test bank for
medical-surgical nursing 5th edition
|all chapters covered 1-48
, chapter 01: caring for medical-surgical patients
multiple choice
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, the primary
purpose of the npa of each state defines the scope of nursing practice in that state.
pts: 1 dif: cognitive level: comprehension
ref: 2
obj: 3 top: npa key: nursing process step:
implementation
msc: nclex: safe, effective care environment: coordinated care
the charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the
vocational nurse has notbeen 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.
pts: 1 dif: cognitive level: 3
, application ref:
obj: 1 top: providing safe care nursing process
key: step: n/a
msc: nclex: safe, effective care environment: coordinated care
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 that should be
addressed by the vocationalnurse. 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
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 with the
general supervision of an rnavailable on site or by phone.
pts: 1 dif: cognitive level: ref: 2
comprehension
obj: 1 top: charge nurse/manager nursi process
key: ng step: n/a
msc: nclex: safe, effective care environment: coordinated care
,the nurse is educating a patient that is a member of a health maintenance organization (hmo). which
informationshould 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.
answer: b
most hmos require preprocedure authorization for treatment. patients are not required to seek a
second opinion, providedocumentation 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
the patient complains to the nurse that he is confused about his “deductible” that he owes the
hospital. whichstatement 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.
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
the nurse compares the characteristics of a health maintenance organization (hmo) and a preferred
providerorganization (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.
c. hmos permit admission to any
facility the member prefers.
d. hmos offer unlimited diagnostic
tests and treatments.
answer: a
hmos require a set fee from each member monthly (capitation). the patient will be treated by the
hmo staff in hmo-approvedfacilities. 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
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.
answer: a
medicare part a covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
medicare part b pays thephysician, 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
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
drugs 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.
pts: 1 dif: cognitive level: ref 8
comprehension :
obj: 9 top: government-sponsored
health insurance
key: nursing process step: implementation
msc: nclex: safe, effective care environment: coordinated care
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- income people with
no insurance.
pts: 1 dif: cognitive level: application
ref: 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
which area is the major focus of healthy people 2020 and the primary mechanism through which to
improve the healthof americans in the second decade of the
, century?
a. research funding
b. health information
distribution
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 to increase effective
immunizations, healthy eating habits, and healthy weight.
pts: 1 dif: cognitive level: ref: 6
comprehension
obj: 7 top: healthy people 2020
key: nursing process step: implementation
msc: nclex: safe, effective care environment: coordinated care
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 of the
patient.
pts: 1 dif: cognitive level: ref: 6
comprehension
obj: 8 top: holistic care
key: nursing process step: planning
msc: nclex: psychosocial integrity: coping and adaptation
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.”
medical-surgical nursing 5th edition
|all chapters covered 1-48
, chapter 01: caring for medical-surgical patients
multiple choice
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, the primary
purpose of the npa of each state defines the scope of nursing practice in that state.
pts: 1 dif: cognitive level: comprehension
ref: 2
obj: 3 top: npa key: nursing process step:
implementation
msc: nclex: safe, effective care environment: coordinated care
the charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the
vocational nurse has notbeen 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.
pts: 1 dif: cognitive level: 3
, application ref:
obj: 1 top: providing safe care nursing process
key: step: n/a
msc: nclex: safe, effective care environment: coordinated care
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 that should be
addressed by the vocationalnurse. 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
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 with the
general supervision of an rnavailable on site or by phone.
pts: 1 dif: cognitive level: ref: 2
comprehension
obj: 1 top: charge nurse/manager nursi process
key: ng step: n/a
msc: nclex: safe, effective care environment: coordinated care
,the nurse is educating a patient that is a member of a health maintenance organization (hmo). which
informationshould 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.
answer: b
most hmos require preprocedure authorization for treatment. patients are not required to seek a
second opinion, providedocumentation 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
the patient complains to the nurse that he is confused about his “deductible” that he owes the
hospital. whichstatement 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.
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
the nurse compares the characteristics of a health maintenance organization (hmo) and a preferred
providerorganization (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.
c. hmos permit admission to any
facility the member prefers.
d. hmos offer unlimited diagnostic
tests and treatments.
answer: a
hmos require a set fee from each member monthly (capitation). the patient will be treated by the
hmo staff in hmo-approvedfacilities. 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
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.
answer: a
medicare part a covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
medicare part b pays thephysician, 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
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
drugs 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.
pts: 1 dif: cognitive level: ref 8
comprehension :
obj: 9 top: government-sponsored
health insurance
key: nursing process step: implementation
msc: nclex: safe, effective care environment: coordinated care
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- income people with
no insurance.
pts: 1 dif: cognitive level: application
ref: 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
which area is the major focus of healthy people 2020 and the primary mechanism through which to
improve the healthof americans in the second decade of the
, century?
a. research funding
b. health information
distribution
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 to increase effective
immunizations, healthy eating habits, and healthy weight.
pts: 1 dif: cognitive level: ref: 6
comprehension
obj: 7 top: healthy people 2020
key: nursing process step: implementation
msc: nclex: safe, effective care environment: coordinated care
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 of the
patient.
pts: 1 dif: cognitive level: ref: 6
comprehension
obj: 8 top: holistic care
key: nursing process step: planning
msc: nclex: psychosocial integrity: coping and adaptation
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.”
