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Test Bank for Dewits Medical Surgical Nursing Concepts and Practice 5th
C C C C C C C C C C
C Edition Stromberg Chapter 1-49 Newest Version 2026
C C C C C C
,Chapter 01: Caring for Medical-Surgical Patients
x x x x x
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
x x x x x x x
MULTIPLE CHOICE x
1. Which statement accurately describes the primary purpose of the state nurse
C C C C C C C C C C
practice act (NPA)?
C C C
a. To test and license LPN/LVNs
C C C C
b. To define the scope of LPN/LVN practice
C C C C C C
c. To improve the quality of care provided by the LPN/LVN
C C C C C C C C C
d. To limit the LPN/LVN employment placement
C C C C C
ANS: B C
While improving quality of care provided by the LPN/LVN may be a
C C C C C C C C C C C
result of the NPA, the primarypurpose of the NPA of each state defines
C C C C C C C C C C C C C
Cthe scope of nursing practice in that state.
C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 C C C C
TOP: NPA
C KEY: Nursing Process Step: Implementation C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that
C C C C C C C C C C C C C C C
the vocational nurse has not been taught during her educational program. How should the
C C C C C C C C C C C C C C
vocational nurse respond?
C C C
a. Ask a more experienced nurse to demonstrate the procedure.
C C C C C C C C
b. Look up the procedure in the procedure manual.
C C C C C C C
c. Attempt to performthe procedure with supervision. C C C C C
d. Informthe charge nurse of her lack of training in this procedure.
C C C C C C C C C C
ANS: D C
The charge nurse should be informed of the lack of training to perform the procedure, and the
C C C C C C C C C C C C C C C C
vocational nurse should seek further training to gain proficiency. Although the other options might
C C C C C C C C C C C C C C
be helpful, they are not safe.
C C C C C C
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 C C C C C
TOP: Providing Safe Care
C KEY: Nursing Process Step: N/A C C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
3. Which patient statement indicates a need for further discharge teaching that the vocational
C C C C C C C C C C C C
nurse should address?
C C C
a. "Ihave no idea of how this drug will affect me."
C C C C C C C C C
b. "Do you know if my physician is coming back today?"
C C C C C C C C C
c. "Will my insurance pay for my stay?" C C C C C C
d. "Am I going to have to go to a nursing home?"
C C C C C C C C C C
ANS: A C
Lack of knowledge at discharge about medication effects and side effects is a concern that should
C C C C C C C C C C C C C C C
be addressed by the vocational nurse. The other concerns in the options are the responsibility of
C C C C C C C C C C C C C C C C
other departments to which the nurse might refer the patient.
C C C C C C C C C C
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 C C C C
TOP: Teaching
C KEY: Nursing Process Step: Implementation
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term
C C C C C C C C C C C C C C
care facility acts in which capacity?
C C C C C C
a. Working under direct supervision of an RN on the unit
C C C C C C C C C
b. Working with the RN in the building C C C C C C
c. Working under general supervision by the RN available on site or byphone
C C C C C C C C C C C
d. Working as an independent vocational nurseC C C C C
ANS: C C
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the
C C C C C C C C C C C C C C C C C
general supervision of an RN available on site or by phone.
C C C C C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1C C C C C
TOP: Charge Nurse/Manager
C C KEY: Nursing Process Step: N/A
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO).
C C C C C C C C C C C C C C C
Which information should the nurse include?
C C C C C C
a. Seek the opinion of an alternate health care provider.
C C C C C C C C
b. Contact the insurance company for coverage details as services maybe limited.
C C C C C C C C C C
c. Providedetailed documentation of all care received for his condition. C C C C C C C C
d. Wait at least 6 months to see a specialist.
C C C C C C C C
ANS: B C
HMOs are a kind of managed care. This is accomplished by paying providers to care for
C C C C C C C C C C C C C C C
groups of patients for a set capitation fee and by limiting services. Patients are not required to
C C C C C C C C C C C C C C C C C
seek a second opinion, provide documentation of care, or wait a specific time period before
C C C C C C C C C C C C C C C
visiting a specialist.
C C C
DIF: Cognitive Level: Application
C C REF: p. 9 OBJ: 9 C C C C C C
TOP: Charge Nurse/Manager
C KEY: Nursing Process Step: Implementation
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the
C C C C C C C C C C C C C C C C
hospital. Which statement accurately explains a deductible?
C C C C C C C
a. An amount of moneyput aside for the payment of future medical bills
C C C C C C C C C C C
b. A one-time fee for service
C C C C
c. An amount of money deducted fromthe bill by the insurance company
C C C C C C C C C C
d. An annual amount of money the patient must pay out-of-pocket for medical care
C C C C C C C C C C C C
ANS: D C
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance
C C C C C C C C C C C C C C
company assuming the cost. This practice improves the profit of the insurance company.
C C C C C C C C C C C C C
DIF: Cognitive Level: Comprehension
C C REF: p. 7 OBJ: 9 C C C C C C C C C
TOP: Health Care Financing KEY: Nursing Process Step: Implementation
C C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
7. Apatient asks the nurse what Medicare Part A covers. Which response is correct?
C C C C C C C C C C C C
a. Medicare Part A covers inpatient hospital costs.
C C C C C C
b. Medicare Part A covers reimbursement to the physician.
C C C C C C C
c. Medicare Part Acovers outpatient hospital services.
C C C C C
d. Medicare Part A covers ambulance transportation.
C C C C C
ANS: A C
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
C C C C C C C C C C C C C
Medicare Part B pays the physician, ambulance transport, and outpatient services.
C C C C C C C C C C C
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 C C C C C C
OBJ: 9 TOP: Government-Sponsored Health Insurance C C C
KEY: Nursing Process Step: Implementation
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C
8. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
C C C C C C C C C
a. Hospitalsfocus onlyon the specific diagnosis. C C C C
b. Hospitals treat and discharge patients quickly.
C C C C C
c. Reduced cost drugs are ordered for specific diagnoses.
C C C C C C C
d. Diagnostic group classification streamlines care. C C C C
ANS: B C
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's
C C C C C C C C C C C C C C C
diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
C C C C C C C C C C C C C C C C
discharge patients before the allotted time, hospitals get to keep the excess payment; cost is
C C C C C C C C C C C C C C C
contained, and the patient is discharged sooner.
C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 C C C C
TOP: Government-Sponsored Health Insurance
C C C C
KEY: Nursing Process Step: Implementation
C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C
9. Thenurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
C C C C C C C C C C C C C C
a. A 35-year-old unemployed single mother with diabetes
C C C C C C
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-
C C C C C C C C C C C C C
term care facility C C
c. An 80-year-old blind woman living in her own home who has inadequate
C C C C C C C C C C C
private insurance
C C
d. A 67-year-old stroke victim with Medicare Part A and an income frominvestments
C C C C C C C C C C C
ANS: A C
Medicaid is a joint effort of federal and state governments geared primarily for low-income people
C C C C C C C C C C C C C C
with no insurance.
C C C
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 C C C C C C
OBJ: 9 TOP: Government-Sponsored Health Insurance—Medicaid C C C
KEY: Nursing Process Step: Assessment
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which
C C C C C C C C C C C C C C C
to improve the health of Americans in the second decade of the century?
C C C C C C C C C C C C C
a. Research funding C
b. Health information distribution C C
c. Healthylifestyle encouragement C
d. Health improvement program designsC C C
ANS: C C
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
C C C C C C C C C C C C C
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
C C C C C C C C C C C C
immunizations, healthy eating habits, and healthy weight.
C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 C C C C
TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation
C C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
Test Bank for Dewits Medical Surgical Nursing Concepts and Practice 5th
C C C C C C C C C C
C Edition Stromberg Chapter 1-49 Newest Version 2026
C C C C C C
,Chapter 01: Caring for Medical-Surgical Patients
x x x x x
Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition
x x x x x x x
MULTIPLE CHOICE x
1. Which statement accurately describes the primary purpose of the state nurse
C C C C C C C C C C
practice act (NPA)?
C C C
a. To test and license LPN/LVNs
C C C C
b. To define the scope of LPN/LVN practice
C C C C C C
c. To improve the quality of care provided by the LPN/LVN
C C C C C C C C C
d. To limit the LPN/LVN employment placement
C C C C C
ANS: B C
While improving quality of care provided by the LPN/LVN may be a
C C C C C C C C C C C
result of the NPA, the primarypurpose of the NPA of each state defines
C C C C C C C C C C C C C
Cthe scope of nursing practice in that state.
C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 C C C C
TOP: NPA
C KEY: Nursing Process Step: Implementation C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that
C C C C C C C C C C C C C C C
the vocational nurse has not been taught during her educational program. How should the
C C C C C C C C C C C C C C
vocational nurse respond?
C C C
a. Ask a more experienced nurse to demonstrate the procedure.
C C C C C C C C
b. Look up the procedure in the procedure manual.
C C C C C C C
c. Attempt to performthe procedure with supervision. C C C C C
d. Informthe charge nurse of her lack of training in this procedure.
C C C C C C C C C C
ANS: D C
The charge nurse should be informed of the lack of training to perform the procedure, and the
C C C C C C C C C C C C C C C C
vocational nurse should seek further training to gain proficiency. Although the other options might
C C C C C C C C C C C C C C
be helpful, they are not safe.
C C C C C C
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 C C C C C
TOP: Providing Safe Care
C KEY: Nursing Process Step: N/A C C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
3. Which patient statement indicates a need for further discharge teaching that the vocational
C C C C C C C C C C C C
nurse should address?
C C C
a. "Ihave no idea of how this drug will affect me."
C C C C C C C C C
b. "Do you know if my physician is coming back today?"
C C C C C C C C C
c. "Will my insurance pay for my stay?" C C C C C C
d. "Am I going to have to go to a nursing home?"
C C C C C C C C C C
ANS: A C
Lack of knowledge at discharge about medication effects and side effects is a concern that should
C C C C C C C C C C C C C C C
be addressed by the vocational nurse. The other concerns in the options are the responsibility of
C C C C C C C C C C C C C C C C
other departments to which the nurse might refer the patient.
C C C C C C C C C C
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 C C C C
TOP: Teaching
C KEY: Nursing Process Step: Implementation
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term
C C C C C C C C C C C C C C
care facility acts in which capacity?
C C C C C C
a. Working under direct supervision of an RN on the unit
C C C C C C C C C
b. Working with the RN in the building C C C C C C
c. Working under general supervision by the RN available on site or byphone
C C C C C C C C C C C
d. Working as an independent vocational nurseC C C C C
ANS: C C
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the
C C C C C C C C C C C C C C C C C
general supervision of an RN available on site or by phone.
C C C C C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1C C C C C
TOP: Charge Nurse/Manager
C C KEY: Nursing Process Step: N/A
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO).
C C C C C C C C C C C C C C C
Which information should the nurse include?
C C C C C C
a. Seek the opinion of an alternate health care provider.
C C C C C C C C
b. Contact the insurance company for coverage details as services maybe limited.
C C C C C C C C C C
c. Providedetailed documentation of all care received for his condition. C C C C C C C C
d. Wait at least 6 months to see a specialist.
C C C C C C C C
ANS: B C
HMOs are a kind of managed care. This is accomplished by paying providers to care for
C C C C C C C C C C C C C C C
groups of patients for a set capitation fee and by limiting services. Patients are not required to
C C C C C C C C C C C C C C C C C
seek a second opinion, provide documentation of care, or wait a specific time period before
C C C C C C C C C C C C C C C
visiting a specialist.
C C C
DIF: Cognitive Level: Application
C C REF: p. 9 OBJ: 9 C C C C C C
TOP: Charge Nurse/Manager
C KEY: Nursing Process Step: Implementation
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the
C C C C C C C C C C C C C C C C
hospital. Which statement accurately explains a deductible?
C C C C C C C
a. An amount of moneyput aside for the payment of future medical bills
C C C C C C C C C C C
b. A one-time fee for service
C C C C
c. An amount of money deducted fromthe bill by the insurance company
C C C C C C C C C C
d. An annual amount of money the patient must pay out-of-pocket for medical care
C C C C C C C C C C C C
ANS: D C
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance
C C C C C C C C C C C C C C
company assuming the cost. This practice improves the profit of the insurance company.
C C C C C C C C C C C C C
DIF: Cognitive Level: Comprehension
C C REF: p. 7 OBJ: 9 C C C C C C C C C
TOP: Health Care Financing KEY: Nursing Process Step: Implementation
C C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
7. Apatient asks the nurse what Medicare Part A covers. Which response is correct?
C C C C C C C C C C C C
a. Medicare Part A covers inpatient hospital costs.
C C C C C C
b. Medicare Part A covers reimbursement to the physician.
C C C C C C C
c. Medicare Part Acovers outpatient hospital services.
C C C C C
d. Medicare Part A covers ambulance transportation.
C C C C C
ANS: A C
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
C C C C C C C C C C C C C
Medicare Part B pays the physician, ambulance transport, and outpatient services.
C C C C C C C C C C C
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 C C C C C C
OBJ: 9 TOP: Government-Sponsored Health Insurance C C C
KEY: Nursing Process Step: Implementation
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C
8. Which is the main cost-containment component of diagnosis-related groups (DRGs)?
C C C C C C C C C
a. Hospitalsfocus onlyon the specific diagnosis. C C C C
b. Hospitals treat and discharge patients quickly.
C C C C C
c. Reduced cost drugs are ordered for specific diagnoses.
C C C C C C C
d. Diagnostic group classification streamlines care. C C C C
ANS: B C
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's
C C C C C C C C C C C C C C C
diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
C C C C C C C C C C C C C C C C
discharge patients before the allotted time, hospitals get to keep the excess payment; cost is
C C C C C C C C C C C C C C C
contained, and the patient is discharged sooner.
C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 C C C C
TOP: Government-Sponsored Health Insurance
C C C C
KEY: Nursing Process Step: Implementation
C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C
9. Thenurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
C C C C C C C C C C C C C C
a. A 35-year-old unemployed single mother with diabetes
C C C C C C
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-
C C C C C C C C C C C C C
term care facility C C
c. An 80-year-old blind woman living in her own home who has inadequate
C C C C C C C C C C C
private insurance
C C
d. A 67-year-old stroke victim with Medicare Part A and an income frominvestments
C C C C C C C C C C C
ANS: A C
Medicaid is a joint effort of federal and state governments geared primarily for low-income people
C C C C C C C C C C C C C C
with no insurance.
C C C
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 C C C C C C
OBJ: 9 TOP: Government-Sponsored Health Insurance—Medicaid C C C
KEY: Nursing Process Step: Assessment
C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which
C C C C C C C C C C C C C C C
to improve the health of Americans in the second decade of the century?
C C C C C C C C C C C C C
a. Research funding C
b. Health information distribution C C
c. Healthylifestyle encouragement C
d. Health improvement program designsC C C
ANS: C C
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
C C C C C C C C C C C C C
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
C C C C C C C C C C C C
immunizations, healthy eating habits, and healthy weight.
C C C C C C C
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 C C C C
TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation
C C C C C C
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
C C C C C C C C
