Test Bank Timby's Introductory Medical-Surgical Nursing 13th Edition MorenoChapter 1 Concepts and Trends in Healthcare
◦ A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurs...
Timby's Introductory Medical-Surgical Nursing 13th Edition Moreno Test
Bank
Chapter 1 Concepts and Trends in Healthcare
◦ A new nurse is working with a preceptor on an inpatient medical-surgical unit. The
preceptor advises the student that which is the priority when working as a professional
nurse?
◦ Attending to holistic client needs
◦ Ensuring client safety
◦ Not making medication errors
◦ Providing client-
focused care
ANS: B
◦ All actions are appropriate for the professional nurse. However, ensuring
client safety is the priority. Up to 98,000 deaths result each year from errors in hospital care,
according to the 2000 Institute of Medicine report. Many more clientshave suffered injuries
and less serious outcomes. Every nurse has the responsibility to guard the clients safety.
◦ DIF: Understanding/Comprehension REF: 2
KEY: Patient safety MSC: Integrated Process: Nursing Process:
Intervention
◦ NOT: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
◦ A nurse is orienting a new client and family to the inpatient unit. What information
does the nurse provide to help the client promote his or her ownsafety?
◦ Encourage the client and family to be active partners.
◦ Have the client monitor hand hygiene in caregivers.
◦ Offer the family the opportunity to stay with the client.
◦ Tell the client to always wear his orher
armband. ANS: A
◦ Each action could be important for the client or family to perform.
However, encouraging the client to be active in his or her health care as a partner isthe
most critical. The other actions are
◦
◦ very limited in scope and do not provide the broad protection that
being active and involved does.
◦ A nurse is caring for a postoperative client on the surgical unit. The clients blood
pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action
by the nurse is best?
◦ Call the Rapid Response Team.
◦ Document and continue to monitor.
◦ Notify the primary care provider.
◦ Repeat blood pressure measurementin
15 minutes. ANS: A
◦ The purpose of the Rapid Response Team (RRT) is to intervene when clients
are deteriorating before they suffer either respiratory or cardiac arrest. Since theclient has
manifested a significant change, the nurse should call the RRT. Changes in blood pressure,
mental status, heart rate, and pain are particularly significant. Documentation is vital, but the
nurse must do more than document. The primary care provider should be notified, but this is
not the priority over calling the RRT. The clients blood pressure should be reassessed
frequently, but the priority is getting the
rapid care to the client.
◦ DIF: Applying/Application REF: 3
◦ KEY: Rapid Response Team (RRT)|
medical emergencies MSC: Integrated Process:
Communication and Documentation
◦ NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
◦
◦ A nurse wishes to provide client-centered care in all interactions. Whichaction
by the nurse best demonstrates this concept?
◦ Assesses for cultural influences affecting health care
◦ Ensures that all the clients basic needs are met
◦ Tells the client and family about all upcoming tests
◦ Thoroughly orients the client and
family to the room ANS: A
◦ Competency in client-focused care is demonstrated when the nurse
focuses on communication, culture, respect, compassion, client education, and
empowerment. By assessing the effect of the
◦
◦ clients culture on health care, this nurse is practicing client-focused care.
Providing for basic needs does not demonstrate this competence. Simply tellingthe client
about all upcoming tests is not providing empowering education. Orienting the client and
family to the room is an important safety measure, but not directly related to demonstrating
client-centered care.
◦ A client is going to be admitted for a scheduled surgical procedure. Which action
does the nurse explain is the most important thing the client can do to protect
against errors?
◦ Bring a list of all medications and what they are for.
◦ Keep the doctors phone number by the telephone.
◦ Make sure all providers wash hands before entering the room.
◦ Write down the name of each caregiver who
comes in the room. ANS: A
◦ Medication errors are the most common type of health care mistake. The
Joint Commissions Speak Up campaign encourages clients to help ensure their safety. One
recommendation is for clients to know all their medications and why theytake them. This
will help prevent medication errors.
◦ DIF: Applying/Application REF: 4
◦ KEY: Speak Up campaign| patient safety MSC: Integrated Process:
Teaching/Learning NOT: Client Needs Category: Safe and EffectiveCare
Environment: Safety and Infection Control
◦ Which action by the nurse working with a client best demonstrates respect for
autonomy?
◦ Asks if the client has questions before signing a consent
◦ Gives the client accurate information when questioned
◦ Keeps the promises made to the client and family
◦ Treats the client fairly
compared to other clients
ANS: A
◦ Autonomy is self-determination. The client should make decisions regarding
care. When the nurse obtains a signature on the consent form, assessing if the client still has
questions is vital, because without full information the client cannotpractice autonomy.
Giving accurate information is practicing with veracity. Keeping promises is upholding
fidelity. Treating the
◦
◦ client fairly is providing social justice.
◦
◦ DIF: Applying/Application REF: 4
◦ KEY: Autonomy| ethical principles MSC: Integrated Process: Caring
◦ NOT: Client Needs Category: Safe and Effective Care Environment: Management
of Care
, ◦
◦ A student nurse asks the faculty to explain best practices when communicatingwith a
person from the lesbian, gay, bisexual, transgender, and queer/ questioning (LGBTQ)
community. What answer by the faculty is most accurate?
◦ Avoid embarrassing the client by asking questions.
◦ Dont make assumptions about their health needs.
◦ Most LGBTQ people do not want to share information.
◦ No differences exist in communicating withthis
population. ANS: B
◦ Many members of the LGBTQ community have faced discrimination from
health care providers and may be reluctant to seek health care. The nurse should never make
assumptions about the needs of members of this population. Rather, respectful questions are
appropriate. If approached with sensitivity, the client with anyhealth care need is more likely
to answer honestly.
◦ DIF: Understanding/Comprehension REF: 4
KEY: LGBTQ| diversity MSC: Integrated Process:
Teaching/Learning
◦ NOT: Client Needs Category: Psychosocial Integrity
◦
◦ A nurse is calling the on-call physician about a client who had a hysterectomy 2days
ago and has pain that is unrelieved by the prescribed narcotic pain medication. Which
statement is part of the SBAR format for communication?
◦ A: I would like you to order a different pain medication.
◦ B: This client has allergies to morphine and codeine.
◦ R: Dr. Smith doesnt like nonsteroidal anti-inflammatory meds.
◦ S: This client had a vaginal
hysterectomy 2 days ago. ANS: B
◦ SBAR is a recommended form of communication, and the acronym stands
for Situation, Background, Assessment, and Recommendation. Appropriate background
information includes allergies to medications the on-call physician mightorder. Situation
describes what is happening right now that must be communicated; the clients surgery 2
days ago would be considered background. Assessment would include an analysis of the
clients problem; asking for a different pain medication is a recommendation.
Recommendation is a statement of what is needed or what
◦
◦ outcome is desired; this information about the surgeons preference
might be better placed in background.
◦ DIF: Applying/
Application REF: 5 KEY:
SBAR| communication
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