CONCEPTS AND S MEDICAL-
SURGICAL PRACTICE 6TH BY
HOLLY COMPLETE CHAPTERS
DETAILED K. STROMBERG 1-49
WITH ANSWERS| A+ VERIFIED
GRADE EDITION QUESTIONS &
GUARANTEED
TEST BANK – Dewit's Medical-Surgical Nursing: Concepts and Practice 6th Edition by Holly K.
Stromberg
Chapter 01: Caring for the LPN/LVN
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
CORRECT ANSWER: B
Rationale: 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.
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.
,CORRECT ANSWER: D
Rationale: 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.
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?
CORRECT ANSWER: A
Rationale: 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.
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
CORRECT ANSWER: C
Rationale: 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.
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.
CORRECT ANSWER: B
Rationale: 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 to seek a
second opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
,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
CORRECT ANSWER: D
Rationale: 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.
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.
CORRECT ANSWER: A
Rationale: 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.
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.
CORRECT ANSWER: B
Rationale: 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.
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
CORRECT ANSWER: A
Rationale: Medicaid is a government-sponsored health insurance program for low-income and disabled
individuals. The 35-year-old unemployed single mother with diabetes would most likely qualify based on
income and disability status.
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
b. Health information distribution
c. Healthy lifestyle encouragement
d. Health improvement program designs
CORRECT ANSWER: C
Rationale: Healthy People 2020 focuses on expanding ongoing programs to include support and
information to reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase
effective immunizations, healthy eating habits, and healthy weight.
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
CORRECT ANSWER: D
Rationale: Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of
the patient.
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.