TEST BANK FOR LEWIS\'S MEDICAL-
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SURGICALNURSING, 12TH EDITION BY MARIAN
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N M. HARDING, JEFFREY KWONG, DEBRA HAGLE
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R CHAPTER 1-
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69 QUESTIONS AND CORRECT ANSWERS
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Chapterl01:lProfessionallNursing
Harding:l Lewis’sl Medical-Surgicall Nursing,l 12thl Edition
MULTIPLElCHOICE
1. Thelnurselcompleteslanladmissionldatabaselandlexplainslthatlthelplanloflcarelandldischargelgoal
slwilllbeldevelopedlwithlthelpatient‗slinput.lThelpatientlasks,l―Howlislthisldifferentlfromlwhatlthe
lphysicianldoes?‖lWhichlresponselwouldlthe lnurselprovide?
a. ―Thelroleloflthelnurselisltoladministerlmedicationslandlotherltreatmentslprescribedlbyl
yourlphysician.‖
b. ―Inladditionltolcaringlforlyoulwhilelyoularelsick,lthelnurseslwilllhelplyoulplanltolmai
ntainlyourlhealth.‖
c. ―Thelnurse‗sljoblisltolcollectlinformationlandlcommunicatelanylproblemslthatloc
curltolthelphysician.‖
d. ―Nurseslperformlmanyloflthelsamelprocedureslaslthelphysician,lbutlnurseslarelwit
hlthelpatientslforlallongerltimelthanlthelphysician.‖
ANS:l B
ThelAmericanlNurseslAssociationl(ANA)ldefinitionloflnursingldescribeslthelroleloflnurseslinlpro
motinglhealth.lThelotherlresponsesldescribeldependentlandlcollaborativelfunctionsloflthelnursin
glrolelbutldolnotlaccuratelyldescribelthelnurse‗sluniquelrolelinlthelhealthlcarelsystem.
DIF:l CognitivelLevel:lAnalyzel(Analysis)
TOP:l NursinglProcess:lImplementationl l MSC:l NCLEX:lSafelandlEffectivelCarelEnvironment
2. Whichlstatementlbylthelnurselaccuratelyldescribesltheluseloflevidence-basedlpracticel(EBP)?
a. ―Patientlcarelislbasedlonlclinicalljudgment,lexperience,landltraditions.‖
b. ―Datalarelanalyzedllaterltolshowlthatlthelpatientloutcomeslarelconsistentlylmet.‖
c. ―Researchlfromlalllpublishedlarticleslarelusedlaslalguidelforlplanninglpatientlcare.‖
d. ―Recommendationslarelbasedlonlresearch,lclinicallexpertise,landlpatientlpr
eferences.‖
ANS:l D
Evidence-basedlpracticel(EBP)lisltheluseloflthelbestlresearch-
basedlevidencelcombinedlwithlclinicianlexpertiselandlconsiderationloflpatientlpreferences.lClin
icalljudgmentlbasedlonlthelnurse‗slclinicallexperiencelislpartloflEBP,lbutlclinicalldecisionlmaki
nglshouldlalsolincorporatelcurrentlresearchlandlresearch-
basedlguidelines.lEvaluationloflpatientloutcomeslislimportant,lbutldatalanalysislislnotlrequiredltol
uselEBP.lAlllpublishedlarticlesldolnotlprovidelresearchlevidence;linterventionslshouldlbelbasedlo
nlcrediblelresearch,lpreferablylrandomizedlcontrolledlstudieslwithlallargelnumberloflsubjects.
DIF: CognitivelLevel:lUnderstandl(Comprehension)
TOP:lNursinglProcess:lPlanninglMSC:l NCLEX:lSafelandlEffectivelCarelEnvironment
,3. Whichlstatementlbylthelnurselprovideslalclearlexplanationloflthelnursinglprocess?
a. ―Thelnursinglprocesslislalresearchlmethodlofldiagnosinglthelpatient‗slhealthlcarelpro
blems.‖
b. ―Thelnursinglprocesslislusedlprimarilyltolexplainlnursinglinterventionsltolotherlhe
althlcarelprofessionals.‖
c. ―Thelnursinglprocesslislalproblem-solvingltoollusedltolidentifylandlmanagelthe
, patients‗lhealthlcarelneeds.‖
d. ―Thelnursinglprocesslislbasedlonlnursingltheorylthatlincorporateslthelbi
opsychosociallnatureloflhumans.‖
ANS:l C
Thelnursinglprocesslislalproblem-
solvinglapproachltolthelidentificationlandltreatmentloflpatients‗lproblems.lNursinglprocessldoe
slnotlrequirelresearchlmethodslforldiagnosis.lThelprimaryluseloflthelnursinglprocesslislinlpatientl
care,lnotltolestablishlnursingltheorylorlexplainlnursinglinterventionsltolotherlhealthlcarelprofessi
onals.
DIF: CognitivelLevel:lUnderstandl(Comprehension)
TOP:lNursinglProcess:lEvaluationlMSC:l NCLEX:lSafelandlEffectivelCarelEnvironment
4. Alpatientladmittedl tol thelhospitall forlsurgeryltellsl thel nurse,l ―Ildol notl feell comfortablelleav
inglmylchildrenlwithlmylparents.‖lWhichlactionlwouldlthelnurseltakelnext?
a. Reassurelthelpatientlthatltheselfeelingslarelcommonlforlparents.
b. Havelthelpatientlcalllthelchildrenltolensurelthatltheylareldoinglwell.
c. Gatherl informationl onl thel patient‗sl concernsl aboutl thel childl carel arrangements.
d. Calllthelpatient‗slparentsltoldeterminelwhetherladequatelchildlcarelislbeinglpr
ovided.
ANS:l C
Becauselalcompletelassessmentlislnecessarylinlorderltolidentifylalproblemlandlchooselanlapprop
riatelintervention,lthelnurse‗slfirstlactionlshouldlbeltolobtainlmorelinformation.lThelotherlaction
slmaylbelappropriate,lbutlmorelassessmentlislneededlbeforelthelbestlinterventionlcanlbelchosen.
DIF: CognitivelLevel:lAnalyzel(Analysis)
TOP:l NursinglProcess:lAssessment MSC:l NCLEX:lPsychosociallIntegrity
5. Alpatientlwithlalbacteriallinfectionlislhypovolemicldueltolalfeverlandlexcessiveldiaphoresis.lWh
ichlexpectedloutcomelwouldlthelnurselselectlforlthislpatient?
a. Patientlhaslalbalancedlintakelandloutput.
b. Patient‗slbeddinglislkeptlcleanlandlfreeloflmoisture.
c. Patientlunderstandslthelneedlforlincreasedlfluidlintake.
d. Patient‗sl skinl remainsl cooll andl drylthroughoutl hospitalization.
ANS:l A
Balancedlintakelandloutputlgiveslmeasurableldatalshowinglresolutionloflthelproblemlofldeficientl
fluidlvolume.lThelotherlstatementslwouldlnotlindicatelthatlthelproblemloflhypovolemialwaslres
olved.
DIF: CognitivelLevel:lApplyl(Application)
TOP:lNursinglProcess:lPlanninglMSC:l NCLEX:lPhysiologicallIntegrity
6. Whichlstatementldescribeslthelpurposeloflthelevaluationlphaseloflthelnursinglprocess?
a. Toldocumentlthelnursinglcarelplanlinlthelprogresslnotesloflthelhealthlrecord
b. Toldetermineliflinterventionslhavelbeenleffectivelinlmeetinglpatientloutcomes
c. Toldecidelwhetherlthelpatient‗slhealthlproblemslhavelbeenlcompletelylresolved
d. Tolestablishliflthelpatientlagreeslthatlthelnursinglcarelprovidedlwaslsatisfactory
ANS:l B
, Evaluationlconsistslofldetermininglwhetherltheldesiredlpatientloutcomeslhavelbeenlmetlandlwh
etherlthelnursinglinterventionslwerelappropriate.lThelotherlresponsesldolnotldescribelthelevalua
tionlphase.
DIF:l CognitivelLevel:lUnderstandl(Comprehension)
TOP:lNursinglProcess:lEvaluationl
MSC:l NCLEX:lSafelandlEffectivelCarelEnvironment
7. Whichlstatementldescribeslthelpurposeloflthelassessmentlphaseloflthelnursinglprocess?
a. Tolteachlinterventionslthatlrelievelhealthlproblems
b. Toluselpatientldataltolevaluatelpatientlcareloutcomes
c. Tolobtainldataltoldiagnoselpatientlstrengthslandlproblems
d. Tolhelplthelpatientlidentifylrealisticloutcomeslforlhealthlproblems
ANS:l C
Duringlthelassessmentlphase,lthelnurselgatherslinformationlaboutlthelpatientltoldiagnoselpatientls
trengthslandlproblems.lThelotherlresponseslarelexamplesloflthelplanning,lintervention,landleval
uationlphasesloflthelnursinglprocess.
DIF: CognitivelLevel:lUnderstandl(Comprehension)
TOP:l NursinglProcess:lAssessment MSC:l NCLEX:lSafelandlEffectivelCarelEnvironment
8. Whenldevelopinglthelplanloflcare,lwhichlcomponentslwouldlthelnurselincludelinlthelclinicallpro
blemlstatement?
a. Thelproblemlandlthelsuggestedlpatientlgoalslorloutcomes
b. Thelproblem,litslcauses,landlthelsignslandlsymptomsloflthelproblem
c. Thelproblemlwithlthelpossibleletiologylandlthelplannedlinterventions
d. Thelproblem,litslpathophysiology,landlthelexpectedloutcome
ANS:l B
Whenlwritinglclinicallproblemslorlnursingldiagnoses,lthelsubjectivelaslwelllaslobjectiveldataltols
upportlthelproblem‗slexistencelshouldlbelincluded.lGoals,loutcomes,landlinterventionslarelnotlinc
ludedlinlthelproblemlstatement.
DIF: CognitivelLevel:lUnderstandl(Comprehension)
TOP:lNursinglProcess:lDiagnosislMSC:l NCLEX:lSafelandlEffectivelCarelEnvironment
9. Whichlpatientlcareltasklwouldlthelnurseldelegateltolexperiencedlassistivelpersonnell(AP)?
a. Instructlthelpatientlaboutlthelneedltolalternatelactivitylandlrest.
b. Monitorllevelloflshortnessloflbreathlorlfatiguelafterlambulation.
c. Obtainlthelpatient‗slbloodlpressurelandlpulselratelafterlambulation.
d. Determinelwhetherlthelpatientlislreadyltolincreaselthelactivityllevel.
ANS:l C
APleducationlincludeslaccuratelvitallsignlmeasurement.lAssessmentlandlpatientlteachinglrequirel
registeredlnurseleducationlandlscopeloflpracticelandlcannotlbeldelegated.
DIF: CognitivelLevel:lApplyl(Application)
TOP:lNursinglProcess:lPlanninglMSC:l NCLEX:lSafelandlEffectivelCarelEnvironment