TESTBANK FOR MEDICAL-SURGICAL NURSING:
CONCEPTS FOR CLINICAL JUDGMENT AND
COLLABORATIVE CARE 11TH EDITION BY
IGNATAVICIUS
,Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Ignatavicius: Medical-Surgical Nursing, 11th Edition
MULTIPLE CHOICE
1. A new nursing attendant is working with a preceptor on a medical-surgical unit. The
preceptor advises thenew nursing attendant that which is the priority when working as a
professional nursing attendant?
a. Attending to holistic patient needs
b. Ensuring patient safety
c. Not making medication errors
d. Providing patient-focused care
ACCURATE ANSWER:
B
Rationale :->>>All actions are appropriate for the professional nursing attendant.
However, ensuring patient safety is the priority. Health care errors have been widely
reported for 25 years, many of which result inpatient injury, death, and increased health
care costs. There are several national and international organizations that have either
recommended or mandated safety initiatives.
Every nursing attendant has the responsibility to guard the patient’s safety. The other actions
are important for quality nursing, but they are not as vital as providing safety. Not making
medication errorsdoes provide safety, but is too narrow in scope to be the best answer.
DIF: Understanding TOPIC: Integrated Process: Nursing Process:
InterventionKEY: Patient safety
MSC: Patient Needs Category: Safe and Effective Care Environment: Safety and Infection Control
2. A nursing attendant is orienting a new patient and family to the medical-surgical unit.
What informationdoes the nursing attendant provide to best help the patient promote his or
her own safety?
a. Encourage the patient and family to be active partners.
b. Have the patient monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the patient.
d. Tell the patient to always wear his or her armband.
ACCURATE
ANSWER: A
Rationale :->>>Each action could be important for the patient or family to perform.
However, encouraging thepatient 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 TOPIC: Integrated Process:
Teaching/LearningKEY: Patient safety
MSC: Patient Needs Category: Safe and Effective Care Environment: Safety and Infection Control
3. A nursing attendant is caring for a postoperative patient on the surgical unit. The patient’s
blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action
would the nursing attendant 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.
, ACCURATE ANSWER: A
Rationale :->>>The purpose of the Rapid Response Team (RRT) is to intervene when
patients are deteriorating before they suffer either respiratory or cardiac arrest. Since the
patient has manifested a significant change, the nursing attendant 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 nursing attendant must do more than document.
The primary health care provider would be notified, but this is not more important than
calling the RRT. The patient’s blood pressure would be reassessed frequently, but the priority
is getting the rapid care to the patient.
DIF: Applying TOPIC: Integrated Process: Communication and
DocumentationKEY: Rapid Response Team (RRT), Clinical judgment
MSC: Patient Needs Category: Physiological Integrity: Physiological Adaptation
4. A nursing attendant wishes to provide patient-centered care in all interactions. Which action by
the nursing attendant
best demonstrates this concept?
a. Assesses for cultural influences affecting health care.
b. Ensures that all the patient’s basic needs are met.
c. Tells the patient and family about all upcoming tests.
d. Thoroughly orients the patient and family to the room.
ACCURATE ANSWER: A
Rationale :->>>Showing respect for the patient and family’s preferences and needs is
essential to ensure a holistic or “whole-person” approach to care. By assessing the effect of
the patient’s culture onhealth care, this nursing attendant is practicing patient-focused care.
Providing for basic needs does not demonstrate this competence. Simply telling the patient
about all upcoming tests is not providing empowering education. Orienting the patient and
family to the room is an important safety measure, but not directly related to demonstrating
patient-centered care.
DIF: Understanding TOPIC: Integrated Process: Culture and Spirituality
KEY: Patient-centered care, Culture MSC: Patient Needs Category: Psychosocial
Integrity
5. A patient is going to be admitted for a scheduled surgical procedure. Which action does
thenursing attendant explain is the most important thing the patient 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.
ACCURATE ANSWER: A
Rationale :->>>Medication reconciliation is a formal process in which the patient’s actual
current medicationsare compared to the prescribed medications at the time of admission,
transfer, or discharge. This National patient Safety Goal is important to reduce medication
errors. The patient would not have to be responsible for providers washing their hands, and
even if the patient 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 TOPIC: Integrated Process:
Teaching/LearningKEY: Patient safety, Informatics
MSC: Patient Needs Category: Safe and Effective Care Environment: Safety and Infection Control
, 6. Which action by the nursing attendant working with a patient best demonstrates respect for
autonomy?
a. Asks if the patient has questions before signing a consent.
b. Gives the patient accurate information when questioned.
c. Keeps the promises made to the patient and family.
d. Treats the patient fairly compared to other patients.
ACCURATE ANSWER: A
Rationale :->>>Autonomy is self-determination. The patient would make decisions regarding
care. When the nursing attendant obtains a signature on the consent form, assessing if the
patient still has questions is vital, because without full information the patient cannot practice
autonomy. Giving accurate information is practicing with veracity. Keeping promises is
upholding fidelity. Treating the patient fairly is providing social justice.
DIF: Applying TOPIC: Integrated Process: Caring KEY: Ethics, Autonomy
MSC: Patient Needs Category: Safe and Effective Care Environment: Management of Care
7. A nursing attendant asks a more seasoned colleague to explain best practices when
communicating with aperson from the lesbian, gay, bisexual, transgender, and
questioning/queer (LGBTQ) community. What answer by the faculty is most accurate?
a. Avoid embarrassing the patient 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.
ACCURATE ANSWER: B
Rationale :->>>Many members of the LGBTQ community have faced discrimination from
health care providers and may be reluctant to seek health care. The nursing attendant would
never make assumptions about the needs of members of this population. Rather, respectful
questions are appropriate. Ifapproached with sensitivity, the patient with any health care need
is more likely to answer honestly.
DIF: Understanding TOPIC: Integrated Process: Teaching/Learning
KEY: Health care disparities, LGBTQ MSC: Patient Needs Category: Psychosocial Integrity
8. A nursing attendant is calling the on-call health care provider about a patient who had a
hysterectomy 2days 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 patient has allergies to morphine and codeine.”
c. “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
d. “This patient had a vaginal hysterectomy 2 days ago.”
ACCURATE ANSWER: B
