Davis Advantage for Medical-Surgical Nursing,
3rd Edition
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy Sullivan
Chapter 1: Foundations for Medical-Surgical Nursing
Question 1
Which competency is most essential for a medical-surgical nurse when caring for a
patient whose condition is changing rapidly?
A. Memorizing standardized care plans
B. Applying clinical judgment to changing patient cues
C. Completing documentation before reassessment
D. Following previous shift routines without modification
Correct Answer: B
Rationale:
Clinical judgment is essential when a patient's condition changes because the nurse must
recognize relevant cues, interpret their significance, determine priorities, and select
appropriate actions. Medical-surgical nursing requires nurses to continuously reassess
patients rather than rely solely on predetermined routines.
Why the other options are incorrect:
• A: Memorization can support practice but does not replace clinical judgment.
1
, • B: Correct. Clinical judgment allows the nurse to recognize and respond
appropriately to changes in patient condition.
• C: Documentation is important, but urgent patient needs take priority over
completing documentation.
• D: Care should be individualized and modified as patient conditions change.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
Question 2
Which statement best describes evidence-based nursing care?
A. Using only interventions that have been used successfully by experienced nurses
B. Selecting interventions based solely on patient preference
C. Integrating current evidence with clinical expertise and patient considerations
D. Following institutional policies without considering individual patient needs
Correct Answer: C
Rationale:
Evidence-based nursing care involves integrating the best available evidence with nursing
expertise and the patient's needs, values, and circumstances. Evidence supports clinical
decision-making but should be applied thoughtfully to the individual patient.
Why the other options are incorrect:
• A: Experience is valuable but should be integrated with current evidence.
• B: Patient preferences matter but are only one component of evidence-based care.
• C: Correct. This reflects the central concept of evidence-based practice.
• D: Policies are important, but individualized care remains necessary.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 3
2
,Which action best demonstrates patient-centered care in a medical-surgical setting?
A. Developing the plan of care without involving the patient
B. Asking the patient about preferences before finalizing the care plan
C. Using the same teaching approach for all hospitalized patients
D. Limiting family involvement regardless of patient preference
Correct Answer: B
Rationale:
Patient-centered care recognizes the patient as an active participant in care decisions.
Asking about preferences promotes individualized care and supports shared decision-
making.
Why the other options are incorrect:
• A: Excluding the patient conflicts with patient-centered care.
• B: Correct. Incorporating patient preferences supports individualized, collaborative
care.
• C: Teaching should be adapted to patient needs, abilities, and preferences.
• D: Family involvement should be based on the patient's wishes and the clinical
situation.
Cognitive Level: Recall
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Planning
Question 4
A medical-surgical nurse receives a report on a 72-year-old patient admitted with
pneumonia. The nurse notes that the patient's respiratory rate has increased from 20/min
to 30/min and the patient is newly restless. Which action best demonstrates clinical
judgment?
A. Document the findings and reassess at the end of the shift
B. Compare the findings with the patient's baseline and perform a focused respiratory
assessment
C. Ask the nursing assistant to monitor the patient's respiratory rate
D. Encourage the patient to rest before obtaining additional assessment data
Correct Answer: B
3
, Rationale:
The increase in respiratory rate and new restlessness may indicate deterioration in
oxygenation. The nurse should recognize the change from baseline and immediately gather
focused assessment data to determine the significance of the findings. Clinical judgment
begins with recognizing important cues and analyzing them in context.
Why the other options are incorrect:
• A: Delaying reassessment may allow deterioration to progress.
• B: Correct. Comparing current findings with baseline and completing a focused
assessment is appropriate.
• C: Although a nursing assistant may obtain selected routine measurements, the RN
is responsible for interpreting a significant change in condition.
• D: Rest should not delay assessment of possible deterioration.
Cognitive Level: Application
NCLEX Client-Needs Category: Reduction of Risk Potential
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 5
A nurse is caring for a patient with newly diagnosed heart failure. During discharge
teaching, the patient says, “I do not think I can follow all of these instructions.” Which
response by the nurse is most appropriate?
A. “You need to follow the instructions exactly as written.”
B. “Your family should make sure you follow the instructions.”
C. “Tell me which part of the plan feels most difficult for you.”
D. “You can discuss your concerns during your next appointment.”
Correct Answer: C
Rationale:
Patient-centered care requires the nurse to explore barriers, preferences, concerns, and
understanding. Asking which part of the plan is difficult helps identify individualized
learning or self-management needs and allows the nurse to collaborate on realistic
strategies.
Why the other options are incorrect:
4
3rd Edition
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy Sullivan
Chapter 1: Foundations for Medical-Surgical Nursing
Question 1
Which competency is most essential for a medical-surgical nurse when caring for a
patient whose condition is changing rapidly?
A. Memorizing standardized care plans
B. Applying clinical judgment to changing patient cues
C. Completing documentation before reassessment
D. Following previous shift routines without modification
Correct Answer: B
Rationale:
Clinical judgment is essential when a patient's condition changes because the nurse must
recognize relevant cues, interpret their significance, determine priorities, and select
appropriate actions. Medical-surgical nursing requires nurses to continuously reassess
patients rather than rely solely on predetermined routines.
Why the other options are incorrect:
• A: Memorization can support practice but does not replace clinical judgment.
1
, • B: Correct. Clinical judgment allows the nurse to recognize and respond
appropriately to changes in patient condition.
• C: Documentation is important, but urgent patient needs take priority over
completing documentation.
• D: Care should be individualized and modified as patient conditions change.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
Question 2
Which statement best describes evidence-based nursing care?
A. Using only interventions that have been used successfully by experienced nurses
B. Selecting interventions based solely on patient preference
C. Integrating current evidence with clinical expertise and patient considerations
D. Following institutional policies without considering individual patient needs
Correct Answer: C
Rationale:
Evidence-based nursing care involves integrating the best available evidence with nursing
expertise and the patient's needs, values, and circumstances. Evidence supports clinical
decision-making but should be applied thoughtfully to the individual patient.
Why the other options are incorrect:
• A: Experience is valuable but should be integrated with current evidence.
• B: Patient preferences matter but are only one component of evidence-based care.
• C: Correct. This reflects the central concept of evidence-based practice.
• D: Policies are important, but individualized care remains necessary.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 3
2
,Which action best demonstrates patient-centered care in a medical-surgical setting?
A. Developing the plan of care without involving the patient
B. Asking the patient about preferences before finalizing the care plan
C. Using the same teaching approach for all hospitalized patients
D. Limiting family involvement regardless of patient preference
Correct Answer: B
Rationale:
Patient-centered care recognizes the patient as an active participant in care decisions.
Asking about preferences promotes individualized care and supports shared decision-
making.
Why the other options are incorrect:
• A: Excluding the patient conflicts with patient-centered care.
• B: Correct. Incorporating patient preferences supports individualized, collaborative
care.
• C: Teaching should be adapted to patient needs, abilities, and preferences.
• D: Family involvement should be based on the patient's wishes and the clinical
situation.
Cognitive Level: Recall
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Planning
Question 4
A medical-surgical nurse receives a report on a 72-year-old patient admitted with
pneumonia. The nurse notes that the patient's respiratory rate has increased from 20/min
to 30/min and the patient is newly restless. Which action best demonstrates clinical
judgment?
A. Document the findings and reassess at the end of the shift
B. Compare the findings with the patient's baseline and perform a focused respiratory
assessment
C. Ask the nursing assistant to monitor the patient's respiratory rate
D. Encourage the patient to rest before obtaining additional assessment data
Correct Answer: B
3
, Rationale:
The increase in respiratory rate and new restlessness may indicate deterioration in
oxygenation. The nurse should recognize the change from baseline and immediately gather
focused assessment data to determine the significance of the findings. Clinical judgment
begins with recognizing important cues and analyzing them in context.
Why the other options are incorrect:
• A: Delaying reassessment may allow deterioration to progress.
• B: Correct. Comparing current findings with baseline and completing a focused
assessment is appropriate.
• C: Although a nursing assistant may obtain selected routine measurements, the RN
is responsible for interpreting a significant change in condition.
• D: Rest should not delay assessment of possible deterioration.
Cognitive Level: Application
NCLEX Client-Needs Category: Reduction of Risk Potential
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 5
A nurse is caring for a patient with newly diagnosed heart failure. During discharge
teaching, the patient says, “I do not think I can follow all of these instructions.” Which
response by the nurse is most appropriate?
A. “You need to follow the instructions exactly as written.”
B. “Your family should make sure you follow the instructions.”
C. “Tell me which part of the plan feels most difficult for you.”
D. “You can discuss your concerns during your next appointment.”
Correct Answer: C
Rationale:
Patient-centered care requires the nurse to explore barriers, preferences, concerns, and
understanding. Asking which part of the plan is difficult helps identify individualized
learning or self-management needs and allows the nurse to collaborate on realistic
strategies.
Why the other options are incorrect:
4
