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 planning care for a patient who has expressed concern that the
treatment plan does not fit the patient's usual daily routines. Which nursing action best
demonstrates patient-centered care?
A. Explain that the prescribed plan is standardized for all patients with the same condition.
B. Ask the patient about preferences, values, and concerns and incorporate appropriate
preferences into the plan of care.
C. Ask the family to decide which aspects of care should be changed.
D. Delay the plan of care until the patient agrees with every recommendation.
Correct Answer: B
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in care. The nurse should
assess the patient's preferences, values, needs, and concerns and incorporate them into care
when clinically appropriate. This approach supports individualized care and respects patient
,autonomy. A dismisses the patient's preferences, C shifts decision-making away from the
patient, and D incorrectly suggests that agreement with every recommendation is required
before nursing care can proceed.
Why the Other Options Are Incorrect:
A: A standardized plan may provide a framework, but patient-centered nursing requires
individualization.
B: Correct. The nurse incorporates the patient's preferences and values into appropriate care
decisions.
C: Family members may be involved when appropriate, but the patient remains central to
decision-making unless circumstances indicate otherwise.
D: The nurse should support informed participation rather than require complete agreement
with every intervention.
Clinical Judgment Focus: Recognize Cues; Generate Solutions
Cognitive Level: Application
Question 2
A nurse notices that a patient is at risk for injury because the patient repeatedly attempts to get
out of bed without assistance. Which action best reflects the safety competency?
A. Tell the patient that independent movement is not permitted.
B. Identify the patient's specific risk factors and implement appropriate measures to reduce the
risk of injury.
C. Ask another patient in the room to notify staff when the patient attempts to stand.
D. Document the behavior only after an injury occurs.
Correct Answer: B
Detailed Rationale:
Safety requires nurses to recognize risks and take proactive steps to prevent harm. The nurse
,should assess why the patient is attempting to get out of bed and implement individualized
safety measures. A is unnecessarily restrictive, C places responsibility on another patient, and D
fails to support prevention.
Why the Other Options Are Incorrect:
A: Restriction without assessment and individualized planning is not the best safety approach.
B: Correct. The nurse identifies risk and proactively reduces the likelihood of harm.
C: Patients should not be used as a safety-monitoring strategy for another patient.
D: Safety focuses on prevention rather than waiting for an adverse event.
Clinical Judgment Focus: Recognize Cues; Take Action
Cognitive Level: Application
Question 3
A newly licensed nurse is working with an experienced practical nurse and a nursing assistant.
Which action best demonstrates teamwork and collaboration?
A. The RN independently completes all patient care to avoid misunderstandings.
B. The RN communicates the plan of care, clarifies responsibilities, and follows up on delegated
activities.
C. The RN delegates all assessments because other staff members have more time.
D. The RN assumes that team members will recognize changes in patient condition without
communication.
Correct Answer: B
Detailed Rationale:
Effective teamwork requires clear communication, appropriate assignment of responsibilities,
coordination, and follow-up. The RN remains accountable for nursing care and should
communicate expectations and evaluate outcomes. A prevents effective collaboration, C
, improperly transfers responsibilities requiring RN judgment, and D assumes communication will
occur without deliberate coordination.
Why the Other Options Are Incorrect:
A: Avoiding collaboration can decrease efficiency and coordination.
B: Correct. Clear communication, role clarification, and follow-up support safe teamwork.
C: Assessment and clinical judgment cannot simply be transferred because another worker has
more time.
D: Effective teams require active communication rather than assumptions.
Clinical Judgment Focus: Generate Solutions; Take Action
Cognitive Level: Application
Question 4
A nurse is reviewing a proposed change in the way patient education is delivered. Which activity
best demonstrates evidence-based practice?
A. Selecting the intervention because it has always been used on the unit
B. Choosing the intervention based only on a senior nurse's preference
C. Integrating available evidence with nursing expertise and the patient's needs and preferences
D. Choosing the intervention that requires the fewest staff members
Correct Answer: C
Detailed Rationale:
Evidence-based practice integrates the best available evidence with clinical expertise and
patient needs and preferences. The goal is not simply to follow tradition or personal preference.
A relies on habit, B relies on one individual's preference, and D focuses on staffing convenience
rather than evidence and patient needs.
Why the Other Options Are Incorrect:
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 planning care for a patient who has expressed concern that the
treatment plan does not fit the patient's usual daily routines. Which nursing action best
demonstrates patient-centered care?
A. Explain that the prescribed plan is standardized for all patients with the same condition.
B. Ask the patient about preferences, values, and concerns and incorporate appropriate
preferences into the plan of care.
C. Ask the family to decide which aspects of care should be changed.
D. Delay the plan of care until the patient agrees with every recommendation.
Correct Answer: B
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in care. The nurse should
assess the patient's preferences, values, needs, and concerns and incorporate them into care
when clinically appropriate. This approach supports individualized care and respects patient
,autonomy. A dismisses the patient's preferences, C shifts decision-making away from the
patient, and D incorrectly suggests that agreement with every recommendation is required
before nursing care can proceed.
Why the Other Options Are Incorrect:
A: A standardized plan may provide a framework, but patient-centered nursing requires
individualization.
B: Correct. The nurse incorporates the patient's preferences and values into appropriate care
decisions.
C: Family members may be involved when appropriate, but the patient remains central to
decision-making unless circumstances indicate otherwise.
D: The nurse should support informed participation rather than require complete agreement
with every intervention.
Clinical Judgment Focus: Recognize Cues; Generate Solutions
Cognitive Level: Application
Question 2
A nurse notices that a patient is at risk for injury because the patient repeatedly attempts to get
out of bed without assistance. Which action best reflects the safety competency?
A. Tell the patient that independent movement is not permitted.
B. Identify the patient's specific risk factors and implement appropriate measures to reduce the
risk of injury.
C. Ask another patient in the room to notify staff when the patient attempts to stand.
D. Document the behavior only after an injury occurs.
Correct Answer: B
Detailed Rationale:
Safety requires nurses to recognize risks and take proactive steps to prevent harm. The nurse
,should assess why the patient is attempting to get out of bed and implement individualized
safety measures. A is unnecessarily restrictive, C places responsibility on another patient, and D
fails to support prevention.
Why the Other Options Are Incorrect:
A: Restriction without assessment and individualized planning is not the best safety approach.
B: Correct. The nurse identifies risk and proactively reduces the likelihood of harm.
C: Patients should not be used as a safety-monitoring strategy for another patient.
D: Safety focuses on prevention rather than waiting for an adverse event.
Clinical Judgment Focus: Recognize Cues; Take Action
Cognitive Level: Application
Question 3
A newly licensed nurse is working with an experienced practical nurse and a nursing assistant.
Which action best demonstrates teamwork and collaboration?
A. The RN independently completes all patient care to avoid misunderstandings.
B. The RN communicates the plan of care, clarifies responsibilities, and follows up on delegated
activities.
C. The RN delegates all assessments because other staff members have more time.
D. The RN assumes that team members will recognize changes in patient condition without
communication.
Correct Answer: B
Detailed Rationale:
Effective teamwork requires clear communication, appropriate assignment of responsibilities,
coordination, and follow-up. The RN remains accountable for nursing care and should
communicate expectations and evaluate outcomes. A prevents effective collaboration, C
, improperly transfers responsibilities requiring RN judgment, and D assumes communication will
occur without deliberate coordination.
Why the Other Options Are Incorrect:
A: Avoiding collaboration can decrease efficiency and coordination.
B: Correct. Clear communication, role clarification, and follow-up support safe teamwork.
C: Assessment and clinical judgment cannot simply be transferred because another worker has
more time.
D: Effective teams require active communication rather than assumptions.
Clinical Judgment Focus: Generate Solutions; Take Action
Cognitive Level: Application
Question 4
A nurse is reviewing a proposed change in the way patient education is delivered. Which activity
best demonstrates evidence-based practice?
A. Selecting the intervention because it has always been used on the unit
B. Choosing the intervention based only on a senior nurse's preference
C. Integrating available evidence with nursing expertise and the patient's needs and preferences
D. Choosing the intervention that requires the fewest staff members
Correct Answer: C
Detailed Rationale:
Evidence-based practice integrates the best available evidence with clinical expertise and
patient needs and preferences. The goal is not simply to follow tradition or personal preference.
A relies on habit, B relies on one individual's preference, and D focuses on staffing convenience
rather than evidence and patient needs.
Why the Other Options Are Incorrect:
