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 four patients. Which nursing action best demonstrates
patient-centered care?
A. Following the same discharge teaching plan for every patient with the same diagnosis
B. Asking the patient about personal goals and incorporating those goals into the plan of care
C. Selecting interventions based primarily on the nurse's preferred routine
D. Limiting family participation because the nurse is responsible for the plan of care
Correct Answer: B. Asking the patient about personal goals and incorporating those goals into
the plan of care
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in decisions about care.
The nurse should identify the patient's preferences, values, needs, and goals and incorporate
them into individualized planning. Standardized approaches may provide structure, but they
,should not replace individualized care. Patient-centered practice supports autonomy and
promotes collaboration between the patient and healthcare team.
Why the Other Options Are Incorrect:
A: Using an identical plan for every patient does not account for individual preferences, needs,
or goals.
B: This option directly supports individualized, patient-centered care.
C: Nursing care should be based on patient needs and professional judgment rather than the
nurse's personal routine.
D: Patients may choose to involve family members or support persons; participation should be
guided by patient preferences and appropriate privacy considerations.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 2
A nurse is participating in a quality and safety initiative on a medical-surgical unit. Which action
best reflects the Quality and Safety Education for Nurses (QSEN) competency of safety?
A. Completing tasks as quickly as possible to reduce the workload
B. Identifying a potential risk and taking action to prevent patient harm
C. Allowing each nurse to develop individual safety practices
D. Delegating all safety-related responsibilities to assistive personnel
Correct Answer: B. Identifying a potential risk and taking action to prevent patient harm
Detailed Rationale:
Safety involves minimizing the risk of harm to patients and providers through both individual
performance and system-based approaches. Nurses are expected to recognize hazards,
communicate concerns, and use appropriate strategies to prevent errors and injury. Safety is not
simply task completion; it requires anticipation and management of risk.
,Why the Other Options Are Incorrect:
A: Speed does not define safe nursing practice and may increase the likelihood of errors.
B: Recognizing and preventing harm is central to the safety competency.
C: Safety practices should be consistent with established standards and organizational processes
rather than based solely on individual preferences.
D: Safety is a responsibility shared by the healthcare team and cannot be transferred entirely to
assistive personnel.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Understanding
Question 3
A nurse notices that a patient is becoming confused and less responsive than during the
previous assessment. The nurse immediately reassesses the patient, compares the current
findings with the baseline, and communicates the change to the appropriate team member.
Which component of clinical judgment is the nurse demonstrating most directly?
A. Recognizing cues
B. Prioritizing hypotheses
C. Evaluating outcomes
D. Generating solutions
Correct Answer: A. Recognizing cues
Detailed Rationale:
Recognizing cues involves identifying relevant clinical information and noticing meaningful
changes in the patient's condition. Comparing current findings with baseline status helps the
nurse identify abnormal or concerning changes that may require further analysis. The
subsequent steps of clinical judgment occur after relevant cues have been recognized and
interpreted.
, Why the Other Options Are Incorrect:
A: Correct. The nurse identifies a significant change in the patient's condition.
B: Prioritizing hypotheses occurs after the nurse has analyzed relevant cues and developed
possible explanations.
C: Evaluation occurs after interventions are implemented and outcomes are assessed.
D: Generating solutions involves planning interventions after the problem has been analyzed.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Application
Question 4
A patient tells the nurse, "I do not understand why this treatment is necessary, and I want more
information before deciding." What is the nurse's best response?
A. "The healthcare provider already decided that this is necessary."
B. "You should agree because the treatment is commonly used."
C. "Let's discuss what you understand and what information you need before making your
decision."
D. "Your family can make the decision for you."
Correct Answer: C. "Let's discuss what you understand and what information you need before
making your decision."
Detailed Rationale:
Respect for patient autonomy requires that patients have an opportunity to participate in
decisions affecting their care. The nurse should assess understanding, identify information
needs, and support informed decision-making without coercion. Patient-centered
communication also requires the nurse to recognize health literacy needs and facilitate
appropriate communication with the healthcare team.
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 caring for four patients. Which nursing action best demonstrates
patient-centered care?
A. Following the same discharge teaching plan for every patient with the same diagnosis
B. Asking the patient about personal goals and incorporating those goals into the plan of care
C. Selecting interventions based primarily on the nurse's preferred routine
D. Limiting family participation because the nurse is responsible for the plan of care
Correct Answer: B. Asking the patient about personal goals and incorporating those goals into
the plan of care
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in decisions about care.
The nurse should identify the patient's preferences, values, needs, and goals and incorporate
them into individualized planning. Standardized approaches may provide structure, but they
,should not replace individualized care. Patient-centered practice supports autonomy and
promotes collaboration between the patient and healthcare team.
Why the Other Options Are Incorrect:
A: Using an identical plan for every patient does not account for individual preferences, needs,
or goals.
B: This option directly supports individualized, patient-centered care.
C: Nursing care should be based on patient needs and professional judgment rather than the
nurse's personal routine.
D: Patients may choose to involve family members or support persons; participation should be
guided by patient preferences and appropriate privacy considerations.
Clinical Judgment Focus: Generate Solutions
Cognitive Level: Application
Question 2
A nurse is participating in a quality and safety initiative on a medical-surgical unit. Which action
best reflects the Quality and Safety Education for Nurses (QSEN) competency of safety?
A. Completing tasks as quickly as possible to reduce the workload
B. Identifying a potential risk and taking action to prevent patient harm
C. Allowing each nurse to develop individual safety practices
D. Delegating all safety-related responsibilities to assistive personnel
Correct Answer: B. Identifying a potential risk and taking action to prevent patient harm
Detailed Rationale:
Safety involves minimizing the risk of harm to patients and providers through both individual
performance and system-based approaches. Nurses are expected to recognize hazards,
communicate concerns, and use appropriate strategies to prevent errors and injury. Safety is not
simply task completion; it requires anticipation and management of risk.
,Why the Other Options Are Incorrect:
A: Speed does not define safe nursing practice and may increase the likelihood of errors.
B: Recognizing and preventing harm is central to the safety competency.
C: Safety practices should be consistent with established standards and organizational processes
rather than based solely on individual preferences.
D: Safety is a responsibility shared by the healthcare team and cannot be transferred entirely to
assistive personnel.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Understanding
Question 3
A nurse notices that a patient is becoming confused and less responsive than during the
previous assessment. The nurse immediately reassesses the patient, compares the current
findings with the baseline, and communicates the change to the appropriate team member.
Which component of clinical judgment is the nurse demonstrating most directly?
A. Recognizing cues
B. Prioritizing hypotheses
C. Evaluating outcomes
D. Generating solutions
Correct Answer: A. Recognizing cues
Detailed Rationale:
Recognizing cues involves identifying relevant clinical information and noticing meaningful
changes in the patient's condition. Comparing current findings with baseline status helps the
nurse identify abnormal or concerning changes that may require further analysis. The
subsequent steps of clinical judgment occur after relevant cues have been recognized and
interpreted.
, Why the Other Options Are Incorrect:
A: Correct. The nurse identifies a significant change in the patient's condition.
B: Prioritizing hypotheses occurs after the nurse has analyzed relevant cues and developed
possible explanations.
C: Evaluation occurs after interventions are implemented and outcomes are assessed.
D: Generating solutions involves planning interventions after the problem has been analyzed.
Clinical Judgment Focus: Recognize Cues
Cognitive Level: Application
Question 4
A patient tells the nurse, "I do not understand why this treatment is necessary, and I want more
information before deciding." What is the nurse's best response?
A. "The healthcare provider already decided that this is necessary."
B. "You should agree because the treatment is commonly used."
C. "Let's discuss what you understand and what information you need before making your
decision."
D. "Your family can make the decision for you."
Correct Answer: C. "Let's discuss what you understand and what information you need before
making your decision."
Detailed Rationale:
Respect for patient autonomy requires that patients have an opportunity to participate in
decisions affecting their care. The nurse should assess understanding, identify information
needs, and support informed decision-making without coercion. Patient-centered
communication also requires the nurse to recognize health literacy needs and facilitate
appropriate communication with the healthcare team.
Why the Other Options Are Incorrect:
