Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• PublisherPublished by F.A.
Davis Copyright© 2024
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario:
A 72-year-old patient with newly diagnosed heart failure is
being discharged. The patient says, “Just tell my daughter what
I need to do. I get overwhelmed with all these instructions.”
Question Stem:
What is the nurse’s best response?
Answer Options:
A. “Your daughter can read the discharge packet and explain it
to you later.”
B. “Let us include your daughter, but I will also review the key
points with you using simple language and teach-back.”
C. “The provider will explain the most important instructions
before discharge.”
D. “You can return to the clinic if you have questions after you
get home.”
Correct Answer:
B
Detailed Rationale:
This response best reflects patient-centered care and safe
discharge planning. The nurse includes the family member
while still addressing the patient directly, using simple language
and teach-back to confirm understanding. This supports self-
,management, autonomy, and retention of essential
information.
Incorrect Option Analysis:
• A: Incorrect. Defers teaching entirely and risks incomplete
understanding. Misconception: family-only teaching is
enough. Safety risk: medication or symptom-management
errors after discharge.
• C: Incorrect. Providers are important, but discharge
teaching is a nursing responsibility. Misconception:
education belongs only to the provider. Safety risk: missed
reinforcement of daily self-care tasks.
• D: Incorrect. Follow-up is helpful but does not replace
discharge teaching. Misconception: questions can safely
wait until after discharge. Safety risk: delayed recognition
of worsening heart failure.
Nursing Process Linkage: Implementation
NCJMM Competencies: Recognize Cues, Generate Solutions,
Take Action
Difficulty: Moderate
Bloom’s Level: Apply
NCLEX Client Needs: Management of Care
Key Learning Objective: Apply patient-centered communication
strategies that support discharge readiness and understanding.
2) MCQ
, Clinical Scenario:
A postoperative patient on the medical-surgical unit becomes
pale, restless, and tachycardic. Blood pressure is 88/54 mm Hg,
and urine output has dropped sharply over the last 2 hours.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Document the findings and recheck vital signs in 30 minutes.
B. Assess the patient for signs of bleeding and notify the rapid
response team or provider immediately.
C. Encourage the patient to rest and increase oral fluids.
D. Administer the prescribed pain medication to reduce
restlessness.
Correct Answer:
B
Detailed Rationale:
The patient shows cues of possible hypovolemia and
hemorrhagic shock. Priority action is to assess for bleeding
while activating urgent help. This reflects early recognition of
deterioration, prioritization of physiologic instability, and timely
escalation of care.
Incorrect Option Analysis:
• A: Incorrect. Delaying action risks progression to shock.
Misconception: repeat vital signs alone are sufficient.
Safety risk: life-threatening delay.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• PublisherPublished by F.A.
Davis Copyright© 2024
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario:
A 72-year-old patient with newly diagnosed heart failure is
being discharged. The patient says, “Just tell my daughter what
I need to do. I get overwhelmed with all these instructions.”
Question Stem:
What is the nurse’s best response?
Answer Options:
A. “Your daughter can read the discharge packet and explain it
to you later.”
B. “Let us include your daughter, but I will also review the key
points with you using simple language and teach-back.”
C. “The provider will explain the most important instructions
before discharge.”
D. “You can return to the clinic if you have questions after you
get home.”
Correct Answer:
B
Detailed Rationale:
This response best reflects patient-centered care and safe
discharge planning. The nurse includes the family member
while still addressing the patient directly, using simple language
and teach-back to confirm understanding. This supports self-
,management, autonomy, and retention of essential
information.
Incorrect Option Analysis:
• A: Incorrect. Defers teaching entirely and risks incomplete
understanding. Misconception: family-only teaching is
enough. Safety risk: medication or symptom-management
errors after discharge.
• C: Incorrect. Providers are important, but discharge
teaching is a nursing responsibility. Misconception:
education belongs only to the provider. Safety risk: missed
reinforcement of daily self-care tasks.
• D: Incorrect. Follow-up is helpful but does not replace
discharge teaching. Misconception: questions can safely
wait until after discharge. Safety risk: delayed recognition
of worsening heart failure.
Nursing Process Linkage: Implementation
NCJMM Competencies: Recognize Cues, Generate Solutions,
Take Action
Difficulty: Moderate
Bloom’s Level: Apply
NCLEX Client Needs: Management of Care
Key Learning Objective: Apply patient-centered communication
strategies that support discharge readiness and understanding.
2) MCQ
, Clinical Scenario:
A postoperative patient on the medical-surgical unit becomes
pale, restless, and tachycardic. Blood pressure is 88/54 mm Hg,
and urine output has dropped sharply over the last 2 hours.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Document the findings and recheck vital signs in 30 minutes.
B. Assess the patient for signs of bleeding and notify the rapid
response team or provider immediately.
C. Encourage the patient to rest and increase oral fluids.
D. Administer the prescribed pain medication to reduce
restlessness.
Correct Answer:
B
Detailed Rationale:
The patient shows cues of possible hypovolemia and
hemorrhagic shock. Priority action is to assess for bleeding
while activating urgent help. This reflects early recognition of
deterioration, prioritization of physiologic instability, and timely
escalation of care.
Incorrect Option Analysis:
• A: Incorrect. Delaying action risks progression to shock.
Misconception: repeat vital signs alone are sufficient.
Safety risk: life-threatening delay.
