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 — Competencies in Medical-Surgical Nursing
Which competency is most important when a medical-surgical nurse assumes care of a
patient whose condition is changing rapidly?
A. Completing all routine documentation before reassessing the patient
B. Recognizing significant changes and using clinical judgment to determine appropriate
action
C. Delegating assessment responsibilities to the UAP to increase efficiency
D. Waiting for the provider to identify the cause of the patient's deterioration
Correct Answer: B
Rationale:
Medical-surgical nursing requires the nurse to recognize changes in patient status,
interpret relevant clinical information, prioritize problems, and take appropriate action.
Clinical competence involves more than completing tasks; it requires integrating
assessment findings with nursing knowledge and patient needs.
Why the other options are incorrect:
• A: Documentation is important, but it should not delay assessment or intervention
when a patient's condition is changing.
1
, • B: Correct. Recognizing changes and applying clinical judgment are central
competencies in medical-surgical nursing.
• C: UAPs may perform appropriate delegated tasks, but assessment and clinical
judgment remain nursing responsibilities.
• D: The nurse is responsible for recognizing deterioration and initiating appropriate
nursing actions rather than waiting for the provider.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 2 — Clinical Judgment
A nurse enters a patient's room and notices that the patient, who was alert and conversing
30 minutes earlier, is now difficult to arouse. The patient's respiratory rate has decreased
from 18/min to 9/min. Which action best demonstrates clinical judgment?
A. Document the change and reassess at the next scheduled assessment
B. Ask the UAP to obtain the patient's temperature
C. Recognize the change as clinically significant and immediately assess the patient's
airway and breathing
D. Contact the patient's family to determine whether this behavior is normal
Correct Answer: C
Rationale:
The nurse must recognize the acute change in level of consciousness and respiratory rate
as potentially indicating serious deterioration. Immediate assessment of airway and
breathing is warranted because impaired ventilation can rapidly become life-threatening.
Why the other options are incorrect:
• A: Delaying reassessment is unsafe because the patient's condition has changed
acutely.
• B: Temperature is not the priority assessment when the patient has decreased
responsiveness and respiratory depression.
• C: Correct. The nurse recognizes important cues and immediately evaluates the
patient's most urgent physiological needs.
2
, • D: Family information may be useful later but should not delay assessment of an
acute deterioration.
Cognitive Level: Analysis
NCLEX Client-Needs Category: Physiological Adaptation
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 3 — Evidence-Based Nursing Care
Which statement best describes evidence-based nursing care?
A. Using interventions that have traditionally been preferred on the nursing unit
B. Following the most experienced nurse's usual approach to patient care
C. Combining current best evidence with clinical expertise and patient preferences
D. Selecting interventions primarily according to the patient's diagnosis
Correct Answer: C
Rationale:
Evidence-based nursing integrates the best available evidence with clinical expertise and
the patient's values, preferences, and circumstances. This approach supports
individualized, scientifically informed care rather than relying solely on tradition or personal
preference.
Why the other options are incorrect:
• A: Traditional practice may not reflect current evidence.
• B: Experience is valuable but should be integrated with evidence and patient
preferences.
• C: Correct. Evidence-based practice incorporates evidence, professional expertise,
and patient preferences.
• D: Diagnosis alone does not determine the most appropriate nursing intervention
for an individual patient.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
3
, Question 4 — Patient-Centered Care
A hospitalized adult tells the nurse, "I understand what the healthcare team recommends,
but I have concerns about how the treatment will affect my ability to care for my spouse."
Which nursing response best demonstrates patient-centered care?
A. "The healthcare provider has already determined that this treatment is necessary."
B. "Your concern is important. Let's discuss it so your preferences and responsibilities can
be considered in the plan of care."
C. "You should focus on getting better before worrying about your spouse."
D. "Your family can discuss those concerns with the social worker after discharge."
Correct Answer: B
Rationale:
Patient-centered care recognizes the individual patient's values, preferences, concerns,
and circumstances. The nurse should acknowledge the patient's concern and incorporate
relevant preferences and goals into care planning while collaborating with the healthcare
team.
Why the other options are incorrect:
• A: This dismisses the patient's concerns and does not promote shared decision-
making.
• B: Correct. The response acknowledges the patient's priorities and supports
individualized care.
• C: This minimizes an important psychosocial concern.
• D: A social worker may be helpful, but the nurse should first acknowledge and
assess the patient's concern rather than simply redirecting it.
Cognitive Level: Application
NCLEX Client-Needs Category: Psychosocial Integrity
Nursing Process: Planning
Question 5 — Patient Safety Outcomes
The nurse is reviewing safety practices with a newly admitted patient. Which intervention
most directly reduces the risk of patient-identification errors?
A. Asking the patient to state their name and date of birth before medication administration
B. Asking the patient to confirm the name of the assigned nurse
4
3rd Edition
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy Sullivan
Chapter 1: Foundations for Medical-Surgical Nursing
Question 1 — Competencies in Medical-Surgical Nursing
Which competency is most important when a medical-surgical nurse assumes care of a
patient whose condition is changing rapidly?
A. Completing all routine documentation before reassessing the patient
B. Recognizing significant changes and using clinical judgment to determine appropriate
action
C. Delegating assessment responsibilities to the UAP to increase efficiency
D. Waiting for the provider to identify the cause of the patient's deterioration
Correct Answer: B
Rationale:
Medical-surgical nursing requires the nurse to recognize changes in patient status,
interpret relevant clinical information, prioritize problems, and take appropriate action.
Clinical competence involves more than completing tasks; it requires integrating
assessment findings with nursing knowledge and patient needs.
Why the other options are incorrect:
• A: Documentation is important, but it should not delay assessment or intervention
when a patient's condition is changing.
1
, • B: Correct. Recognizing changes and applying clinical judgment are central
competencies in medical-surgical nursing.
• C: UAPs may perform appropriate delegated tasks, but assessment and clinical
judgment remain nursing responsibilities.
• D: The nurse is responsible for recognizing deterioration and initiating appropriate
nursing actions rather than waiting for the provider.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 2 — Clinical Judgment
A nurse enters a patient's room and notices that the patient, who was alert and conversing
30 minutes earlier, is now difficult to arouse. The patient's respiratory rate has decreased
from 18/min to 9/min. Which action best demonstrates clinical judgment?
A. Document the change and reassess at the next scheduled assessment
B. Ask the UAP to obtain the patient's temperature
C. Recognize the change as clinically significant and immediately assess the patient's
airway and breathing
D. Contact the patient's family to determine whether this behavior is normal
Correct Answer: C
Rationale:
The nurse must recognize the acute change in level of consciousness and respiratory rate
as potentially indicating serious deterioration. Immediate assessment of airway and
breathing is warranted because impaired ventilation can rapidly become life-threatening.
Why the other options are incorrect:
• A: Delaying reassessment is unsafe because the patient's condition has changed
acutely.
• B: Temperature is not the priority assessment when the patient has decreased
responsiveness and respiratory depression.
• C: Correct. The nurse recognizes important cues and immediately evaluates the
patient's most urgent physiological needs.
2
, • D: Family information may be useful later but should not delay assessment of an
acute deterioration.
Cognitive Level: Analysis
NCLEX Client-Needs Category: Physiological Adaptation
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 3 — Evidence-Based Nursing Care
Which statement best describes evidence-based nursing care?
A. Using interventions that have traditionally been preferred on the nursing unit
B. Following the most experienced nurse's usual approach to patient care
C. Combining current best evidence with clinical expertise and patient preferences
D. Selecting interventions primarily according to the patient's diagnosis
Correct Answer: C
Rationale:
Evidence-based nursing integrates the best available evidence with clinical expertise and
the patient's values, preferences, and circumstances. This approach supports
individualized, scientifically informed care rather than relying solely on tradition or personal
preference.
Why the other options are incorrect:
• A: Traditional practice may not reflect current evidence.
• B: Experience is valuable but should be integrated with evidence and patient
preferences.
• C: Correct. Evidence-based practice incorporates evidence, professional expertise,
and patient preferences.
• D: Diagnosis alone does not determine the most appropriate nursing intervention
for an individual patient.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
3
, Question 4 — Patient-Centered Care
A hospitalized adult tells the nurse, "I understand what the healthcare team recommends,
but I have concerns about how the treatment will affect my ability to care for my spouse."
Which nursing response best demonstrates patient-centered care?
A. "The healthcare provider has already determined that this treatment is necessary."
B. "Your concern is important. Let's discuss it so your preferences and responsibilities can
be considered in the plan of care."
C. "You should focus on getting better before worrying about your spouse."
D. "Your family can discuss those concerns with the social worker after discharge."
Correct Answer: B
Rationale:
Patient-centered care recognizes the individual patient's values, preferences, concerns,
and circumstances. The nurse should acknowledge the patient's concern and incorporate
relevant preferences and goals into care planning while collaborating with the healthcare
team.
Why the other options are incorrect:
• A: This dismisses the patient's concerns and does not promote shared decision-
making.
• B: Correct. The response acknowledges the patient's priorities and supports
individualized care.
• C: This minimizes an important psychosocial concern.
• D: A social worker may be helpful, but the nurse should first acknowledge and
assess the patient's concern rather than simply redirecting it.
Cognitive Level: Application
NCLEX Client-Needs Category: Psychosocial Integrity
Nursing Process: Planning
Question 5 — Patient Safety Outcomes
The nurse is reviewing safety practices with a newly admitted patient. Which intervention
most directly reduces the risk of patient-identification errors?
A. Asking the patient to state their name and date of birth before medication administration
B. Asking the patient to confirm the name of the assigned nurse
4
