. Wait at least 6 months to see a specialist.
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ANS: B
Most HMOs require preprocedure authorization for treatment. Patients are not required to seek a second opinion, provide documentation
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of care, or wait a specific time period before visiting a specialist.
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PTS: 1 DIF: Cognitive Level: Application REF: v v v 9
OBJ: 9 TOP: Charge Nurse/Manager v




KEY: Nursing Process Step: Implementation v v v



MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




6. The patient complains to the nurse that he is confused about his “deductible” that he owes the hospital. Which
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statement accurately explains a deductible?
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a. An amount of money put aside for the payment of future medical bills
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b. A one-time fee for service
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c. An amount of money deducted from the bill by the insurance company
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d. An annual amount of money the patient must pay out-of-pocket for medical care
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ANS: D
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company assuming the cost. This
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practice improves the profit of the insurance company.
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PTS: 1 DIF: Cognitive Level: Comprehension v v REF: 7
OBJ: 9 TOP: Health Care Financing v v




KEY: Nursing Process Step: Implementation v v v



MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




7. The nurse compares the characteristics of a health maintenance organization (HMO) and a preferred provider
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organization (PPO). Which information should the nurse include about HMOs?
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a. HMOs require a set fee of each member monthly.
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b. HMOs allow the member to select his health care provider.
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c. HMOs permit admission to any facility the member prefers.
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d. HMOs offer unlimited diagnostic tests and treatments.
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ANS: A
HMOs require a set fee from each member monthly (capitation). The patient will be treated by the HMO staff in HMO-approved
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facilities. Excessive use of diagnostic tests and treatments is discouraged by the HMO.
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PTS: 1 DIF: Cognitive Level: Application REF: v v v 9
OBJ: 9 TOP: Managed Care v




KEY: Nursing Process Step: Implementation v v v



MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




8. A patient asks the nurse what Medicare Part A covers. Which response is correct?
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a. Medicare Part A covers inpatient hospital costs. v v v v v v




b. Medicare Part A covers reimbursement to the physician.
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c. Medicare Part A covers outpatient hospital services.v v v v v v




d. Medicare Part A covers ambulance transportation. v v v v v




ANS: A
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care. Medicare Part B pays the
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physician, ambulance transport, and outpatient services.
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PTS: 1 DIF: Cognitive Level: Comprehension REF: v v 7, Box 1-4
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OBJ: 9 TOP: Government-Sponsored Health Insurance v v




KEY: Nursing Process Step: Implementation v v v



MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




9. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
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, a. Hospitals focus only on the specific diagnosis. v v v v v v




b. Hospitals treat and discharge patients quickly. v v v v v




c. Reduced cost drugs are ordered for specific diagnoses. v v v v v v v




d. Diagnostic group classification streamlines care. v v v v




ANS: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s diagnostic category regardless of the
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length of time in the hospital. If hospitals can treat and discharge patients before the allotted time, hospitals get to keep the excess
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payment; cost is contained, and the patient is discharged sooner.
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PTS: 1 DIF: Cognitive Level: Comprehension REF: v v 8
OBJ: 9 TOP: Government-Sponsored Health Insurance v v




KEY: v v Nursing Process Step: Implementation v v v



MSC: v v NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




10. The nurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
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a. A 35-year-old unemployed single mother with diabetes
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b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term care facility
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c. An 80-year-old blind woman living in her own home who has inadequate private insurance
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d. A 67-year-old stroke victim with Medicare Part A and an income from investments
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ANS: A
Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no insurance.
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PTS: 1 DIF: Cognitive Level: Application REF: 8, Box 1-5 v v v v v



OBJ:
v 9 TOP: Government-Sponsored Health Insurance–Medicaid v v



KEY:
v Nursing Process Step: Assessment v v v



MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




11. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to improve the health of
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Americans in the second decade of the century?
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a. Research funding v




b. Health information distribution v v




c. Healthy lifestyle encouragement v v




d. Health improvement program designs v v v




ANS: C
Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce infant mortality, cancer,
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cardiovascular disease, and HIV/AIDS, and to increase effective immunizations, healthy eating habits, and healthy weight.
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PTS: 1 DIF: Cognitive Level: Comprehension v v REF: 6
OBJ: 7 TOP: Healthy People 2020 v v




KEY: Nursing Process Step: Implementation v v v



MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care v v v v v v




12. Which term explains the type of care that addresses interventions for all dimensions of a patient’s life?
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a. Focused care v




b. General care v




c. Directed care v




d. Holistic care v




ANS: D
Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of the patient.
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PTS: 1 DIF: Cognitive Level: Comprehension v v REF: 6
OBJ: 8 TOP: Holistic Care v




KEY: Nursing Process Step: Planning v v v



MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation v v v v v




13. A patient furiously says, “My doctor was so busy giving me instructions that he didn’t hear what I was trying to ask
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him!” Which response is most empathetic?
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a. “When people ignore me, I really get mad.” v v v v v v v




b. “I’m sure that the doctor was rushed and unaware of your needs.”
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