Test Bank Medical-Surgical Nursing: Concepts for
Interprofessional Collaborative Care, Single Volume 9th
Edition by Donna D
,Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
MULTIPLEi CHOICE
1. Ai nurseiwishesi toi providei client-
centeredi carei ini alli interactions.i Whichi actioni byi thei nursei bestidemonstratesithisiconcept?
a. Assessesi fori culturali influencesi affectingi healthi care
b. Ensuresithati alli theiclientsi basici needsi arei met
c. Tellsithei clienti andi familyi abouti alli upcomingi tests
d. Thoroughlyi orientsi thei clienti andifamilyi toi thei room
ANS:iA
Competencyi ini client-
focusedi carei isi demonstratedi wheni thei nursei focusesi oni communication,i culture,i respecticompassion,i clienti edu
cation,i andi empowerment.i Byi assessingi thei effecti ofi theiclientsi culturei oni healthi care,ithisi nursei isi practicingi cli
ent-
focusedicare.i Providingi fori basici needsi doesinoti demonstratei thisi competence.iSimplyitellingi thei clienti abouti alli
upcomingi testsi isi noti providingi empoweringi education.i Orientingi thei clientiandi familyi toi thei roomi isi ani importa
nti safetyi measure,i buti noti directlyi relatedi toi demonstratingi client-centeredicare.
DIF:i Understanding/Comprehensioni REF:i 3
KEY:i Patient-
centeredi care|i culturei MSC:i Integratedi Process:i CaringiNOT:iClientiN
eedsiCategory:iPsychosocialiIntegrity
2. Ai nursei isi caringi fori ai postoperativei clienti oni thei surgicali unit.i Thei clientsi bloodi pressurei wasi 142/76i mmi
Hgi30iminutesiago,iandinowiisi88/50immiHg.iWhatiactionibyitheinurseiisibest?
a. Calli theiRapidiResponseiTeam.
b. Documenti andi continuei toi monitor.
c. Notifyi thei primaryi carei provider.
d. Repeati bloodi pressurei measurementi ini 15i minutes.
ANS:iA
TheipurposeiofitheiRapidiResponseiTeami(RRT)iisitoiinterveneiwheniclientsiareideterioratingibeforeitheyisuffe
ri eitheri respiratoryi ori cardiaci arrest.i Sincei thei clienti hasi manifestedi ai significanti change,i thei nursei shouldicallithei
RRT.iChangesiinibloodipressure,imentalistatus,iheartirate,iandipainiareiparticularlyisignificant.
Documentationiisivital,ibutitheinurseimustidoimoreithanidocument.iTheiprimaryicareiproviderishouldibeinoti
fied,ibutithisiisinotitheipriorityiovericallingitheiRRT.iTheiclientsibloodipressureishouldibeireassessedifrequen
tly,ibutitheipriorityiisigettingitheirapidicareitoitheiclient.
DIF:i Applying/Applicationi REF:i 3
KEY:iRapidiResponseiTeami(RRT)|imedicaliemergenciesiMSC
:i Integratedi Process:i Communicationi andi Documentation
NOT:i Clienti Needsi Category:i Physiologicali Integrity:i Physiologicali Adaptation
3. Ai nursei isi orientingi ai newi clienti andi familyi toi thei inpatienti unit.i Whati informationi doesi thei nursei providei toih
elpitheiclientipromoteihisioriheriownisafety?
a. Encourageithei clienti andi familyi toi bei activei partners.
b. Havei thei clienti monitori handi hygienei ini caregivers.
c. Offeri theifamilyi thei opportunityi toi stayiwithi thei client.
d. Tellithei clienti toi alwaysi weari hisi ori heri armband.
ANS:iA
Eachiactionicouldibeiimportantiforitheiclientiorifamilyitoiperform.iHowever,iencouragingitheiclientitoibeiacti
vei ini hisi ori heri healthicarei asi ai partneri isi thei mosti critical.iThei otheri actionsi arei veryi limitedi ini scopei andidoinoti
provideitheibroadiprotectionithatibeingiactiveiandiinvolvedidoes.
,DIF:i Understanding/Comprehensioni REF:i 3i
KEY:iPatientisafety
MSC:i Integratedi Process:i Teaching/Learning
NOT:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
4. Ai newi nursei isi workingiwithi ai preceptori oniani inpatienti medical-
surgicali unit.i Theipreceptori advisesi theistudentithatiwhichiisitheipriorityiwheniworkingiasiaiprofessionalinu
rse?
a. Attendingitoi holistici clienti needs
b. Ensuringi clienti safety
c. Noti makingi medicationi errors
d. Providingi client-focusedi care
ANS:iB
Alliactionsiareiappropriateiforitheiprofessionalinurse.iHowever,iensuringiclientisafetyiisitheipriority.iUpitoi98,
000i deathsi resulti eachi yeari fromi errorsi ini hospitali care,i accordingi toithei 2000i Institutei ofi Medicinei report.iMan
yimoreiclientsihaveisufferediinjuriesiandilessiseriousioutcomes.iEveryinurseihasitheiresponsibilityitoiguardith
eiclientsisafety.
DIF:i Understanding/Comprehensioni REF:i 2i
KEY:iPatientisafety
MSC:i Integratedi Process:i Nursingi Process:i Intervention
NOT:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
5. Ai clienti isi goingi toi bei admittedi fori ai scheduledi surgicali procedure.i Whichi actioni doesi thei nursei explaini isit
heimostiimportantithingitheiclienticanidoitoiprotectiagainstierrors?
a. Bringiailistiofiallimedicationsiandiwhatitheyiareifor.
b. Keepithei doctorsi phonei numberi byi thei telephone.
c. Makei surei alli providersi washi handsibeforei enteringi thei room.
d. Writei downi theinamei ofi eachi caregiveriwhoi comesi ini theiroom.
ANS:iA
Medicationierrorsiareitheimosticommonitypeiofihealthicareimistake.iTheiJointiCommissionsiSpeakiUpicampa
igni encouragesi clientsi toi helpi ensurei theiri safety.i Onei recommendationi isi fori clientsi toi knowi alli theirimedicatio
nsiandiwhyitheyitakeithem.iThisiwillihelpipreventimedicationierrors.
DIF:i Applying/Applicationi REF:i 4
KEY:i Speaki Upi campaign|i patienti safetyi MSC:i Integratedi Process:i Teaching/Learning
NOT:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
6. Whichi actioni byi theinursei workingi withi ai clienti besti demonstratesi respecti fori autonomy?
a. Asksiifi thei clienti hasi questionsi beforei signingi ai consent
b. Givesi thei clienti accuratei informationi wheni questioned
c. Keepsi thei promisesi madei toi thei clientiandi family
d. Treatsi theiclienti fairlyi comparedi toi otheri clients
ANS:iA
Autonomyi isi self-
determination.i Thei clienti shouldi makei decisionsi regardingi care.i Wheni thei nursei obtainsi aisignatureionitheiconsen
tiform,iassessingiifitheiclientistillihasiquestionsiisivital,ibecauseiwithoutifulliinformationi thei clienti cannoti practic
ei autonomy.i Givingi accuratei informationi isi practicingi withi veracity.
Keepingi promisesi isi upholdingi fidelity.i Treatingi thei clienti fairlyi isi providingi sociali justice.
DIF:i Applying/Applicationi REF:i 4
KEY:i Autonomy|i ethicali principlesi MSC:i Integratedi Process:i Caring
NOT:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi Care
7. Aistudentinurseiasksitheifacultyitoiexplainibestipracticesiwhenicommunicatingiwithiaipersonifromitheilesbi
an,igay,ibisexual,itransgender,iandiqueer/questioningi(LGBTQ)icommunity.iWhatiansweribyitheifacultyiisimostiac
curate?
a. Avoidiembarrassingi thei clienti byi askingi questions.
b. Donti makei assumptionsi abouti theiri healthi needs.
, c. Mosti LGBTQi peoplei doi noti wanti toi sharei information.
d. Noi differencesi existi ini communicatingi withi thisi population.
ANS:iB
Manyi membersi ofi thei LGBTQi communityi havei facedi discriminationi fromi healthi carei providersi andi mayi beireluct
anti toi seekihealthi care.i Theinursei shouldi neveri makei assumptionsi abouti thei needsi ofimembersi ofi thisipopulation.i
Rather,irespectfuliquestionsiareiappropriate.iIfiapproachediwithisensitivity,itheiclientiwithianyihealthicareineedii
simoreilikelyitoianswerihonestly.
DIF:i Understanding/Comprehensioni REF:i 4i
KEY:iLGBTQ|idiversity
MSC:i Integratedi Process:i Teaching/Learning
NOT:i Clienti Needsi Category:i Psychosociali Integrity
8. Ainursei isi callingi thei on-
calliphysiciani abouti ai clientiwhoi hadi ai hysterectomyi 2i daysiagoi andihasi paini thatiisiunrelievedibyitheiprescrib
edinarcoticipainimedication.iWhichistatementiisipartiofitheiSBARiformatiforicommunication?
a. A:iIiwouldi likei youi toi orderi ai differenti paini medication.
b. B:iThisi clienti hasi allergiesi toi morphineiandi codeine.
c. R:i Dr.i Smithi doesnti likei nonsteroidali anti-inflammatoryi meds.
d. S:iThisi clienti hadi ai vaginali hysterectomyi 2i daysiago.
ANS:iB
SBARiisiairecommendediformioficommunication,ianditheiacronymistandsiforiSituation,iBackground,iAssess
ment,iandiRecommendation.iAppropriateibackgroundiinformationiincludesiallergiesitoimedicationsitheion-
calli physiciani mighti order.i Situationi describesi whati isi happeningi righti nowi thati musti bei communicated;i theiclien
tsisurgeryi2idaysiagoiwouldibeiconsideredibackground.iAssessmentiwouldiincludeianianalysisiofitheiclientsipr
oblem;iaskingiforiaidifferentipainimedicationiisiairecommendation.iRecommendationiisiaistatementiofiwhatiisi
neededioriwhatioutcomeiisidesired;ithisiinformationiaboutitheisurgeonsipreferenceimightibeibetteriplacediiniba
ckground.
DIF:i Applying/Applicationi REF:i 5i
KEY:i SBAR|icommunication
MSC:i Integratedi Process:i Communicationi andi Documentation
NOT:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi Care
9. Ainurseiworkingioniaicardiaciunitidelegateditakingivitalisignsitoianiexperiencediunlicensediassistiveip
ersonneli (UAP).i Fouri hoursilater,i thei nursei notesi thei clientsi bloodi pressurei isi muchi higheri thani previousire
adings,ianditheiclientsimentalistatusihasichanged.iWhatiactionibyitheinurseiwouldimostilikelyihaveipreve
ntedithisinegativeioutcome?
a. Determiningi ifi theiUAPi knewi howi toi takei bloodi pressure
b. Double-checkingi thei UAPi byi takingi anotheri bloodi pressure
c. Providingi morei appropriatei supervisioni ofi thei UAP
d. Takingi thei bloodi pressurei insteadi ofi delegatingi thei task
ANS:iC
Supervisioniisioneiofitheifiveirightsiofidelegationiandiincludesidirecting,ievaluating,iandifollowingiupionideleg
ateditasks.iTheinurseishouldieitherihaveiaskeditheiUAPiaboutitheivitalisignsioriinstructeditheiUAPitoireportithe
mirightiaway.iAniexperiencediUAPishouldiknowihowitoitakeivitalisignsianditheinurseishouldinotihaveitoiassess
ithisiatithisipoint.iDouble-
checkingitheiworkidefeatsitheipurposeiofidelegation.iVitalisignsiareiwithini thei scopei ofi practicei fori ai UAPi andi ar
ei permissiblei toi delegate.i Thei onlyi appropriatei answeri isithati theinurseididinotiprovideiadequateiinstructionitoithe
iUAP.
DIF:i Applying/Applicationi REF:i 6
KEY:iSupervision|idelegation|iunlicensediassistiveipersonneliM
SC:i Integratedi Process:i Communicationi andi Documentation
NOT:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi Care
10. Ainursei isitalkingiwithi ai clientiwhoi isi movingi toiai newi statei andi needsi toifindi ai newi doctori andi hospitalith
ere.iWhatiadviceibyitheinurseiisibest?
