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 client who has been newly diagnosed with a chronic illness.
The client states, “I want my spouse involved in decisions about my care, but I want to make the
final decisions myself.” Which nursing action best demonstrates patient-centered care?
A. Encourage the spouse to make decisions because the client may become overwhelmed.
B. Provide the client with relevant information and support the client’s preferences in decision-
making.
C. Ask the healthcare provider to determine which treatment the client should receive.
D. Delay discussing treatment options until the spouse is available.
Correct Answer: B. Provide the client with relevant information and support the client’s
preferences in decision-making.
Detailed Rationale:
Patient-centered care recognizes the client as an active participant in decisions about care. The
nurse supports the client by providing understandable information, identifying preferences, and
,respecting the client’s role in decision-making. The goal is not for the nurse, spouse, or provider
to make decisions for the client when the client is able and willing to participate.
Why the Other Options Are Incorrect:
A: This removes decision-making authority from the client and does not respect the client's
preferences.
B: This promotes active participation, respect for preferences, and individualized care.
C: The healthcare provider may provide treatment information and recommendations, but the
client remains central to decisions about care.
D: Delaying discussion unnecessarily prevents the client from participating in timely decisions.
Clinical Judgment Focus: Recognize cues related to patient preferences and generate a patient-
centered solution.
Cognitive Level: Application
Question 2
A medical-surgical nurse notices that a client’s identification information on the medication
administration record does not match the identification information on the client’s wristband.
What should the nurse do first?
A. Administer the medication because the client’s room assignment matches the record.
B. Ask another nurse to administer the medication instead.
C. Stop the medication-administration process and resolve the identification discrepancy.
D. Document that the medication was withheld and return later.
Correct Answer: C. Stop the medication-administration process and resolve the identification
discrepancy.
Detailed Rationale:
Safety is the immediate priority. A discrepancy in client identification creates a risk for
medication error. The nurse should not continue the medication-administration process until
the discrepancy has been resolved using appropriate identification procedures.
,Why the Other Options Are Incorrect:
A: Room assignment is not sufficient evidence of correct client identification.
B: Transferring the same unresolved safety concern to another nurse does not correct the
problem.
C: Correctly identifying the client before proceeding reduces the risk of harm.
D: Documentation alone does not address the immediate safety concern.
Clinical Judgment Focus: Recognize a safety cue and take action to reduce immediate risk.
Cognitive Level: Analysis
Question 3
Which action by a nurse best demonstrates teamwork and collaboration?
A. Completing every nursing task independently to maintain control of the plan of care.
B. Sharing relevant client information with appropriate members of the healthcare team.
C. Waiting until the end of the shift to communicate changes in the client’s condition.
D. Asking assistive personnel to independently determine changes in the client’s treatment plan.
Correct Answer: B. Sharing relevant client information with appropriate members of the
healthcare team.
Detailed Rationale:
Effective teamwork depends on timely communication and coordinated efforts among members
of the healthcare team. Sharing relevant information supports continuity, reduces errors, and
helps the team respond appropriately to changes in the client’s condition.
Why the Other Options Are Incorrect:
A: Refusing collaboration can fragment care and increase risk.
B: Appropriate information sharing supports coordinated, safe care.
C: Significant information should not be unnecessarily delayed.
D: Determining changes in treatment is beyond the role of assistive personnel.
, Clinical Judgment Focus: Recognize the importance of communication in coordinated care.
Cognitive Level: Understanding
Question 4
A nurse is reviewing a proposed change in practice intended to improve client outcomes. Which
action best reflects evidence-based practice?
A. Implementing the change because another nurse prefers it.
B. Using available evidence along with clinical expertise and client considerations when
evaluating the change.
C. Choosing the intervention that requires the least staff effort.
D. Continuing the current practice because it has always been used.
Correct Answer: B. Using available evidence along with clinical expertise and client
considerations when evaluating the change.
Detailed Rationale:
Evidence-based practice involves integrating relevant evidence with professional clinical
expertise and the needs and preferences of the client. It is not simply adopting a popular
intervention or maintaining a traditional practice without evaluating its effectiveness.
Why the Other Options Are Incorrect:
A: Personal preference alone is insufficient evidence for practice decisions.
B: This reflects an integrated approach to evidence-based nursing care.
C: Convenience or reduced workload does not establish that an intervention is clinically
appropriate.
D: Longstanding practice does not automatically mean the practice remains effective.
Clinical Judgment Focus: Analyze information and determine whether a proposed practice is
supported by appropriate evidence.
Cognitive Level: Application
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 client who has been newly diagnosed with a chronic illness.
The client states, “I want my spouse involved in decisions about my care, but I want to make the
final decisions myself.” Which nursing action best demonstrates patient-centered care?
A. Encourage the spouse to make decisions because the client may become overwhelmed.
B. Provide the client with relevant information and support the client’s preferences in decision-
making.
C. Ask the healthcare provider to determine which treatment the client should receive.
D. Delay discussing treatment options until the spouse is available.
Correct Answer: B. Provide the client with relevant information and support the client’s
preferences in decision-making.
Detailed Rationale:
Patient-centered care recognizes the client as an active participant in decisions about care. The
nurse supports the client by providing understandable information, identifying preferences, and
,respecting the client’s role in decision-making. The goal is not for the nurse, spouse, or provider
to make decisions for the client when the client is able and willing to participate.
Why the Other Options Are Incorrect:
A: This removes decision-making authority from the client and does not respect the client's
preferences.
B: This promotes active participation, respect for preferences, and individualized care.
C: The healthcare provider may provide treatment information and recommendations, but the
client remains central to decisions about care.
D: Delaying discussion unnecessarily prevents the client from participating in timely decisions.
Clinical Judgment Focus: Recognize cues related to patient preferences and generate a patient-
centered solution.
Cognitive Level: Application
Question 2
A medical-surgical nurse notices that a client’s identification information on the medication
administration record does not match the identification information on the client’s wristband.
What should the nurse do first?
A. Administer the medication because the client’s room assignment matches the record.
B. Ask another nurse to administer the medication instead.
C. Stop the medication-administration process and resolve the identification discrepancy.
D. Document that the medication was withheld and return later.
Correct Answer: C. Stop the medication-administration process and resolve the identification
discrepancy.
Detailed Rationale:
Safety is the immediate priority. A discrepancy in client identification creates a risk for
medication error. The nurse should not continue the medication-administration process until
the discrepancy has been resolved using appropriate identification procedures.
,Why the Other Options Are Incorrect:
A: Room assignment is not sufficient evidence of correct client identification.
B: Transferring the same unresolved safety concern to another nurse does not correct the
problem.
C: Correctly identifying the client before proceeding reduces the risk of harm.
D: Documentation alone does not address the immediate safety concern.
Clinical Judgment Focus: Recognize a safety cue and take action to reduce immediate risk.
Cognitive Level: Analysis
Question 3
Which action by a nurse best demonstrates teamwork and collaboration?
A. Completing every nursing task independently to maintain control of the plan of care.
B. Sharing relevant client information with appropriate members of the healthcare team.
C. Waiting until the end of the shift to communicate changes in the client’s condition.
D. Asking assistive personnel to independently determine changes in the client’s treatment plan.
Correct Answer: B. Sharing relevant client information with appropriate members of the
healthcare team.
Detailed Rationale:
Effective teamwork depends on timely communication and coordinated efforts among members
of the healthcare team. Sharing relevant information supports continuity, reduces errors, and
helps the team respond appropriately to changes in the client’s condition.
Why the Other Options Are Incorrect:
A: Refusing collaboration can fragment care and increase risk.
B: Appropriate information sharing supports coordinated, safe care.
C: Significant information should not be unnecessarily delayed.
D: Determining changes in treatment is beyond the role of assistive personnel.
, Clinical Judgment Focus: Recognize the importance of communication in coordinated care.
Cognitive Level: Understanding
Question 4
A nurse is reviewing a proposed change in practice intended to improve client outcomes. Which
action best reflects evidence-based practice?
A. Implementing the change because another nurse prefers it.
B. Using available evidence along with clinical expertise and client considerations when
evaluating the change.
C. Choosing the intervention that requires the least staff effort.
D. Continuing the current practice because it has always been used.
Correct Answer: B. Using available evidence along with clinical expertise and client
considerations when evaluating the change.
Detailed Rationale:
Evidence-based practice involves integrating relevant evidence with professional clinical
expertise and the needs and preferences of the client. It is not simply adopting a popular
intervention or maintaining a traditional practice without evaluating its effectiveness.
Why the Other Options Are Incorrect:
A: Personal preference alone is insufficient evidence for practice decisions.
B: This reflects an integrated approach to evidence-based nursing care.
C: Convenience or reduced workload does not establish that an intervention is clinically
appropriate.
D: Longstanding practice does not automatically mean the practice remains effective.
Clinical Judgment Focus: Analyze information and determine whether a proposed practice is
supported by appropriate evidence.
Cognitive Level: Application
