Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,Question 1 — MCQ
Clinical Scenario
A nurse begins the morning shift caring for four patients on a
medical-surgical unit. During report, the nurse learns that one
patient with pneumonia has become increasingly restless and
confused over the last hour.
Question Stem
Which action demonstrates the nurse's use of clinical
judgment?
Answer Options
A. Continue the medication pass and reassess the patient at the
next scheduled vital sign check.
B. Notify the provider immediately without further assessment.
C. Assess oxygen saturation, respiratory status, and compare
findings with previous data.
D. Document the report findings and wait for laboratory results.
Correct Answer
C. Assess oxygen saturation, respiratory status, and
compare findings with previous data.
,Detailed Rationale
Clinical judgment involves recognizing cues, analyzing
information, prioritizing hypotheses, and taking appropriate
actions. New confusion and restlessness are early
manifestations of hypoxemia in older adults and patients with
respiratory illness. Before contacting the provider, the nurse
should gather additional assessment data to determine the
severity of deterioration and guide subsequent interventions.
Prompt assessment promotes early recognition of deterioration
and supports patient safety.
Incorrect Option Analysis
A. Continue medication pass
Why Incorrect
Delays assessment of potentially worsening hypoxemia.
Common Misconception
Routine tasks should always be completed first.
Safety Risk
Delayed intervention may lead to respiratory failure.
B. Notify provider immediately
, Why Incorrect
The provider needs objective assessment data.
Common Misconception
Reporting without assessment demonstrates urgency.
Safety Risk
Incomplete information may delay appropriate treatment.
D. Wait for laboratory results
Why Incorrect
The patient requires immediate bedside assessment.
Common Misconception
Laboratory values are more important than physical findings.
Safety Risk
Failure to recognize deterioration promptly.
Nursing Process Linkage
Assessment
NCJMM Competencies
• Recognize Cues
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,Question 1 — MCQ
Clinical Scenario
A nurse begins the morning shift caring for four patients on a
medical-surgical unit. During report, the nurse learns that one
patient with pneumonia has become increasingly restless and
confused over the last hour.
Question Stem
Which action demonstrates the nurse's use of clinical
judgment?
Answer Options
A. Continue the medication pass and reassess the patient at the
next scheduled vital sign check.
B. Notify the provider immediately without further assessment.
C. Assess oxygen saturation, respiratory status, and compare
findings with previous data.
D. Document the report findings and wait for laboratory results.
Correct Answer
C. Assess oxygen saturation, respiratory status, and
compare findings with previous data.
,Detailed Rationale
Clinical judgment involves recognizing cues, analyzing
information, prioritizing hypotheses, and taking appropriate
actions. New confusion and restlessness are early
manifestations of hypoxemia in older adults and patients with
respiratory illness. Before contacting the provider, the nurse
should gather additional assessment data to determine the
severity of deterioration and guide subsequent interventions.
Prompt assessment promotes early recognition of deterioration
and supports patient safety.
Incorrect Option Analysis
A. Continue medication pass
Why Incorrect
Delays assessment of potentially worsening hypoxemia.
Common Misconception
Routine tasks should always be completed first.
Safety Risk
Delayed intervention may lead to respiratory failure.
B. Notify provider immediately
, Why Incorrect
The provider needs objective assessment data.
Common Misconception
Reporting without assessment demonstrates urgency.
Safety Risk
Incomplete information may delay appropriate treatment.
D. Wait for laboratory results
Why Incorrect
The patient requires immediate bedside assessment.
Common Misconception
Laboratory values are more important than physical findings.
Safety Risk
Failure to recognize deterioration promptly.
Nursing Process Linkage
Assessment
NCJMM Competencies
• Recognize Cues
