TESTBANK
n
,Chapter 01: Caring for Medical-Surgical Patients
n n n n n
Stromberg:Medical-Surgical Nursing: Concepts and Practice, 5th Edition
n n n n n n n
MULTIPLE CHOICE n
1. Which statement accuratelydescribes the primarypurpose of the state nurse
n n n n n n n n n n
practice act (NPA)?
n n n
a. To test and license LPN/LVNs
n n n n
b. To define the scope of LPN/LVN practice
n n n n n n
c. To improve the qualityof care provided by the LPN/LVN
n n n n n n n n n
d. Tolimitthe LPN/LVNemployment placement
n n n n n
ANS: B n
While improving quality of care provided by the LPN/LVN may be a result of
n n n n n n n n n n n n n
the NPA, the primarypurpose of the NPA of each state defines the scope of
n n n n n n n n n n n n n n
nursing practice in that state.
n n n n n
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 n n n n n
TOP: NPA
n KEY: Nursing Process Step: Implementation
n n n n n
nMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
n n n n n n n n n n n n n n n n n
nurse has not been taught during her educational program. How should the vocational nurse respond?
n n n n n n n n n n n n n n n
a. Ask a more experienced nurse to demonstrate the procedure.
n n n n n n n n
b. Lookup the procedure in the procedure manual. n n n n n n n
c. Attempt to performthe procedure with supervision. n n n n n n
d. Informthe charge nurse of her lack of trainingin thisprocedure. n n n n n n n n n n n
ANS: D n
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational
n n n n n n n n n n n n n n n n n
nurse should seek further training to gain proficiency. Although the other options might be helpful, they
n n n n n n n n n n n n n n n n
are not safe.
n n n
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 n n n n n
TOP: Providing Safe Care
n n KEY: Nursing Process Step: N/A n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
n n n n n n n n n n n n n
should address?
n n
a. "Ihave no idea of how thisdrug will affect me."
n n n n n n n n n n
b. "Do you know if my physician is comingbacktoday?"
n n n n n n n n n
c. "Will my insurance pay for my stay?" n n n n n n
d. "Am I going to have to go to a nursinghome?" n n n n n n n n n n
ANS: A n
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
n n n n n n n n n n n n n n n n
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
n n n n n n n n n n n n n n n n
departments to which the nurse might refer the patient.
n n n n n n n n n
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 n n n n n
TOP: Teaching
n KEY: Nursing Process Step: Implementation
n n n n n
nMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts
n n n n n n n n n n n n n n n n n
in which capacity?
n n n
a. Workingunder direct supervision of an RN on the unit n n n n n n n n n
b. Working with the RNin thebuilding n n n n n n
c. Workingunder general supervision bythe RNavailable on site or byphone n n n n n n n n n n n n
d. Workingas anindependent vocational nurse n n n n n
ANS: C n
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
n n n n n n n n n n n n n n n n n n
supervision of an RN available on site or by phone.
n n n n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 n n n n n
TOP: Charge Nurse/Manager
n n KEY: Nursing Process Step: N/A n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
n n n n n n n n n n n n n n n n
information should the nurse include?
n n n n n
a. Seekthe opinion of an alternate health care provider.
n n n n n n n n
b. Contactthe insurance company for coverage details asservices maybe limited.
n n n n n n n n n n n
c. Providedetailed documentation of all care received forhis condition. n n n n n n n n n
d. Wait at least 6 months to see a specialist. n n n n n n n n
ANS: B n
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups of
n n n n n n n n n n n n n n n n n
patients for a set capitation fee and by limiting services. Patients are not required to seek a second
n n n n n n n n n n n n n n n n n n
opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
n n n n n n n n n n n n n n n
DIF: Cognitive Level: Application
n n REF: p. 9 OBJ: 9 n n n n n n
TOP: Charge Nurse/Manager
n KEY: Nursing Process Step: Implementation n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
n n n n n n n n n n n n n n n n n
Which statement accurately explains a deductible?
n n n n n n
a. An amount of moneyput aside for the payment of future medical bills
n n n n n n n n n n n n
b. A one-time fee for service
n n n n
c. An amount of money deducted fromthe bill by the insurance company
n n n n n n n n n n n
d. An annual amount of moneythe patient must pay out-of-pocket for medical care
n n n n n n n n n n n n
ANS: D n
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
n n n n n n n n n n n n n n n
assuming the cost. This practice improves the profit of the insurance company.
n n n n n n n n n n n n
DIF: Cognitive Level: Comprehension
n n REF: p. 7 OBJ: 9 n n n n n n n n
TOP: Health Care Financing
n KEY: Nursing Process Step: Implementation n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
7. Apatient asks the nurse what Medicare Part Acovers.Which response iscorrect?
n n n n n n n n n n n n n
a. Medicare Part Acovers inpatient hospital costs. n n n n n n
b. Medicare Part Acovers reimbursement to the physician. n n n n n n n
c. Medicare Part Acovers outpatient hospital services. n n n n n n
d. Medicare Part Acovers ambulance transportation. n n n n n
ANS: A n
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
n n n n n n n n n n n n n
Medicare Part B pays the physician, ambulance transport, and outpatient services.
n n n n n n n n n n n
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 n n n n n n
OBJ: 9 n TOP: Government-Sponsored Health Insurance n n n
KEY: Nursing Process Step: Implementation
n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
8. Whichisthemain cost-containment component of diagnosis-related groups(DRGs)?
n n n n n n n n n
a. Hospitalsfocus onlyon thespecificdiagnosis. n n n n n n
b. Hospitals treat and discharge patientsquickly. n n n n n
c. Reduced cost drugs are ordered for specific diagnoses. n n n n n n n
d. Diagnosticgroupclassification streamlines care. n n n n
ANS: B n
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
n n n n n n n n n n n n n n n n
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before
n n n n n n n n n n n n n n n n n n
the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged
n n n n n n n n n n n n n n n n n n
sooner.
n
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 n n n n n
TOP: Government-Sponsored Health Insurance
n n n n
KEY: NursingProcess Step: Implementation
n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
9. Thenurseis assessinga group of patients. Which patient would most likelyqualifyforMedicaid?
n n n n n n n n n n n n n n n
a. A35-year-oldunemployed single mother withdiabetes
n n n n n n
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
n n n n n n n n n n n n n
care facility
n n
c. An 80-year-old blind woman living in her own home who has inadequate private
n n n n n n n n n n n n
insurance
n
d. A67-year-old stroke victimwith Medicare Part Aand an income frominvestments
n n n n n n n n n n n n
ANS: A n
Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no
n n n n n n n n n n n n n n n n
insurance.
n
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 n n n n n n
OBJ: 9 n TOP: Government-Sponsored Health Insurance—Medicaid n n n
KEY: Nursing Process Step: Assessment
n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
n n n n n n n n n n n n n n n n
improve the health of Americans in the second decade of the century?
n n n n n n n n n n n n
a. Research funding n
b. Health information distribution n n
c. Healthylifestyle encouragement n n
d. Health improvement program designs n n n
ANS: C n
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
n n n n n n n n n n n n n
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
n n n n n n n n n n n n
immunizations, healthy eating habits, and healthy weight.
n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 n n n n n n
TOP: Healthy People 2020
n KEY: Nursing Process Step: Implementation n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
n
,Chapter 01: Caring for Medical-Surgical Patients
n n n n n
Stromberg:Medical-Surgical Nursing: Concepts and Practice, 5th Edition
n n n n n n n
MULTIPLE CHOICE n
1. Which statement accuratelydescribes the primarypurpose of the state nurse
n n n n n n n n n n
practice act (NPA)?
n n n
a. To test and license LPN/LVNs
n n n n
b. To define the scope of LPN/LVN practice
n n n n n n
c. To improve the qualityof care provided by the LPN/LVN
n n n n n n n n n
d. Tolimitthe LPN/LVNemployment placement
n n n n n
ANS: B n
While improving quality of care provided by the LPN/LVN may be a result of
n n n n n n n n n n n n n
the NPA, the primarypurpose of the NPA of each state defines the scope of
n n n n n n n n n n n n n n
nursing practice in that state.
n n n n n
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 n n n n n
TOP: NPA
n KEY: Nursing Process Step: Implementation
n n n n n
nMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational
n n n n n n n n n n n n n n n n n
nurse has not been taught during her educational program. How should the vocational nurse respond?
n n n n n n n n n n n n n n n
a. Ask a more experienced nurse to demonstrate the procedure.
n n n n n n n n
b. Lookup the procedure in the procedure manual. n n n n n n n
c. Attempt to performthe procedure with supervision. n n n n n n
d. Informthe charge nurse of her lack of trainingin thisprocedure. n n n n n n n n n n n
ANS: D n
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational
n n n n n n n n n n n n n n n n n
nurse should seek further training to gain proficiency. Although the other options might be helpful, they
n n n n n n n n n n n n n n n n
are not safe.
n n n
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 n n n n n
TOP: Providing Safe Care
n n KEY: Nursing Process Step: N/A n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
3. Which patient statement indicates a need for further discharge teaching that the vocational nurse
n n n n n n n n n n n n n
should address?
n n
a. "Ihave no idea of how thisdrug will affect me."
n n n n n n n n n n
b. "Do you know if my physician is comingbacktoday?"
n n n n n n n n n
c. "Will my insurance pay for my stay?" n n n n n n
d. "Am I going to have to go to a nursinghome?" n n n n n n n n n n
ANS: A n
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
n n n n n n n n n n n n n n n n
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
n n n n n n n n n n n n n n n n
departments to which the nurse might refer the patient.
n n n n n n n n n
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 n n n n n
TOP: Teaching
n KEY: Nursing Process Step: Implementation
n n n n n
nMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
,4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care facility acts
n n n n n n n n n n n n n n n n n
in which capacity?
n n n
a. Workingunder direct supervision of an RN on the unit n n n n n n n n n
b. Working with the RNin thebuilding n n n n n n
c. Workingunder general supervision bythe RNavailable on site or byphone n n n n n n n n n n n n
d. Workingas anindependent vocational nurse n n n n n
ANS: C n
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
n n n n n n n n n n n n n n n n n n
supervision of an RN available on site or by phone.
n n n n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 n n n n n
TOP: Charge Nurse/Manager
n n KEY: Nursing Process Step: N/A n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which
n n n n n n n n n n n n n n n n
information should the nurse include?
n n n n n
a. Seekthe opinion of an alternate health care provider.
n n n n n n n n
b. Contactthe insurance company for coverage details asservices maybe limited.
n n n n n n n n n n n
c. Providedetailed documentation of all care received forhis condition. n n n n n n n n n
d. Wait at least 6 months to see a specialist. n n n n n n n n
ANS: B n
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups of
n n n n n n n n n n n n n n n n n
patients for a set capitation fee and by limiting services. Patients are not required to seek a second
n n n n n n n n n n n n n n n n n n
opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
n n n n n n n n n n n n n n n
DIF: Cognitive Level: Application
n n REF: p. 9 OBJ: 9 n n n n n n
TOP: Charge Nurse/Manager
n KEY: Nursing Process Step: Implementation n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the hospital.
n n n n n n n n n n n n n n n n n
Which statement accurately explains a deductible?
n n n n n n
a. An amount of moneyput aside for the payment of future medical bills
n n n n n n n n n n n n
b. A one-time fee for service
n n n n
c. An amount of money deducted fromthe bill by the insurance company
n n n n n n n n n n n
d. An annual amount of moneythe patient must pay out-of-pocket for medical care
n n n n n n n n n n n n
ANS: D n
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
n n n n n n n n n n n n n n n
assuming the cost. This practice improves the profit of the insurance company.
n n n n n n n n n n n n
DIF: Cognitive Level: Comprehension
n n REF: p. 7 OBJ: 9 n n n n n n n n
TOP: Health Care Financing
n KEY: Nursing Process Step: Implementation n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
7. Apatient asks the nurse what Medicare Part Acovers.Which response iscorrect?
n n n n n n n n n n n n n
a. Medicare Part Acovers inpatient hospital costs. n n n n n n
b. Medicare Part Acovers reimbursement to the physician. n n n n n n n
c. Medicare Part Acovers outpatient hospital services. n n n n n n
d. Medicare Part Acovers ambulance transportation. n n n n n
ANS: A n
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
n n n n n n n n n n n n n
Medicare Part B pays the physician, ambulance transport, and outpatient services.
n n n n n n n n n n n
, DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 n n n n n n
OBJ: 9 n TOP: Government-Sponsored Health Insurance n n n
KEY: Nursing Process Step: Implementation
n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
8. Whichisthemain cost-containment component of diagnosis-related groups(DRGs)?
n n n n n n n n n
a. Hospitalsfocus onlyon thespecificdiagnosis. n n n n n n
b. Hospitals treat and discharge patientsquickly. n n n n n
c. Reduced cost drugs are ordered for specific diagnoses. n n n n n n n
d. Diagnosticgroupclassification streamlines care. n n n n
ANS: B n
DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient's diagnostic
n n n n n n n n n n n n n n n n
category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before
n n n n n n n n n n n n n n n n n n
the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged
n n n n n n n n n n n n n n n n n n
sooner.
n
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 9 n n n n n
TOP: Government-Sponsored Health Insurance
n n n n
KEY: NursingProcess Step: Implementation
n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
9. Thenurseis assessinga group of patients. Which patient would most likelyqualifyforMedicaid?
n n n n n n n n n n n n n n n
a. A35-year-oldunemployed single mother withdiabetes
n n n n n n
b. A 70-year-old Medicare recipient with retirement income who needs to be in a long-term
n n n n n n n n n n n n n
care facility
n n
c. An 80-year-old blind woman living in her own home who has inadequate private
n n n n n n n n n n n n
insurance
n
d. A67-year-old stroke victimwith Medicare Part Aand an income frominvestments
n n n n n n n n n n n n
ANS: A n
Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no
n n n n n n n n n n n n n n n n
insurance.
n
DIF: Cognitive Level: Application REF: p. 8, Box 1-5 n n n n n n
OBJ: 9 n TOP: Government-Sponsored Health Insurance—Medicaid n n n
KEY: Nursing Process Step: Assessment
n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n
10. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to
n n n n n n n n n n n n n n n n
improve the health of Americans in the second decade of the century?
n n n n n n n n n n n n
a. Research funding n
b. Health information distribution n n
c. Healthylifestyle encouragement n n
d. Health improvement program designs n n n
ANS: C n
Healthy People 2020 focuses on expanding ongoing programs to include support and information to
n n n n n n n n n n n n n
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to increase effective
n n n n n n n n n n n n
immunizations, healthy eating habits, and healthy weight.
n n n n n n n
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 7 n n n n n n
TOP: Healthy People 2020
n KEY: Nursing Process Step: Implementation n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
n n n n n n n n
