Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario: A postoperative adult patient is on the
medical-surgical unit 2 hours after abdominal surgery. The
nurse notes BP 88/54 mmHg, HR 122/min, RR 22/min, and a
saturated abdominal dressing. The patient says, “I feel faint
when I try to sit up.”
Question Stem: What is the nurse’s priority action?
Answer Options:
A. Encourage the patient to drink clear fluids
B. Assess for active bleeding and notify the provider using SBAR
C. Administer the prescribed oral pain medication
D. Reassess vital signs in 1 hour
Correct Answer: B
Detailed Rationale:
The cues suggest possible hemorrhage and hypovolemia:
hypotension, tachycardia, faintness, and a saturated dressing.
The nurse must recognize deteriorating cues, perform a
focused assessment for bleeding, and escalate care promptly.
SBAR supports clear, timely communication and patient safety.
Incorrect Option Analysis:
• A: Incorrect; oral fluids are not the priority in a potentially
unstable postoperative patient. Misconception: thinking
, dehydration is the most likely issue. Risk: delays treatment
of bleeding.
• C: Incorrect; pain medication does not address the cause
of instability and may worsen hypotension. Risk: further
hemodynamic compromise.
• D: Incorrect; waiting risks rapid deterioration. Risk: missed
recognition of shock.
Nursing Process Linkage: Assessment / Implementation
NCJMM Competencies: Recognize Cues; Analyze Cues; Take
Action
Difficulty: Moderate
Bloom’s Level: Analyze
NCLEX Client Needs: Physiological Adaptation
Key Learning Objective: Identify priority action when
postoperative cues indicate possible internal bleeding.
2) MCQ
Clinical Scenario: A nurse is reviewing a proposed new wound-
care protocol on a medical-surgical unit.
Question Stem: Which source provides the strongest evidence
for deciding whether to adopt the protocol?
Answer Options:
A. One experienced nurse’s opinion
B. A manufacturer brochure for the dressing
, C. A recent systematic review and professional guideline
D. A single case report from one hospital
Correct Answer: C
Detailed Rationale:
Evidence-based practice relies on the best available research,
especially systematic reviews and clinical guidelines that
synthesize multiple studies and support safer, more effective
care.
Incorrect Option Analysis:
• A: Anecdotal opinion is useful clinically but not strong
evidence. Risk: practice based on tradition rather than
data.
• B: Manufacturer brochures may be biased toward product
use. Risk: conflict of interest.
• D: A single case report is too limited for practice change.
Risk: weak generalizability.
Nursing Process Linkage: Planning
NCJMM Competencies: Generate Solutions; Analyze Cues
Difficulty: Easy
Bloom’s Level: Understand
NCLEX Client Needs: Management of Care
Key Learning Objective: Select the strongest evidence source
for clinical practice decisions.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario: A postoperative adult patient is on the
medical-surgical unit 2 hours after abdominal surgery. The
nurse notes BP 88/54 mmHg, HR 122/min, RR 22/min, and a
saturated abdominal dressing. The patient says, “I feel faint
when I try to sit up.”
Question Stem: What is the nurse’s priority action?
Answer Options:
A. Encourage the patient to drink clear fluids
B. Assess for active bleeding and notify the provider using SBAR
C. Administer the prescribed oral pain medication
D. Reassess vital signs in 1 hour
Correct Answer: B
Detailed Rationale:
The cues suggest possible hemorrhage and hypovolemia:
hypotension, tachycardia, faintness, and a saturated dressing.
The nurse must recognize deteriorating cues, perform a
focused assessment for bleeding, and escalate care promptly.
SBAR supports clear, timely communication and patient safety.
Incorrect Option Analysis:
• A: Incorrect; oral fluids are not the priority in a potentially
unstable postoperative patient. Misconception: thinking
, dehydration is the most likely issue. Risk: delays treatment
of bleeding.
• C: Incorrect; pain medication does not address the cause
of instability and may worsen hypotension. Risk: further
hemodynamic compromise.
• D: Incorrect; waiting risks rapid deterioration. Risk: missed
recognition of shock.
Nursing Process Linkage: Assessment / Implementation
NCJMM Competencies: Recognize Cues; Analyze Cues; Take
Action
Difficulty: Moderate
Bloom’s Level: Analyze
NCLEX Client Needs: Physiological Adaptation
Key Learning Objective: Identify priority action when
postoperative cues indicate possible internal bleeding.
2) MCQ
Clinical Scenario: A nurse is reviewing a proposed new wound-
care protocol on a medical-surgical unit.
Question Stem: Which source provides the strongest evidence
for deciding whether to adopt the protocol?
Answer Options:
A. One experienced nurse’s opinion
B. A manufacturer brochure for the dressing
, C. A recent systematic review and professional guideline
D. A single case report from one hospital
Correct Answer: C
Detailed Rationale:
Evidence-based practice relies on the best available research,
especially systematic reviews and clinical guidelines that
synthesize multiple studies and support safer, more effective
care.
Incorrect Option Analysis:
• A: Anecdotal opinion is useful clinically but not strong
evidence. Risk: practice based on tradition rather than
data.
• B: Manufacturer brochures may be biased toward product
use. Risk: conflict of interest.
• D: A single case report is too limited for practice change.
Risk: weak generalizability.
Nursing Process Linkage: Planning
NCJMM Competencies: Generate Solutions; Analyze Cues
Difficulty: Easy
Bloom’s Level: Understand
NCLEX Client Needs: Management of Care
Key Learning Objective: Select the strongest evidence source
for clinical practice decisions.
