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 68-year-old patient is 6 hours post abdominal surgery. The
nurse finds the patient sitting upright, restless, and stating, “I
cannot catch my breath.” The respiratory rate is 28/min, SpO₂ is
88% on room air, and the skin is pale.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Offer reassurance and encourage slow breathing
B. Place the patient in high Fowler’s position and apply oxygen
per protocol
C. Obtain a full set of vital signs before intervening
D. Notify the surgeon after documenting the finding
Correct Answer:
B
Detailed Rationale:
This patient shows cues of impaired oxygenation and possible
acute respiratory compromise. The priority is to support
airway/breathing immediately using positioning and oxygen
while continuing rapid assessment. Early intervention reduces
risk of deterioration and aligns with ABC prioritization.
Incorrect Option Analysis:
, • A: Reassurance alone does not correct hypoxemia.
Common misconception: anxiety is assumed to be the
primary issue. Risk: delayed treatment.
• C: Additional data are useful, but oxygenation comes first.
Risk: worsening hypoxia.
• D: Provider notification is important, but not before
immediate stabilizing action. Risk: avoidable deterioration.
Nursing Process Linkage:
Implementation
Clinical Judgment Competencies (NCJMM):
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty Level: Moderate
Bloom’s Cognitive Level: Apply
NCLEX Client Needs Category: Physiological Adaptation
Key Learning Objective:
Identify and respond to acute postoperative respiratory
compromise using priority nursing action.
2) MCQ
Clinical Scenario:
A nurse is reviewing articles to update a unit protocol for
preventing hospital-acquired pressure injuries.
, Question Stem:
Which source provides the strongest evidence for practice
change?
Answer Options:
A. A seasoned nurse’s opinion about what works best
B. A systematic review of randomized controlled trials
C. A textbook chapter published 10 years ago
D. A single case report from one hospital
Correct Answer:
B
Detailed Rationale:
Systematic reviews synthesize multiple high-quality studies and
provide stronger evidence than opinion, older textbooks, or
isolated case reports. Evidence-based nursing practice relies on
the best available research combined with clinical expertise and
patient values.
Incorrect Option Analysis:
• A: Valuable for experience, but not the strongest evidence.
Risk: inconsistent practice.
• C: Textbooks can be outdated and are secondary sources.
Risk: obsolete guidance.
• D: Case reports are useful for generating ideas, not
establishing best practice. Risk: weak generalizability.
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 68-year-old patient is 6 hours post abdominal surgery. The
nurse finds the patient sitting upright, restless, and stating, “I
cannot catch my breath.” The respiratory rate is 28/min, SpO₂ is
88% on room air, and the skin is pale.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Offer reassurance and encourage slow breathing
B. Place the patient in high Fowler’s position and apply oxygen
per protocol
C. Obtain a full set of vital signs before intervening
D. Notify the surgeon after documenting the finding
Correct Answer:
B
Detailed Rationale:
This patient shows cues of impaired oxygenation and possible
acute respiratory compromise. The priority is to support
airway/breathing immediately using positioning and oxygen
while continuing rapid assessment. Early intervention reduces
risk of deterioration and aligns with ABC prioritization.
Incorrect Option Analysis:
, • A: Reassurance alone does not correct hypoxemia.
Common misconception: anxiety is assumed to be the
primary issue. Risk: delayed treatment.
• C: Additional data are useful, but oxygenation comes first.
Risk: worsening hypoxia.
• D: Provider notification is important, but not before
immediate stabilizing action. Risk: avoidable deterioration.
Nursing Process Linkage:
Implementation
Clinical Judgment Competencies (NCJMM):
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty Level: Moderate
Bloom’s Cognitive Level: Apply
NCLEX Client Needs Category: Physiological Adaptation
Key Learning Objective:
Identify and respond to acute postoperative respiratory
compromise using priority nursing action.
2) MCQ
Clinical Scenario:
A nurse is reviewing articles to update a unit protocol for
preventing hospital-acquired pressure injuries.
, Question Stem:
Which source provides the strongest evidence for practice
change?
Answer Options:
A. A seasoned nurse’s opinion about what works best
B. A systematic review of randomized controlled trials
C. A textbook chapter published 10 years ago
D. A single case report from one hospital
Correct Answer:
B
Detailed Rationale:
Systematic reviews synthesize multiple high-quality studies and
provide stronger evidence than opinion, older textbooks, or
isolated case reports. Evidence-based nursing practice relies on
the best available research combined with clinical expertise and
patient values.
Incorrect Option Analysis:
• A: Valuable for experience, but not the strongest evidence.
Risk: inconsistent practice.
• C: Textbooks can be outdated and are secondary sources.
Risk: obsolete guidance.
• D: Case reports are useful for generating ideas, not
establishing best practice. Risk: weak generalizability.
