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 patient who has expressed a preference about how care
should be organized during the day. Which nursing action best demonstrates patient-centered
care?
A. Organizing care solely according to the unit routine
B. Incorporating the patient's preferences when planning care
C. Asking the patient's family to make routine decisions
D. Using the same care plan for every patient with the same diagnosis
Correct Answer: B. Incorporating the patient's preferences when planning care
Detailed Rationale:
Patient-centered care involves recognizing the patient as an active participant in care and
incorporating the patient's preferences into the plan whenever appropriate. The nurse should
avoid treating patients as though a standard diagnosis automatically determines an identical
plan of care. Individual preferences are an important part of individualized nursing care.
,Why the Other Options Are Incorrect:
A: Unit routines may guide care organization, but they should not automatically override
appropriate patient preferences.
B: Correct. Incorporating patient preferences is a direct application of patient-centered care.
C: Family participation may be appropriate, but the patient should remain central to decisions
about the patient's care when able to participate.
D: Patients with the same diagnosis may have different needs, values, and preferences;
therefore, identical care plans are inappropriate.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Application
Question 2
A nurse identifies that a patient's current care plan does not reflect a newly expressed patient
preference. What is the nurse's best action?
A. Continue the existing plan because it was already established
B. Modify the plan to incorporate the patient's preference when clinically appropriate
C. Delay the patient's request until discharge planning begins
D. Ask another patient how the preference should be handled
Correct Answer: B. Modify the plan to incorporate the patient's preference when clinically
appropriate
Detailed Rationale:
Patient-centered care requires ongoing assessment and adaptation of care. A patient's
preferences should be considered as the nurse develops and updates the plan of care. The plan
should therefore be responsive to relevant patient input rather than treated as a fixed
document.
Why the Other Options Are Incorrect:
,A: A care plan should be responsive to current patient needs and preferences.
B: Correct. Updating the plan appropriately reflects individualized, patient-centered care.
C: Waiting unnecessarily delays patient participation in care planning.
D: Another patient cannot determine an individual patient's preferences.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 3
During a shift, a nurse notices that a medication-related safety concern could affect more than
one patient. Which action best reflects the Safety competency?
A. Ignore the concern unless a patient is already harmed
B. Identify the concern and take appropriate steps to reduce risk
C. Document the concern at the end of the month
D. Assume another nurse will address it
Correct Answer: B. Identify the concern and take appropriate steps to reduce risk
Detailed Rationale:
Safety in professional nursing emphasizes recognizing risks and acting to reduce the possibility
of patient harm. Waiting until harm occurs is inconsistent with a proactive safety approach.
Nurses have a responsibility to identify hazards and respond appropriately.
Why the Other Options Are Incorrect:
A: Safety practice is preventive, not limited to responding after harm occurs.
B: Correct. Early recognition and risk reduction are fundamental safety behaviors.
C: Delaying action allows the potential risk to continue.
D: Assuming another person will intervene can leave the safety concern unresolved.
, Clinical Judgment Focus: Recognize Cues → Take Action
Cognitive Level: Analysis
Question 4
A nurse is caring for a patient whose condition requires input from several members of the
health care team. Which action best demonstrates teamwork and collaboration?
A. Making all decisions independently
B. Sharing relevant information with appropriate team members
C. Limiting communication to avoid conflicting opinions
D. Asking the patient to communicate all clinical information to the team
Correct Answer: B. Sharing relevant information with appropriate team members
Detailed Rationale:
Teamwork and collaboration require effective communication and coordinated participation
among members of the health care team. Relevant information should be shared so that team
members can contribute appropriately to patient care. Professional collaboration reduces
fragmented care and supports continuity.
Why the Other Options Are Incorrect:
A: Independent nursing judgment is important, but complex care often requires collaboration.
B: Correct. Timely communication of relevant information promotes coordinated care.
C: Avoiding communication can create gaps and inconsistencies in care.
D: The nurse remains responsible for communicating relevant clinical information rather than
placing that responsibility entirely on the patient.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Understanding
Question 5
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 patient who has expressed a preference about how care
should be organized during the day. Which nursing action best demonstrates patient-centered
care?
A. Organizing care solely according to the unit routine
B. Incorporating the patient's preferences when planning care
C. Asking the patient's family to make routine decisions
D. Using the same care plan for every patient with the same diagnosis
Correct Answer: B. Incorporating the patient's preferences when planning care
Detailed Rationale:
Patient-centered care involves recognizing the patient as an active participant in care and
incorporating the patient's preferences into the plan whenever appropriate. The nurse should
avoid treating patients as though a standard diagnosis automatically determines an identical
plan of care. Individual preferences are an important part of individualized nursing care.
,Why the Other Options Are Incorrect:
A: Unit routines may guide care organization, but they should not automatically override
appropriate patient preferences.
B: Correct. Incorporating patient preferences is a direct application of patient-centered care.
C: Family participation may be appropriate, but the patient should remain central to decisions
about the patient's care when able to participate.
D: Patients with the same diagnosis may have different needs, values, and preferences;
therefore, identical care plans are inappropriate.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Application
Question 2
A nurse identifies that a patient's current care plan does not reflect a newly expressed patient
preference. What is the nurse's best action?
A. Continue the existing plan because it was already established
B. Modify the plan to incorporate the patient's preference when clinically appropriate
C. Delay the patient's request until discharge planning begins
D. Ask another patient how the preference should be handled
Correct Answer: B. Modify the plan to incorporate the patient's preference when clinically
appropriate
Detailed Rationale:
Patient-centered care requires ongoing assessment and adaptation of care. A patient's
preferences should be considered as the nurse develops and updates the plan of care. The plan
should therefore be responsive to relevant patient input rather than treated as a fixed
document.
Why the Other Options Are Incorrect:
,A: A care plan should be responsive to current patient needs and preferences.
B: Correct. Updating the plan appropriately reflects individualized, patient-centered care.
C: Waiting unnecessarily delays patient participation in care planning.
D: Another patient cannot determine an individual patient's preferences.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 3
During a shift, a nurse notices that a medication-related safety concern could affect more than
one patient. Which action best reflects the Safety competency?
A. Ignore the concern unless a patient is already harmed
B. Identify the concern and take appropriate steps to reduce risk
C. Document the concern at the end of the month
D. Assume another nurse will address it
Correct Answer: B. Identify the concern and take appropriate steps to reduce risk
Detailed Rationale:
Safety in professional nursing emphasizes recognizing risks and acting to reduce the possibility
of patient harm. Waiting until harm occurs is inconsistent with a proactive safety approach.
Nurses have a responsibility to identify hazards and respond appropriately.
Why the Other Options Are Incorrect:
A: Safety practice is preventive, not limited to responding after harm occurs.
B: Correct. Early recognition and risk reduction are fundamental safety behaviors.
C: Delaying action allows the potential risk to continue.
D: Assuming another person will intervene can leave the safety concern unresolved.
, Clinical Judgment Focus: Recognize Cues → Take Action
Cognitive Level: Analysis
Question 4
A nurse is caring for a patient whose condition requires input from several members of the
health care team. Which action best demonstrates teamwork and collaboration?
A. Making all decisions independently
B. Sharing relevant information with appropriate team members
C. Limiting communication to avoid conflicting opinions
D. Asking the patient to communicate all clinical information to the team
Correct Answer: B. Sharing relevant information with appropriate team members
Detailed Rationale:
Teamwork and collaboration require effective communication and coordinated participation
among members of the health care team. Relevant information should be shared so that team
members can contribute appropriately to patient care. Professional collaboration reduces
fragmented care and supports continuity.
Why the Other Options Are Incorrect:
A: Independent nursing judgment is important, but complex care often requires collaboration.
B: Correct. Timely communication of relevant information promotes coordinated care.
C: Avoiding communication can create gaps and inconsistencies in care.
D: The nurse remains responsible for communicating relevant clinical information rather than
placing that responsibility entirely on the patient.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Understanding
Question 5
