Medical-Surgical Nursing
11th Edition
• Author(s)Donna D. Ignatavicius; Cherie R. Rebar; Nicole
M. Heimgartner
PRACTICE QUESTIONS, DETAILED RATIONALES AND CLINICAL JUDGEMENT
Chapter 1: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Question 1
A medical-surgical nurse is caring for a hospitalized patient who has expressed concern about
participating in the plan of care. Which nursing action best demonstrates patient-centered
care?
A. Provide the treatment plan and ask the patient to follow it exactly.
B. Ask the patient about personal preferences and incorporate them into the plan when
clinically appropriate.
C. Ask the family to make decisions because they know the patient best.
D. Delay patient involvement until the health care provider has completed the treatment plan.
Correct Answer: B
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in health care decisions.
The nurse should assess the patient's preferences, values, concerns, and goals and incorporate
these considerations into care when they are compatible with safe, appropriate treatment.
Patient participation promotes autonomy and individualized care.
,Why the Other Options Are Incorrect:
A: This approach makes the patient a passive recipient rather than a participant in care.
B: Correct. This approach respects patient preferences while maintaining clinical
appropriateness and safety.
C: Family members may provide valuable support, but the patient should remain involved in
decisions whenever capable.
D: Patient-centered care should begin during the planning process rather than after decisions
have already been made.
Clinical Judgment Focus: Recognize Cues; Generate Solutions
Cognitive Level: Application
Question 2
A nurse identifies that a hospitalized patient is at increased risk for falling because of weakness
and an unfamiliar environment. Which action most directly addresses the Safety QSEN
competency?
A. Ask the patient to remain in bed throughout hospitalization.
B. Explain the patient's fall risk and implement individualized fall-prevention measures.
C. Allow the patient to request assistance only when necessary.
D. Document the patient's weakness after the patient experiences a fall.
Correct Answer: B
Detailed Rationale:
Safety involves minimizing the risk of harm to patients through effective assessment and
preventive interventions. The nurse should identify risks and implement individualized
measures before an adverse event occurs. Fall prevention should be based on the patient's
specific risk factors rather than automatically restricting activity.
Why the Other Options Are Incorrect:
,A: Complete bed rest may create additional risks and is not automatically indicated for a patient
at risk for falls.
B: Correct. Identifying risk and implementing preventive interventions demonstrates proactive
safety practice.
C: Patients at increased risk may require proactive nursing assistance rather than relying solely
on self-initiated requests.
D: Documentation after an injury does not prevent the event and therefore does not represent
proactive safety practice.
Clinical Judgment Focus: Recognize Cues; Take Action
Cognitive Level: Application
Question 3 — Select All That Apply
Which nursing behaviors demonstrate effective teamwork and collaboration in medical-surgical
practice? Select all that apply.
A. Communicating important changes in the patient's condition to appropriate team members
B. Clarifying responsibilities when roles overlap
C. Withholding information until the end of the shift to avoid interrupting another discipline
D. Respecting the expertise of other members of the health care team
E. Independently making decisions that require input from another professional
Correct Answers: A, B, D
Detailed Rationale:
Teamwork and collaboration require effective communication, respect for the roles and
expertise of others, and clarification of responsibilities. Nurses must share relevant patient
information in a timely manner and collaborate with other professionals when their expertise
contributes to patient care.
Why the Other Options Are Incorrect:
, A: Correct. Timely communication promotes coordinated and safe care.
B: Correct. Clarifying responsibilities reduces duplication, omissions, and misunderstandings.
C: Incorrect. Delaying important information can jeopardize patient safety.
D: Correct. Respect for interdisciplinary expertise supports effective collaboration.
E: Incorrect. Decisions that require interdisciplinary input should be developed collaboratively
rather than independently.
Clinical Judgment Focus: Recognize Cues; Generate Solutions
Cognitive Level: Analysis
Question 4
A nurse is reviewing current evidence before implementing a new intervention for a group of
medical-surgical patients. Which action best reflects evidence-based practice?
A. Select the intervention based solely on personal experience.
B. Use the intervention because it has always been used on the unit.
C. Integrate relevant evidence with clinical expertise and patient considerations.
D. Adopt the intervention because another nurse reports that it works well.
Correct Answer: C
Detailed Rationale:
Evidence-based practice involves integrating the best available evidence with clinical expertise
and patient needs, preferences, and circumstances. Practice should not depend solely on
tradition, anecdotal experience, or individual preference.
Why the Other Options Are Incorrect:
A: Personal experience can contribute to clinical expertise but should not be the sole basis for
practice decisions.
B: Tradition does not necessarily represent current or best evidence.
C: Correct. This reflects the integration that characterizes evidence-based practice.
D: One person's experience is insufficient evidence for changing practice.
11th Edition
• Author(s)Donna D. Ignatavicius; Cherie R. Rebar; Nicole
M. Heimgartner
PRACTICE QUESTIONS, DETAILED RATIONALES AND CLINICAL JUDGEMENT
Chapter 1: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Question 1
A medical-surgical nurse is caring for a hospitalized patient who has expressed concern about
participating in the plan of care. Which nursing action best demonstrates patient-centered
care?
A. Provide the treatment plan and ask the patient to follow it exactly.
B. Ask the patient about personal preferences and incorporate them into the plan when
clinically appropriate.
C. Ask the family to make decisions because they know the patient best.
D. Delay patient involvement until the health care provider has completed the treatment plan.
Correct Answer: B
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in health care decisions.
The nurse should assess the patient's preferences, values, concerns, and goals and incorporate
these considerations into care when they are compatible with safe, appropriate treatment.
Patient participation promotes autonomy and individualized care.
,Why the Other Options Are Incorrect:
A: This approach makes the patient a passive recipient rather than a participant in care.
B: Correct. This approach respects patient preferences while maintaining clinical
appropriateness and safety.
C: Family members may provide valuable support, but the patient should remain involved in
decisions whenever capable.
D: Patient-centered care should begin during the planning process rather than after decisions
have already been made.
Clinical Judgment Focus: Recognize Cues; Generate Solutions
Cognitive Level: Application
Question 2
A nurse identifies that a hospitalized patient is at increased risk for falling because of weakness
and an unfamiliar environment. Which action most directly addresses the Safety QSEN
competency?
A. Ask the patient to remain in bed throughout hospitalization.
B. Explain the patient's fall risk and implement individualized fall-prevention measures.
C. Allow the patient to request assistance only when necessary.
D. Document the patient's weakness after the patient experiences a fall.
Correct Answer: B
Detailed Rationale:
Safety involves minimizing the risk of harm to patients through effective assessment and
preventive interventions. The nurse should identify risks and implement individualized
measures before an adverse event occurs. Fall prevention should be based on the patient's
specific risk factors rather than automatically restricting activity.
Why the Other Options Are Incorrect:
,A: Complete bed rest may create additional risks and is not automatically indicated for a patient
at risk for falls.
B: Correct. Identifying risk and implementing preventive interventions demonstrates proactive
safety practice.
C: Patients at increased risk may require proactive nursing assistance rather than relying solely
on self-initiated requests.
D: Documentation after an injury does not prevent the event and therefore does not represent
proactive safety practice.
Clinical Judgment Focus: Recognize Cues; Take Action
Cognitive Level: Application
Question 3 — Select All That Apply
Which nursing behaviors demonstrate effective teamwork and collaboration in medical-surgical
practice? Select all that apply.
A. Communicating important changes in the patient's condition to appropriate team members
B. Clarifying responsibilities when roles overlap
C. Withholding information until the end of the shift to avoid interrupting another discipline
D. Respecting the expertise of other members of the health care team
E. Independently making decisions that require input from another professional
Correct Answers: A, B, D
Detailed Rationale:
Teamwork and collaboration require effective communication, respect for the roles and
expertise of others, and clarification of responsibilities. Nurses must share relevant patient
information in a timely manner and collaborate with other professionals when their expertise
contributes to patient care.
Why the Other Options Are Incorrect:
, A: Correct. Timely communication promotes coordinated and safe care.
B: Correct. Clarifying responsibilities reduces duplication, omissions, and misunderstandings.
C: Incorrect. Delaying important information can jeopardize patient safety.
D: Correct. Respect for interdisciplinary expertise supports effective collaboration.
E: Incorrect. Decisions that require interdisciplinary input should be developed collaboratively
rather than independently.
Clinical Judgment Focus: Recognize Cues; Generate Solutions
Cognitive Level: Analysis
Question 4
A nurse is reviewing current evidence before implementing a new intervention for a group of
medical-surgical patients. Which action best reflects evidence-based practice?
A. Select the intervention based solely on personal experience.
B. Use the intervention because it has always been used on the unit.
C. Integrate relevant evidence with clinical expertise and patient considerations.
D. Adopt the intervention because another nurse reports that it works well.
Correct Answer: C
Detailed Rationale:
Evidence-based practice involves integrating the best available evidence with clinical expertise
and patient needs, preferences, and circumstances. Practice should not depend solely on
tradition, anecdotal experience, or individual preference.
Why the Other Options Are Incorrect:
A: Personal experience can contribute to clinical expertise but should not be the sole basis for
practice decisions.
B: Tradition does not necessarily represent current or best evidence.
C: Correct. This reflects the integration that characterizes evidence-based practice.
D: One person's experience is insufficient evidence for changing practice.
