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 nurse is caring for a hospitalized adult who says, “I do not understand why this treatment is
necessary, and I want to know what choices I have.” Which nursing action best demonstrates
patient-centered care?
A. Explain that the prescribed treatment is standard for the patient's diagnosis.
B. Ask the patient about concerns, preferences, and understanding before discussing available
options.
C. Tell the patient that the provider will make the final decision.
D. Encourage the patient's family to decide which treatment should be used.
Correct Answer: B
Detailed Rationale:
Patient-centered care requires the nurse to recognize the patient as an active participant in
care. Asking about concerns, preferences, and current understanding supports individualized
,care and shared decision-making. The nurse should provide understandable information and
support the patient's ability to participate in decisions.
Why the Other Options Are Incorrect:
A: Standard treatment does not eliminate the patient's need for information or participation.
B: Correct. This approach begins with the patient's values, concerns, preferences, and
understanding.
C: The nurse should facilitate informed participation rather than dismiss the patient's role in
decision-making.
D: Family involvement may be appropriate when desired by the patient, but the family should
not automatically replace the patient's preferences.
Clinical Judgment Focus: Recognize patient preferences and generate a patient-centered
solution.
Cognitive Level: Application
Question 2
Which nursing action best reflects the QSEN competency of teamwork and collaboration?
A. Completing all patient-care activities independently to avoid confusion.
B. Reporting a patient's change in condition to the appropriate team member and contributing
relevant assessment findings.
C. Asking another nurse to assume responsibility for an unfamiliar patient without
communicating the patient's status.
D. Waiting until the end of the shift to discuss a nonroutine clinical concern.
Correct Answer: B
Detailed Rationale:
Teamwork and collaboration require effective communication, sharing relevant information, and
coordinating care among members of the health-care team. Timely communication of a change
in condition helps the team respond appropriately and supports continuity and patient safety.
,Why the Other Options Are Incorrect:
A: Independent work without communication can fragment care.
B: Correct. Timely sharing of clinically relevant information supports coordinated care.
C: Transfer of responsibility without adequate communication creates safety risks.
D: Delaying clinically important information may allow a patient's condition to worsen.
Clinical Judgment Focus: Recognize the importance of timely interdisciplinary communication.
Cognitive Level: Understanding
Question 3
A nurse notices that two patients with similar medication orders have different documented
allergies. Before administering the medications, what is the nurse's priority action?
A. Administer the medication because it was prescribed by the provider.
B. Verify the medication orders and allergy information before administration.
C. Ask the patients whether they have experienced an allergy previously.
D. Document the discrepancy after the medication has been administered.
Correct Answer: B
Detailed Rationale:
Safety requires the nurse to identify discrepancies before they result in harm. Medication
administration should be preceded by verification of relevant patient information, including
allergies and the prescribed therapy. The nurse should resolve uncertainty before proceeding.
Why the Other Options Are Incorrect:
A: A prescription does not eliminate the nurse's responsibility to identify safety concerns.
B: Correct. Verification should occur before medication administration.
C: Patient input is valuable, but the nurse must also verify the documented information and
prescription.
D: Documenting after administration does not prevent a potential adverse event.
, Clinical Judgment Focus: Recognize a safety risk and take preventive action.
Cognitive Level: Application
Question 4 — Select All That Apply
A nurse is evaluating whether an intervention reflects evidence-based practice. Which elements
should the nurse consider?
A. Current evidence related to the clinical problem
B. Clinical expertise
C. Patient preferences and values
D. Tradition alone
E. Relevant patient circumstances
Correct Answers: A, B, C, E
Detailed Rationale:
Evidence-based practice integrates the best available evidence with clinical expertise and
patient preferences and circumstances. Evidence-based care is not simply the use of tradition;
the nurse should determine whether available evidence and professional judgment support the
intervention for the individual patient.
Why the Other Options Are Incorrect:
A: Correct. Current, relevant evidence is a foundation of evidence-based practice.
B: Correct. Clinical expertise helps determine how evidence should be applied.
C: Correct. Patient preferences and values are part of individualized evidence-based care.
D: Tradition alone does not establish that an intervention is evidence based.
E: Correct. Patient-specific circumstances influence how evidence is applied.
Clinical Judgment Focus: Analyze information needed to support evidence-based decisions.
Cognitive Level: Analysis
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 nurse is caring for a hospitalized adult who says, “I do not understand why this treatment is
necessary, and I want to know what choices I have.” Which nursing action best demonstrates
patient-centered care?
A. Explain that the prescribed treatment is standard for the patient's diagnosis.
B. Ask the patient about concerns, preferences, and understanding before discussing available
options.
C. Tell the patient that the provider will make the final decision.
D. Encourage the patient's family to decide which treatment should be used.
Correct Answer: B
Detailed Rationale:
Patient-centered care requires the nurse to recognize the patient as an active participant in
care. Asking about concerns, preferences, and current understanding supports individualized
,care and shared decision-making. The nurse should provide understandable information and
support the patient's ability to participate in decisions.
Why the Other Options Are Incorrect:
A: Standard treatment does not eliminate the patient's need for information or participation.
B: Correct. This approach begins with the patient's values, concerns, preferences, and
understanding.
C: The nurse should facilitate informed participation rather than dismiss the patient's role in
decision-making.
D: Family involvement may be appropriate when desired by the patient, but the family should
not automatically replace the patient's preferences.
Clinical Judgment Focus: Recognize patient preferences and generate a patient-centered
solution.
Cognitive Level: Application
Question 2
Which nursing action best reflects the QSEN competency of teamwork and collaboration?
A. Completing all patient-care activities independently to avoid confusion.
B. Reporting a patient's change in condition to the appropriate team member and contributing
relevant assessment findings.
C. Asking another nurse to assume responsibility for an unfamiliar patient without
communicating the patient's status.
D. Waiting until the end of the shift to discuss a nonroutine clinical concern.
Correct Answer: B
Detailed Rationale:
Teamwork and collaboration require effective communication, sharing relevant information, and
coordinating care among members of the health-care team. Timely communication of a change
in condition helps the team respond appropriately and supports continuity and patient safety.
,Why the Other Options Are Incorrect:
A: Independent work without communication can fragment care.
B: Correct. Timely sharing of clinically relevant information supports coordinated care.
C: Transfer of responsibility without adequate communication creates safety risks.
D: Delaying clinically important information may allow a patient's condition to worsen.
Clinical Judgment Focus: Recognize the importance of timely interdisciplinary communication.
Cognitive Level: Understanding
Question 3
A nurse notices that two patients with similar medication orders have different documented
allergies. Before administering the medications, what is the nurse's priority action?
A. Administer the medication because it was prescribed by the provider.
B. Verify the medication orders and allergy information before administration.
C. Ask the patients whether they have experienced an allergy previously.
D. Document the discrepancy after the medication has been administered.
Correct Answer: B
Detailed Rationale:
Safety requires the nurse to identify discrepancies before they result in harm. Medication
administration should be preceded by verification of relevant patient information, including
allergies and the prescribed therapy. The nurse should resolve uncertainty before proceeding.
Why the Other Options Are Incorrect:
A: A prescription does not eliminate the nurse's responsibility to identify safety concerns.
B: Correct. Verification should occur before medication administration.
C: Patient input is valuable, but the nurse must also verify the documented information and
prescription.
D: Documenting after administration does not prevent a potential adverse event.
, Clinical Judgment Focus: Recognize a safety risk and take preventive action.
Cognitive Level: Application
Question 4 — Select All That Apply
A nurse is evaluating whether an intervention reflects evidence-based practice. Which elements
should the nurse consider?
A. Current evidence related to the clinical problem
B. Clinical expertise
C. Patient preferences and values
D. Tradition alone
E. Relevant patient circumstances
Correct Answers: A, B, C, E
Detailed Rationale:
Evidence-based practice integrates the best available evidence with clinical expertise and
patient preferences and circumstances. Evidence-based care is not simply the use of tradition;
the nurse should determine whether available evidence and professional judgment support the
intervention for the individual patient.
Why the Other Options Are Incorrect:
A: Correct. Current, relevant evidence is a foundation of evidence-based practice.
B: Correct. Clinical expertise helps determine how evidence should be applied.
C: Correct. Patient preferences and values are part of individualized evidence-based care.
D: Tradition alone does not establish that an intervention is evidence based.
E: Correct. Patient-specific circumstances influence how evidence is applied.
Clinical Judgment Focus: Analyze information needed to support evidence-based decisions.
Cognitive Level: Analysis
Question 5
