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Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
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Medical Surgical Nursing 10th Edition IgnataviciusWorkman Test Bank
Chapter 01: Overview of Professional Nursing
Concepts for Medical-Surgical Nursing Ignatavicius:
Medical-Surgical Nursing, 10th Edition
MULTIPLE
CHOICE
1. A new nurse is working with a preceptor on a
medical-surgical unit. The preceptor advises the new
nurse that which is the priority when working as a
professional nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
ANS: B
All actions are appropriate for the professional nurse.
However, ensuring client safety is the priority. Health
care errors have been widely reported for 25 years,
many of which result in client injury, death, and
increased health care costs. There are several national
and international organizations that have either
recommended or mandated safety initiatives.
Every nurse has the responsibility to guard the client’s
safety. The other actions are important
for quality nursing, but they are not as vital as
providing safety. Not making medication errors does
provide safety, but is too narrow in scope to be the best
answer.
DIF: Understanding TOP: Integrated Process:
Nursing Process: Intervention KEY: Client safety
MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
,2. A nurse is orienting a new client and family to the
medical-surgical unit. What information does the
nurse provide to best help the client promote his or
her own safety?
a. Encourage the client and family to be active partners.
b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the
client.
d. Tell the client to always wear his or her armband.
ANS: A
Each action could be important for the client or family
to perform. However, encouraging the client to be
active in his or her health care as a safety partner is the
most critical. The other actions are very limited in
scope and do not provide the broad protection that
being active and involved does.
DIF: Understanding TOP: Integrated
Process: Teaching/Learning KEY: Client
safety
MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
3. A nurse is caring for a postoperative client on the
surgical unit. The client’s blood pressure was 142/76
mm Hg 30 minutes ago, and now is 88/50 mm Hg.
What action would the nurse take first?
a. Call the Rapid Response Team.
b. Document and continue to monitor.
c. Notify the primary health care provider.
d. Repeat the blood pressure in 15 minutes.
Btestbanks.com
, ANS: A
The purpose of the Rapid Response Team (RRT) is to
intervene when clients are deteriorating before they
suffer either respiratory or cardiac arrest. Since the
client has manifested a significant change, the nurse
would call the RRT. Changes in blood pressure,
mental status, heart rate, temperature, oxygen
saturation, and last 2 hours’ urine output are
particularly significant and are part of the Modified
Early Warning System guide. Documentation is vital,
but the nurse must do more than document. The
primary health care provider would be notified, but
this is not more important than calling the RRT. The
client’s blood pressure would be reassessed frequently,
but the priority is getting the rapid care to the client.
DIF: Applying TOP: Integrated
Process: Communication and Documentation
KEY: Rapid Response Team (RRT),
Clinical judgment
MSC: Client Needs Category: Physiological Integrity:
Physiological Adaptation
4. A nurse wishes to provide client-centered care in all
interactions. Which action by the nurse
best demonstrates this concept?
a. Assesses for cultural influences affecting health care.
b. Ensures that all the client’s basic needs are met.
c. Tells the client and family about all upcoming tests.
d. Thoroughly orients the client and family to the room.
ANS: A
Showing respect for the client and family’s
preferences and needs is essential to ensure a holistic
or “whole-person” approach to care. By assessing the
effect of the client’s culture on health care, this nurse
is practicing client-focused care. Providing for basic
needs does not demonstrate this competence. Simply
, telling the client about all upcoming tests is not
providing empowering education. Orienting the client
and family to the room is an important safety measure,
but not directly related to demonstrating client-
centered care.
DIF: Understanding TOP: Integrated Process:
Culture and Spirituality KEY: Client-centered care,
Culture MSC: Client Needs
Category: Psychosocial Integrity
5. A client is going to be admitted for a scheduled
surgical procedure. Which action does the nurse
explain is the most important thing the client can do
to protect against errors?
a. Bring a list of all medications and what they are for.
b. Keep the provider’s phone number by the telephone.
c. Make sure that all providers wash hands before
entering the room.
d. Write down the name of each caregiver who comes in
the room.
ANS: A
Medication reconciliation is a formal process in which
the client’s actual current medications are compared to
the prescribed medications at the time of admission,
transfer, or discharge. This National client Safety Goal
is important to reduce medication errors. The client
would not have to be responsible for providers
washing their hands, and even if the client does so,
this is too narrow to be the most important action to
prevent errors. Keeping the provider’s phone number
nearby and documenting everyone who enters the
room also do not guarantee safety.
DIF: Applying TOP:
Integrated Process:
Teaching/Learning KEY: Client
safety, Informatics
,MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
Btestbanks.com
,6. Which action by the nurse working with a client best
demonstrates respect for autonomy?
a. Asks if the client has questions before signing a
consent.
b. Gives the client accurate information when
questioned.
c. Keeps the promises made to the client and family.
d. Treats the client fairly compared to other clients.
ANS: A
Autonomy is self-determination. The client would make
decisions regarding care. When the nurse obtains a
signature on the consent form, assessing if the client
still has questions is vital, because without full
information the client cannot practice autonomy.
Giving accurate information is practicing with veracity.
Keeping promises is upholding fidelity. Treating the
client fairly is providing social justice.
DIF: Applying TOP:
Integrated Process: Caring KEY:
Ethics, Autonomy MSC: Client Needs Category:
Safe and Effective Care Environment:
Management of Care
7. A nurse asks a more seasoned colleague to explain
best practices when communicating with a person
from the lesbian, gay, bisexual, transgender, and
questioning/queer (LGBTQ) community. What
answer by the faculty is most accurate?
a. Avoid embarrassing the client by asking questions.
b. Don’t make assumptions about his or her health
needs.
c. Most LGBTQ people do not want to share
information.
d. No differences exist in communicating with this
population.
ANS: B
Many members of the LGBTQ community have faced
discrimination from health care providers and may be
, reluctant to seek health care. The nurse would never
make assumptions about the needs of members of this
population. Rather, respectful questions are
appropriate. If approached with sensitivity, the client
with any health care need is more likely to answer
honestly.
DIF: Understanding TOP: Integrated Process:
Teaching/Learning
KEY: Health care disparities, LGBTQ MSC: Client
Needs Category: Psychosocial Integrity
8. A nurse is calling the on-call health care provider
about a client who had a hysterectomy 2 days ago
and has pain that is unrelieved by the prescribed
opioid pain medication. Which statement comprises
the background portion of the SBAR format for
communication?
a. “I would like you to order a different pain
medication.”
b. “This client has allergies to morphine and codeine.”
c. “Dr. Smith doesn’t like nonsteroidal anti-
inflammatory meds.”
d. “This client had a vaginal hysterectomy 2 days ago.”
ANS: B
,Btestbanks.com
, SBAR is a recommended form of communication, and
the acronym stands for Situation, Background,
Assessment, and Recommendation. Appropriate
background information includes allergies to
medications the on-call health care provider might
order. Situation
describes what is happening right now that must be
communicated; the client’s surgery 2 days
ago would be considered background. Assessment
would include an analysis of the client’s
problem; none of the options has assessment
information. Asking for a different pain medication is
a recommendation. Recommendation is a statement of
what is needed or what outcome is desired.
DIF: Applying TOP: Integrated
Process: Communication and Documentation
KEY: Teamwork and collaboration, SBAR
MSC: Client Needs Category: Safe and Effective Care
Environment: Management of Care
9. A nurse working on a cardiac unit delegated taking
vital signs to an experienced assistive personnel (AP).
Four hours later, the nurse notes that the client’s
blood pressure taken by the AP was much higher than
previous readings, and the client’s mental status has
changed. What action by the nurse would most likely
have prevented this negative outcome?
a. Determining if the AP knew how to take blood
pressure
b. Double-checking the AP by taking another blood
pressure
c. Providing more appropriate supervision of the AP
d. Taking the blood pressure instead of delegating the
task
ANS: C
Supervision is one of the five rights of delegation and
includes directing, evaluating, and following up on
delegated tasks. The nurse would either have asked the
AP about the vital signs or instructed the AP to report
, them right away. An experienced AP would know how
to take vital signs and the nurse would not have to
assess this at this point. Double-checking the work
defeats the purpose of delegation. Vital signs are
within the scope of practice for a AP and are
permissible to delegate. The only appropriate answer
is that the nurse did not provide adequate instruction to
the AP.
DIF: Analyzing TOP: Integrated
Process: Communication and Documentation
KEY: Teamwork and collaboration,
Delegation
MSC: Client Needs Category: Safe and Effective Care
Environment: Management of Care
10. A newly graduated nurse in the hospital states that
because of being so new, participation in quality
improvement (QI) projects is not wise. What response
by the precepting nurse is best?
a. “All staff nurses are required to participate in quality
improvement here.”
b. “Even being new, you can implement activities
designed to improve care.”
c. “It’s easy to identify what indicators would be used
to measure quality.”
d. “You should ask to be assigned to the research and
quality committee.”
ANS: B
The preceptor would try to reassure the nurse that
implementing QI measures is not out of line for a
newly licensed nurse. Simply stating that all nurses are
required to participate does not help the nurse
understand how that is possible and is dismissive.
Identifying indicators of quality is not an easy, quick
process and would not be the best place to suggest a
new nurse to start. Asking to be assigned to the QI
committee does not give the nurse information about
how to implement QI in daily practice.
DIF: Applying TOP: Integrated Process:
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