,Chapter / f 01: / f Caring / f for / f Medical-Surgical / f Patients
deWit: / f Medical-Surgical / f Nursing: / f Concepts / f & / f Practice, / f 3rd / f Edition
MULTIPLE / f CHOICE
1. Which / f statement / f accurately / f describes / f the / f primary / f purpose / f of / f the / f state / f nurse / f practice / f act / f (NPA)?
a. To / f test / f and / f license / f LPN/LVNs.
b. To / f define / f the / f scope / f of / f LPN/LVN / f practice.
c. To / f improve / f the / f quality / f of / f care / f provided / f by / f the
/fLPN/LVN.
d. To / f limit / f the / f LPN/LVN / f employment / f placement.
ANS: B
While / f improving / f quality / f of / f care / f provided / f by / f the / f LPN/LVN / f may / f be / f a / f result / f of / f the / f NPA, / f the / f primary
/ f purpose / f of / f the / f NPA /fof / f each / f state / f defines / f the / f scope / f of / f nursing / f practice / f in / f that / f state.
PTS: 1 DIF: Cognitive / f Level: / f Comprehension REF: 2
OBJ: 3 TOP: NPA KEY: Nursing /fProcess / fStep:
/f Implementation
MSC: NCLEX: /fSafe, / fEffective / f Care /fEnvironment: / f Coordinated / f Care
2. The / f charge / f nurse / f asks / f the / f new / f vocational / f nurse / f to / f start / f an / f intravenous / f infusion, / f a / f skill / f that
/f the / f vocational / f nurse /fhas / f notbeen / f taught / f during / f her / f educational / f program. / f How / f should / f the / f vocational
/ f nurse / f respond?
a. Ask / f a / f more / f experienced / f nurse / f to / f demonstrate / f the
/ f procedure.
b. Look / f up / f the / f procedure / f in / f the / f procedure / f manual.
c. Attempt / f to / f perform / f the / f procedure / f with / f supervision.
d. Inform / f the / f charge / f nurse / f of / f her / f lack / f of / f training / f in
/ f this
procedure.
ANS: D
The / f charge / f nurse / f should / f be / f informed / f of / f the / f lack / f of / f training / f to / f perform / f the / f procedure, / f and / f the
/ f vocational / f nurse / f should /fseek / f further / f training / f to / f gain / f proficiency. / f Although / f the / f other / f options / f might
/ f be / f helpful, / f they / f are / f not / f safe.
PTS: 1 DIF: Cognitive / f Level: / f Application REF: 3
OBJ: 1 TOP: Providing / f Safe / f Care KEY: Nursing / fProcess / fStep:
/ f N/A
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
3. Which / f patient / f statement / f indicates / f a / f need / f for / f further / f discharge / f teaching / f that / f the / f vocational / f nurse / f should
/ f address?
a. ―I / f have / f no / f idea / f of / f how / f this / f drug / f will / f affect
/ f me.‖
b. ―Do / f you / f know / f if / f my / f physician / f is / f coming / f back
/ftoday?‖
c. ―Will / f my / f insurance / f pay / f for / f my / f stay?‖
d. ―Am / f I / f going / f to / f have / f to / f go / f to / f a / f nursing
/ f home?‖
ANS: A
Lack /fof /fknowledge /fat /fdischarge /fabout /fmedication /feffects /fand /fside /feffects /fis /fa /fconcern /fthat /fshould /fbe /faddressed /fby /fthe
/fvocationalnurse. / f The / f other / f concerns / f in / f the / f options / f are / f the / f responsibility / f of / f other / f departments / f to / f which
/ f the / f nurse / f might /frefer / f the / f patient.
PTS: / f / f / f 1 DIF: / f / f / f Cognitive / f Level: / f Application / f / f / f REF: / f / f 2
OBJ: 1
/f TOP: Teaching / f KEY: Nursing /fProcess /fStep:
/fImplementation /fMSC: NCLEX: /fSafe, /fEffective /fCare /fEnvironment: /fCoordinated
/fCare
4. According / f to / f most / f state / f NPAs, / f the / f vocational / f nurse / f acting / f as / f charge / f nurse / f in / f a / f long-term
care / f facility / f acts / f in /fwhich / f capacity?
/ f
a. Working / f under / f direct / f supervision / f of / f an / f RN / f on / f the / f unit
b. Working / f with / f the / f RN / f in / f the / f building
c. Working / f under / f general / f supervision / f by / f the / f RN / f available / f on / f site
/ f or / f by
phone
d. Working / f as / f an / f independent / f vocational / f nurse
,ANS: C
The / f vocational / f nurse / f in / f the / f capacity / f of / f the / f charge / f nurse / f in / f a / f long-term / f care / f facility / f acts / f with / f the
/ f general / f supervision / f of / f an /fRN / f available / f on / f site / f or / f by / f phone.
PTS: 1 DIF: Cognitive / f Level: / f Comprehension REF: 2
OBJ: 1 TOP: Charge / f Nurse/Manager KEY: Nursing Process /fStep:
/ f N/A
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: /fCoordinated / f Care
, 5. The / f nurse / f is / f educating / f a / f patient / f that / f is / f a / f member / f of / f a / f health / f maintenance / f organization
(HMO). / f Which /finformationshould / f the / f nurse / f include?
/ f
a. Seek / f the / f opinion / f of / f an / f alternate / f health / f care / f provider.
b. Obtain / f insurance / f approval / f for / f medical / f services / f prior / f to
/ f treatment.
c. Provide / f detailed / f documentation / f of / f all / f care / f received / f for
/ f his /fcondition.
d. Wait / f at / f least / f 6 / f months / f to / f see / f a / f specialist.
ANS: B
Most / f HMOs / f require / f preprocedure / f authorization / f for / f treatment. / f Patients / f are / f not / f required / f to / f seek / f a / f second
/ f opinion, / f provide /fdocumentation / f of / f care, / f or / f wait / f a / f specific / f time / f period / f before / f visiting / f a / f specialist.
PTS: 1 DIF: Cognitive / f Level: / f Application REF: / f
/ f 9
OBJ: 9 TOP: Charge /fNurse/Manager
KEY: Nursing /fProcess / f Step: / f Implementation
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
6. The / f patient / f complains / f to / f the / f nurse / f that / f he / f is / f confused / f about / f his / f ―deductible‖ / f that / f he
/fowes / f the / f hospital. /fWhich statement / f accurately / f explains / f a / f deductible?
cc
a. An / f amount / f of / f money / f put / f aside / f for / f the / f payment / f of / f future
/ f medical / f bills
b. A / f one-time / f fee / f for / f service
c. An / f amount / f of / f money / f deducted / f from / f the / f bill / f by / f the / f insurance
/ f company
d. An / f annual / f amount / f of / f money / f the / f patient / f must / f pay / f out-of-pocket
/ f for / f medical
care
ANS: D
The / f deductible / f is / f the / f annual / f amount / f the / f insured / f must / f pay / f out-of-pocket / f prior / f to / f the / f insurance / f company
/ f assuming / f the / f cost. /fThis / f practice / f improves / f the / f profit / f of / f the / f insurance / f company.
PTS: 1 DIF: Cognitive / f Level: / f Comprehension REF: 7
OBJ: 9 TOP: Health / f Care / f Financing
KEY: Nursing /fProcess / fStep: /fImplementation
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
7. The / f nurse / f compares / f the / f characteristics / f of / f a / f health / f maintenance / f organization / f (HMO)
/f and / f a / f preferred /fproviderorganization / f (PPO). / f Which / f information / f should / f the / f nurse / f include
/ f about / f HMOs?
a. HMOs / f require / f a / f set / f fee / f of / f each / f member
/ f monthly.
b. HMOs / f allow / f the / f member / f to / f select / f his / f health
/ f care /fprovider.
c. HMOs / f permit / f admission / f to / f any / f facility / f the
/ f member /f prefers.
d. HMOs / f offer / f unlimited / f diagnostic / f tests / f and
/ f treatments.
ANS: A
HMOs / f require / f a / f set / f fee / f from / f each / f member / f monthly / f (capitation). / f The / f patient / f will / f be / f treated / f by / f the / f HMO
/ f staff / f in / f HMO- /fapproved / f facilities. / f Excessive / f use / f of / f diagnostic / f tests / f and / f treatments / f is / f discouraged / f by / f the
/ f HMO.
PTS: 1 DIF: Cognitive / f Level: / f Application REF: / f
/ f 9
OBJ: 9 TOP: Managed / f Care
KEY: Nursing /fProcess / fStep: /fImplementation
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
8. A / f patient / f asks / f the / f nurse / f what / f Medicare / f Part / f A / f covers. / f Which / f response / f is / f correct?
a. Medicare / f Part / f A / f covers / f inpatient / f hospital / f costs.
b. Medicare / f Part / f A / f covers / f reimbursement / f to / f the
/fphysician.
c. Medicare / f Part / f A / f covers / f outpatient / f hospital
/ f services.
d. Medicare / f Part / f A / f covers / f ambulance
/ f transportation.
ANS: A
deWit: / f Medical-Surgical / f Nursing: / f Concepts / f & / f Practice, / f 3rd / f Edition
MULTIPLE / f CHOICE
1. Which / f statement / f accurately / f describes / f the / f primary / f purpose / f of / f the / f state / f nurse / f practice / f act / f (NPA)?
a. To / f test / f and / f license / f LPN/LVNs.
b. To / f define / f the / f scope / f of / f LPN/LVN / f practice.
c. To / f improve / f the / f quality / f of / f care / f provided / f by / f the
/fLPN/LVN.
d. To / f limit / f the / f LPN/LVN / f employment / f placement.
ANS: B
While / f improving / f quality / f of / f care / f provided / f by / f the / f LPN/LVN / f may / f be / f a / f result / f of / f the / f NPA, / f the / f primary
/ f purpose / f of / f the / f NPA /fof / f each / f state / f defines / f the / f scope / f of / f nursing / f practice / f in / f that / f state.
PTS: 1 DIF: Cognitive / f Level: / f Comprehension REF: 2
OBJ: 3 TOP: NPA KEY: Nursing /fProcess / fStep:
/f Implementation
MSC: NCLEX: /fSafe, / fEffective / f Care /fEnvironment: / f Coordinated / f Care
2. The / f charge / f nurse / f asks / f the / f new / f vocational / f nurse / f to / f start / f an / f intravenous / f infusion, / f a / f skill / f that
/f the / f vocational / f nurse /fhas / f notbeen / f taught / f during / f her / f educational / f program. / f How / f should / f the / f vocational
/ f nurse / f respond?
a. Ask / f a / f more / f experienced / f nurse / f to / f demonstrate / f the
/ f procedure.
b. Look / f up / f the / f procedure / f in / f the / f procedure / f manual.
c. Attempt / f to / f perform / f the / f procedure / f with / f supervision.
d. Inform / f the / f charge / f nurse / f of / f her / f lack / f of / f training / f in
/ f this
procedure.
ANS: D
The / f charge / f nurse / f should / f be / f informed / f of / f the / f lack / f of / f training / f to / f perform / f the / f procedure, / f and / f the
/ f vocational / f nurse / f should /fseek / f further / f training / f to / f gain / f proficiency. / f Although / f the / f other / f options / f might
/ f be / f helpful, / f they / f are / f not / f safe.
PTS: 1 DIF: Cognitive / f Level: / f Application REF: 3
OBJ: 1 TOP: Providing / f Safe / f Care KEY: Nursing / fProcess / fStep:
/ f N/A
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
3. Which / f patient / f statement / f indicates / f a / f need / f for / f further / f discharge / f teaching / f that / f the / f vocational / f nurse / f should
/ f address?
a. ―I / f have / f no / f idea / f of / f how / f this / f drug / f will / f affect
/ f me.‖
b. ―Do / f you / f know / f if / f my / f physician / f is / f coming / f back
/ftoday?‖
c. ―Will / f my / f insurance / f pay / f for / f my / f stay?‖
d. ―Am / f I / f going / f to / f have / f to / f go / f to / f a / f nursing
/ f home?‖
ANS: A
Lack /fof /fknowledge /fat /fdischarge /fabout /fmedication /feffects /fand /fside /feffects /fis /fa /fconcern /fthat /fshould /fbe /faddressed /fby /fthe
/fvocationalnurse. / f The / f other / f concerns / f in / f the / f options / f are / f the / f responsibility / f of / f other / f departments / f to / f which
/ f the / f nurse / f might /frefer / f the / f patient.
PTS: / f / f / f 1 DIF: / f / f / f Cognitive / f Level: / f Application / f / f / f REF: / f / f 2
OBJ: 1
/f TOP: Teaching / f KEY: Nursing /fProcess /fStep:
/fImplementation /fMSC: NCLEX: /fSafe, /fEffective /fCare /fEnvironment: /fCoordinated
/fCare
4. According / f to / f most / f state / f NPAs, / f the / f vocational / f nurse / f acting / f as / f charge / f nurse / f in / f a / f long-term
care / f facility / f acts / f in /fwhich / f capacity?
/ f
a. Working / f under / f direct / f supervision / f of / f an / f RN / f on / f the / f unit
b. Working / f with / f the / f RN / f in / f the / f building
c. Working / f under / f general / f supervision / f by / f the / f RN / f available / f on / f site
/ f or / f by
phone
d. Working / f as / f an / f independent / f vocational / f nurse
,ANS: C
The / f vocational / f nurse / f in / f the / f capacity / f of / f the / f charge / f nurse / f in / f a / f long-term / f care / f facility / f acts / f with / f the
/ f general / f supervision / f of / f an /fRN / f available / f on / f site / f or / f by / f phone.
PTS: 1 DIF: Cognitive / f Level: / f Comprehension REF: 2
OBJ: 1 TOP: Charge / f Nurse/Manager KEY: Nursing Process /fStep:
/ f N/A
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: /fCoordinated / f Care
, 5. The / f nurse / f is / f educating / f a / f patient / f that / f is / f a / f member / f of / f a / f health / f maintenance / f organization
(HMO). / f Which /finformationshould / f the / f nurse / f include?
/ f
a. Seek / f the / f opinion / f of / f an / f alternate / f health / f care / f provider.
b. Obtain / f insurance / f approval / f for / f medical / f services / f prior / f to
/ f treatment.
c. Provide / f detailed / f documentation / f of / f all / f care / f received / f for
/ f his /fcondition.
d. Wait / f at / f least / f 6 / f months / f to / f see / f a / f specialist.
ANS: B
Most / f HMOs / f require / f preprocedure / f authorization / f for / f treatment. / f Patients / f are / f not / f required / f to / f seek / f a / f second
/ f opinion, / f provide /fdocumentation / f of / f care, / f or / f wait / f a / f specific / f time / f period / f before / f visiting / f a / f specialist.
PTS: 1 DIF: Cognitive / f Level: / f Application REF: / f
/ f 9
OBJ: 9 TOP: Charge /fNurse/Manager
KEY: Nursing /fProcess / f Step: / f Implementation
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
6. The / f patient / f complains / f to / f the / f nurse / f that / f he / f is / f confused / f about / f his / f ―deductible‖ / f that / f he
/fowes / f the / f hospital. /fWhich statement / f accurately / f explains / f a / f deductible?
cc
a. An / f amount / f of / f money / f put / f aside / f for / f the / f payment / f of / f future
/ f medical / f bills
b. A / f one-time / f fee / f for / f service
c. An / f amount / f of / f money / f deducted / f from / f the / f bill / f by / f the / f insurance
/ f company
d. An / f annual / f amount / f of / f money / f the / f patient / f must / f pay / f out-of-pocket
/ f for / f medical
care
ANS: D
The / f deductible / f is / f the / f annual / f amount / f the / f insured / f must / f pay / f out-of-pocket / f prior / f to / f the / f insurance / f company
/ f assuming / f the / f cost. /fThis / f practice / f improves / f the / f profit / f of / f the / f insurance / f company.
PTS: 1 DIF: Cognitive / f Level: / f Comprehension REF: 7
OBJ: 9 TOP: Health / f Care / f Financing
KEY: Nursing /fProcess / fStep: /fImplementation
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
7. The / f nurse / f compares / f the / f characteristics / f of / f a / f health / f maintenance / f organization / f (HMO)
/f and / f a / f preferred /fproviderorganization / f (PPO). / f Which / f information / f should / f the / f nurse / f include
/ f about / f HMOs?
a. HMOs / f require / f a / f set / f fee / f of / f each / f member
/ f monthly.
b. HMOs / f allow / f the / f member / f to / f select / f his / f health
/ f care /fprovider.
c. HMOs / f permit / f admission / f to / f any / f facility / f the
/ f member /f prefers.
d. HMOs / f offer / f unlimited / f diagnostic / f tests / f and
/ f treatments.
ANS: A
HMOs / f require / f a / f set / f fee / f from / f each / f member / f monthly / f (capitation). / f The / f patient / f will / f be / f treated / f by / f the / f HMO
/ f staff / f in / f HMO- /fapproved / f facilities. / f Excessive / f use / f of / f diagnostic / f tests / f and / f treatments / f is / f discouraged / f by / f the
/ f HMO.
PTS: 1 DIF: Cognitive / f Level: / f Application REF: / f
/ f 9
OBJ: 9 TOP: Managed / f Care
KEY: Nursing /fProcess / fStep: /fImplementation
MSC: NCLEX: /fSafe, /fEffective / f Care /fEnvironment: / f Coordinated / f Care
8. A / f patient / f asks / f the / f nurse / f what / f Medicare / f Part / f A / f covers. / f Which / f response / f is / f correct?
a. Medicare / f Part / f A / f covers / f inpatient / f hospital / f costs.
b. Medicare / f Part / f A / f covers / f reimbursement / f to / f the
/fphysician.
c. Medicare / f Part / f A / f covers / f outpatient / f hospital
/ f services.
d. Medicare / f Part / f A / f covers / f ambulance
/ f transportation.
ANS: A
