TEST BANK FOR DAVIS ADVANTAGE FOR
UNDERSTANDING MEDICAL-SURGICAL NURSING
SEVENTH EDITION BY WILLIAMS, HOPPER| ALL CHAPTERS |
QUESTIONS AND ANSWERS WITH RATIONALES
NEWEST VERSION
,Chapter 1 — Foundations of Medical-Surgical Nursing
Q1. A 68-year-old patient is admitted with community-acquired pneumonia.
Which nursing action most directly decreases the patient’s risk of hospital-acquired
infection?
A. Encourage the patient to cough and deep-breathe every 2 hours.
B. Place the patient in a private room with the door closed.
C. Use an alcohol-based hand rub before entering and after leaving the patient’s
room.
D. Apply a surgical mask when providing bedside care.
Answer: C
Rationale: Hand hygiene is the single most effective intervention to prevent
transmission of pathogens and hospital-acquired infections. Alcohol-based hand
rubs are recommended unless hands are visibly soiled. Encouraging cough and
deep breathing helps lung expansion but does not directly reduce transmission of
pathogens. Private rooms and masks are useful in certain situations (e.g.,
airborne/contact precautions) but universal hand hygiene remains the most direct
preventive measure.
Q2. A patient with chronic hypertension asks why the nurse checks orthostatic
vital signs. The nurse’s best response is:
A. “To determine whether you have an infection.”
B. “To assess for a drop in blood pressure that could cause dizziness or fainting.”
C. “To check how quickly your heart rate returns to normal after exercise.”
D. “To measure your blood sugar level while standing.”
Answer: B
Rationale: Orthostatic vital signs are obtained to detect a significant drop in blood
pressure (and/or increase in heart rate) when moving from supine to standing,
which can indicate volume depletion or impaired autonomic regulation and risk for
syncope. Options A, C, and D are incorrect descriptions.
,Q3. The nurse delegates vital signs and blood glucose monitoring to a licensed
practical nurse (LPN/LVN) for a stable postoperative patient. Which action by the
registered nurse (RN) demonstrates correct delegation?
A. Telling the LPN to call only if the blood glucose is over 300 mg/dL.
B. Completing a focused assessment and being available for questions.
C. Leaving the unit since the LPN is competent to manage care.
D. Assuming responsibility for any omissions by the LPN.
Answer: B
Rationale: Proper delegation requires the RN to assess the patient, determine
appropriateness of task delegation, ensure the delegatee’s competence, provide
clear instructions, and be available for supervision/questions. The RN retains
accountability but should not micromanage or abandon the unit. Option A gives an
unsafe threshold; D is incorrect because while the RN is accountable, saying
“assuming responsibility” is not an action—supervision is required. C is unsafe.
Q4. A patient refuses a prescribed prn opioid for severe postoperative pain. The
nurse should first:
A. Notify the physician and document the refusal.
B. Encourage the patient to take the medication every 4 hours.
C. Ask about the reason for refusal and collect further information.
D. Replace the opioid with a nonopioid analgesic immediately.
Answer: C
Rationale: The first action when a patient refuses medication is to explore reasons
(e.g., fear of addiction, side effects, sedation, religious beliefs). Understanding the
reason allows informed negotiation and appropriate alternatives or education.
Notification and documentation occur after assessment; automatic replacement or
coercion is inappropriate.
, Q5. A patient is on contact precautions for a draining wound infected with MRSA.
Which PPE combination is appropriate for routine care?
A. N95 respirator and face shield.
B. Gown and gloves.
C. Surgical mask only.
D. Sterile gown and sterile gloves.
Answer: B
Rationale: Contact precautions require gloves and a gown to prevent transmission
via direct contact or contaminated surfaces. N95 respirators and face shields are for
airborne or droplet/eye protection situations as indicated. Sterile attire is not
necessary for routine contact precautions.
Q6. The nurse prepares to give discharge teaching to an older adult with new heart
failure diagnosis. Which teaching strategy is best to optimize comprehension?
A. Give the patient a 12-page printed handout to read.
B. Provide one or two essential points, use teach-back, and include a family
member.
C. Explain all medications, lab testing, dietary changes, and follow-up at once.
D. Tell the patient to call the clinic if they have questions.
Answer: B
Rationale: Teach-back (asking the patient to explain in their own words) ensures
understanding; focusing on a few key points and involving family/caregiver
enhances retention—particularly for older adults. Overloading with too much
information or only giving written material without confirmation is less effective.
Q7. During handoff, the nurse receives a report that a patient is “NPO after
midnight.” The nurse should:
A. Accept the report and order a bed tray.
B. Clarify the reason and duration of the NPO status and verify orders.
C. Assume NPO means the patient cannot have fluids.
D. Immediately obtain the patient’s vital signs.
UNDERSTANDING MEDICAL-SURGICAL NURSING
SEVENTH EDITION BY WILLIAMS, HOPPER| ALL CHAPTERS |
QUESTIONS AND ANSWERS WITH RATIONALES
NEWEST VERSION
,Chapter 1 — Foundations of Medical-Surgical Nursing
Q1. A 68-year-old patient is admitted with community-acquired pneumonia.
Which nursing action most directly decreases the patient’s risk of hospital-acquired
infection?
A. Encourage the patient to cough and deep-breathe every 2 hours.
B. Place the patient in a private room with the door closed.
C. Use an alcohol-based hand rub before entering and after leaving the patient’s
room.
D. Apply a surgical mask when providing bedside care.
Answer: C
Rationale: Hand hygiene is the single most effective intervention to prevent
transmission of pathogens and hospital-acquired infections. Alcohol-based hand
rubs are recommended unless hands are visibly soiled. Encouraging cough and
deep breathing helps lung expansion but does not directly reduce transmission of
pathogens. Private rooms and masks are useful in certain situations (e.g.,
airborne/contact precautions) but universal hand hygiene remains the most direct
preventive measure.
Q2. A patient with chronic hypertension asks why the nurse checks orthostatic
vital signs. The nurse’s best response is:
A. “To determine whether you have an infection.”
B. “To assess for a drop in blood pressure that could cause dizziness or fainting.”
C. “To check how quickly your heart rate returns to normal after exercise.”
D. “To measure your blood sugar level while standing.”
Answer: B
Rationale: Orthostatic vital signs are obtained to detect a significant drop in blood
pressure (and/or increase in heart rate) when moving from supine to standing,
which can indicate volume depletion or impaired autonomic regulation and risk for
syncope. Options A, C, and D are incorrect descriptions.
,Q3. The nurse delegates vital signs and blood glucose monitoring to a licensed
practical nurse (LPN/LVN) for a stable postoperative patient. Which action by the
registered nurse (RN) demonstrates correct delegation?
A. Telling the LPN to call only if the blood glucose is over 300 mg/dL.
B. Completing a focused assessment and being available for questions.
C. Leaving the unit since the LPN is competent to manage care.
D. Assuming responsibility for any omissions by the LPN.
Answer: B
Rationale: Proper delegation requires the RN to assess the patient, determine
appropriateness of task delegation, ensure the delegatee’s competence, provide
clear instructions, and be available for supervision/questions. The RN retains
accountability but should not micromanage or abandon the unit. Option A gives an
unsafe threshold; D is incorrect because while the RN is accountable, saying
“assuming responsibility” is not an action—supervision is required. C is unsafe.
Q4. A patient refuses a prescribed prn opioid for severe postoperative pain. The
nurse should first:
A. Notify the physician and document the refusal.
B. Encourage the patient to take the medication every 4 hours.
C. Ask about the reason for refusal and collect further information.
D. Replace the opioid with a nonopioid analgesic immediately.
Answer: C
Rationale: The first action when a patient refuses medication is to explore reasons
(e.g., fear of addiction, side effects, sedation, religious beliefs). Understanding the
reason allows informed negotiation and appropriate alternatives or education.
Notification and documentation occur after assessment; automatic replacement or
coercion is inappropriate.
, Q5. A patient is on contact precautions for a draining wound infected with MRSA.
Which PPE combination is appropriate for routine care?
A. N95 respirator and face shield.
B. Gown and gloves.
C. Surgical mask only.
D. Sterile gown and sterile gloves.
Answer: B
Rationale: Contact precautions require gloves and a gown to prevent transmission
via direct contact or contaminated surfaces. N95 respirators and face shields are for
airborne or droplet/eye protection situations as indicated. Sterile attire is not
necessary for routine contact precautions.
Q6. The nurse prepares to give discharge teaching to an older adult with new heart
failure diagnosis. Which teaching strategy is best to optimize comprehension?
A. Give the patient a 12-page printed handout to read.
B. Provide one or two essential points, use teach-back, and include a family
member.
C. Explain all medications, lab testing, dietary changes, and follow-up at once.
D. Tell the patient to call the clinic if they have questions.
Answer: B
Rationale: Teach-back (asking the patient to explain in their own words) ensures
understanding; focusing on a few key points and involving family/caregiver
enhances retention—particularly for older adults. Overloading with too much
information or only giving written material without confirmation is less effective.
Q7. During handoff, the nurse receives a report that a patient is “NPO after
midnight.” The nurse should:
A. Accept the report and order a bed tray.
B. Clarify the reason and duration of the NPO status and verify orders.
C. Assume NPO means the patient cannot have fluids.
D. Immediately obtain the patient’s vital signs.
