Chapter 01: Caring for Medical-Surgical Patients
MULTIPLE CHOICE
1. The new nurse demonstrates an understanding of the primary purpose of the state nurse
practice act (NPA) by explaining that it acts to:
a. test and license LPN/LVNs.
b. define the scope of LPN/LVN practice.
c. improve the quality of care provided by the LPN/LVN.
d. 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.
DIF: Cognitive Level: Comprehension REF: 1-2 OBJ: 1 (theory)
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. Because the
vocational nurse has not been taught this skill during her educational program, the vocational
nurse should:
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.
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.
DIF: Cognitive Level: Application REF: 2 OBJ: 1 (theory)
TOP: Providing Safe Care KEY: Nursing Process Step: NA

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
3. The nurse recognizes the need for further discharge education when the patient says:
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.
DIF: Cognitive Level: Analysis REF: 2 OBJ: 1 (theory)
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 is acting in which capacity?
a. Under direct supervision of an RN on the unit
b. With the RN in the building
c. Under general supervision by the RN available on site or by phone
d. 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.
DIF: Cognitive Level: Comprehension REF: 3 OBJ: 1 (theory)
TOP: Charge Nurse/Manager KEY: Nursing Process Step: NA
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. The nurse reminds the patient who is a member of a health maintenance organization that prior
to treatment he will need to:

a. seek the opinion of another physician.
b. have medical services approved by his insurance.
c. provide documentation of all care received for his condition.
d. wait 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.
DIF: Cognitive Level: Application REF: 5 OBJ: 3 (theory)
TOP: Charge Nurse/Manager KEY: Nursing Process Step: Implementation
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. The nurse explains that the deductible is a(n):
a. amount of money put aside for the payment of future medical bills.
b. one-time fee for service.
c. amount of money deducted from the bill by the insurance company.
d. 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.
DIF: Cognitive Level: Application REF: 4 OBJ: 5 (theory)
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), pointing out that an HMO:
a. requires a set fee of each member monthly.
b. allows the member to select his health care provider.

c. permits admission to any facility the member prefers.
d. offers unlimited diagnostics tests and treatments.
ANS: A
HMOs require a set fee from each member monthly (capitation). The patient will be treated by
the HMO staff in HMO-approved facilities. Excessive use of diagnostic tests and treatments is
discouraged by the HMO.
DIF: Cognitive Level: Application REF: 5 OBJ: 3 (theory)
TOP: Managed Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
8. When the patient asks the nurse what his Medicare Part A covers, the nurse responds that it
covers:
a. inpatient hospital costs.
b. reimbursement to the physician.
c. outpatient hospital services.
d. ambulance transportation.
ANS: A
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, lab work, and intensive care.
Medicare Part B pays the physician, ambulance transport, and outpatient services.
DIF: Cognitive Level: Comprehension REF: 5 | Box 1-3 OBJ: 4 (theory)
TOP: Government-Sponsored Health Insurance
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
9. The nurse explains that the main cost containment component of diagnosis-related groups
(DRGs) is that:
a. hospitals focus only on the specific diagnosis.
b. hospitals treat and discharge patients quickly.

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a. funding research.
b. distributing health information.
c. encouraging healthy lifestyles.
d. designing programs for health improvement.
ANS: C
Healthy People focuses on helping ongoing programs to incorporate support and information to
reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS and to increase effective
immunizations, healthy eating habits, and healthy weight.
DIF: Cognitive Level: Comprehension REF: 6-7 OBJ: 7

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c. “I’ll bet that made you feel very frustrated.”
d. “Take a deep breath and plan what you will say to him tomorrow.”
ANS: C
Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the
emotion. Belittling the patient’s feelings, showing sympathy, or defending the doctor makes the
patient feel devalued.
DIF: Cognitive Level: Analysis REF: 8 OBJ: 9 (theory)
TOP: Nurse

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1. Basic to the ability to apply critical thinking, the nurse must have:
a. unshakable beliefs and values.
b. an open attitude.
c. the ability to disregard evidence inconsistent with set goals.
d. the ability to recognize the perfect solution.
ANS: B
An open attitude not clouded by unshakable beliefs and values or preset goals allows the
application of critical thinking. Acceptance that there may not be a perfect solution

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b.
“The HbA1c provides information relative to blood sugar levels from the past 2 to 3
months.”
c. “Hemoglobin levels and blood sugar levels are closely related.”
d. “The HbA1c tells if you have type 1 or type 2 diabetes.”
ANS: B
HbA1c evaluates the average blood glucose level for the last 2 to 3 months.
DIF: Cognitive Level: Comprehension REF: 24 OBJ: 2 (clinical)
TOP: Diagnostic Studies KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance

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Medical-Surgical Nursing: Concepts & Practice 3rd Edition Test Bank

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