Updated/Latest Medical-Surgical Nursing in Canada 4th Edition Sharon L. Lewis Linda Bucher Margaret M. Heitkemper Mariann M. Harding Jeffrey Kwong Dottie Roberts Test Bank Complete All Chapters Comprehensive Adult Health Nursing Questions Answers Rational

Medical-Surgical Nursing in Canada 4th Edition Lewi Test F, T L F, T L F,T L L
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Bank
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Chapter 01: Introduction to Medical-Surgical Nursing Practice in Canada
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Lewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
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MULTIPLE CHOICE L
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1. When caring for clients using evidence-informed practice, which of the following does the
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a. Clinical judgement based on experience L
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b. Evidence from a clinical research study F,T L F,T L L
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c. The best available evidence to guide clinical expertise L
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d. Evaluation of data showing that the client outcomes are met F,T L F,T L F,T L L
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ANS: F , T L C
Evidence-informed nursing practice is a continuous interactive process involving the L
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explicit, conscientious, and judicious consideration of the best available evidence to provide
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care. Four primary elements are: (a) clinical state, setting, and circumstances; (b) client
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preferences and actions; (c) best research evidence; and (d) health care resources. Clinical
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judgement based on the nurse’s clinical experience is part of EIP, but clinical decision
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making also should incorporate current research and research-based guidelines. Evidence
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from one clinical research study does not provide an adequate substantiation for
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interventions. Evaluation of client outcomes is important, but interventions should be based
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on research from randomized control studies with a large number of subjects.
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DIF: Cognitive Level: Comprehension L
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2. Which of the following best e xp l a i n s t h e nu r s e s ’ pr imary use of the nursing process when
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providing care to clients? F, T L L
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a. To explain nursing interventions to other health care professionals F,T L F,T L F,T L F,T L F,T L L
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b. As a problem-solving tool to identify and treat clients’ health care needs
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c. As a scientific-based process of diagnosing the client’s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
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ANS: F , T L B
The nursing process is an assertive problem-solving approach to the identification and
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treatment of clients’ problems. Diagnosis is only one phase of the nursing process. The
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primary use of the nursing process is in client care, not to establish nursing theory or explain
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nursing interventions to other health care professionals.
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DIF: Cognitive Level: Comprehension L
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3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-hour
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turning schedule to prevent skin breakdown. Which type of nursing function is
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demonstrated with this turning schedule?
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a. Dependent
b. Cooperative
c. Independent
d. Collaborative
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, Medical-Surgical Nursing in Canada 4th Edition Lewi Test F, T L F, T L F,T L F, TL F ,T L F, T L F, T L



Bank
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When implementing collaborative nursing actions, the nurse is responsible primarily for
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monitoring for complications of acute illness or providing care to prevent or treat
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complications. Independent nursing actions are focused on health promotion, illness
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prevention, and client advocacy. A dependent action would require a physician order to
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implement. Cooperative nursing functions are not described as one of the formal nursing
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functions.
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4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
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nurse, “I do not feel right about leaving my children with my neighbour.” Which action
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should the nurse take next?
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a. Reassure the client that these feelings are common for parents. L
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b. Have the client call the children to ensure that they are doing well. F,TL F, T L F,T L F,T L F,T L F,T L F,T L L
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c. Call the neighbour to determine whether adequate childcare is being provided.
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d. Gather more data about the client’s feelings about the childcare arrangements. F,T L L
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ANS: F , T L D
Since a complete assessment is necessary in order to identify a problem and choose an
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appropriate intervention, the nurse’s first action should be to obtain more information. The
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other actions may be appropriate, but more assessment is needed before the best intervention
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can be chosen.
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DIF: Cognitive Level: Application F,T L L
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5. The nurse is caring for a client who has left-sided paralysis as the result of a stroke and
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assesses a pressure injury on t he clie nt ’s left h ip . W hich of the following is the most
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appropriate nursing diagnosis fUo r t Shis cNl i e nTt ? O F , T L F , T L F , T L F , T L F , T L



a. Impaired physical mobility related to decrease in muscle control (left-sided F,T L F,TL L
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paralysis)
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b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
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protecting tissue integrity
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c. Impaired skin integrity related to pressure over bony prominence (impaired L
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circulation)
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d. Ineffective tissue perfusion related to sedentary lifestyle L
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ANS: F , T L C
The client’s major problem is the impaired skin integrity as demonstrated by the presence of a
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pressure injury. The nurse is able to treat the cause of altered circulation and pressure by
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frequently repositioning the client. Although left-sided weakness is a problem for the client,
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the nurse cannot treat the weakness. The “risk for” diagnosis is not appropriate for this
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client, who already has impaired tissue integrity. The client does have ineffective tissue
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perfusion, but the impaired skin integrity diagnosis indicates more clearly what the health
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problem is.
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DIF: Cognitive Level: Application F,T L L
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6. The nurse caring for a client with an infection has a nursing diagnosis of deficient
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fluid volume related to excessive diaphoresis. Which of the following is an appropriate
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client outcome?
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a. Client has a balanced intake and output. F,T L F,T L F,TL F,T L L
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b. Client’s bedding is changed when it becomes damp. F,T L L
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NURSINGTB.COM

, Medical-Surgical Nursing in Canada 4th Edition Lewi Test F, T L L
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Bank
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c. Client understands the need for increased fluid intake. L
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d. Client’s skin remains cool and dry throughout hospitalization. F,T L F,T L F,TL F,T L F,T L F, T L F,T L




ANS: F , T L A
This statement gives measurable data showing resolution of the problem of deficient fluid
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volume that was identified in the nursing diagnosis statement. The other statements would not
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indicate that the problem of deficient fluid volume was resolved.
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DIF: Cognitive Level: Application F,T L F,T L TOP: F , T L Nursing Process: Planning L
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7. Which of the following represents a nursing activity that is carried out during the evaluation
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phase of the nursing process?
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a. Determining if interventions have been effective in meeting client outcomes F,T L L
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b. Documenting the nursing care plan in the progress notes in the medical record F,T L L
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c. Deciding whether the client’s health problems have been completely resolved F,T L L
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d. Asking the client to evaluate whether the nursing care provided was satisfactory F,T L L
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ANS: F , T L A
Evaluation consists of determining whether the desired client outcomes have been met and F, T L F,T L L
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whether the nursing interventions were appropriate. The other responses do not describe the
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evaluation phase.
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DIF: Cognitive Level: Comprehension F,T L F,T L TOP: F , T L Nursing Process: Evaluation L
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8. Which of the following would the nurse perform during the assessment phase of the nursing
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process?
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a. Obtains data with which to diagnose client problems L
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b. Uses client data to develoN pUpR
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c. Teaches interventions to relieve client health problems F,T L L
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d. Assists the client to identify realistic outcomes to health problems L
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ANS: F , T L A
During the assessment phase, the nurse gathers information about the client. The other
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responses are examples of the intervention, diagnosis, and planning phases of the nursing
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process.
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DIF: Cognitive Level: Knowledge F,T L F,T L TOP: F , T L Nursing Process: Assessment L
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9. Which of the following is an example of a correctly written nursing diagnosis statement?
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a. Altered tissue perfusion related to heart failure L
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b. Risk for impaired tissue integrity related to sacral redness
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c. Ineffective coping related to insufficient sense of control. F,T L F,T L F,TL F,T L F,T L L
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d. Altered urinary elimination related to urinary tract infection L
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ANS: F , T L C
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
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a client’s response to a health problem that can be treated by nursing. The use of a medical
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diagnosis (as in the responses beginning “Altered tissue perfusion” and “Altered urinary
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elimination”) is not appropriate. The response beginning “Risk for impaired tissue
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integrity” uses the defining characteristics as the etiology.
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DIF: Cognitive Level: Comprehension F,TL F,T L TOP: F , T L Nursing Process: Diagnosis L
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NURSINGTB.COM

, Medical-Surgical Nursing in Canada 4th Edition Lewi Test F, T L F, T L F,T L F, T L F ,T L F, TL L
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Bank
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10. Which of the following includes the components required for a complete nursing diagnosis
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F,T statement?
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a. A problem and the suggested client goals or outcomes
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b. A problem, its cause, and objective data that support the problem
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c. A problem with all its possible causes and the planned interventions
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d. A problem with its etiology and the signs and symptoms of the problem
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ANS: F , T L D
The PES format is used when writing nursing diagnoses. The subjective, as well as objective,
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data should be included in the defining characteristics. Interventions and outcomes are not
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included in the nursing diagnosis statement.
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DIF: Cognitive Level: Knowledge F,T L L
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11. Which of the following refers to a situation that results in unintended harm to the client and is
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related to the care or services provided rather than the client’s medical condition?
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a. Negligence
b. Adverse event F,T L



c. Incident report L
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d. Nonmaleficence
ANS: F , T L B
An adverse event is an event that results in unintended harm to the client and is related to the
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care or services provided to the client rather than to the client’s underlying medical condition.
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DIF: Cognitive Level: Knowledge F,T L L
F,T TOP: F , T L Nursing Process: Evaluation L
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NURSINGTB.COM
12. When using the Five Steps of the evidence-informed practice (EIP) Process, which of the
F,T L F,T L F,T L F,T L L
F,T F,T L L
F,T L
F,T L
F,T L
F,T L
F,T L
F,T L
F,T




flowing elements is the final step when constructing a clinical question?
L
F,T L
F,T F,T L F,T L F,T L F,T L F,T L L
F,T L
F,T F,T L



a. Comparison of interest F, T L F,T L



b. Population of interest F, T L F, T L



c. Outcome of interest F,T L F,T L



d. Timeframe of interest F,T L F,T L




ANS: F , T L D
The order of the nurse’s statements follows the PICOT format with the final step being the
L
F,T L
F,T F,TL L
F,T L
F,T F,T L F,T L L
F,T F,T L F,T L L
F,T F,T L F,T L L
F,T F,T L



“T”, or timeframe of interest.
F,T L F,T L F,T L F,T L F,T L




DIF: Cognitive Level: Application F,T L L
F,T TOP: F , T L Nursing Process: Implementation L
F,T L
F,T





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