TESTBANK FOR BRUNNER & SUDDARTH'S MEDICAL-SURGICAL NURSING, 16TH EDITION
AMAZON
, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 16th Edition
ISBN-13: 978-1975221133
Table of Contents
UNIT 1 – Principles of Nursing Practice
• Chapter 1: Professional Nursing Practice
• Chapter 2: Medical-Surgical Nursing
• Chapter 3: Health Education and Health Promotion
• Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment
• Chapter 5: Stress and Inflammatory Responses
• Chapter 6: Genetics and Genomics in Nursing
• Chapter 7: Disability and Chronic Illness
• Chapter 8: Care of the Older Adult
UNIT 2 – Concepts and Principles of Patient Management
• Chapter 9: Pain Management
• Chapter 10: Principles of Fluid and Electrolytes
• Chapter 11: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
• Chapter 12: Oncologic Management
• Chapter 13: Palliative and End-of-Life Care
UNIT 3 – Perioperative Concepts and Nursing Management
• Chapter 14: Preoperative Nursing Management
• Chapter 15: Intraoperative Nursing Management
• Chapter 16: Postoperative Nursing Management
UNIT 4 – Gas Exchange and Respiratory Function
• Chapter 17: Assessment of Respiratory Function
• Chapter 18: Upper Respiratory Disorders
• Chapter 19: Acute Lower Respiratory Disorders
• Chapter 20: Nonacute Lower Respiratory Disorders
• Chapter 21: Critical Care
,UNIT 5 – Cardiovascular and Circulatory Function
• Chapter 22: Assessment of Cardiovascular Function
• Chapter 23: Management of Patients With Hypertension
• Chapter 24: Management of Patients With Coronary Vascular Disorders
• Chapter 25: Management of Patients With Structural, Infectious, and Inflammatory Cardiac Disorders
• Chapter 26: Management of Patients With Dysrhythmias and Conduction Problems
• Chapter 27: Management of Patients With Vascular Disorders
• Chapter 28: Management of Patients With Circulatory Shock and Heart Failure
UNIT 6 – Hematologic Function
• Chapter 29: Assessment and Management of Patients With Hematologic Disorders
• Chapter 30: Management of Patients With Hematologic Neoplasms
• Chapter 31: Hematopoietic Stem Cell Transplantation
UNIT 7 – Immunologic Function
• Chapter 32: Assessment and Management of Patients With Immune Disorders
• Chapter 33: Management of Patients With HIV Infection and AIDS
• Chapter 34: Management of Patients With Rheumatic Disorders
• Chapter 35: Management of Patients With Connective Tissue Disorders
UNIT 8 – Musculoskeletal Function
• Chapter 36: Assessment and Management of Patients With Musculoskeletal Disorders
• Chapter 37: Management of Patients With Musculoskeletal Trauma
• Chapter 38: Management of Patients With Musculoskeletal and Connective Tissue Disorders
UNIT 9 – Digestive and Gastrointestinal Function
• Chapter 39: Assessment of Digestive and Gastrointestinal Function
• Chapter 40: Management of Patients With Oral and Esophageal Disorders
• Chapter 41: Management of Patients With Gastric and Intestinal Disorders
• Chapter 42: Management of Patients With Hepatic, Biliary, and Pancreatic Disorders
UNIT 10 – Metabolic and Endocrine Function
• Chapter 43: Assessment and Management of Patients With Metabolic Disorders
• Chapter 44: Management of Patients With Diabetes Mellitus
, • Chapter 45: Management of Patients With Endocrine Disorders
• Chapter 46: Management of Patients With Obesity
• Chapter 47: Management of Patients With Nutritional Disorders
UNIT 11 – Kidney and Urinary Tract Function
• Chapter 48: Assessment of Kidney and Urinary Tract Function
• Chapter 49: Management of Patients With Kidney Disorders
• Chapter 50: Management of Patients With Urinary Disorders
UNIT 12 – Reproductive Function
• Chapter 51: Assessment of Reproductive Function
• Chapter 52: Management of Patients With Breast Disorders
• Chapter 53: Management of Patients With Female Reproductive Disorders
• Chapter 54: Management of Patients With Male Reproductive Disorders
• Chapter 55: Management of Patients With Sexually Transmitted Infections
UNIT 13 – Integumentary Function
• Chapter 56: Assessment of Integumentary Function
• Chapter 57: Management of Patients With Skin Disorders
• Chapter 58: Management of Patients With Burns
UNIT 14 – Sensory Function
• Chapter 59: Assessment and Management of Patients With Eye and Vision Disorders
• Chapter 60: Assessment and Management of Patients With Ear and Hearing Disorders
UNIT 15 – Neurologic Function
• Chapter 61: Assessment of Neurologic Function
• Chapter 62: Management of Patients With Neurologic Dysfunction
• Chapter 63: Management of Patients With Stroke
• Chapter 64: Management of Patients With Neurologic Trauma
• Chapter 65: Management of Patients With Degenerative Neurologic Disorders
• Chapter 66: Management of Patients With Neurologic Infections and Disorders
UNIT 16 – Acute Community-Based Challenges
• Chapter 67: Management of Patients With Infectious Diseases
, • Chapter 68: Emergency Nursing
• Chapter 69: Disaster Nursing
UNIT 1 – Principles of Nursing Practice
Chapter 1: Professional Nursing Practice
Clinical Challenge 1
During the morning handoff, the nurse receives reports on four patients. Which patient should the nurse assess
first?
A. A patient with chronic heart failure who reports mild ankle swelling after missing one dose of furosemide.
B. A postoperative patient who suddenly develops shortness of breath, restlessness, and an oxygen saturation
of 86% on room air.
C. A patient with type 2 diabetes requesting assistance with selecting meals from the lunch menu.
D. A patient awaiting discharge who asks for clarification about home medications.
Correct Answer: B
Rationale
The postoperative patient showing sudden hypoxemia, restlessness, and dyspnea may be experiencing a life-
threatening complication such as pulmonary embolism or acute respiratory compromise. Applying the ABC
(Airway, Breathing, Circulation) framework and prioritization principles, the nurse must assess and intervene
immediately to prevent further deterioration.
Why the Other Options Are Less Appropriate
A. Mild peripheral edema requires follow-up but does not indicate immediate instability.
C. Dietary education is important but can safely be delayed until unstable patients have been evaluated.
D. Discharge teaching is appropriate after urgent patient needs have been addressed.
Exam Pearl
Always prioritize patients with acute changes in airway, breathing, circulation, or level of consciousness over
stable patients with routine care needs.
Clinical Challenge 2
While preparing morning medications, a nurse notices that a prescribed dose of insulin appears significantly
higher than the patient's usual dose. What is the nurse's most appropriate action?
A. Administer the medication because it has already been prescribed.
,B. Ask another nurse to administer the medication instead.
C. Withhold the medication permanently without notifying anyone.
D. Verify the prescription, review the patient's blood glucose results, and clarify the order with the healthcare
provider before administration.
Correct Answer: D
Rationale
Nurses are professionally accountable for ensuring medication safety. When an order appears inconsistent with
the patient's condition or previous therapy, it must be verified before administration. Clarifying questionable
prescriptions helps prevent medication errors and protects patient safety.
Why the Other Options Are Less Appropriate
A. Nurses remain responsible for questioning unsafe or unclear medication orders.
B. Delegating administration does not remove professional accountability.
C. Medication should not be permanently withheld without appropriate clinical communication.
Exam Pearl
Never administer a medication that seems unsafe or questionable. Stop, verify, and clarify before proceeding.
Clinical Challenge 3
Assessment of an older adult reveals new confusion, agitation, and difficulty following simple commands
several hours after surgery. Which nursing action is the priority?
A. Reorient the patient while immediately assessing oxygenation, vital signs, pain, and possible causes of the
mental status change.
B. Apply physical restraints to prevent injury.
C. Request a psychiatric consultation before further assessment.
D. Encourage the patient to sleep and reassess later.
Correct Answer: A
Rationale
Acute postoperative confusion may indicate hypoxia, infection, medication effects, metabolic disturbances, or
delirium. The nurse must first perform a focused assessment to identify and address reversible causes before
considering other interventions.
Why the Other Options Are Less Appropriate
B. Restraints are a last resort and should never replace assessment.
,C. Psychiatric consultation is inappropriate before evaluating potential physiological causes.
D. Delaying assessment may allow a serious condition to worsen.
Exam Pearl
Sudden confusion is a clinical symptom—not a diagnosis. Always assess for reversible physiological causes
first.
Clinical Challenge 4
A newly licensed nurse asks why evidence-based practice is emphasized during patient care planning. Which
response by the experienced nurse is most accurate?
A. It replaces clinical judgment with standardized treatment plans.
B. It ensures that every patient receives identical nursing care.
C. It integrates the best available evidence, clinical expertise, and patient preferences to improve outcomes.
D. It eliminates the need for individualized nursing assessments.
Correct Answer: C
Rationale
Evidence-based practice combines current research, professional expertise, and patient values to guide clinical
decisions. This approach supports individualized, safe, and effective patient care rather than relying solely on
tradition or routine.
Why the Other Options Are Less Appropriate
A. Clinical judgment remains essential in applying evidence appropriately.
B. Nursing care should always be individualized.
D. Comprehensive assessment remains the foundation of safe nursing practice.
Exam Pearl
Evidence-based practice is built on research evidence + clinical expertise + patient preferences.
Clinical Challenge 5
Following a busy shift, a nurse realizes that a scheduled medication was unintentionally omitted. What is the
nurse's priority action?
A. Document the medication as administered to avoid disciplinary action.
,B. Inform the charge nurse and healthcare provider, assess the patient, document the omission accurately, and
follow institutional policy.
C. Wait until the next shift and allow the incoming nurse to manage the situation.
D. Administer a double dose at the next scheduled time.
Correct Answer: B
Rationale
Professional accountability requires prompt recognition, reporting, and documentation of medication errors or
omissions. The nurse should assess the patient for any adverse effects, notify appropriate personnel, and follow
organizational protocols to ensure patient safety.
Why the Other Options Are Less Appropriate
A. Falsifying documentation is unethical and may have legal consequences.
C. Delaying intervention places the patient at unnecessary risk.
D. Administering a double dose without an order may cause harm.
Exam Pearl
When an error occurs, protect the patient first, report promptly, document truthfully, and learn from the
event.
Clinical Challenge 6
During interdisciplinary rounds, the nurse disagrees with a proposed discharge plan because the patient
demonstrates unsafe medication management. What is the nurse's best course of action?
A. Remain silent because discharge decisions belong exclusively to the physician.
B. Advocate for the patient by communicating the safety concerns and recommending further evaluation
before discharge.
C. Tell the patient's family that the discharge plan is unsafe without discussing it with the healthcare team.
D. Delay the discharge paperwork without informing anyone.
Correct Answer: B
Rationale
Patient advocacy is a fundamental responsibility of professional nursing practice. Nurses should communicate
evidence-based concerns respectfully and collaborate with the healthcare team to promote safe, patient-
centered care.
Why the Other Options Are Less Appropriate
,A. Nurses are responsible for advocating when patient safety is at risk.
C. Concerns should first be addressed through appropriate professional communication.
D. Delaying care without communication is unprofessional and ineffective.
Exam Pearl
Advocacy means speaking up for patient safety, even when it requires respectfully questioning the current
plan.
Clinical Challenge 7
A nurse is delegating tasks during a busy medical-surgical shift. Which assignment is most appropriate for an
experienced unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of intravenous pain medication.
B. Teaching a patient how to use an incentive spirometer.
C. Measuring and documenting routine vital signs for a stable patient.
D. Assessing a patient who reports sudden chest pain.
Correct Answer: C
Rationale
Routine vital signs for stable patients are within the typical role of a trained UAP. Assessment, patient
education, evaluation, and clinical judgment remain the responsibility of the registered nurse.
Why the Other Options Are Less Appropriate
A. Evaluation of patient response requires RN clinical judgment.
B. Initial teaching is an RN responsibility.
D. Assessment of acute symptoms must be performed by the RN.
Exam Pearl
Delegate stable, predictable, routine tasks—never assessment, teaching, evaluation, or clinical decision-
making.
Clinical Challenge 8
While reviewing quality improvement data, a nurse notices an increase in patient falls on the medical-surgical
unit over the past three months. Which nursing action best supports continuous quality improvement?
A. Wait for management to implement changes before taking action.
, B. Participate in analyzing contributing factors and implementing evidence-based fall-prevention strategies.
C. Focus only on documenting falls after they occur.
D. Counsel only the nurses involved in previous fall incidents.
Correct Answer: B
Rationale
Quality improvement focuses on identifying system issues, analyzing trends, and implementing evidence-based
interventions to improve patient outcomes. Collaborative efforts are more effective than assigning individual
blame.
Why the Other Options Are Less Appropriate
A. All nurses share responsibility for quality improvement.
C. Documentation alone does not reduce future falls.
D. Quality improvement emphasizes system improvement rather than individual blame.
Exam Pearl
Quality improvement asks "How can we improve the system?" rather than "Who is at fault?"
Clinical Challenge 9
A nurse is preparing to administer a newly prescribed antibiotic when the patient states, "I'm allergic to that
medication." The electronic health record does not list any allergies. What should the nurse do first?
A. Administer the antibiotic because there is no documented allergy.
B. Ask the patient whether the previous reaction was severe after administering the medication.
C. Withhold the medication, further assess the reported allergy, and notify the healthcare provider before
administration.
D. Request that the pharmacist remove the medication from the medication administration record.
Correct Answer: C
Rationale
Patient safety is the nurse's highest priority. Any reported allergy should be thoroughly assessed before
medication administration, even if it is not documented. The nurse should clarify the reaction, withhold the
medication, and collaborate with the healthcare provider to determine the safest course of action.
Why the Other Options Are Less Appropriate
A. Absence of documentation does not mean an allergy does not exist.
B. The medication should never be administered before verifying allergy information.
AMAZON
, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 16th Edition
ISBN-13: 978-1975221133
Table of Contents
UNIT 1 – Principles of Nursing Practice
• Chapter 1: Professional Nursing Practice
• Chapter 2: Medical-Surgical Nursing
• Chapter 3: Health Education and Health Promotion
• Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment
• Chapter 5: Stress and Inflammatory Responses
• Chapter 6: Genetics and Genomics in Nursing
• Chapter 7: Disability and Chronic Illness
• Chapter 8: Care of the Older Adult
UNIT 2 – Concepts and Principles of Patient Management
• Chapter 9: Pain Management
• Chapter 10: Principles of Fluid and Electrolytes
• Chapter 11: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
• Chapter 12: Oncologic Management
• Chapter 13: Palliative and End-of-Life Care
UNIT 3 – Perioperative Concepts and Nursing Management
• Chapter 14: Preoperative Nursing Management
• Chapter 15: Intraoperative Nursing Management
• Chapter 16: Postoperative Nursing Management
UNIT 4 – Gas Exchange and Respiratory Function
• Chapter 17: Assessment of Respiratory Function
• Chapter 18: Upper Respiratory Disorders
• Chapter 19: Acute Lower Respiratory Disorders
• Chapter 20: Nonacute Lower Respiratory Disorders
• Chapter 21: Critical Care
,UNIT 5 – Cardiovascular and Circulatory Function
• Chapter 22: Assessment of Cardiovascular Function
• Chapter 23: Management of Patients With Hypertension
• Chapter 24: Management of Patients With Coronary Vascular Disorders
• Chapter 25: Management of Patients With Structural, Infectious, and Inflammatory Cardiac Disorders
• Chapter 26: Management of Patients With Dysrhythmias and Conduction Problems
• Chapter 27: Management of Patients With Vascular Disorders
• Chapter 28: Management of Patients With Circulatory Shock and Heart Failure
UNIT 6 – Hematologic Function
• Chapter 29: Assessment and Management of Patients With Hematologic Disorders
• Chapter 30: Management of Patients With Hematologic Neoplasms
• Chapter 31: Hematopoietic Stem Cell Transplantation
UNIT 7 – Immunologic Function
• Chapter 32: Assessment and Management of Patients With Immune Disorders
• Chapter 33: Management of Patients With HIV Infection and AIDS
• Chapter 34: Management of Patients With Rheumatic Disorders
• Chapter 35: Management of Patients With Connective Tissue Disorders
UNIT 8 – Musculoskeletal Function
• Chapter 36: Assessment and Management of Patients With Musculoskeletal Disorders
• Chapter 37: Management of Patients With Musculoskeletal Trauma
• Chapter 38: Management of Patients With Musculoskeletal and Connective Tissue Disorders
UNIT 9 – Digestive and Gastrointestinal Function
• Chapter 39: Assessment of Digestive and Gastrointestinal Function
• Chapter 40: Management of Patients With Oral and Esophageal Disorders
• Chapter 41: Management of Patients With Gastric and Intestinal Disorders
• Chapter 42: Management of Patients With Hepatic, Biliary, and Pancreatic Disorders
UNIT 10 – Metabolic and Endocrine Function
• Chapter 43: Assessment and Management of Patients With Metabolic Disorders
• Chapter 44: Management of Patients With Diabetes Mellitus
, • Chapter 45: Management of Patients With Endocrine Disorders
• Chapter 46: Management of Patients With Obesity
• Chapter 47: Management of Patients With Nutritional Disorders
UNIT 11 – Kidney and Urinary Tract Function
• Chapter 48: Assessment of Kidney and Urinary Tract Function
• Chapter 49: Management of Patients With Kidney Disorders
• Chapter 50: Management of Patients With Urinary Disorders
UNIT 12 – Reproductive Function
• Chapter 51: Assessment of Reproductive Function
• Chapter 52: Management of Patients With Breast Disorders
• Chapter 53: Management of Patients With Female Reproductive Disorders
• Chapter 54: Management of Patients With Male Reproductive Disorders
• Chapter 55: Management of Patients With Sexually Transmitted Infections
UNIT 13 – Integumentary Function
• Chapter 56: Assessment of Integumentary Function
• Chapter 57: Management of Patients With Skin Disorders
• Chapter 58: Management of Patients With Burns
UNIT 14 – Sensory Function
• Chapter 59: Assessment and Management of Patients With Eye and Vision Disorders
• Chapter 60: Assessment and Management of Patients With Ear and Hearing Disorders
UNIT 15 – Neurologic Function
• Chapter 61: Assessment of Neurologic Function
• Chapter 62: Management of Patients With Neurologic Dysfunction
• Chapter 63: Management of Patients With Stroke
• Chapter 64: Management of Patients With Neurologic Trauma
• Chapter 65: Management of Patients With Degenerative Neurologic Disorders
• Chapter 66: Management of Patients With Neurologic Infections and Disorders
UNIT 16 – Acute Community-Based Challenges
• Chapter 67: Management of Patients With Infectious Diseases
, • Chapter 68: Emergency Nursing
• Chapter 69: Disaster Nursing
UNIT 1 – Principles of Nursing Practice
Chapter 1: Professional Nursing Practice
Clinical Challenge 1
During the morning handoff, the nurse receives reports on four patients. Which patient should the nurse assess
first?
A. A patient with chronic heart failure who reports mild ankle swelling after missing one dose of furosemide.
B. A postoperative patient who suddenly develops shortness of breath, restlessness, and an oxygen saturation
of 86% on room air.
C. A patient with type 2 diabetes requesting assistance with selecting meals from the lunch menu.
D. A patient awaiting discharge who asks for clarification about home medications.
Correct Answer: B
Rationale
The postoperative patient showing sudden hypoxemia, restlessness, and dyspnea may be experiencing a life-
threatening complication such as pulmonary embolism or acute respiratory compromise. Applying the ABC
(Airway, Breathing, Circulation) framework and prioritization principles, the nurse must assess and intervene
immediately to prevent further deterioration.
Why the Other Options Are Less Appropriate
A. Mild peripheral edema requires follow-up but does not indicate immediate instability.
C. Dietary education is important but can safely be delayed until unstable patients have been evaluated.
D. Discharge teaching is appropriate after urgent patient needs have been addressed.
Exam Pearl
Always prioritize patients with acute changes in airway, breathing, circulation, or level of consciousness over
stable patients with routine care needs.
Clinical Challenge 2
While preparing morning medications, a nurse notices that a prescribed dose of insulin appears significantly
higher than the patient's usual dose. What is the nurse's most appropriate action?
A. Administer the medication because it has already been prescribed.
,B. Ask another nurse to administer the medication instead.
C. Withhold the medication permanently without notifying anyone.
D. Verify the prescription, review the patient's blood glucose results, and clarify the order with the healthcare
provider before administration.
Correct Answer: D
Rationale
Nurses are professionally accountable for ensuring medication safety. When an order appears inconsistent with
the patient's condition or previous therapy, it must be verified before administration. Clarifying questionable
prescriptions helps prevent medication errors and protects patient safety.
Why the Other Options Are Less Appropriate
A. Nurses remain responsible for questioning unsafe or unclear medication orders.
B. Delegating administration does not remove professional accountability.
C. Medication should not be permanently withheld without appropriate clinical communication.
Exam Pearl
Never administer a medication that seems unsafe or questionable. Stop, verify, and clarify before proceeding.
Clinical Challenge 3
Assessment of an older adult reveals new confusion, agitation, and difficulty following simple commands
several hours after surgery. Which nursing action is the priority?
A. Reorient the patient while immediately assessing oxygenation, vital signs, pain, and possible causes of the
mental status change.
B. Apply physical restraints to prevent injury.
C. Request a psychiatric consultation before further assessment.
D. Encourage the patient to sleep and reassess later.
Correct Answer: A
Rationale
Acute postoperative confusion may indicate hypoxia, infection, medication effects, metabolic disturbances, or
delirium. The nurse must first perform a focused assessment to identify and address reversible causes before
considering other interventions.
Why the Other Options Are Less Appropriate
B. Restraints are a last resort and should never replace assessment.
,C. Psychiatric consultation is inappropriate before evaluating potential physiological causes.
D. Delaying assessment may allow a serious condition to worsen.
Exam Pearl
Sudden confusion is a clinical symptom—not a diagnosis. Always assess for reversible physiological causes
first.
Clinical Challenge 4
A newly licensed nurse asks why evidence-based practice is emphasized during patient care planning. Which
response by the experienced nurse is most accurate?
A. It replaces clinical judgment with standardized treatment plans.
B. It ensures that every patient receives identical nursing care.
C. It integrates the best available evidence, clinical expertise, and patient preferences to improve outcomes.
D. It eliminates the need for individualized nursing assessments.
Correct Answer: C
Rationale
Evidence-based practice combines current research, professional expertise, and patient values to guide clinical
decisions. This approach supports individualized, safe, and effective patient care rather than relying solely on
tradition or routine.
Why the Other Options Are Less Appropriate
A. Clinical judgment remains essential in applying evidence appropriately.
B. Nursing care should always be individualized.
D. Comprehensive assessment remains the foundation of safe nursing practice.
Exam Pearl
Evidence-based practice is built on research evidence + clinical expertise + patient preferences.
Clinical Challenge 5
Following a busy shift, a nurse realizes that a scheduled medication was unintentionally omitted. What is the
nurse's priority action?
A. Document the medication as administered to avoid disciplinary action.
,B. Inform the charge nurse and healthcare provider, assess the patient, document the omission accurately, and
follow institutional policy.
C. Wait until the next shift and allow the incoming nurse to manage the situation.
D. Administer a double dose at the next scheduled time.
Correct Answer: B
Rationale
Professional accountability requires prompt recognition, reporting, and documentation of medication errors or
omissions. The nurse should assess the patient for any adverse effects, notify appropriate personnel, and follow
organizational protocols to ensure patient safety.
Why the Other Options Are Less Appropriate
A. Falsifying documentation is unethical and may have legal consequences.
C. Delaying intervention places the patient at unnecessary risk.
D. Administering a double dose without an order may cause harm.
Exam Pearl
When an error occurs, protect the patient first, report promptly, document truthfully, and learn from the
event.
Clinical Challenge 6
During interdisciplinary rounds, the nurse disagrees with a proposed discharge plan because the patient
demonstrates unsafe medication management. What is the nurse's best course of action?
A. Remain silent because discharge decisions belong exclusively to the physician.
B. Advocate for the patient by communicating the safety concerns and recommending further evaluation
before discharge.
C. Tell the patient's family that the discharge plan is unsafe without discussing it with the healthcare team.
D. Delay the discharge paperwork without informing anyone.
Correct Answer: B
Rationale
Patient advocacy is a fundamental responsibility of professional nursing practice. Nurses should communicate
evidence-based concerns respectfully and collaborate with the healthcare team to promote safe, patient-
centered care.
Why the Other Options Are Less Appropriate
,A. Nurses are responsible for advocating when patient safety is at risk.
C. Concerns should first be addressed through appropriate professional communication.
D. Delaying care without communication is unprofessional and ineffective.
Exam Pearl
Advocacy means speaking up for patient safety, even when it requires respectfully questioning the current
plan.
Clinical Challenge 7
A nurse is delegating tasks during a busy medical-surgical shift. Which assignment is most appropriate for an
experienced unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of intravenous pain medication.
B. Teaching a patient how to use an incentive spirometer.
C. Measuring and documenting routine vital signs for a stable patient.
D. Assessing a patient who reports sudden chest pain.
Correct Answer: C
Rationale
Routine vital signs for stable patients are within the typical role of a trained UAP. Assessment, patient
education, evaluation, and clinical judgment remain the responsibility of the registered nurse.
Why the Other Options Are Less Appropriate
A. Evaluation of patient response requires RN clinical judgment.
B. Initial teaching is an RN responsibility.
D. Assessment of acute symptoms must be performed by the RN.
Exam Pearl
Delegate stable, predictable, routine tasks—never assessment, teaching, evaluation, or clinical decision-
making.
Clinical Challenge 8
While reviewing quality improvement data, a nurse notices an increase in patient falls on the medical-surgical
unit over the past three months. Which nursing action best supports continuous quality improvement?
A. Wait for management to implement changes before taking action.
, B. Participate in analyzing contributing factors and implementing evidence-based fall-prevention strategies.
C. Focus only on documenting falls after they occur.
D. Counsel only the nurses involved in previous fall incidents.
Correct Answer: B
Rationale
Quality improvement focuses on identifying system issues, analyzing trends, and implementing evidence-based
interventions to improve patient outcomes. Collaborative efforts are more effective than assigning individual
blame.
Why the Other Options Are Less Appropriate
A. All nurses share responsibility for quality improvement.
C. Documentation alone does not reduce future falls.
D. Quality improvement emphasizes system improvement rather than individual blame.
Exam Pearl
Quality improvement asks "How can we improve the system?" rather than "Who is at fault?"
Clinical Challenge 9
A nurse is preparing to administer a newly prescribed antibiotic when the patient states, "I'm allergic to that
medication." The electronic health record does not list any allergies. What should the nurse do first?
A. Administer the antibiotic because there is no documented allergy.
B. Ask the patient whether the previous reaction was severe after administering the medication.
C. Withhold the medication, further assess the reported allergy, and notify the healthcare provider before
administration.
D. Request that the pharmacist remove the medication from the medication administration record.
Correct Answer: C
Rationale
Patient safety is the nurse's highest priority. Any reported allergy should be thoroughly assessed before
medication administration, even if it is not documented. The nurse should clarify the reaction, withhold the
medication, and collaborate with the healthcare provider to determine the safest course of action.
Why the Other Options Are Less Appropriate
A. Absence of documentation does not mean an allergy does not exist.
B. The medication should never be administered before verifying allergy information.
