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Helpful notes to help study, Study Guides, Projects, Research of Nursing

Southern West Virginia Community and Technical CollegeNursing

Helpful notes to help study for exams

Typology: Study Guides, Projects, Research

2024/2025

Uploaded on 02/24/2026

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Chapter 01: Caring for Medical-Surgical Patients
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd 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.
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.
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Chapter 01: Caring for Medical-Surgical Patients

deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd 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.

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?

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 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

OBJ: 9 TOP: Government-Sponsored Health Insurance KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

10. The nurse is assessing a group of patients. Which patient would most likely qualify for

Medicaid?

a. A 35-year-old unemployed single mother with diabetes

b. A 70-year-old Medicare recipient with retirement income who needs to be in a

long-term care facility

c. An 80-year-old blind woman living in her own home who has inadequate private

insurance

d. A 67-year-old stroke victim with Medicare Part A and an income from investments

ANS: A

Medicaid is a joint effort of federal and state governments geared primarily for low-income

people with no insurance.

PTS: 1 DIF: Cognitive Level: Application REF: 8, Box 1- OBJ: 9 TOP: Government-Sponsored Health Insurance–Medicaid KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

11. Which area is the major focus of Healthy People 2020 and the primary mechanism through

which to improve the health of Americans in the second decade of the century?

a. Research funding

b. Health information distribution

c. Healthy lifestyle encouragement

d. Health improvement program designs

ANS: C

Healthy People 2020 focuses on expanding ongoing programs to include support and

information to reduce infant mortality, cancer, cardiovascular disease, and HIV/AIDS, and to

increase effective immunizations, healthy eating habits, and healthy weight.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 OBJ: 7 TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

12. Which term explains the type of care that addresses interventions for all dimensions of a

patient’s life?

a. Focused care

b. General care

c. Directed care

d. Holistic care

ANS: D

Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of

the patient.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 6 OBJ: 8 TOP: Holistic Care KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

13. A patient furiously says, “My doctor was so busy giving me instructions that he didn’t hear

what I was trying to ask him!” Which response is most empathetic?

a. “When people ignore me, I really get mad.”

b. “I’m sure that the doctor was rushed and unaware of your needs.”

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.

PTS: 1 DIF: Cognitive Level: Analysis REF: 10 OBJ: 10 TOP: Nurse–Patient Relationship KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity

14. The nurse is explaining differences in a therapeutic relationship and a social relationship to a

patient. Which information about therapeutic relationships is most important for the nurse to

include in the explanation?

a. Therapeutic relationships lack formal boundaries.

b. Therapeutic relationships are goal directed.

c. Therapeutic relationships meet the needs of each person in the relationship.

d. Therapeutic relationships extend past the hospitalization period.

ANS: B

The therapeutic relationship is focused on the patient and is goal directed and designed to meet

only the needs of the patient and does not extend past the period of hospitalization.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 9 OBJ: 10 TOP: Therapeutic Relationship KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity

15. The long-term care facility nurse is caring for a newly admitted 80-year-old patient who is

depressed. Which approach is best for the nurse to employ?

a. Encourage the resident to engage in an activity.

b. Remind the resident of reasons to be positive.

c. Point out episodes of negative behavior.

d. Present a bright and cheerful behavior.

ANS: A

Activity and social interaction are helpful to depressed patients. Presenting a cheery approach

and pointing out negative behavior and reasons to be positive are not therapeutic at this stage

of the relationship.

A matter-of-fact response to a manipulative request limits the effect of the manipulation,

thereby helping the nurse to avoid becoming defensive or being swayed by flattery.

PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 10 TOP: Manipulative Behavior KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity

19. A female patient who has recently been diagnosed with an inoperable brain tumor asks the

nurse, “Do you think God punishes us?” Which response demonstrates therapeutic

communication?

a. “What do you think?”

b. “God loves you.”

c. “Would like to speak with the chaplain?”

d. “God will not give you more than you can bear.”

ANS: A

Sitting with the patient and offering oneself to listen to the patient’s concerns and encouraging

reflection is the best approach rather than responding with a cliché or suggesting speaking with

the chaplain.

PTS: 1 DIF: Cognitive Level: Application REF: 10 OBJ: 10 TOP: Spiritual Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity

20. The nurse is communicating with a patient who voices concern about an upcoming high-risk

procedure. Which statement best demonstrates empathy?

a. “Would you like to talk about your feelings regarding the procedure?”

b. “My mother had the same procedure and did very well.”

c. “I can’t imagine how you feel.”

d. “It must be difficult preparing for the procedure; how are you feeling?”

ANS: D

This statement by the nurse displays empathy by trying to place oneself in the patient’s

circumstance and validating the patient’s feelings. Simply asking patients if they would like to

talk about their feelings does not show empathy and may elicit a “yes” or “no” response.

Telling the patient one’s mother had the procedure or stating “I can’t imagine how you feel”

does not show empathy toward the patient.

PTS: 1 DIF: Cognitive Level: Application REF: 10 OBJ: 10 TOP: Nurse–Patient Relationship KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity MULTIPLE RESPONSE

21. Which of the following are sources of clear guidelines for upholding clinical standards for safe

and competent care? ( Select all that apply. )

a. The state’s nurse practice act (NPA)

b. The State Board of Nurse Examiners (BNE)

c. The National Association for Practical Nurse Education and Service (NAPNES)

d. Institutional policies

e. The National Federation of Licensed Practical Nurses, Inc. (NFLPN)

ANS: C, E

NAPNES and the NFLPN give clear guidelines for clinical standards that can be used as a

basis for court decisions. The NPA has broad guidelines, and institutional policies may not be

complete. The BNE enforces the NPA.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 5 OBJ: 3 TOP: Upholding Clinical Standards KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

22. Which statement(s) accurately describes the role of the LPN/LVN regardless of employment

placement? ( Select all that apply. )

a. Uphold clinical standards

b. Educate patients

c. Communicate effectively

d. Collaborate with the health care team

e. Initiate a care plan immediately after admission

ANS: A, B, C, D

The LPN/LVN has the accountability to uphold clinical standards, educate patients,

communicate effectively, and collaborate with the health care team. Depending on the type of

facility, initiation of a care plan is often the role of the registered nurse.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 OBJ: 3 TOP: Roles of LPN/LVNs KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

23. The newly licensed LPN/LVN demonstrates an understanding of employment opportunities

when applying to a position in which area(s)? ( Select all that apply. )

a. An outpatient clinic

b. A home health care agency

c. An intravenous (IV) therapy team

d. A long-term care facility

e. An ambulatory care unit

ANS: A, B, D, E

With the exception of an IV therapy team, which requires postgraduate education and/or

certification, the other options are open to newly graduated vocational nurses.

PTS: 1 DIF: Cognitive Level: Application REF: 2 OBJ: 2 TOP: Employment Opportunities for LPN/LVNs KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

PTS: 1 DIF: Cognitive Level: Comprehension REF: 7 OBJ: 9 TOP: Health Care Financing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

27. The nurse explains that the term _____________ refers to the severity of illness.

ANS:

acuity

Acuity is the term referring to the severity of illness or condition of a patient.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 4 OBJ: 6 TOP: Acuity KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care