, COMPREHENSIVE TEST BANK: Lewis's Medical-Surgical Nursing:
Assessment and Management of Clinical Problems, 12th Edition
2026 update.
Editors: Mariann M. Harding, Jeffrey Kwong, Debra Hagler, Courtney
Reinisch
SECTION ONE: CONCEPTS IN NURSING PRACTICE
Table of Contents for Section One
Chapter 1: Professional Nursing
Chapter 2: Social Determinants of Health
Chapter 3: Health History and Physical Examination
Chapter 4: Patient and Caregiver Teaching
Chapter 5: Chronic Illness and Older Adults
Chapter 6: Caring for Lesbian, Gay, Bisexual, Transgender, Queer or
Questioning, and Gender Diverse Patients
,Chapter 1: Professional Nursing
Chapter Summary
This chapter introduces the foundational concepts of professional
nursing practice. It defines nursing according to the American Nurses
Association (ANA) as "the protection, promotion, and optimization of
health and abilities, prevention of illness and injury, facilitation of
healing, alleviation of suffering through the diagnosis and treatment of
human response, and advocacy in the care of individuals, families,
groups, communities, and populations." The chapter explores
the nursing process (assessment, diagnosis, planning, implementation,
evaluation) as a systematic problem-solving approach to patient care. It
emphasizes evidence-based practice (EBP) —the integration of best
research evidence, clinical expertise, and patient preferences in clinical
decision making. Other key topics include clinical
judgment, interprofessional collaboration, delegation principles
(right task, right circumstance, right person, right
direction/communication, right
supervision/evaluation), accountability, and ethical practice. The
chapter also addresses the various roles of nurses (caregiver, advocate,
educator, leader, researcher) and the importance of self-care and
professional development.
,Chapter Questions
1. The nurse completes an admission database and explains that the
plan of care and discharge goals will be developed with the
patient's input. The patient asks, "How is this different from what
the physician does?" Which response would the nurse provide?
A) "The role of the nurse is to administer medications and other
treatments prescribed by your physician."
B) "In addition to caring for you while you are sick, the nurses will help
you plan to maintain your health."
C) "The nurse's job is to collect information and communicate any
problems that occur to the physician."
D) "Nurses perform many of the same procedures as the physician, but
nurses are with the patients for a longer time than the physician."
Answer: B
Rationale: The American Nurses Association (ANA) definition of nursing
describes the role of nurses in promoting health. This response
accurately reflects nursing's unique contribution—helping patients
maintain health, not just treating illness. Option A describes only
dependent functions (carrying out physician orders). Option C limits
nursing to information gathering and reporting. Option D focuses on
duration of contact rather than the distinct professional role of nursing
in health promotion.
,2. Which statement by the nurse accurately describes the use of
evidence-based practice (EBP)?
A) "Patient care is based on clinical judgment, experience, and
traditions."
B) "Data are analyzed later to show that the patient outcomes are
consistently met."
C) "Research from all published articles is used as a guide for planning
patient care."
D) "Recommendations are based on research, clinical expertise, and
patient preferences."
Answer: D
Rationale: Evidence-based practice (EBP) is the integration of the best
research evidence with clinical expertise and consideration of patient
values and preferences. Option A describes tradition-based practice, not
EBP. Option B describes outcomes evaluation, which is important but not
the definition of EBP. Option C is incorrect because not all published
articles provide valid research evidence; EBP requires critical appraisal
of research quality.
,3. Which statement by the nurse provides a clear explanation of the
nursing process?
A) "The nursing process is a research method of diagnosing the patient's
health care problems."
B) "The nursing process is used primarily to explain nursing
interventions to other health care professionals."
C) "The nursing process is a problem-solving tool used to identify and
manage the patients' health care needs."
D) "The nursing process is based on nursing theory that incorporates the
biopsychosocial nature of humans."
Answer: C
Rationale: The nursing process is a systematic, problem-solving
approach to identifying and treating patient health problems. It consists
of five phases: assessment, diagnosis, planning, implementation, and
evaluation. Option A is incorrect because diagnosis is only one phase, not
the purpose of the entire process. Option B misstates the primary
purpose. Option D describes theoretical foundations but not the
definition of the nursing process itself.
,4. A patient admitted to the hospital for surgery tells the nurse, "I
do not feel comfortable leaving my children with my parents."
Which action would the nurse take next?
A) Reassure the patient that these feelings are common for parents.
B) Have the patient call the children to ensure that they are doing well.
C) Gather information about the patient's concerns regarding the child
care arrangements.
D) Call the patient's parents to determine whether adequate child care is
being provided.
Answer: C
Rationale: The nursing process begins with assessment. Before
intervening, the nurse must gather more data to fully understand the
patient's concerns. Options A and B are interventions that may be
appropriate after further assessment. Option D violates patient
confidentiality and assumes a problem without assessment data.
5. A patient with a bacterial infection is hypovolemic due to fever
and excessive diaphoresis. Which expected outcome would the
nurse select for this patient?
A) Patient has a balanced intake and output.
B) Patient's bedding is kept clean and free of moisture.
,C) Patient understands the need for increased fluid intake.
D) Patient's skin remains cool and dry throughout hospitalization.
Answer: A
Rationale: Balanced intake and output provides measurable data
showing resolution of deficient fluid volume—the problem identified in
the scenario. Option B addresses comfort but not fluid volume. Option C
addresses knowledge, not the physiological problem. Option D is
inconsistent with the fever and diaphoresis that necessitated treatment.
6. Which nursing diagnosis statement is written correctly?
A) Altered tissue perfusion related to heart failure
B) Risk for impaired tissue integrity related to sacral redness
C) Ineffective coping related to response to biopsy test results
D) Altered urinary elimination related to urinary tract infection
Answer: C
Rationale: A correctly written nursing diagnosis includes a NANDA
diagnostic label and an etiology that describes the patient's response to a
health problem that nursing can treat. Option C uses "related to" to link
the nursing diagnosis (ineffective coping) to a treatable cause (response
to biopsy results). Options A and D use medical diagnoses (heart failure,
,urinary tract infection) as etiologies, which is inappropriate because
nurses treat human responses, not medical diseases. Option B uses a
defining characteristic (sacral redness) as the etiology.
7. A nurse asks the patient if pain was relieved after receiving
medication. What is the purpose of the evaluation phase of the
nursing process?
A) To determine if interventions have been effective in meeting patient
outcomes
B) To document the nursing care plan in the progress notes of the
medical record
C) To decide whether the patient's health problems have been
completely resolved
D) To establish if the patient agrees that the nursing care provided was
satisfactory
Answer: A
Rationale: Evaluation determines whether desired patient outcomes
have been met and whether nursing interventions were appropriate.
Option B describes documentation, which occurs throughout the nursing
process. Option C is too narrow—evaluation may show partial progress,
, not just complete resolution. Option D addresses patient satisfaction,
which is one aspect but not the primary purpose of evaluation.
8. The nurse interviews a patient while completing the health
history and physical examination. What is the purpose of the
assessment phase of the nursing process?
A) To teach interventions that relieve health problems
B) To use patient data to evaluate patient care outcomes
C) To obtain data with which to diagnose patient problems
D) To help the patient identify realistic outcomes for health problems
Answer: C
Rationale: During assessment, the nurse gathers information to identify
patient strengths and problems. This data forms the basis for nursing
diagnoses. Option A describes implementation. Option B describes
evaluation. Option D describes planning.
9. Which patient care task would the nurse delegate to experienced
assistive personnel (AP)?
Assessment and Management of Clinical Problems, 12th Edition
2026 update.
Editors: Mariann M. Harding, Jeffrey Kwong, Debra Hagler, Courtney
Reinisch
SECTION ONE: CONCEPTS IN NURSING PRACTICE
Table of Contents for Section One
Chapter 1: Professional Nursing
Chapter 2: Social Determinants of Health
Chapter 3: Health History and Physical Examination
Chapter 4: Patient and Caregiver Teaching
Chapter 5: Chronic Illness and Older Adults
Chapter 6: Caring for Lesbian, Gay, Bisexual, Transgender, Queer or
Questioning, and Gender Diverse Patients
,Chapter 1: Professional Nursing
Chapter Summary
This chapter introduces the foundational concepts of professional
nursing practice. It defines nursing according to the American Nurses
Association (ANA) as "the protection, promotion, and optimization of
health and abilities, prevention of illness and injury, facilitation of
healing, alleviation of suffering through the diagnosis and treatment of
human response, and advocacy in the care of individuals, families,
groups, communities, and populations." The chapter explores
the nursing process (assessment, diagnosis, planning, implementation,
evaluation) as a systematic problem-solving approach to patient care. It
emphasizes evidence-based practice (EBP) —the integration of best
research evidence, clinical expertise, and patient preferences in clinical
decision making. Other key topics include clinical
judgment, interprofessional collaboration, delegation principles
(right task, right circumstance, right person, right
direction/communication, right
supervision/evaluation), accountability, and ethical practice. The
chapter also addresses the various roles of nurses (caregiver, advocate,
educator, leader, researcher) and the importance of self-care and
professional development.
,Chapter Questions
1. The nurse completes an admission database and explains that the
plan of care and discharge goals will be developed with the
patient's input. The patient asks, "How is this different from what
the physician does?" Which response would the nurse provide?
A) "The role of the nurse is to administer medications and other
treatments prescribed by your physician."
B) "In addition to caring for you while you are sick, the nurses will help
you plan to maintain your health."
C) "The nurse's job is to collect information and communicate any
problems that occur to the physician."
D) "Nurses perform many of the same procedures as the physician, but
nurses are with the patients for a longer time than the physician."
Answer: B
Rationale: The American Nurses Association (ANA) definition of nursing
describes the role of nurses in promoting health. This response
accurately reflects nursing's unique contribution—helping patients
maintain health, not just treating illness. Option A describes only
dependent functions (carrying out physician orders). Option C limits
nursing to information gathering and reporting. Option D focuses on
duration of contact rather than the distinct professional role of nursing
in health promotion.
,2. Which statement by the nurse accurately describes the use of
evidence-based practice (EBP)?
A) "Patient care is based on clinical judgment, experience, and
traditions."
B) "Data are analyzed later to show that the patient outcomes are
consistently met."
C) "Research from all published articles is used as a guide for planning
patient care."
D) "Recommendations are based on research, clinical expertise, and
patient preferences."
Answer: D
Rationale: Evidence-based practice (EBP) is the integration of the best
research evidence with clinical expertise and consideration of patient
values and preferences. Option A describes tradition-based practice, not
EBP. Option B describes outcomes evaluation, which is important but not
the definition of EBP. Option C is incorrect because not all published
articles provide valid research evidence; EBP requires critical appraisal
of research quality.
,3. Which statement by the nurse provides a clear explanation of the
nursing process?
A) "The nursing process is a research method of diagnosing the patient's
health care problems."
B) "The nursing process is used primarily to explain nursing
interventions to other health care professionals."
C) "The nursing process is a problem-solving tool used to identify and
manage the patients' health care needs."
D) "The nursing process is based on nursing theory that incorporates the
biopsychosocial nature of humans."
Answer: C
Rationale: The nursing process is a systematic, problem-solving
approach to identifying and treating patient health problems. It consists
of five phases: assessment, diagnosis, planning, implementation, and
evaluation. Option A is incorrect because diagnosis is only one phase, not
the purpose of the entire process. Option B misstates the primary
purpose. Option D describes theoretical foundations but not the
definition of the nursing process itself.
,4. A patient admitted to the hospital for surgery tells the nurse, "I
do not feel comfortable leaving my children with my parents."
Which action would the nurse take next?
A) Reassure the patient that these feelings are common for parents.
B) Have the patient call the children to ensure that they are doing well.
C) Gather information about the patient's concerns regarding the child
care arrangements.
D) Call the patient's parents to determine whether adequate child care is
being provided.
Answer: C
Rationale: The nursing process begins with assessment. Before
intervening, the nurse must gather more data to fully understand the
patient's concerns. Options A and B are interventions that may be
appropriate after further assessment. Option D violates patient
confidentiality and assumes a problem without assessment data.
5. A patient with a bacterial infection is hypovolemic due to fever
and excessive diaphoresis. Which expected outcome would the
nurse select for this patient?
A) Patient has a balanced intake and output.
B) Patient's bedding is kept clean and free of moisture.
,C) Patient understands the need for increased fluid intake.
D) Patient's skin remains cool and dry throughout hospitalization.
Answer: A
Rationale: Balanced intake and output provides measurable data
showing resolution of deficient fluid volume—the problem identified in
the scenario. Option B addresses comfort but not fluid volume. Option C
addresses knowledge, not the physiological problem. Option D is
inconsistent with the fever and diaphoresis that necessitated treatment.
6. Which nursing diagnosis statement is written correctly?
A) Altered tissue perfusion related to heart failure
B) Risk for impaired tissue integrity related to sacral redness
C) Ineffective coping related to response to biopsy test results
D) Altered urinary elimination related to urinary tract infection
Answer: C
Rationale: A correctly written nursing diagnosis includes a NANDA
diagnostic label and an etiology that describes the patient's response to a
health problem that nursing can treat. Option C uses "related to" to link
the nursing diagnosis (ineffective coping) to a treatable cause (response
to biopsy results). Options A and D use medical diagnoses (heart failure,
,urinary tract infection) as etiologies, which is inappropriate because
nurses treat human responses, not medical diseases. Option B uses a
defining characteristic (sacral redness) as the etiology.
7. A nurse asks the patient if pain was relieved after receiving
medication. What is the purpose of the evaluation phase of the
nursing process?
A) To determine if interventions have been effective in meeting patient
outcomes
B) To document the nursing care plan in the progress notes of the
medical record
C) To decide whether the patient's health problems have been
completely resolved
D) To establish if the patient agrees that the nursing care provided was
satisfactory
Answer: A
Rationale: Evaluation determines whether desired patient outcomes
have been met and whether nursing interventions were appropriate.
Option B describes documentation, which occurs throughout the nursing
process. Option C is too narrow—evaluation may show partial progress,
, not just complete resolution. Option D addresses patient satisfaction,
which is one aspect but not the primary purpose of evaluation.
8. The nurse interviews a patient while completing the health
history and physical examination. What is the purpose of the
assessment phase of the nursing process?
A) To teach interventions that relieve health problems
B) To use patient data to evaluate patient care outcomes
C) To obtain data with which to diagnose patient problems
D) To help the patient identify realistic outcomes for health problems
Answer: C
Rationale: During assessment, the nurse gathers information to identify
patient strengths and problems. This data forms the basis for nursing
diagnoses. Option A describes implementation. Option B describes
evaluation. Option D describes planning.
9. Which patient care task would the nurse delegate to experienced
assistive personnel (AP)?
