Test Bank for Dewits Medical Surgical Nursing Concepts and Practice
5TH Edition Stromberg /All Chapters 1-49. Complete Guide with
Rationales 2024-2025 LATEST EDITION GRADED A+
,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.
CORRECT: 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 REFERENCE: 2
OBJ: 3 TOPIC: 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 thevocational 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: D
The charge NURSE should be informed of the lack of training to perform the procedure, and
thevocational NURSE should seek further training to gain proficiency. Although the other
options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application REFERENCE: 3
OBJ: 1 TOPIC: Providing Safe Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
3. Which client 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: A
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 client.
PTS: 1 DIF: Cognitive Level: Application REFERENCE: 2
OBJ: 1 TOPIC: Teaching KEY: Nursing Process Step: Implementation
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
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
CORRECT: 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.
PTS: 1 DIF: Cognitive Level: Comprehension REFERENCE: 2
OBJ: 1 TOPIC: Charge NURSE/Manager KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. The NURSE is educating a client 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. 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.
CORRECT: B
Most HMOs require preprocedure authorization for treatment. Clients are not required to
seek a second opinion, provide documentation of care, or wait a specific time period before
visiting a specialist.
PTS: 1 DIF: Cognitive Level: Application
REFERENCE: 9OBJ: 9
TOPIC: Charge NURSE/Manager
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The client complains to the NURSE that he is confused about his “deductible” that he owes
thehospital. 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 client must pay out-of-pocket for medical care
CORRECT: 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: Comprehension
REFERENCE: 7OBJ: 9
TOPIC: Health Care Financing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
7. The NURSE compares the characteristics of a health maintenance organization (HMO) and
a preferred provider organization (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.
CORRECT: A
HMOs require a set fee from each member monthly (capitation). The client will be treated by
the HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is
discouraged by the HMO.
PTS: 1 DIF: Cognitive Level: Application
REFERENCE: 9OBJ: 9
TOPIC: Managed Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. A client asks the NURSE what Medicare Part A covers. Which response is correct?
a. Medicare Part A covers inclient hospital costs.
b. Medicare Part A covers reimbursement to the physician.
c. Medicare Part A covers outclient hospital services.
d. Medicare Part A covers ambulance transportation.
CORRECT: A
Medicare Part A covers inclient hospital expenses, drugs, x-rays, laboratory work, and
intensive care. Medicare Part B pays the physician, ambulance transport, and outclient
services.
PTS: 1 DIF: Cognitive Level: Comprehension REFERENCE:
7, Box 1-4OBJ: 9 TOPIC: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. 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 clients quickly.
c. Reduced cost drugs are ordered for specific diagnoses.
d. Diagnostic group classification streamlines care.
CORRECT: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each client’s
diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
discharge clients before the allotted time, hospitals get to keep the excess payment; cost is
contained, and the client is discharged sooner.
PTS: 1 DIF: Cognitive Level: Comprehension
REFERENCE: 8OBJ: 9
TOPIC: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5TH Edition Stromberg /All Chapters 1-49. Complete Guide with
Rationales 2024-2025 LATEST EDITION GRADED A+
,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.
CORRECT: 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 REFERENCE: 2
OBJ: 3 TOPIC: 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 thevocational 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: D
The charge NURSE should be informed of the lack of training to perform the procedure, and
thevocational NURSE should seek further training to gain proficiency. Although the other
options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application REFERENCE: 3
OBJ: 1 TOPIC: Providing Safe Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
3. Which client 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: A
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 client.
PTS: 1 DIF: Cognitive Level: Application REFERENCE: 2
OBJ: 1 TOPIC: Teaching KEY: Nursing Process Step: Implementation
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
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
CORRECT: 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.
PTS: 1 DIF: Cognitive Level: Comprehension REFERENCE: 2
OBJ: 1 TOPIC: Charge NURSE/Manager KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. The NURSE is educating a client 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. 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.
CORRECT: B
Most HMOs require preprocedure authorization for treatment. Clients are not required to
seek a second opinion, provide documentation of care, or wait a specific time period before
visiting a specialist.
PTS: 1 DIF: Cognitive Level: Application
REFERENCE: 9OBJ: 9
TOPIC: Charge NURSE/Manager
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The client complains to the NURSE that he is confused about his “deductible” that he owes
thehospital. 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 client must pay out-of-pocket for medical care
CORRECT: 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: Comprehension
REFERENCE: 7OBJ: 9
TOPIC: Health Care Financing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
7. The NURSE compares the characteristics of a health maintenance organization (HMO) and
a preferred provider organization (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.
CORRECT: A
HMOs require a set fee from each member monthly (capitation). The client will be treated by
the HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is
discouraged by the HMO.
PTS: 1 DIF: Cognitive Level: Application
REFERENCE: 9OBJ: 9
TOPIC: Managed Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. A client asks the NURSE what Medicare Part A covers. Which response is correct?
a. Medicare Part A covers inclient hospital costs.
b. Medicare Part A covers reimbursement to the physician.
c. Medicare Part A covers outclient hospital services.
d. Medicare Part A covers ambulance transportation.
CORRECT: A
Medicare Part A covers inclient hospital expenses, drugs, x-rays, laboratory work, and
intensive care. Medicare Part B pays the physician, ambulance transport, and outclient
services.
PTS: 1 DIF: Cognitive Level: Comprehension REFERENCE:
7, Box 1-4OBJ: 9 TOPIC: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. 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 clients quickly.
c. Reduced cost drugs are ordered for specific diagnoses.
d. Diagnostic group classification streamlines care.
CORRECT: B
DRGs are a prospective payment plan in which hospitals receive a flat fee for each client’s
diagnostic category regardless of the length of time in the hospital. If hospitals can treat and
discharge clients before the allotted time, hospitals get to keep the excess payment; cost is
contained, and the client is discharged sooner.
PTS: 1 DIF: Cognitive Level: Comprehension
REFERENCE: 8OBJ: 9
TOPIC: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
