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TEST BANK FOR LEWIS'S MEDICAL-SURGICAL NURSING
ASSESSMENT ANDMANAGEMENT OF CLINICAL PROBLEMS
12TH EDITION BY HARDING & KWONG
Chapter01:Professional Nursing
g io
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
g g g g g
MULTIPLE CHOICE g
1. The nurse completes an admission database and explains that the plan
g g of care and g g g g g g g g g g g
gdischarge goals will be developed with the patient‗s input. The patient asks, ―How is
g g g g g g g g g g g g g g g g
gthis different from what the physician does?‖ Which response would the nurse provide?
g g g g g g g g g g g g
a. ―Theroleofthenurseis to administermedications and othertreatments prescribed by g g g g g g g
your physician.‖
g g
b. ―In addition to caring for you while you aresick, thenurses will help you plan to
g g g io g g g g g g g g g g
maintain your health.‖
g g g
c. ―Thenurse‗sjob isto collectinformationand communicate anyproblems that
g io g io g io io g
occur to the physician.‖
g g g g
d. ―Nurses perform manyof the same procedures as the physician, but nurses are
g g g g g g g g g
with the patients for a longer time than the physician.‖
g g g g g g g g g g
ANS: B g
The American Nurses Association (ANA) definition of nursing describes the role of nurses
g g g g g g g g g g g g
ginpromoting health. The other responses describe dependent and collaborative functions of
g g g g g g g g g g
gthe nursing role but do not accurately describe the nurse‗s unique role in the health care
g g g g g g g g g g g g g g g
gsystem.
DIF: gggg g Cognitive Level: Analyze(Analysis) g g
TOP: gggg g Nursing Process: Implementation io g gggggggg MSC: NCLEX: Safe and Effective Care Environment
gg g g g g g g
2. Which statement bythe nurse accuratelydescribes the use of evidence-based practice (EBP)?
g g g g g g g g g g
a. ―Patient care is based on clinical judgment, experience, and traditions.‖
g g g g g g g g g
b. ―Data areanalyzed later to show that thepatient outcomes areconsistentlymet.‖
g g g g g g g
c. ―Research from all published articles are used as a guide forplanningpatient care.‖
g g g g g g g g g g g
d. ―Recommendations arebased onresearch, clinical expertise,and patient g g g g io
g preferences.‖
ANS: D g
Evidence-based practice (EBP) is the use of the best research-based evidence combined
g g g g g g g g g g g
withclinician expertise and consideration of patient preferences. Clinical judgment based
g g g g g g g g g g
onthe nurse‗s clinical experience is part of EBP, but clinical decision making should also
g g g g g g g g g g g g g g g
incorporate current research and research-based guidelines. Evaluation of patient outcomes
g g g g g g g g g g
isimportant, but data analysis is not required to use EBP. All published articles do not
g g g g g g g g g g g g g g g
provide research evidence; interventions should be based on credible research, preferably
g g g g g g g g g g g
randomizedcontrolled studies with a large number of subjects.
g g g g g g g g
DIF: Cognitive Level: Understand (Comprehension) TOP:
g g g
NursingProcess:PlanningMSC: NCLEX: Safe and Effective Care Environment
g g io gg g g g g g g
3. Which statement bythe nurse provides a clear explanation of the nursing process?
g g g g g g g g g g g
a. ―Thenursingprocess is a research method ofdiagnosing thepatient‗s health care g g g g g io g g g
g problems.‖
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,b. ―Thenursing process is used primarilyto explain nursing interventions to other
io g g g io io g g
health care professionals.‖
g g g
c. ―Thenursing process is a problem-solving tool used to identifyand manage the
io g g g io g g g g
?
, patients‗ health care needs.‖ g g g
d. ―Thenursing process is basedon nursingtheorythat incorporates the io g io g g
g biopsychosocial nature of humans.‖ g g g
ANS: C g
The nursing process is a problem-solving approach to the identification and treatment of
g g g g g g g g g g g g
patients‗ problems. Nursing process does not require research methods for diagnosis.
g g g g g g g g g g g
Theprimaryuse of the nursing process is in patient care, not to establish nursing theoryor
g g g g g g g g g g g g g g g
explainnursing interventions to other health care professionals.
g io g g g g g g
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing g g g g
Process:EvaluationMSC: NCLEX: Safe and Effective Care Environment
g g io gg g g g g g g
4. A patient admitted to the hospital for surgery tells the nurse, ―I do not feel
g g g g g g g g g g g g g g
comfortableleaving my children with my parents.‖ Which action would the
g g g g g g g g g g
nursetake next?
g g g
a. Reassurethe patient that these feelings are common for parents. g g g g g g g g
b. Have the patient call the children to ensure that theyare doing well.
g g g g g g g g g g g
c. Gatherinformation on the patient‗s concerns about thechild carearrangements. g g g g g g g
d. Call the patient‗s parents to determine whether adequate child
g g g g g g g g
careisbeingprovided.
g g io
ANS: C g
Because a complete assessment is necessary in order to identify a problem and choose an
g g g g g g g g g g g g g g
appropriate intervention, the nurse‗s first action should be to obtain more information.
g g g g g g g g g g g g
Theother actions maybe appropriate, but more assessment is needed before the best
g g g g g g g g g g g g g
interventioncan be chosen.
g io g g
DIF: CognitiveLevel: Analyze (Analysis) g g g
TOP: NursingProcess: Assessment MSC: NCLEX: Psychosocial Integrity g g g g g
5. A patient with a bacterial infection is hypovolemic due to a fever and
g g g g g g g g g g g g
excessivediaphoresis.Which expected outcome would the nurse select for
g g g g g g g g g
this patient?
g g
a. Patient has abalanced intake and output. g g g g g
b. Patient‗s beddingis kept clean and freeof moisture. g g g g g g
c. Patient understands the need forincreased fluid intake.
g g g g g g
d. Patient‗s skin remains cool and dry throughout hospitalization.
g g g g g g g
ANS: A g
Balanced intake and output gives measurable data showingresolution of the problem
g g g g g g g g g g
ofdeficient fluid volume. The other statements would not indicate that the problem
g g g g g g g g g g g g
ofhypovolemia was resolved.
g g g g
DIF: Cognitive Level: Apply (Application) g g g TOP: Nursing Process: g gg io
PlanningMSC: NCLEX: Physiological Integrity
g io gg g g g
6. Which statement describes the purpose of the evaluation phase of the nursing process?
g g g g g g g g g g g g
a. To document the nursing care plan in the progress notes of the health record
g g g g g g g g g g g g g
b. To determine if interventions have been effective in meetingpatient outcomes
g g g g g g g g g
c. To decide whether the patient‗s health problems have been completelyresolved
g g g g g g g g g
d. To establish if the patient agrees that the nursing care provided was satisfactory
g g g g g g g g g g g g
ANS: B g
?
, Evaluation consists of determining whether the desired patient outcomes have been
g g g g g g g g g g
met and whether the nursing interventions were appropriate. The other responses do not
g g g g g g g g g g g g g
describe theevaluation phase.
g g g
DIF: Cognitive Level: Understand (Comprehension)
gggg g TOP: g g g Nursing
Process:EvaluationMSC: NCLEX: Safe and Effective Care Environment
g g g g g g g g
7. Which statement describes the purpose of the assessment phase of the nursing process?
g g g g g g g g g g g g
a. To teach interventions that relieve health problems
g g g g g g
b. To use patient data to evaluate patient care outcomes
g g g g g g g g
c. To obtain data to diagnose patient strengths and problems
g g g g g g g g
d. To help the patient identifyrealistic outcomes for health problems
g g g g g g g g
ANS: C g
During the assessment phase, the nurse gathers information about the patient to diagnosepatient
io g g g g g g g g g g g
strengths and problems. The other responses are examples of the planning,intervention, and
g g g g g g g g g g g g g
evaluation phases of the nursing process.
g g g g g g
DIF: Cognitive Level: Understand (Comprehension) g g g
TOP: NursingProcess: Assessment MSC: NCLEX: Safe and Effective Care Environment
g g g g g g g g
8. When developing the plan of care, which components would the nurse include in
g g g g g g g g g g g g
gtheclinicalproblem statement?
g g
a. Theproblem and the suggested patient goals or outcomes g g g g g g g
b. Theproblem, its causes, and the signs and symptoms of the problem
g g g g g g g g g g g
c. The problem with the possible etiologyand the planned interventions
g g g g g g g g
d. Theproblem, its pathophysiology, and the expected outcome g g g g g g
ANS: B g
When writing clinical problems or nursing diagnoses, the subjective as well as objective data
g g g g g g g g g g g g g
to support the problem‗s existence should be included. Goals, outcomes, and interventions
g g g g g g g g g g g g
arenot included in the problem statement.
g g g g g g
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process:g g g g g io
DiagnosisMSC: NCLEX: Safe and Effective Care Environment
g io gg g g g g g g
9. Which patient care task would the nurse delegate to experienced assistive personnel (AP)?
g g g g g g g g g g g g
a. Instruct the patient about the need to alternate activityand rest.
g g g g g g g g g
b. Monitor level of shortness of breath or fatigue after ambulation.
g g g g g g g g g
c. Obtainthepatient‗s blood pressure and pulse rate after ambulation. g g g g g g g
d. Determine whether the patient is readyto increase the activitylevel.
g g g g g g g g
ANS: C g
AP education includes accurate vital sign measurement. Assessment and patient
g g g g g g g g g
teachingrequire registered nurse education and scope of practice and cannot be delegated.
g g g g g g g g g g g g
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process:g g g g gg io
PlanningMSC: NCLEX: Safe and Effective Care Environment
g io gg g g g g g g
?
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