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Chapter 01: Caring for Medical-Surgical Patients
deWit: Medical-Surgical Nursing: Concepts & Practice, 5th Edition
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.
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 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
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.
Qq1111
, 222222
ANS: 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: Application REF: 3
OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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?”
ANS: 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 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
4. According to most state NPAs, the vocational nurse acting as charge nurse in a
long-term care facility acts in which capacity?
Qq1111
, 222222
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
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 on site or by phone.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
OBJ: 1 TOP: Charge Nurse/Manager KEY: Nursing Process Step:
N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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. 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.
ANS: B
Most HMOs require preprocedure authorization for treatment. Patients 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 REF: 9
OBJ: 9 TOP: Charge Nurse/Manager
KEY: Nursing Process Step: Implementation
Qq1111
, 222222
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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
ANS: 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 REF: 7
OBJ: 9 TOP: Health Care Financing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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.
Qq1111
Chapter 01: Caring for Medical-Surgical Patients
deWit: Medical-Surgical Nursing: Concepts & Practice, 5th Edition
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.
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 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
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.
Qq1111
, 222222
ANS: 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: Application REF: 3
OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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?”
ANS: 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 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
4. According to most state NPAs, the vocational nurse acting as charge nurse in a
long-term care facility acts in which capacity?
Qq1111
, 222222
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
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 on site or by phone.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
OBJ: 1 TOP: Charge Nurse/Manager KEY: Nursing Process Step:
N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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. 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.
ANS: B
Most HMOs require preprocedure authorization for treatment. Patients 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 REF: 9
OBJ: 9 TOP: Charge Nurse/Manager
KEY: Nursing Process Step: Implementation
Qq1111
, 222222
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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
ANS: 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 REF: 7
OBJ: 9 TOP: Health Care Financing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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.
Qq1111
