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Medical Surgical Nursing, 11th Edition
All Chapters Covered -Test Bank
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Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Ignatavicius: Medical-Surgical Nursing, 11th Edition
MULTIPLE CHOICE
1. A new registered nurse is working with a preceptor on a medical-surgical unit. The preceptor
advises thenew registered nurse that which is the priority when working as a professional
registered nurse?
a. Attending to holistic patient needs
b. Ensuring patient safety
c. Not making medication errors
d. Providing patient-focused care
ANSWER:B
All actions are appropriate for the professional registered nurse. However, ensuring patient
safety is thepriority. 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 registered nurse 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.
DIFFERENT: Understanding TOP: Integrated Process: Nursing Process: InterventionKEY: Patient
safety
MSC: Patient Needs Category: Safe and Effective Care Environment: Safety and Infection Control
2. A registered nurse is orienting a new patient and family to the medical-surgical unit. What
informationdoes the registered nurse 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.
ANSWER: A
Each action could be important for the patient or family to perform. However, encouraging
the patient 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.
DIFFERENT: Understanding TOP: Integrated Process: Teaching/LearningKEY: Patient
safety
MSC: Patient Needs Category: Safe and Effective Care Environment: Safety and Infection Control
3. A registered nurse 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 registered 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.
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ANSWER: A
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 registered 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 registered 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 patient’s blood pressure would be reassessed frequently, but the priority is getting the
rapid care to the patient.
DIFFERENT: Applying TOP: Integrated Process: Communication and
DocumentationKEY: Rapid Response Team (RRT), Clinical judgment
MSC: Patient Needs Category: Physiological Integrity: Physiological Adaptation
4. A registered nurse wishes to provide patient-centered care in all interactions. Which action by
the registered nurse
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.
ANSWER: A
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 registered nurse 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.
DIFFERENT: Understanding TOP: 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
theregistered nurse 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.
ANSWER: A
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.
DIFFERENT:Applying TOP: Integrated Process:
Teaching/LearningKEY: Patient safety, Informatics
MSC: Patient Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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6. Which action by the registered nurse 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.
ANSWER: A
Autonomy is self-determination. The patient would make decisions regarding care. When the
registered nurse 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.
DIFFERENT: Applying TOP: Integrated Process: Caring KEY: Ethics, Autonomy
MSC: Patient Needs Category: Safe and Effective Care Environment: Management of Care
7. A registered nurse asks a more seasoned colleague to explain best practices when
communicating with aperson from the lesbian, gay, bisexual, trans gender, and
questioning/queer (LGBTQ) community. What we cover 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.
ANSWER: B
Many members of the LGBTQ community have faced discrimination from health care
providers and may be reluctant to seek health care. The registered nurse 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 wo honestly.
DIFFERENT:UnderstandingTOP: Integrated Process: Teaching/Learning
KEY: Health care disparities, LGBTQ MSC: Patient Needs Category: Psychosocial Integrity
8. A registered nurse 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.”
ANSWER: B
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