Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario
A newly admitted patient with pneumonia says, “I feel too
weak to get out of bed,” and the nurse notes a respiratory rate
of 28/min and oxygen saturation of 90% on room air.
Question Stem
Which action should the nurse take first using clinical
judgment?
Answer Options
A. Document the finding in the chart
B. Reassess the oxygen saturation in 30 minutes
C. Apply supplemental oxygen and reassess the patient
D. Teach the patient how to use incentive spirometry
Correct Answer
C
Detailed Rationale
The patient shows cues of impaired oxygenation. The nurse
should take action immediately to improve oxygen delivery,
then reassess response. Supplemental oxygen is a priority
because oxygenation is foundational to stability and safety.
Incorrect Option Analysis
, • A. Documentation is necessary, but not the first priority
when oxygenation is impaired.
Misconception: charting is always the first nursing
responsibility.
Risk: delay in correcting hypoxemia.
• B. Waiting to reassess delays intervention.
Misconception: mild desaturation can be watched.
Risk: worsening respiratory compromise.
• D. Teaching is appropriate later, but not before stabilizing
the patient.
Misconception: education should occur before immediate
needs are addressed.
Risk: delayed treatment of low oxygenation.
Nursing Process Linkage
Implementation
Clinical Judgment Competencies
Recognize Cues, Prioritize Hypotheses, Take Action
Difficulty Level
Moderate
Bloom’s Cognitive Level
Apply
NCLEX Client Needs Category
Physiological Adaptation
, Key Learning Objective
Prioritize immediate nursing action when cues suggest impaired
oxygenation.
2) MCQ
Clinical Scenario
A nurse is caring for a patient with uncontrolled diabetes who
reports, “I have not been taking my medication because it is too
expensive.”
Question Stem
Which nursing process step is the nurse using when identifying
this concern as a barrier to adherence?
Answer Options
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer
B
Detailed Rationale
The nurse is interpreting assessment data and identifying a
human response to a health problem: ineffective health
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario
A newly admitted patient with pneumonia says, “I feel too
weak to get out of bed,” and the nurse notes a respiratory rate
of 28/min and oxygen saturation of 90% on room air.
Question Stem
Which action should the nurse take first using clinical
judgment?
Answer Options
A. Document the finding in the chart
B. Reassess the oxygen saturation in 30 minutes
C. Apply supplemental oxygen and reassess the patient
D. Teach the patient how to use incentive spirometry
Correct Answer
C
Detailed Rationale
The patient shows cues of impaired oxygenation. The nurse
should take action immediately to improve oxygen delivery,
then reassess response. Supplemental oxygen is a priority
because oxygenation is foundational to stability and safety.
Incorrect Option Analysis
, • A. Documentation is necessary, but not the first priority
when oxygenation is impaired.
Misconception: charting is always the first nursing
responsibility.
Risk: delay in correcting hypoxemia.
• B. Waiting to reassess delays intervention.
Misconception: mild desaturation can be watched.
Risk: worsening respiratory compromise.
• D. Teaching is appropriate later, but not before stabilizing
the patient.
Misconception: education should occur before immediate
needs are addressed.
Risk: delayed treatment of low oxygenation.
Nursing Process Linkage
Implementation
Clinical Judgment Competencies
Recognize Cues, Prioritize Hypotheses, Take Action
Difficulty Level
Moderate
Bloom’s Cognitive Level
Apply
NCLEX Client Needs Category
Physiological Adaptation
, Key Learning Objective
Prioritize immediate nursing action when cues suggest impaired
oxygenation.
2) MCQ
Clinical Scenario
A nurse is caring for a patient with uncontrolled diabetes who
reports, “I have not been taking my medication because it is too
expensive.”
Question Stem
Which nursing process step is the nurse using when identifying
this concern as a barrier to adherence?
Answer Options
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer
B
Detailed Rationale
The nurse is interpreting assessment data and identifying a
human response to a health problem: ineffective health
