Test Bank for Understanding Medical-Surgical Nursing 5TH Edition Paula D. Hopper, Linda S. Williams, MSN, RN

Test Bank for Understanding Medical-Surgical Nursing 5TH Edition Paula D. Hopper, Linda S. Williams, MSN, RN. The LPN is reviewing the nursing care plan for a patient with acute pain related to a fractured ankle. Which of the following would determine whether the care plan is effective? 1. Assessment of the patient‘s ability to walk 2. Evaluation of the patient‘s fracture on X-ray 3. Elevating the patient‘s foot on two pillows 4. Evaluation of the patient‘s pain rating on a 10-point scale. 7. A patient with a history of cardiac disease reports a feeling of tightness in the chest that radiates down the left arm. Which of the following actions by the LPN should be carried out immediately? 1. Check the patient‘s vital signs. 2. Formulate nursing diagnoses related to an acute myocardial infarction. 3. Determine the patient‘s outcome after nitroglycerin has been administered. 4. Plan interventions to reduce long-term cardiac damage. 8. The LPN is documenting patient data. Which of the following should the nurse document under objective data? 1. Denies nausea 2. Shortness of breath 3. Heart rate 72 beats per minute 4. Midsternal chest pain 9. A patient is admitted with chest pain, which has resolved. The patient states, ―I hope I can live a normal life.‖ According to Maslow‘s hierarchy of needs, which of the following levels is best reflected by this statement? 1. Physiological needs 2. Safety and security 3. Love and belonging 4. Self-esteem 10. A patient has a nursing diagnosis of impaired swallowing related to muscle weakness as evidenced by drooling, coughing, and choking. Which of the following outcomes is appropriate for this patient‘s nursing diagnosis? 1. Improved airway clearance within 8 hours as evidenced by clear lung sounds and productive cough 2. Baseline body weight maintained as evidenced by no weight loss 3. Improved muscle strength as evidenced by ability to sit up while eating 4. Improved swallowing within 48 hours as evidenced by no coughing or choking 11. The LPN is providing care for a patient with a medical diagnosis of congestive heart failure who is very short of breath. Which of the following is a nursing diagnosis that is correctly stated in the PES (problem, etiology, and signs and symptoms) format? 1. Deficient knowledge related to disease process and self-care for shortness of breath 2. Impaired gas exchange related to excess interstitial fluid as evidenced by respiratory rate of 32 per minute and patient stating he feels short of breath 3. Congestive heart failure related to decreased cardiac output as evidenced by abnormal arterial blood gasses 4. Acute dyspnea related to congestive heart failure as evidenced by swollen lower extremities and confusion. REVIEW QUESTIONS—TEST PREPARATION Test Bank for Understanding Medical-Surgical Nursing 5th Edition latest update 2022 Evidence-Based Practice 2 VOCABULARY Define the following terms. 1. Evidence-based practice 2. Randomized controlled trials 3. Research 4. Systematic review EVIDENCE-BASED PRACTICE 1. Evidence is the of effectiveness behind nursing practice. 2. It is important for the in which the evidence will be used to be considered. 3. Evidence-based practice (EBP) is a complex but important, necessary process to facilitate care and optimal patient outcomes. 4. Evidence-based practice is used by nurses to give the best possible. 9. Patient-centered care meets the needs and preferred schedules. 10. Evidence is the core that directs safe, quality-driven, excellent patient care. CRITICAL THINKING Read the following case study and answer the questions. Nurses on a surgical unit were interested in knowing if music would reduce the preoperative anxiety of patients on their unit. 1. How are these nurses contributing to quality care? 5. Level I is the evidence and is an analysis of many controlled trials. 6. Nurses will know from measured that they are giving the best care possible. 2. What should the nurses do to begin the process? 7. Evidence-based practice is considered the standard of health care. 8. The Quality and Safety Education for Nurses (QSEN) project focuses on education that promotes the continual improvement of quality and safety in patient care. 3. What are some examples of resources that can be used to find evidence? 5 Test Bank for Understanding Medical-Surgical Nursing 5th Edition latest update 2022 6 UNITONEUnderstanding Health Care Issues 4. The nurses found Level I research studies that showed music therapy could be beneficial in reducing anxiety. What step should the nurses take next? 5. The planned intervention was implemented, data were collected during the implementation, and now the pilot study has ended. What step should the nurses take next? Choose the best answer unless directed otherwise. 1. Which of the following is considered significant evidence to guide nursing care? 1. Research studies that are quasi-experimental 2. Cochrane Reviews 3. Nursing information from the Internet 4. The opinion of a nationally known nursing expert 2. A nurse would like to find other studies on wound care that might be relevant to how wound care is done. Which of the following would be the best for searching for nursing articles on wound care? 1. CINAHL 2. Medline 3. Cochrane Review 4. PubMed 3. A nurse on the safety committee is assigned to review the current National Patient Safety Goals. In which of these ways will the nurse find the goals? 1. Review Joanna Briggs Best Practices. 2. Review a fundamentals nursing textbook. 3. Go to . 4. Search Cochrane Reviews. 4. Which of the following best describes a randomized clinical trial (RCT)? 1. An observational study designed to collect subjective data 2. An experimental study in which multiple factors affecting the results are controlled 3. A specific design categorizing modifiable and nonmodifiable risk factors 4. Tracking of disease occurrence over a set period of time 5. Evidence-based practice most often begins with which of the following? 1. Asking how to solve a clinical problem 2. Initiating a literature search 3. Analyzing available evidence 4. Measuring baseline outcomes Choose the best answer unless directed otherwise. 6. The nurse is reviewing the patient‘s plan of care and ordered treatments. Which of the following is an independent nursing intervention? Select all that apply. 1. Giving Tylenol 650 milligrams orally every 4 hours as needed (prn) 2. Assisting patient to position of comfort 3. Giving hand massage daily 4. Initiating high-risk fall protocol 5. Placing call button within reach at all times 6. Teaching deep breathing and relaxation techniques as needed 7. A nurse on the research committee is assigned to review the best evidence on patient centered bathing. Which of the following kinds of evidence would the nurse select for Level I research? Select all that apply. 1. A Cochrane review 2. One RCT 3. Four quasi-experimental studies that show similar results 4. The opinion of a national nursing expert on the subject 5. A Joanna Briggs Best Practice Review REVIEW QUESTIONS—TEST PREPARATION REVIEW QUESTIONS—CONTENT REVIEW Test Bank for Understanding Medical-Surgical Nursing 5th Edition latest update 2022 8. The nurse will include which of the following in applying the process of evidence-based practice to patient centered care? Select all that apply. 1. Evaluate the change. 2. Determine current practice. 3. Ask a burning question. 4. Know how to conduct an RCT. 5. Search for the best available evidence. 6. Make it happen. 9. The nurse provides care for residents on an Alzheimer‘s unit and is working with family members of a 67-year-old patient who was recently admitted. Which of the following statements reveals the nurse‘s awareness of evidence-based reality orientation practice? 1. ―Patients on this unit are generally very sweet, so your loved one will quickly fit right in.‖ 2. ―Our dietician provides high-protein snacks twice daily to help prevent brain degeneration.‖ 3. ―You‘ll notice clocks, calendars, and the use of patient pictures in the hallways to help residents stay oriented.‖ 4. ―Alzheimer‘s is a devastating disease, so it is mandatory that family members participate in our weekly support groups.‖ Chapter 2 Evidence-Based Practice 7 10. A nurse investigating the effect of 12-hour shifts on medication errors identifies 962 articles published on the topic of 12-hour shifts in the past 5 years. Which action should the nurse take next? 1. Find out how many of the articles can be found at the institution. 2. Request all 962 articles and determine their validity. 3. Limit the request to articles published in the past 3 years. 4. Narrow the search to identify which articles discuss medication errors. Test Bank for Understanding Medical-Surgical Nursing 5th Edition latest update 2022 Issues in Nursing Practice VOCABULARY Match the term with the appropriate definition or statement. 1. Assault 2. Battery 3. Defamation 4. False imprisonment 5. Outrage 6. Invasion of privacy and wrongful disclosure of confidential information 1. Unlawful touching of another 2. Unlawful conduct that places another in the immediate fear of unlawful touching or battery; the real threat of bodily harm 3. Unlawful restriction of a person‘s freedom 4. Extreme and outrageous conduct by a defendant relating to the care of the patient or the body of a deceased individual 5. Wrongful injury to another‘s reputation or standing in a community; may be written (libel) or spoken (slander) 6. Liability when a patient‘s privacy is invaded physically or if records are released without authority NURSING PRACTICE AND ETHICAL AND LEGAL PRINCIPLES 1. The health–illness continuum represents the potential shifting between health and poor health throughout the span. 2. Nurses must be licensed to practice to the public and maintain the of health care services. 3. is a central virtue in nursing. 4. Nursing care uses the following principles: ensuring and respect, confidentiality, respecting the patient‘s right to make care choices, and maintaining a professional relationship with the patient. 5. Effective leaders are about the management process, , positive thinkers, and use to earn the of their coworkers. VALUES CLARIFICATION Complete the following sentences. 1. The one thing I have always wanted to do is . 2. If I inherited 5 million dollars, I would . 3. As president of the United States, I would . 4. If I died today, I would like my obituary to say . 5. If I could control the world and its destiny, I would . 8 3 Test Bank for Understanding Medical-Surgical Nursing 5th Edition latest update 2022 Complete this list of things people value with any other items you believe should be included, then rank the value you believe each item has, with 1 being the highest value. Rank Valued Item Rank Valued Item Family Professionalism Career Religion Honor Material possessions Health Recreation What have you learned about yourself by doing this exercise? What do the rankings signify? Can you identify yourself as more utilitarian or more deontological? (There are no answers to this section because this is an exercise requiring personal responses.) CRITICAL THINKING Read the following case study and answer the questions. Mrs. Reo, a 5 foot, 3 inch, 105-lb, 86-year-old retired cleaning lady, was admitted to a general medical-surgical unit in a small rural hospital. She was diagnosed 3 months ago with metastatic cancer that had spread from her liver to her lungs Chapter 3 Issues in Nursing Practice 9 perhaps sepsis. In her already weakened condition, an infection or sepsis would most likely be fatal. Betsy, who had been a licensed practical nurse for some 15 years, disagreed with the manager. Her feeling was that causing this obviously terminal patient so much pain by turning her was cruel and violated her dignity as a human being. She stated that she could not stand to hear Mrs. Reo yell anymore and refused to take care of her until some other decision was made about her nursing care. Sally, a new graduate nurse, felt that the patient should have some say in her own care and that perhaps some type of compromise could be reached about turning her, perhaps turning her less frequently or providing more pain relief medication. Monica, a registered nurse who had worked on the unit for 2 years, felt that the physician should make the decision about turning this patient, and then the nurses should follow the order. This last suggestion was met with strong negative comments by the other nurses present. They felt that patient comfort and turning were nursing measures. 1. What are the important ethical principles in this dilemma? 2. How does the Code of Ethics apply to this situation? and bone marrow. She received chemotherapy and radiation therapy for several weeks, but the treatment was not effective. She was admitted to the hospital because she became too weak to walk or care for herself at home. The cancer returned, and the large doses of oral narcotic medications taken at home were having little effect on her pain while increasing her confusion and weakness. Her oncologist decided that further chemotherapy or radiation therapy would not be effective, and she ordered Mrs. Reo to be kept comfortable with medications. A continuous morphine intravenous (IV) drip was started to help control the pain. Even with this medication, Mrs. Reo cried 3. What are the legal issues? 4. Are there ever any situations when a nurse might legally and ethically violate a standard of care? out in pain, particularly when morning care was given, and begged the nurses not to move her. Because she was severely underweight, the skin over her bony prominences quickly became reddened and showed the beginning signs of breakdown. The hospital standards of care for immobile patients 5. What are some other possible solutions to this dilemma? What types of consequences might they have? require that they be repositioned at least every 2 hours. Mrs. Reo yelled so loudly when she was turned that the nursing staff wondered if they were really helping her or hurting her. To help decide what should be done, the nurses who gave care to Mrs. Reo called a patient care conference. The manager of the unit stated clearly that the hospital standards of care required Mrs. Reo be repositioned at least every 2 hours to prevent skin breakdown, infections, and (There are no correct answers to this section because this is an ethical exercise that has many choices to be considered for the best outcome for the patient. Discuss your options with classmates.) Test Bank for Understanding Medical-Surgical Nursing 5th Edition latest update 2022 10 UNITONEUnderstanding Health Care Issues Choose the best answer unless directed otherwise. 1. The ethical principle that the primary goal of health care and nursing is to do good for others is called which of the following? 1. Autonomy 2. Fidelity 3. Beneficence 4. Veracity 2. The ethical principle of nonmaleficence is defined as which of the following? 1. Health care workers avoiding harm to patients 2. Telling the truth to patients in all matters 3. Being faithful to commitments made to patients 4. The right of self-determination of patients 3. Which of the following is the term used to describe an ethical situation that arises in which there is a choice between two equally unfavorable alternatives? 1. Tort 2. Ethical antagonism 3. Contraindication 4. Ethical dilemma 4. Which of the following is the first step in the ethical decision-making process? 1. Analyze the alternatives. 2. Identify the ethical dilemma. 3. Consider the consequences of the actions. 4. Make a decision. 5. Ethical dilemmas most often involve which of the following situations? 1. A conflict of basic human rights 2. Violations of the Nurses‘ Code of Ethics 3. Nurses who do not understand the ethical code 4. Patients who wish to die 6. When applying the ethical principle of autonomy to patient care, the nurse should understand that which of the following is applicable to autonomy? 1. Autonomy is an absolute principle that has no exceptions. 2. Only patients who are awake and oriented have the right to autonomy. 3. Under certain conditions, autonomy can be limited. 4. Autonomy is the same as the principle of nonmaleficence. 7. Which of the following punishments distinguishes criminal liability from civil liability? 1. Personal liability 2. Financial recovery 3. Loss of license 4. Potential loss of freedom 8. Which of the following is an unintentional tort? 1. Negligence 2. Outrage 3. Assault 4. Privacy invasion Choose the best answer unless directed otherwise. 9. A patient with emphysema is being seen by the home health nurse. The patient is on oxygen, lives alone, and is able to perform activities of daily living, prepare meals, and do light household tasks with rest periods. The patient is unable to perform yard work, which was a favorite hobby. Which of the following would describe the patient‘s location on the health–illness continuum? 1. Near death 2. High-level wellness 3. Poor health 4. Moderate-level wellness 10. A Nurses‘ Code of Ethics states, ―The nurse safeguards the patient‘s right to privacy by judiciously protecting information of a confidential nature.‖ This statement is based on which of the following principles? 1. The right to privacy is an inalienable right of all persons. 2. The nurse–patient relationship is based on trust. 3. A breach of confidentiality may expose the nurse to liability. 4. Nurses know what is best for patients‘ health care. We offer online tutoring and help with assignments for all majors. For assistance contact Tutor Alpha..