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Test Bank Medical Surgical Nursing 10th Edition Ignatavicius Workman
Test Bank Medical Surgical Nursing 10th Edition Ignatavicius Workman
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Medical SurgicalNursing 10th
Edition Ignatavicius
Workman Test
Bank
,Chapter 01: Overview of Professional Nursing Concepts for
Medical-Surgical Nursing Ignatavicius: Medical-Surgical
Nursing, 10th Edition
MULTIPLE
CHOICE
1. A new nurse is working with a preceptor on a medical-
surgical unit. The preceptor advises the new nurse that
which is the priority when working as a professional nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
ANS: B
All actions are appropriate for the professional nurse.
However, ensuring client safety is the priority. Health care
errors have been widely reported for 25 years, many of
which result in client injury, death, and increased health
care costs. There are several national and international
organizations that have either recommended or mandated
safety initiatives.
Every nurse has the responsibility to guard the client’s
safety. The other actions are important
for quality nursing, but they are not as vital as providing
safety. Not making medication errors does provide safety,
but is too narrow in scope to be the best answer.
DIF: Understanding TOP: Integrated Process:
Nursing Process: Intervention KEY: Client safety
MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
2. A nurse is orienting a new client and family to the
medical-surgical unit. What information does the nurse
provide to best help the client promote his or her own
safety?
a. Encourage the client and family to be active partners.
b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the client.
d. Tell the client to always wear his or her 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 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 TOP: Integrated Process:
Teaching/Learning KEY: Client safety
MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
3. A nurse is caring for a postoperative client on the surgical
unit. The client’s blood pressure was 142/76 mm Hg 30
minutes ago, and now is 88/50 mm Hg. What action
would the nurse 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.
Btestbanks.com
, 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 the client has
manifested a significant change, the nurse 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 nurse must do more than document. The
primary health care provider would be notified, but this is
not more important than calling the RRT. The client’s
blood pressure would be reassessed frequently, but the
priority is getting the rapid care to the client.
DIF: Applying TOP: Integrated Process:
Communication and Documentation KEY: Rapid
Response Team (RRT), Clinical judgment
MSC: Client Needs Category: Physiological Integrity:
Physiological Adaptation
4. A nurse wishes to provide client-centered care in all
interactions. Which action by the nurse
best demonstrates this concept?
a. Assesses for cultural influences affecting health care.
b. Ensures that all the client’s basic needs are met.
c. Tells the client and family about all upcoming tests.
d. Thoroughly orients the client and family to the room.
ANS: A
Showing respect for the client and family’s preferences and
needs is essential to ensure a holistic or “whole-person”
approach to care. By assessing the effect of the client’s
culture on health care, this nurse is practicing client-
focused care. Providing for basic needs does not
demonstrate this competence. Simply telling the 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.
, DIF: Understanding TOP: Integrated Process:
Culture and Spirituality KEY: Client-centered care,
Culture MSC: Client Needs Category:
Psychosocial Integrity
5. 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?
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.
ANS: A
Medication reconciliation is a formal process in which the
client’s actual current medications are compared to the
prescribed medications at the time of admission, transfer,
or discharge. This National client Safety Goal is important
to reduce medication errors. The client would not have to
be responsible for providers washing their hands, and even
if the client 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 TOP:
Integrated Process: Teaching/Learning
KEY: Client safety, Informatics
MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
Btestbanks.com
,6. Which action by the nurse working with a client best
demonstrates respect for autonomy?
a. Asks if the client has questions before signing a consent.
b. Gives the client accurate information when questioned.
c. Keeps the promises made to the client and family.
d. Treats the client fairly compared to other clients.
ANS: A
Autonomy is self-determination. The client would 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 cannot
practice autonomy. Giving accurate information is practicing
with veracity. Keeping promises is upholding fidelity.
Treating the client fairly is providing social justice.
DIF: Applying TOP:
Integrated Process: Caring KEY: Ethics,
Autonomy MSC: Client Needs Category: Safe and
Effective Care Environment: Management of Care
7. A nurse asks a more seasoned colleague to explain best
practices when communicating with a person from the
lesbian, gay, bisexual, transgender, and questioning/queer
(LGBTQ) community. What answer by the faculty is most
accurate?
a. Avoid embarrassing the client 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.
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 would never make
assumptions about the needs of members of this population.
Rather, respectful questions are appropriate. If approached
with sensitivity, the client with any health care need is more
likely to answer honestly.
DIF: Understanding TOP: Integrated Process:
Teaching/Learning
, KEY: Health care disparities, LGBTQ MSC: Client Needs
Category: Psychosocial Integrity
8. A nurse is calling the on-call health care provider about a
client who had a hysterectomy 2 days 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 client has allergies to morphine and codeine.”
c. “Dr. Smith doesn’t like nonsteroidal anti-inflammatory
meds.”
d. “This client had a vaginal hysterectomy 2 days ago.”
ANS: B
Btestbanks.com
, 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 health care
provider might order. Situation
describes what is happening right now that must be
communicated; the client’s surgery 2 days
ago would be considered background. Assessment would
include an analysis of the client’s
problem; none of the options has assessment information.
Asking for a different pain medication is a
recommendation. Recommendation is a statement of what
is needed or what outcome is desired.
DIF: Applying TOP: Integrated Process:
Communication and Documentation KEY:
Teamwork and collaboration, SBAR
MSC: Client Needs Category: Safe and Effective Care
Environment: Management of Care
9. A nurse working on a cardiac unit delegated taking vital
signs to an experienced assistive personnel (AP). Four
hours later, the nurse notes that the client’s blood pressure
taken by the AP was much higher than previous readings,
and the client’s mental status has changed. What action by
the nurse would most likely have prevented this negative
outcome?
a. Determining if the AP knew how to take blood pressure
b. Double-checking the AP by taking another blood pressure
c. Providing more appropriate supervision of the AP
d. Taking the blood pressure instead of delegating the task
ANS: C
Supervision is one of the five rights of delegation and
includes directing, evaluating, and following up on
delegated tasks. The nurse would either have asked the AP
about the vital signs or instructed the AP to report them
right away. An experienced AP would know how to take
vital signs and the nurse would not have to assess this at
this point. Double-checking the work defeats the purpose of
delegation. Vital signs are within the scope of practice for a
AP and are permissible to delegate. The only appropriate
answer is that the nurse did not provide adequate
, instruction to the AP.
DIF: Analyzing TOP: Integrated Process:
Communication and Documentation KEY:
Teamwork and collaboration, Delegation
MSC: Client Needs Category: Safe and Effective Care
Environment: Management of Care
10. A newly graduated nurse in the hospital states that because
of being so new, participation in quality improvement (QI)
projects is not wise. What response by the precepting nurse
is best?
a. “All staff nurses are required to participate in quality
improvement here.”
b. “Even being new, you can implement activities designed
to improve care.”
c. “It’s easy to identify what indicators would be used to
measure quality.”
d. “You should ask to be assigned to the research and quality
committee.”
ANS: B
The preceptor would try to reassure the nurse that
implementing QI measures is not out of line for a newly
licensed nurse. Simply stating that all nurses are required to
participate does not help the nurse understand how that is
possible and is dismissive. Identifying indicators of quality
is not an easy, quick process and would not be the best
place to suggest a new nurse to start. Asking to be assigned
to the QI committee does not give the nurse information
about how to implement QI in daily practice.
DIF: Applying TOP: Integrated Process:
Communication and Documentation
Btestbanks.com
, KEY: Systems thinking, Quality improvement
MSC: Client Needs Category: Safe and Effective Care
Environment: Management of Care
11. A nurse is talking with a co-worker who is moving to a
new state and needs to find new employment there.
What advice by the nurse is best?
a. Ask the hospitals there about standard nurse–client ratios.
b. Choose the hospital that has the newest technology.
c. Find a hospital that has achieved Magnet status.
d. Work in a facility affiliated with a medical or nursing
school.
ANS: C
Client Magnet status is awarded by The Joint Commission
(TJC) and certifies that nurses can demonstrate how best
current evidence guides their practice. New technology
doesn’t necessarily mean that the hospital is safe.
Affiliation with a health profession school has several
advantages, but safety is most important.
DIF: Understanding
TOP: Integrated Process:
Communication and Documentation
KEY: Evidence-based practice,
Magnet status
MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
MULTIPLE RESPONSE
1. A nurse manager wishes to ensure that the nurses on the
unit are practicing at their highest levels of competency.
Which areas would the manager assess to determine if the
nursing staff demonstrate competency according to the
Institute of Medicine (IOM) report Health Professions
Education: A Bridge to Quality? (Select all that apply.)
a. Collaborating with an interprofessional team
b. Implementing evidence-based care
c. Providing family-focused care
d. Routinely using informatics in practice
e. Using quality improvement in client care
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