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TEST BANK FOR LEWIS MEDICAL-SURGICAL
NURSING IN CANADA 5TH EDITION

,CHAPTER 01: Introduction to Medical Surgical Nursing Practice in
Canada Lewis: Medical-Surgical Nursing in Canada, 5th Canadian
Edition

MULTIPLE CHOICE :

1. The professional nurse is caring for a patient with a new diagnosis of
pneumonia and explains to the patient that together they will plan the
patient’s care and set goals for discharge. The patient asks, “How is that
different from what the doctor does?” Which response by the
professional nurse is most appropriate?

a. “The role of the professional nurse is to administer medications and other
treatments prescribed
by your doctor.”
b. “The professional nurse’s job is to help the doctor by collecting data and
communicating when there are problems.”
c. “Professional nurses perform many of the procedures done by physicians, but
professional nurses are here in
the health center for a longer time than doctors.”
d. “In addition to caring for you while you are sick, the professional nurses will assist
you to
develop an individualized plan to maintain your health.”
CORRECT CHOICE:- D
This response is consistent with the Canadian nurses Association (CNA) definition of nursing.
Registered professional nurses are self-regulated health care professionals who work autonomously and
in collaboration with others. RNs enable individuals, families, groups, communities and populations to
achieve their optimal level of health. RNs coordinate health care, deliver direct services, and support
patients in their self-care decisions and actions in situations of health, illness, injury, and disability in all
stages of life. The other responses describe some of the dependent and collaborative functions of the
nursing role but do not accurately describe the professional nurse’s role in the health care system.

DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment

2. When caring for patients using evidence-informed practice, which of the following does the professional
nurse use?
a. Clinical judgement based on experience
b. Evidence from a clinical research study
c. The best available evidence to guide clinical expertise
d. Evaluation of data showing that the patient outcomes are
met
CORRECT CHOICE:- C
Evidence-informed nursing practice is a continuous interactive process involving the explicit,
conscientious, and judicious consideration of the best available evidence to provide care. Four primary
elements are: (a) clinical state, setting, and circumstances; (b) patient preferences and actions; (c) best
research evidence, and (d) health care resources. Clinical judgement based on the professional nurse’s
clinical experience is part of EIP, but clinical decision making also should incorporate current
research and research-based guidelines. Evidence from one clinical research study does not provide an
adequate substantiation for interventions. Evaluation of patient outcomes is important, but
interventions should be based on research from randomized control studies with a large number of
subjects.

, DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Planning MSC: NCLEX: Safe and Effective Care Environment

3. Which of the following best explains the professional nurses’ primary use of the nursing process
when providing care to patients?
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat patients’ health care needs
c. As a scientific-based process of diagnosing the patient’s health care problems
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
CORRECT CHOICE:- B
The nursing process is an assertive problem-solving approach to the identification and treatment of
patients’ problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing
process is in patient care, not to establish nursing theory or explain nursing interventions to other health
care professionals.

DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment

4. The professional nurse is caring for a critically ill patient in the intensive care unit and plans an every-
2-hour turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated
with this turning schedule?
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
CORRECT CHOICE:- D
When implementing collaborative nursing actions, the professional nurse is responsible primarily for
monitoring for complications of acute illness or providing care to prevent or treat complications.
Independent nursing actions are focused on health promotion, illness prevention, and patient
advocacy. A dependent action would require a physician order to implement. Cooperative nursing
functions are not described as one of the formal nursing functions.

DIF: Cognitive Level: Application TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment

5. The professional nurse is caring for a patient who has been admitted to the health center for surgery
and tells the professional nurse, “I do not feel right about leaving my children with my neighbour.”
Which action should the professional nurse take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing well.
c. Call the neighbour to determine whether adequate childcare is being provided.
d. Gather more data about the patient’s feelings about the childcare arrangements.
CORRECT CHOICE:- D
Since a complete assessment is necessary in order to identify a problem and choose an appropriate
intervention, the professional nurse’s first action should be to obtain more information. The other actions
may be appropriate, but more assessment is needed before the best intervention can be chosen.

, DIF: Cognitive Level: Application TOPIC: Nursing Process:
Assessment MSC: NCLEX: Psychosocial Integrity

6. The professional nurse is caring for a patient who has left-sided paralysis as the result of a stroke
and assesses a pressure injury on the patient’s left hip. Which of the following is the most
appropriate nursing diagnosis for this patient?
a. Impaired physical mobility related to decrease in muscle control (left-sided
paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
protecting tissue integrity
c. Impaired skin integrity related to pressure over bony prominence (impaired
circulation)
d. Ineffective peripheral tissue perfusion related to sedentary lifestyle
CORRECT CHOICE:- C
The patient’s major problem is the impaired skin integrity as demonstrated by the presence of a
pressure injury. The professional nurse is able to treat the cause of impaired circulation and pressure
over bony prominence by frequently repositioning the patient. Although left-sided weakness is a
problem for the patient, the professional nurse cannot treat the weakness. The “risk for” diagnosis is
not appropriate for this patient, who already has impaired tissue integrity. The patient does have
ineffective peripheral tissue perfusion, but the impaired skin integrity diagnosis indicates more clearly
what the health problem is.

DIF: Cognitive Level: Application TOPIC: Nursing Process:
Diagnosis MSC: NCLEX: Physiological Integrity

7. The professional nurse caring for a patient with an infection has a nursing diagnosis of deficient fluid
volume related to excessive fluid loss through normal route (diaphoresis). Which of the following is
an appropriate patient outcome?
a. Patient has a balanced intake and output.
b. Patient’s bedding is changed when it becomes damp.
c. Patient understands the need for increased fluid intake.
d. Patient’s skin remains cool and dry throughout hospitalization.
CORRECT CHOICE:- A
This statement gives measurable data showing resolution of the problem of deficient fluid volume that
was identified in the nursing diagnosis statement. The other statements would not indicate that the
problem of deficient fluid volume was resolved.

DIF: Cognitive Level: Application TOPIC: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity

8. Which of the following represents a nursing activity that is carried out during the evaluation phase of
the nursing process?
a. Determining if interventions have been effective in meeting patient outcomes.
b. Documenting the nursing care plan in the progress notes in the medical record.
c. Deciding whether the patient’s health problems have been completely resolved.
d. Asking the patient to evaluate whether the nursing care provided was
satisfactory.
CORRECT CHOICE:- A

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