Test Bank for Lewis’s Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems (5th Edition)

TEST BANK FOR LEWIS MEDICAL-
SURGICAL NURSING IN CANADA 5TH
EDITION

,CHAPTER 01: Introduction to Medical Surgical Nursing
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Practice in Canada Lewis: Medical-Surgical Nursing in Canada, 5th Canadian Edition
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MULTIPLE CHOICE : S S




1. The medical attendant is caring for a hospital client with a new diagnosis of
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pneumonia and explains to the hospital client that together they will plan the
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hospital client‘s care and set goals for discharge. The hospital client asks, ―H
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ow is that different from what the doctor does?‖ Which response by the m
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edical attendant is most appropriate?S S S S




a. ―The role of the medical attendant is to administer medications and other treat
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ments prescribed S



by your doctor.‖ S S



b. ―The medical attendant‘s job is to help the doctor by collecting data and com
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municating when there are problems.‖ S S S S



c. ―Medical attendants perform many of the procedures done by physicians, but medi S S S S S S S S S S S



cal attendants are here in S S S S



the health center for a longer time than doctors.‖
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d. ―In addition to caring for you while you are sick, the medical attendants will assist you to
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develop an individualized plan to maintain your health.‖ S S S S S S S




PRECISE CHOICE:-D S



Reasoning :- S



>>>This response is consistent with the Canadian nurses Association (CNA) definition of nursing. Regis
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tered medical attendants are self-
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regulated health care professionals who work autonomously and in collaboration with others. RNs enable i
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ndividuals, families, groups, communities and populations to achieve their optimal level of health. RNs co
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ordinate health care, deliver direct services, and support hospital clients in their self-
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care decisions and actions in situations of health, illness, injury, and disability in all stages of life. The other
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responses describe some of the dependent and collaborative functions of the nursing role but do not accura
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tely describe the medical attendant‘s role in the health care system.
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DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S



Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S




2. When caring for hospital clients using evidence-
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informed practice, which of the following does the medical attendant use?
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a. Clinical judgement based on experience S S S S



b. Evidence from a clinical research study S S S S S



c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the hospital client outcomes S S S S S S S S S



are met S




PRECISE CHOICE:-C S



Reasoning :->>>Evidence- S



informed nursing practice is a continuous interactive process involving the explicit, conscientious, and ju
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dicious consideration of the best available evidence to provide care. Four primary elements are: (a) clinical
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Sstate, setting, and circumstances; (b) hospital client preferences and actions; (c) best research evidence, a
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nd (d) health care resources. Clinical judgement based on the medical attendant‘s clinical experience is pa
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rt of EIP, but clinical decision making also should incorporate current research and research-
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based guidelines. Evidence from one clinical research study does not provide an adequate substantiation f
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or interventions. Evaluation of hospital client outcomes is important, but interventions should be based on
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Sresearch from randomized control studies with a large number of
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, subjects.

DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S



Planning MSC: NCLEX: Safe and Effective Care Environment
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3. Which of the following best explains the medical attendants‘ primary use of the nursing process when
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providing care to hospital clients? S S S S



a. To explain nursing interventions to other health care professionals
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b. As a problem-solving tool to identify and treat hospital clients‘ health care needs
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c. As a scientific-based process of diagnosing the hospital client‘s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
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PRECISE CHOICE:-B S



Reasoning :->>>The nursing process is an assertive problem-
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solving approach to the identification and treatment of hospital clients‘ problems. Diagnosis is only one ph
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ase of the nursing process. The primary use of the nursing process is in hospital client care, not to establish n
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ursing theory or explain nursing interventions to other health care professionals.
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DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S



Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S




4. The medical attendant is caring for a critically ill hospital client in the intensive care unit and plans an every
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- 2-
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hour turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated with t
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his turning schedule?
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a. Dependent
b. Cooperative
c. Independent
d. Collaborative
PRECISE CHOICE:-D S



Reasoning :- S



>>>When implementing collaborative nursing actions, the medical attendant is responsible primarily for mo
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nitoring for complications of acute illness or providing care to prevent or treat complications.
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Independent nursing actions are focused on health promotion, illness prevention, and hospital client advo
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cacy. A dependent action would require a physician order to implement. Cooperative nursing functions
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are not described as one of the formal nursing functions.
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DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S



Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S




5. The medical attendant is caring for a hospital client who has been admitted to the health center for surgery a
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nd tells the medical attendant, ―I do not feel right about leaving my children with my neighbour.‖ Which act
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ion should the medical attendant take next?
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a. Reassure the hospital client that these feelings are common for parents.
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b. Have the hospital client call the children to ensure that they are doing well.
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c. Call the neighbour to determine whether adequate childcare is being provided.
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d. Gather more data about the hospital client‘s feelings about the childcare arrangements.
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PRECISE CHOICE:-D S



Reasoning :- S



>>>Since a complete assessment is necessary in order to identify a problem and choose an appropriate inter
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vention, the medical attendant‘s first action should be to obtain more information. The other actions may be ap
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propriate, but more assessment is needed before the best intervention can be chosen.
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, DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S



Assessment MSC: NCLEX: Psychosocial Integrity
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6. The medical attendant is caring for a hospital client who has left-
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sided paralysis as the result of a stroke and assesses a pressure injury on the hospital client‘s left hip.
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Which of the following is the most appropriate nursing diagnosis for this hospital client?
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a. Impaired physical mobility related to decrease in muscle control (left-
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sided paralysis) S



b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about prot
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ecting tissue integrity S S



c. Impaired skin integrity related to pressure over bony prominence (impaired circ
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ulation)
d. Ineffective peripheral tissue perfusion related to sedentary lifestyle
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PRECISE CHOICE:-C S



Reasoning :- S



>>>The hospital client‘s major problem is the impaired skin integrity as demonstrated by the presence of a
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Spressure injury. The medical attendant is able to treat the cause of impaired circulation and pressure over
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bony prominence by frequently repositioning the hospital client. Although left-
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sided weakness is a problem for the hospital client, the medical attendant cannot treat the weakness. The ―
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risk for‖ diagnosis is not appropriate for this hospital client, who already has impaired tissue integrity. The
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Shospital client does have ineffective peripheral tissue perfusion, but the impaired skin integrity diagnosis
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indicates more clearly what the health problem is.
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DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S



Diagnosis MSC: NCLEX: Physiological Integrity
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7. The medical attendant caring for a hospital client with an infection has a nursing diagnosis of deficient fluid v
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olume related to excessive fluid loss through normal route (diaphoresis). Which of the following is an ap
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propriate hospital client outcome?
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a. Hospital client has a balanced intake and output. S S S S S S S



b. Hospital client‘s bedding is changed when it becomes damp.
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c. Hospital client understands the need for increased fluid intake.
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d. Hospital client‘s skin remains cool and dry throughout hospitalization.
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PRECISE CHOICE:-A S



Reasoning :- S



>>>This statement gives measurable data showing resolution of the problem of deficient fluid volume that w
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as identified in the nursing diagnosis statement. The other statements would not indicate that the problem
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of deficient fluid volume was resolved.
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DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S



Planning MSC: NCLEX: Physiological Integrity
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8. Which of the following represents a nursing activity that is carried out during the evaluation phase of the n
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ursing process? S



a. Determining if interventions have been effective in meeting hospital client outcomes.
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b. Documenting the nursing care plan in the progress notes in the medical record. S S S S S S S S S S S S



c. Deciding whether the hospital client‘s health problems have been completely resolved.
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d. Asking the hospital client to evaluate whether the nursing care provided w
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as satisfactory.
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