LEMONE AND BURKE'S MEDICAL-
SURGICAL NURSING
CLINICAL REASONING IN PATIENT CARE
7TH EDITION
AUTHOR(S)GERENE BAULDOFF RN,
PHD, FAAN; PAULA GUBRUD;
MARGARET CARNO
TEST BANK
Question 1 (MCQ)
Clinical Scenario
A nurse begins a shift caring for four medical-surgical patients.
During handoff, the nurse notes that one patient has newly
developed confusion, another needs discharge teaching, a third
is awaiting routine morning medications, and a fourth is
scheduled for a dressing change.
,Question Stem
Which patient should the nurse assess first?
Answer Options
A. Patient awaiting discharge education
B. Patient with newly developed confusion
C. Patient scheduled for a dressing change
D. Patient due for routine medications
Correct Answer
B. Patient with newly developed confusion
Detailed Rationale
New-onset confusion is a significant clinical cue that may
indicate hypoxia, infection, stroke, medication effects,
metabolic imbalance, or deterioration. Clinical reasoning
requires prioritizing assessment of unstable patients before
routine care tasks.
Incorrect Option Analysis
A: Important but not urgent. Delay may affect discharge
efficiency but not safety.
C: Dressing changes are scheduled interventions and can wait
until patient stability is verified.
D: Routine medications are important but generally lower
priority than assessing potential deterioration.
Nursing Process Linkage
,Assessment
NCJMM Competencies
Recognize Cues
Prioritize Hypotheses
Clinical Reasoning Focus
Priority Setting
Difficulty
Easy
Bloom's Level
Analyze
NCLEX Category
Management of Care
Key Learning Objective
Apply clinical judgment to prioritize patient assessment.
Question 2 (SATA)
Clinical Scenario
A nurse participates in a quality improvement meeting
discussing QSEN-related competencies.
Question Stem
, Which nursing actions demonstrate core competencies for safe
and effective healthcare?
Answer Options
A. Using current evidence to guide care
B. Reporting near-miss medication events
C. Ignoring patient preferences when time is limited
D. Collaborating with interprofessional team members
E. Using technology to improve safety
F. Delegating without considering competency
Correct Answers
A, B, D, E
Detailed Rationale
Safe healthcare requires evidence-based practice, teamwork,
quality improvement, patient-centered care, and informatics.
Incorrect Option Analysis
C: Violates patient-centered care principles.
F: Unsafe delegation may result in patient harm.
Nursing Process Linkage
Implementation
NCJMM Competencies
Generate Solutions
Take Action
SURGICAL NURSING
CLINICAL REASONING IN PATIENT CARE
7TH EDITION
AUTHOR(S)GERENE BAULDOFF RN,
PHD, FAAN; PAULA GUBRUD;
MARGARET CARNO
TEST BANK
Question 1 (MCQ)
Clinical Scenario
A nurse begins a shift caring for four medical-surgical patients.
During handoff, the nurse notes that one patient has newly
developed confusion, another needs discharge teaching, a third
is awaiting routine morning medications, and a fourth is
scheduled for a dressing change.
,Question Stem
Which patient should the nurse assess first?
Answer Options
A. Patient awaiting discharge education
B. Patient with newly developed confusion
C. Patient scheduled for a dressing change
D. Patient due for routine medications
Correct Answer
B. Patient with newly developed confusion
Detailed Rationale
New-onset confusion is a significant clinical cue that may
indicate hypoxia, infection, stroke, medication effects,
metabolic imbalance, or deterioration. Clinical reasoning
requires prioritizing assessment of unstable patients before
routine care tasks.
Incorrect Option Analysis
A: Important but not urgent. Delay may affect discharge
efficiency but not safety.
C: Dressing changes are scheduled interventions and can wait
until patient stability is verified.
D: Routine medications are important but generally lower
priority than assessing potential deterioration.
Nursing Process Linkage
,Assessment
NCJMM Competencies
Recognize Cues
Prioritize Hypotheses
Clinical Reasoning Focus
Priority Setting
Difficulty
Easy
Bloom's Level
Analyze
NCLEX Category
Management of Care
Key Learning Objective
Apply clinical judgment to prioritize patient assessment.
Question 2 (SATA)
Clinical Scenario
A nurse participates in a quality improvement meeting
discussing QSEN-related competencies.
Question Stem
, Which nursing actions demonstrate core competencies for safe
and effective healthcare?
Answer Options
A. Using current evidence to guide care
B. Reporting near-miss medication events
C. Ignoring patient preferences when time is limited
D. Collaborating with interprofessional team members
E. Using technology to improve safety
F. Delegating without considering competency
Correct Answers
A, B, D, E
Detailed Rationale
Safe healthcare requires evidence-based practice, teamwork,
quality improvement, patient-centered care, and informatics.
Incorrect Option Analysis
C: Violates patient-centered care principles.
F: Unsafe delegation may result in patient harm.
Nursing Process Linkage
Implementation
NCJMM Competencies
Generate Solutions
Take Action
