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 adult who has several chronic health
conditions. During the admission assessment, the nurse asks the patient which health goals are
most important and incorporates those preferences into the plan of care. Which Quality and
Safety Education for Nurses (QSEN) competency is best demonstrated?
A. Safety
B. Patient-centered care
C. Informatics
D. Quality improvement
Correct Answer: B. Patient-centered care
Detailed Rationale:
Patient-centered care involves recognizing the patient as a partner in care and respecting the
patient's preferences, values, needs, and expressed goals. The nurse does not simply impose a
,standardized plan but works collaboratively with the patient to develop individualized care. This
approach supports respect for autonomy and individualized nursing practice.
Why the Other Options Are Incorrect:
A: Safety focuses on minimizing the risk of harm to patients and healthcare providers. Although
safety remains important, the scenario specifically emphasizes patient preferences and goals.
B: Correct. The nurse is incorporating the patient's values and preferences into care planning.
C: Informatics involves using information and technology to communicate, manage knowledge,
and support care. No technology-related activity is described.
D: Quality improvement involves systematic efforts to improve healthcare processes and
outcomes. The scenario does not describe an improvement project.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Understanding
Question 2
A nurse is preparing to administer medications to four patients. Which action best demonstrates
the QSEN competency of safety?
A. Asking a patient about preferred meal choices
B. Verifying the patient's identity using approved identifiers before medication administration
C. Reviewing a recent nursing research article
D. Entering a patient's discharge summary into the electronic record
Correct Answer: B. Verifying the patient's identity using approved identifiers before medication
administration
Detailed Rationale:
Safety in nursing practice includes actions that reduce the risk of preventable harm. Correct
patient identification before medication administration is a fundamental safety practice. It helps
prevent medication errors and supports reliable nursing processes.
Why the Other Options Are Incorrect:
,A: Patient meal preferences demonstrate patient-centered care rather than the safety
competency being tested.
B: Correct. Patient identification is a direct safety intervention that reduces the likelihood of
medication-related harm.
C: Reviewing research supports evidence-based practice.
D: Documentation in the electronic health record relates primarily to informatics and
information management.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 3
A nurse is working with a physical therapist and a pharmacist to develop a patient's plan of care.
The nurse communicates the patient's current status and clarifies each professional's role in the
patient's treatment. Which QSEN competency is most directly demonstrated?
A. Teamwork and collaboration
B. Health equity
C. Informatics
D. Ethics
Correct Answer: A. Teamwork and collaboration
Detailed Rationale:
Teamwork and collaboration require healthcare professionals to communicate effectively,
respect one another's roles and expertise, and work together to achieve safe, patient-centered
outcomes. Clearly communicating patient information and clarifying responsibilities help
prevent fragmented care.
Why the Other Options Are Incorrect:
A: Correct. The scenario directly addresses interprofessional communication and role
clarification.
, B: Health equity focuses on ensuring fair and appropriate care and addressing barriers that
contribute to unequal outcomes.
C: Informatics focuses on information management and technology.
D: Ethics involves principles guiding professional decision-making and conduct.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 4
A nurse questions a routine practice used on the unit because recent research suggests another
intervention may produce better patient outcomes. What should the nurse do first?
A. Stop the current practice immediately
B. Locate and evaluate relevant evidence supporting the proposed intervention
C. Ask a coworker whether the new intervention is popular
D. Implement the new intervention with selected patients without discussion
Correct Answer: B. Locate and evaluate relevant evidence supporting the proposed intervention
Detailed Rationale:
Evidence-based practice integrates the best available evidence with clinical expertise and
patient preferences. Before changing practice, the nurse should determine whether credible
evidence supports the proposed intervention and evaluate the quality and applicability of that
evidence. Abruptly changing practice without adequate evaluation could create safety concerns.
Why the Other Options Are Incorrect:
A: Immediately stopping a current practice without evaluating the evidence may place patients
at risk.
B: Correct. Evidence should be identified and critically evaluated before practice changes are
made.
C: Popularity is not evidence of effectiveness or safety.
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 adult who has several chronic health
conditions. During the admission assessment, the nurse asks the patient which health goals are
most important and incorporates those preferences into the plan of care. Which Quality and
Safety Education for Nurses (QSEN) competency is best demonstrated?
A. Safety
B. Patient-centered care
C. Informatics
D. Quality improvement
Correct Answer: B. Patient-centered care
Detailed Rationale:
Patient-centered care involves recognizing the patient as a partner in care and respecting the
patient's preferences, values, needs, and expressed goals. The nurse does not simply impose a
,standardized plan but works collaboratively with the patient to develop individualized care. This
approach supports respect for autonomy and individualized nursing practice.
Why the Other Options Are Incorrect:
A: Safety focuses on minimizing the risk of harm to patients and healthcare providers. Although
safety remains important, the scenario specifically emphasizes patient preferences and goals.
B: Correct. The nurse is incorporating the patient's values and preferences into care planning.
C: Informatics involves using information and technology to communicate, manage knowledge,
and support care. No technology-related activity is described.
D: Quality improvement involves systematic efforts to improve healthcare processes and
outcomes. The scenario does not describe an improvement project.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Understanding
Question 2
A nurse is preparing to administer medications to four patients. Which action best demonstrates
the QSEN competency of safety?
A. Asking a patient about preferred meal choices
B. Verifying the patient's identity using approved identifiers before medication administration
C. Reviewing a recent nursing research article
D. Entering a patient's discharge summary into the electronic record
Correct Answer: B. Verifying the patient's identity using approved identifiers before medication
administration
Detailed Rationale:
Safety in nursing practice includes actions that reduce the risk of preventable harm. Correct
patient identification before medication administration is a fundamental safety practice. It helps
prevent medication errors and supports reliable nursing processes.
Why the Other Options Are Incorrect:
,A: Patient meal preferences demonstrate patient-centered care rather than the safety
competency being tested.
B: Correct. Patient identification is a direct safety intervention that reduces the likelihood of
medication-related harm.
C: Reviewing research supports evidence-based practice.
D: Documentation in the electronic health record relates primarily to informatics and
information management.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 3
A nurse is working with a physical therapist and a pharmacist to develop a patient's plan of care.
The nurse communicates the patient's current status and clarifies each professional's role in the
patient's treatment. Which QSEN competency is most directly demonstrated?
A. Teamwork and collaboration
B. Health equity
C. Informatics
D. Ethics
Correct Answer: A. Teamwork and collaboration
Detailed Rationale:
Teamwork and collaboration require healthcare professionals to communicate effectively,
respect one another's roles and expertise, and work together to achieve safe, patient-centered
outcomes. Clearly communicating patient information and clarifying responsibilities help
prevent fragmented care.
Why the Other Options Are Incorrect:
A: Correct. The scenario directly addresses interprofessional communication and role
clarification.
, B: Health equity focuses on ensuring fair and appropriate care and addressing barriers that
contribute to unequal outcomes.
C: Informatics focuses on information management and technology.
D: Ethics involves principles guiding professional decision-making and conduct.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 4
A nurse questions a routine practice used on the unit because recent research suggests another
intervention may produce better patient outcomes. What should the nurse do first?
A. Stop the current practice immediately
B. Locate and evaluate relevant evidence supporting the proposed intervention
C. Ask a coworker whether the new intervention is popular
D. Implement the new intervention with selected patients without discussion
Correct Answer: B. Locate and evaluate relevant evidence supporting the proposed intervention
Detailed Rationale:
Evidence-based practice integrates the best available evidence with clinical expertise and
patient preferences. Before changing practice, the nurse should determine whether credible
evidence supports the proposed intervention and evaluate the quality and applicability of that
evidence. Abruptly changing practice without adequate evaluation could create safety concerns.
Why the Other Options Are Incorrect:
A: Immediately stopping a current practice without evaluating the evidence may place patients
at risk.
B: Correct. Evidence should be identified and critically evaluated before practice changes are
made.
C: Popularity is not evidence of effectiveness or safety.
