TEST BANK for Medical-Surgical Nursing: Concepts
for Clinical Judgment and Collaborative Care
11th Edition by Donna D. Ignatavicius,
All 65 chapters Available
C
o
ntents
,1. Overview of Professional Nursing Concepts for Medical-Surgical Nursing
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2. Clinical Judgment and Systems Thinking
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3. Overview of Health Concepts for Medical-Surgical Nursing
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4. Concepts of Care for Older Adults
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5. Concepts of Care for Transgender and Non-Binary Patients
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6. Assessment and Concepts of Care for Patients with Pain
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7. Concepts of Rehabilitation for Chronic and Disabling Health Conditions
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8. Concepts of Care for Patients at End-of-Life
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9. Concepts of Care for Perioperative Patients
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10. Concepts of Emergency and Trauma Nursing
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11. Concepts of Care for Patients with Common Environmental Emergencies
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12. Concepts of Disaster Preparedness
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13. Concepts of Fluid and Electrolyte Balance and Imbalance
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14. Concepts of Acid-Base Balance and Imbalance
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15. Concepts of Infusion Therapy
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16. Concepts of Inflammation and Immunity
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17. Concepts of Care for Patients with Allergy and Immunity Conditions
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18. Concepts of Care for Patients with Cancer
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19. Concepts of Care for Patients with Infection
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20. Assessment of the Skin, Hair, and Nails
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21. Concepts of Care for Patients with Conditions of the Skin, Hair, and Nails
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22. Assessment of the Respiratory System
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23. Concepts of Care for Patients with Noninfectious Upper Respiratory Conditions
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24. Concepts of Care for Patients with Noninfectious Lower Respiratory Conditions
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25. Concepts of Care for Patients with Infectious Respiratory Conditions
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26. Critical Care of Patients with Respiratory Emergencies
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27. Assessment of the Cardiovascular System
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28. Concepts of Care for Patients with Dysrhythmias
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29. Concepts of Care for Patients with Cardiac Conditions
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30. Concepts of Care for Patients with Vascular Conditions
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31. Critical Care of Patients with Shock
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32. Critical Care of Patients with Acute Coronary Syndromes
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33. Assessment of the Hematologic System
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34. Concepts of Care for Patients with Hematologic Conditions
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35. Assessment of the Nervous System
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36. Concepts of Care for Patients with Conditions of the Central Nervous System: The Brain
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37. Concepts of Care for Patients with Conditions of the Central Nervous System: The Spinal C
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ord
38. Critical Care of Patients with Neurologic Emergencies
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39. Assessment and Concepts of Care for Patients with Eye and Vision Conditions
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40. Assessment and Concepts of Care for Patients with Ear and Hearing Conditions
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41. Assessment of the Musculoskeletal System
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42. Concepts of Care for Patients with Musculoskeletal Conditions
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43. Concepts of Care for Patients with Arthritis and Total Joint Arthroplasty
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44. Concepts of Care for Patients with Musculoskeletal Trauma
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45. Assessment of the Gastrointestinal System
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46. Concepts of Care for Patients with Oral Cavity and Esophageal Conditions
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47. Concepts of Care for Patients with Stomach Conditions
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48. Concepts of Care for Patients with Noninflammatory Intestinal Conditions
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49. Concepts of Care for Patients with Inflammatory Intestinal Conditions
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50. Concepts of Care for Patients with Liver Conditions
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,51. Concepts of Care for Patients with Conditions of the Biliary System and Pancreas
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52. Concepts of Care for Patients with Malnutrition: Undernutrition and Obesity
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53. Assessment of the Endocrine System
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54. Concepts of Care for Patients with Pituitary and Adrenal Gland Conditions
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55. Concepts of Care for Patients with Conditions of the Thyroid and Parathyroid Glands
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56. Concepts of Care for Patients with Diabetes Mellitus
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57. Assessment of the Renal/Urinary System
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58. Concepts of Care for Patients with Urinary Conditions
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59. Concepts of Care for Patients with Kidney Conditions
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60. Concepts of Care for Patients with Acute Kidney Injury and Chronic Kidney Disease
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61. Assessment of the Reproductive System
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62. Concepts of Care for Patients with Breast Conditions
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63. Concepts of Care for Patients with Gynecologic Conditions
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64. Concepts of Care for Patients with Male Reproductive Conditions
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65. Concepts of Care for Patients with Sexually Transmitted Infections
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,Chapter 01: Overview of Professional Nursing Concepts for Medical-
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Surgical Nursing Ignatavicius: Medical-Surgical Nursing, 11th Edition
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MULTIPLE CHOICE JI
1. A new nurse is working with a preceptor on a medical-
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surgical unit. The preceptor advises the new nurse that which is the priority when working as a p
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rofessional nurse? JI
a. Attending to holistic client needs JI JI JI JI
b. Ensuring client safety JI JI
c. Not making medication errors JI JI JI
d. Providing client-focused care JI JI
CORRECT ANSWER: B JI J I
All actions are appropriate for the professional nurse. However, ensuring client safety is the priori
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ty. Health care errors have been widely reported for 25 years, many of which result in client injur
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y, death, and increased health care costs. There are several national and international organizati
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ons that have either recommended or mandated safety initiatives.
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Every nurse has the responsibility to guard the client’s safety. The other actions are important fo
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r quality nursing, but they are not as vital as providing safety. Not making medication errors does
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Iprovide safety, but is too narrow in scope to be the best answer.
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DIF: Understanding
TOP: Integrated Process: Nursing Process: Intervention KEY: Client safety
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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2. A nurse is orienting a new client and family to the medical-
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surgical unit. What information does the nurse provide to best help the client promote his or
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her own safety? JI JI
a. Encourage the client and family to be active partners. JI JI JI JI JI JI JI JI
b. Have the client monitor hand hygiene in caregivers. JI JI JI JI JI JI JI
c. Offer the family the opportunity to stay with the client. JI JI JI JI JI JI JI JI JI
d. Tell the client to always wear his or her armband. JI JI JI JI JI JI JI JI JI
CORRECT ANSWER: A JI J I
Each action could be important for the client or family to perform. However, encouraging the clie
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nt to be active in his or her health care as a safety partner is the most critical. The other actions are
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very limited in scope and do not provide the broad protection that being active and involved does.
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, DIF: Understanding
TOP: Integrated Process: Teaching/Learning KEY: Client safety
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure was
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I142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nurse take fi
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rst?
a. Call the Rapid Response Team.
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b. Document and continue to monitor. JI JI JI JI
c. Notify the primary health care provider.
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d. Repeat the blood pressure in 15 minutes.
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, CORRECT ANSWER: A JI J I
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating be
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fore they suffer either respiratory or cardiac arrest. Since the client has manifested a significant c
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hange, the nurse would call the RRT. Changes in blood pressure, mental status, heart rate, tempe
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rature, oxygen saturation, and last 2 hours’ urine output are particularly significant and are part
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of the Modified Early Warning System guide. Documentation is vital, but the nurse must do mor
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e than document. The primary health care provider would be notified, but this is not more import
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ant than calling the RRT. The client’s blood pressure would be reassessed frequently, but the pri
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ority is getting the rapid care to the client.
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DIF: Applying
TOP: Integrated Process: Communication and Documentation KEY: Rapid R
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esponse Team (RRT), Clinical judgment JI JI JI JI
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
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4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
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best demonstrates this concept?
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a. Assesses for cultural influences affecting health care. JI JI JI JI JI JI
b. Ensures that all the client’s basic needs are met. JI JI JI JI JI JI JI JI
c. Tells the client and family about all upcoming tests. JI JI JI JI JI JI JI JI
d. Thoroughly orients the client and family to the room. JI JI JI JI JI JI JI JI
CORRECT ANSWER: A JI J I
Showing respect for the client and family’s preferences and needs is essential to ensure a holistic o
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r “whole-
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person” approach to care. By assessing the effect of the client’s culture on health care, this nurse is
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practicing client- JI
focused care. Providing for basic needs does not demonstrate this competence. Simply telling the
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Iclient about all upcoming tests is not providing empowering education. Orienting the client and f
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amily to the room is an important safety measure, but not directly related to demonstrating client
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-centered care. JI
DIF: Understanding
TOP: Integrated Process: Culture and Spirituality KEY: Client-centered care, Culture
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MSC: Client Needs Category: Psychosocial Integrity J I JI JI JI JI
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the nur
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se explain is the most important thing the client can do to protect against errors?
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a. Bring a list of all medications and what they are for. JI JI JI JI JI JI JI JI JI JI
b. Keep the provider’s phone number by the telephone. JI JI JI JI JI JI JI
c. Make sure that all providers wash hands before entering the room. JI JI JI JI JI JI JI JI JI JI
d. Write down the name of each caregiver who comes in the room. JI JI JI JI JI JI JI JI JI JI JI
,CORRECT ANSWER: A JI J I
Medication reconciliation is a formal process in which the client’s actual current medications are
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compared to the prescribed medications at the time of admission, transfer, or discharge. This Na
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tional client Safety Goal is important to reduce medication errors. The client would not have to b
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e responsible for providers washing their hands, and even if the client does so, this is too narrow t
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o be the most important action to prevent errors. Keeping the provider’s phone number nearby a
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nd documenting everyone who enters the room also do not guarantee safety.
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DIF: Applying
TOP: Integrated Process:Teaching/Learning KEY: Client s
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afety, Informatics
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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,6. Which action by the nurse working with a client best demonstrates respect for autonomy?
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a. Asks if the client has questions before signing a consent. JI JI JI JI JI JI JI JI JI
b. Gives the client accurate information when questioned. JI JI JI JI JI JI
c. Keeps the promises made to the client and family. JI JI JI JI JI JI JI JI
d. Treats the client fairly compared to other clients. JI JI JI JI JI JI JI
CORRECT ANSWER: A JI J I
Autonomy is self- JI JI
determination. The client would make decisions regarding care. When the nurse obtains a signat JI JI JI JI JI JI JI JI JI JI JI JI JI
ure on the consent form, assessing if the client still has questions is vital, because without full infor
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mation the client cannot practice autonomy. Giving accurate information is practicing with vera
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city. Keeping promises is upholding fidelity. Treating the client fairly is providing social justice.
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DIF: Applying TOP: Integrated Process: Caring J I JI JI
KEY: Ethics,Autonomy MSC: Client Needs Category: Safe and Effective Care Envir
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onment: Management of Care JI JI JI
7. A nurse asks a more seasoned colleague to explain best practices when communicating with a per
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son from the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) community.
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What answer by the faculty is most accurate?
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a. Avoid embarrassing the client by asking questions. JI JI JI JI JI JI
b. Don’t make assumptions about his or her health needs. JI JI JI JI JI JI JI JI
c. Most LGBTQ people do not want to share information. JI JI JI JI JI JI JI JI
d. No differences exist in communicating with this population.
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CORRECT ANSWER: B JI J I
Many members of the LGBTQ community have faced discrimination from health care providers
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and may be reluctant to seek health care. The nurse would never make assumptions about the nee
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ds of members of this population. Rather, respectful questions are appropriate. If approached with
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JIsensitivity, the client with any health care need is more likely to answer honestly. JI JI JI JI JI JI JI JI JI JI JI JI JI
DIF: Understanding TOP: Integrated Process: Teaching/Learning J I JI JI
KEY: Health care disparities, LGBTQ
J I JI JI JI MSC: Client Needs Category: Psychosocial Integrity
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8. A nurse is calling the on-
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call health care provider about a client who had a hysterectomy 2 days ago and has pain that is
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unrelieved by the prescribed opioid pain medication. Which statement comprises the backgr JI JI JI JI JI JI JI JI JI JI JI
ound portion of the SBAR format for communication?
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a. “I would like you to order a different pain medication.”
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b. “This client has allergies to morphine and codeine.” JI JI JI JI JI JI JI
c. “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
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d. “This client had a vaginal hysterectomy 2 days ago.” JI JI JI JI JI JI JI JI
,CORRECT ANSWER: B
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, SBAR is a recommended form of communication, and the acronym stands for Situation, Backgrou
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nd, Assessment, and Recommendation. Appropriate background information includes allergies to
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medications the on- JI JI
call health care provider might order. Situation describes what is happening right now that must
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be communicated; the client’s surgery 2 days ago would be considered background. Assessment w
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ould include an analysis of the client’s problem; none of the options has assessment information.
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Asking for a different pain medication is a recommendation. Recommendation is a statement of wh
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at is needed or what outcome is desired.
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DIF: Applying
TOP: Integrated Process: Communication and Documentation KEY: Teamwo
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rk and collaboration, SBAR
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MSC: Client Needs Category: Safe and Effective Care Environment: Management of Care
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9. A nurse working on a cardiac unit delegated taking vital signs to an experienced assistive person
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nel (AP). Four hours later, the nurse notes that the client’s blood pressure taken by the AP was m
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uch higher than previous readings, and the client’s mental status has changed. What action by th
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e nurse would most likely have prevented this negative outcome?
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a. Determining if the AP knew how to take blood pressure JI JI JI JI JI JI JI JI JI
b. Double-checking the AP by taking another blood pressure JI JI JI JI JI JI JI
c. Providing more appropriate supervision of the AP JI JI JI JI JI JI
d. Taking the blood pressure instead of delegating the task JI JI JI JI JI JI JI JI
CORRECT ANSWER: C JI J I
Supervision is one of the five rights of delegation and includes directing, evaluating, and followi JI JI JI JI JI JI JI JI JI JI JI JI JI JI
ng up on delegated tasks. The nurse would either have asked the AP about the vital signs or instr
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ucted the AP to report them right away. An experienced AP would know how to take vital signs a
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nd the nurse would not have to assess this at this point. Double-
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checking the work defeats the purpose of delegation. Vital signs are within the scope of practice f
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or a AP and are permissible to delegate. The only appropriate answer is that the nurse did not pro
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vide adequate instruction to the AP. JI JI JI JI JI
DIF: Analyzing
TOP: Integrated Process: Communication and Documentation KEY: Teamwo
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rk and collaboration, Delegation
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MSC: Client Needs Category: Safe and Effective Care Environment: Management of Care
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10. A newly graduated nurse in the hospital states that because of being so new, participation in qual
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ity improvement (QI) projects is not wise. What response by the precepting nurse is best?
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a. “All staff nurses are required to participate in quality improvement here.”
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b. “Even being new, you can implement activities designed to improve care.” JI JI JI JI JI JI JI JI JI JI
c. “It’s easy to identify what indicators would be used to measure quality.”
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