Lewis's Medical-Surgical Nursing in Canada
Assessment and Management of Clinical
Problems
• 5th Edition - June 15, 2022
• Latest edition
• Authors: Jane Tyerman, Shelley Cobbett,
Mariann M. Harding, Jeffrey Kwong, Dottie
Roberts, Debra Hagler, Courtney Reinisch
TEST BANK
Lewis’s Medical-Surgical Nursing in Canada, 5th ed. (2022)
Section 1: Concepts in Nursing Practice
Chapter 1: Introduction to Medical-Surgical Nursing Practice in
Canada
Blueprint applied:
• Emphasis on clinical judgment & prioritization
• ~60% application
, • Increased NCLEX-style priority decision-making
1. A nurse is caring for a hospitalized patient with multiple
chronic conditions. Which action best reflects the patient-
centred care model described in Lewis?
A. Prioritizing physician orders over patient preferences
B. Including the patient and family in shared decision-making
C. Limiting information to prevent patient anxiety
D. Focusing exclusively on acute medical problems
Answer: B
Rationale: Patient-centred care emphasizes collaboration,
respect for patient preferences, and shared decision-making.
Inclusion of family when appropriate is central to Canadian
nursing practice.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Ch. 1.
2. Which patient should the nurse assess first?
A. Stable patient awaiting discharge teaching
B. Patient with new onset confusion
C. Patient requesting pain medication rated 6/10
D. Patient scheduled for routine dressing change
Answer: B
Rationale: New onset confusion may indicate hypoxia,
,infection, metabolic imbalance, or neurological compromise.
Acute change in mental status is a priority assessment finding.
Citation: Lewis, 5th ed., Ch. 1 (Clinical Judgment &
Prioritization).
3. A nurse applies the Clinical Judgment Measurement Model
(CJMM) by first:
A. Evaluating patient outcomes
B. Implementing interventions
C. Recognizing and analyzing cues
D. Documenting findings
Answer: C
Rationale: Clinical judgment begins with cue recognition and
analysis before planning and intervention.
Citation: Lewis, 5th ed., Ch. 1.
4. A patient with sepsis has hypotension and tachycardia.
Which nursing action reflects priority clinical reasoning?
A. Documenting findings
B. Notifying the health care provider immediately
C. Administering scheduled oral medications
D. Providing routine hygiene care
Answer: B
Rationale: Hypotension and tachycardia in sepsis indicate
, possible shock. Escalation is a priority safety intervention.
Citation: Lewis, 5th ed., Ch. 1 (Patient Safety & Early
Recognition).
5. Which statement best describes evidence-informed practice
in Canadian nursing?
A. Following institutional policy without question
B. Relying on physician preference
C. Integrating best research evidence with clinical expertise and
patient values
D. Using only randomized controlled trials
Answer: C
Rationale: Evidence-informed practice integrates research,
clinical expertise, and patient preferences.
Citation: Lewis, 5th ed., Ch. 1.
6. A nurse delegates vital signs to an unregulated care provider
(UCP). Which situation requires the nurse to perform the
assessment personally?
A. Stable post-op day 3 patient
B. Patient with new chest pain
C. Patient ambulating independently
D. Patient awaiting discharge
Assessment and Management of Clinical
Problems
• 5th Edition - June 15, 2022
• Latest edition
• Authors: Jane Tyerman, Shelley Cobbett,
Mariann M. Harding, Jeffrey Kwong, Dottie
Roberts, Debra Hagler, Courtney Reinisch
TEST BANK
Lewis’s Medical-Surgical Nursing in Canada, 5th ed. (2022)
Section 1: Concepts in Nursing Practice
Chapter 1: Introduction to Medical-Surgical Nursing Practice in
Canada
Blueprint applied:
• Emphasis on clinical judgment & prioritization
• ~60% application
, • Increased NCLEX-style priority decision-making
1. A nurse is caring for a hospitalized patient with multiple
chronic conditions. Which action best reflects the patient-
centred care model described in Lewis?
A. Prioritizing physician orders over patient preferences
B. Including the patient and family in shared decision-making
C. Limiting information to prevent patient anxiety
D. Focusing exclusively on acute medical problems
Answer: B
Rationale: Patient-centred care emphasizes collaboration,
respect for patient preferences, and shared decision-making.
Inclusion of family when appropriate is central to Canadian
nursing practice.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Ch. 1.
2. Which patient should the nurse assess first?
A. Stable patient awaiting discharge teaching
B. Patient with new onset confusion
C. Patient requesting pain medication rated 6/10
D. Patient scheduled for routine dressing change
Answer: B
Rationale: New onset confusion may indicate hypoxia,
,infection, metabolic imbalance, or neurological compromise.
Acute change in mental status is a priority assessment finding.
Citation: Lewis, 5th ed., Ch. 1 (Clinical Judgment &
Prioritization).
3. A nurse applies the Clinical Judgment Measurement Model
(CJMM) by first:
A. Evaluating patient outcomes
B. Implementing interventions
C. Recognizing and analyzing cues
D. Documenting findings
Answer: C
Rationale: Clinical judgment begins with cue recognition and
analysis before planning and intervention.
Citation: Lewis, 5th ed., Ch. 1.
4. A patient with sepsis has hypotension and tachycardia.
Which nursing action reflects priority clinical reasoning?
A. Documenting findings
B. Notifying the health care provider immediately
C. Administering scheduled oral medications
D. Providing routine hygiene care
Answer: B
Rationale: Hypotension and tachycardia in sepsis indicate
, possible shock. Escalation is a priority safety intervention.
Citation: Lewis, 5th ed., Ch. 1 (Patient Safety & Early
Recognition).
5. Which statement best describes evidence-informed practice
in Canadian nursing?
A. Following institutional policy without question
B. Relying on physician preference
C. Integrating best research evidence with clinical expertise and
patient values
D. Using only randomized controlled trials
Answer: C
Rationale: Evidence-informed practice integrates research,
clinical expertise, and patient preferences.
Citation: Lewis, 5th ed., Ch. 1.
6. A nurse delegates vital signs to an unregulated care provider
(UCP). Which situation requires the nurse to perform the
assessment personally?
A. Stable post-op day 3 patient
B. Patient with new chest pain
C. Patient ambulating independently
D. Patient awaiting discharge
