TestBank for Brunner & Suddarth's Medical-Surgical Nursing
16th Edition
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Brunner & Suddarth's Medical-Surgical
Nursing
16th Edition — Corrected Chapter-Aligned
TestBank
Table of Contents
Use Word’s Navigation Pane to jump directly to any Unit or Chapter heading. The table below also shows the corrected 16th-
edition chapter structure and question ranges.
Chapter Coverage & Question Ranges
Chapter Official 16th-Edition Questions Range
Chapter Title
1 Professional Nursing Practice 16 1–16
2 Medical-Surgical Nursing 16 17–32
Health Education and Health
3 16 33–48
Promotion
Adult Health and Physical,
4 Nutritional, and Cultural 26 49–74
Assessment
Stress and Inflammatory
5 16 75–90
Responses
Genetics and Genomics in
6 16 91–106
Nursing
7 Disability and Chronic Illness 16 107–122
8 Care of the Older Adult 16 123–138
9 Pain Management 16 139–154
Principles of Fluid and
10 32 155–186
Electrolytes
Shock, Sepsis, and Multiple
11 26 187–212
Organ Dysfunction Syndrome
12 Oncologic Management 16 213–228
13 Palliative and End-of-Life Care 16 229–244
Preoperative Nursing
14 16 245–260
Management
Intraoperative Nursing
15 16 261–276
Management
Postoperative Nursing
16 8 277–284
Management
Assessment of Respiratory
17 16 285–300
Function
Management of Patients with
18 Upper Respiratory Tract 8 301–308
Disorders
Management of Patients with
19 Acute Disorders of the Chest and 10 309–318
Lower Respiratory Tract
Page 2 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Chapter Official 16th-Edition Questions Range
Chapter Title
Management of Patients with
Non-Acute Disorders of the
20 Chest and Lower Respiratory 19 319–337
Tract and Disorders of the
Pulmonary Vasculature
Management of Patients with
21 8 338–345
Chronic Pulmonary Disease
22 Assessment of Cardiac Function 18 346–363
Management of Patients with
23 Arrhythmias and Conduction 10 364–373
Disorders
Management of Patients with
24 10 374–383
Coronary Vascular Disorders
Management of Patients with
25 Structural, Infectious, and 15 384–398
Inflammatory Cardiac Disorders
Management of Patients with
26 9 399–407
Complications of Heart Disease
Assessment and Management of
Patients with Vascular Disorders
27 10 408–417
and Disorders of Peripheral
Circulation
Assessment and Management of
28 10 418–427
Patients with Hypertension
Assessment of Hematologic
29 Function and Treatment 8 428–435
Modalities
Management of Patients with
30 Nonmalignant Hematologic 8 436–443
Disorders
Management of Patients with
31 30 444–473
Hematologic Neoplasms
32 Assessment of Immune Function 8 474–481
Management of Patients with
33 24 482–505
Immune Deficiency Disorders
Assessment and Management of
34 8 506–513
Patients with Allergic Disorders
Assessment and Management of
35 Patients with Inflammatory 51 514–564
Rheumatic Disorders
Assessment of Musculoskeletal
36 8 565–572
Function
Management of Patients with
37 14 573–586
Musculoskeletal Disorders
Management of Patients with
38 15 587–601
Musculoskeletal Trauma
Assessment of Digestive and
39 15 602–616
Gastrointestinal Function
Management of Patients with
40 15 617–631
Oral and Esophageal Disorders
Management of Patients with
41 8 632–639
Gastric and Duodenal Disorders
Management of Patients with
42 12 640–651
Intestinal and Rectal Disorders
Assessment and Management of
43 13 652–664
Patients with Obesity
Page 3 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Chapter Official 16th-Edition Questions Range
Chapter Title
Assessment and Management of
44 8 665–672
Patients with Hepatic Disorders
Assessment and Management of
45 8 673–680
Patients with Biliary Disorders
Assessment and Management of
46 Patients with Endocrine 15 681–695
Disorders
Assessment and Management of
47 16 696–711
Patients with Diabetes
Assessment of Kidney and
48 14 712–725
Urinary Function
Management of Patients with
49 14 726–739
Kidney Disorders
Management of Patients with
50 14 740–753
Urinary Disorders
Assessment and Management of
51 Patients with Female Physiologic 8 754–761
Processes
Management of Patients with
52 23 762–784
Female Physiologic Disorders
Assessment and Management of
53 16 785–800
Patients with Breast Disorders
Assessment and Management of
54 Patients with Male Reproductive 18 801–818
Disorders
Assessment and Management of
55 20 819–838
Patients who are LGBTQ
Assessment of Integumentary
56 22 839–860
Function
Management of Patients with
57 Dermatologic Disorders and 18 861–878
Wounds
Management of Patients with
58 28 879–906
Burn Injury
Assessment and Management of
59 Patients with Eye and Vision 20 907–926
Disorders
Assessment and Management of
60 Patients with Hearing and 20 927–946
Balance Disorders
Assessment of Neurologic
61 20 947–966
Function
Management of Patients with
62 20 967–986
Neurologic Dysfunction
Management of Patients with
63 30 987–1016
Cerebrovascular Disorders
Management of Patients with
64 50 1017–1066
Neurologic Trauma
Management of Patients with
Neurologic Infections,
65 52 1067–1118
Autoimmune Disorders, and
Neuropathies
Management of Patients with
66 Oncologic or Degenerative 68 1119–1186
Neurologic Disorders
Management of Patients with
67 81 1187–1267
Infectious Diseases
Page 4 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Chapter Official 16th-Edition Questions Range
Chapter Title
68 Emergency Nursing 40 1268–1307
69 Disaster Nursing 50 1308–1357
Page 5 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
UNIT 1 — Principles of Nursing Practice
Chapter 1: Professional Nursing Practice
Question 1
During the morning handoff, the nurse receives reports on four patients. Which patient should the nurse
assess first?
A. A patient awaiting discharge who asks for clarification about home medications.
B. A patient with chronic heart failure who reports mild ankle swelling after missing one dose of furosemide.
C. A patient with type 2 diabetes requesting assistance with selecting meals from the lunch menu.
D. A postoperative patient who suddenly develops shortness of breath, restlessness, and an oxygen saturation of 86%
on room air.
Correct Answer: D
Rationale
The postoperative patient showing sudden hypoxemia, restlessness, and dyspnea may be experiencing a life-
threatening complication such as pulmonary embolism or acute respiratory compromise. Applying the ABC (Airway,
Breathing, Circulation) framework and prioritization principles, the nurse must assess and intervene immediately to
prevent further deterioration.
Why the Other Options Are Less Appropriate
A. Discharge teaching is appropriate after urgent patient needs have been addressed.
B. Mild peripheral edema requires follow-up but does not indicate immediate instability.
C. Dietary education is important but can safely be delayed until unstable patients have been evaluated.
Clinical Pearl
Always prioritize patients with acute changes in airway, breathing, circulation, or level of consciousness over stable patients
with routine care needs.
Question 2
While preparing morning medications, a nurse notices that a prescribed dose of insulin appears
significantly higher than the patient's usual dose. What is the nurse's most appropriate action?
A. Verify the prescription, review the patient's blood glucose results, and clarify the order with the healthcare provider
before administration.
B. Ask another nurse to administer the medication instead.
C. Withhold the medication permanently without notifying anyone.
D. Administer the medication because it has already been prescribed.
Correct Answer: A
Rationale
Nurses are professionally accountable for ensuring medication safety. When an order appears inconsistent with the
patient's condition or previous therapy, it must be verified before administration. Clarifying questionable prescriptions
helps prevent medication errors and protects patient safety.
Why the Other Options Are Less Appropriate
B. Delegating administration does not remove professional accountability.
C. Medication should not be permanently withheld without appropriate clinical communication.
D. Nurses remain responsible for questioning unsafe or unclear medication orders.
Clinical Pearl
Never administer a medication that seems unsafe or questionable. Stop, verify, and clarify before proceeding.
Page 6 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Question 3
Assessment of an older adult reveals new confusion, agitation, and difficulty following simple commands
several hours after surgery. Which nursing action is the priority?
A. Request a psychiatric consultation before further assessment.
B. Encourage the patient to sleep and reassess later.
C. Reorient the patient while immediately assessing oxygenation, vital signs, pain, and possible causes of the mental
status change.
D. Apply physical restraints to prevent injury.
Correct Answer: C
Rationale
Acute postoperative confusion may indicate hypoxia, infection, medication effects, metabolic disturbances, or
delirium. The nurse must first perform a focused assessment to identify and address reversible causes before
considering other interventions.
Why the Other Options Are Less Appropriate
A. Psychiatric consultation is inappropriate before evaluating potential physiological causes.
B. Delaying assessment may allow a serious condition to worsen.
D. Restraints are a last resort and should never replace assessment.
Clinical Pearl
Sudden confusion is a clinical symptom—not a diagnosis. Always assess for reversible physiological causes first.
Question 4
A newly licensed nurse asks why evidence-based practice is emphasized during patient care planning.
Which response by the experienced nurse is most accurate?
A. It eliminates the need for individualized nursing assessments.
B. It replaces clinical judgment with standardized treatment plans.
C. It integrates the best available evidence, clinical expertise, and patient preferences to improve outcomes.
D. It ensures that every patient receives identical nursing care.
Correct Answer: C
Rationale
Evidence-based practice combines current research, professional expertise, and patient values to guide clinical
decisions. This approach supports individualized, safe, and effective patient care rather than relying solely on tradition
or routine.
Why the Other Options Are Less Appropriate
A. Comprehensive assessment remains the foundation of safe nursing practice.
B. Clinical judgment remains essential in applying evidence appropriately.
D. Nursing care should always be individualized.
Clinical Pearl
Evidence-based practice is built on research evidence + clinical expertise + patient preferences.
Question 5
Following a busy shift, a nurse realizes that a scheduled medication was unintentionally omitted. What is
the nurse's priority action?
A. Inform the charge nurse and healthcare provider, assess the patient, document the omission accurately, and follow
institutional policy.
B. Administer a double dose at the next scheduled time.
C. Document the medication as administered to avoid disciplinary action.
D. Wait until the next shift and allow the incoming nurse to manage the situation.
Page 7 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Correct Answer: A
Rationale
Professional accountability requires prompt recognition, reporting, and documentation of medication errors or
omissions. The nurse should assess the patient for any adverse effects, notify appropriate personnel, and follow
organizational protocols to ensure patient safety.
Why the Other Options Are Less Appropriate
B. Administering a double dose without an order may cause harm.
C. Falsifying documentation is unethical and may have legal consequences.
D. Delaying intervention places the patient at unnecessary risk.
Clinical Pearl
When an error occurs, protect the patient first, report promptly, document truthfully, and learn from the event.
Question 6
During interdisciplinary rounds, the nurse disagrees with a proposed discharge plan because the patient
demonstrates unsafe medication management. What is the nurse's best course of action?
A. Remain silent because discharge decisions belong exclusively to the physician.
B. Delay the discharge paperwork without informing anyone.
C. Advocate for the patient by communicating the safety concerns and recommending further evaluation before
discharge.
D. Tell the patient's family that the discharge plan is unsafe without discussing it with the healthcare team.
Correct Answer: C
Rationale
Patient advocacy is a fundamental responsibility of professional nursing practice. Nurses should communicate
evidence-based concerns respectfully and collaborate with the healthcare team to promote safe, patient-centered
care.
Why the Other Options Are Less Appropriate
A. Nurses are responsible for advocating when patient safety is at risk.
B. Delaying care without communication is unprofessional and ineffective.
D. Concerns should first be addressed through appropriate professional communication.
Clinical Pearl
Advocacy means speaking up for patient safety, even when it requires respectfully questioning the current plan.
Question 7
During clinical rounds, a nurse is delegating tasks during a busy medical-surgical shift. Which assignment
is most appropriate for an experienced unlicensed assistive personnel (UAP)?
A. Measuring and documenting routine vital signs for a stable patient.
B. Assessing a patient who reports sudden chest pain.
C. Teaching a patient how to use an incentive spirometer.
D. Evaluating the effectiveness of intravenous pain medication.
Correct Answer: A
Rationale
Routine vital signs for stable patients are within the typical role of a trained UAP. Assessment, patient education,
evaluation, and clinical judgment remain the responsibility of the registered nurse.
Why the Other Options Are Less Appropriate
B. Assessment of acute symptoms must be performed by the RN.
C. Initial teaching is an RN responsibility.
D. Evaluation of patient response requires RN clinical judgment.
Page 8 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Clinical Pearl
Delegate stable, predictable, routine tasks—never assessment, teaching, evaluation, or clinical decision-making.
Question 8
While reviewing quality improvement data, a nurse notices an increase in patient falls on the medical-
surgical unit over the past three months. Which nursing action best supports continuous quality
improvement?
A. Wait for management to implement changes before taking action.
B. Counsel only the nurses involved in previous fall incidents.
C. Focus only on documenting falls after they occur.
D. Participate in analyzing contributing factors and implementing evidence-based fall-prevention strategies.
Correct Answer: D
Rationale
Quality improvement focuses on identifying system issues, analyzing trends, and implementing evidence-based
interventions to improve patient outcomes. Collaborative efforts are more effective than assigning individual blame.
Why the Other Options Are Less Appropriate
A. All nurses share responsibility for quality improvement.
B. Quality improvement emphasizes system improvement rather than individual blame.
C. Documentation alone does not reduce future falls.
Clinical Pearl
Quality improvement asks "How can we improve the system?" rather than "Who is at fault?"
Question 9
During the shift, a nurse is preparing to administer a newly prescribed antibiotic when the patient states,
"I'm allergic to that medication." The electronic health record does not list any allergies. What should the
nurse do first?
A. Request that the pharmacist remove the medication from the medication administration record.
B. Administer the antibiotic because there is no documented allergy.
C. Ask the patient whether the previous reaction was severe after administering the medication.
D. Withhold the medication, further assess the reported allergy, and notify the healthcare provider before
administration.
Correct Answer: D
Rationale
Patient safety is the nurse's highest priority. Any reported allergy should be thoroughly assessed before medication
administration, even if it is not documented. The nurse should clarify the reaction, withhold the medication, and
collaborate with the healthcare provider to determine the safest course of action.
Why the Other Options Are Less Appropriate
A. Pharmacy involvement may be necessary later, but the immediate priority is protecting the patient.
B. Absence of documentation does not mean an allergy does not exist.
C. The medication should never be administered before verifying allergy information.
Clinical Pearl
Always investigate patient-reported allergies, even when documentation is incomplete.
Question 10
A patient's family requests detailed information about the patient's diagnosis while the patient is awake
and capable of making decisions. The patient has not given permission to share health information. What
is the nurse's best response?
A. Explain that patient information cannot be shared without the patient's permission and ask the patient how they
would like information communicated.
Page 9 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
B. Ask another nurse to speak with the family.
C. Provide the requested information because the family is directly involved in care.
D. Share only laboratory results because they are less confidential than the diagnosis.
Correct Answer: A
Rationale
Respect for patient autonomy and confidentiality requires the nurse to protect private health information. When the
patient has decision-making capacity, permission should be obtained before discussing medical information with
family members.
Why the Other Options Are Less Appropriate
B. Responsibility cannot be transferred to avoid an ethical obligation.
C. Family involvement does not override patient privacy rights.
D. All protected health information is confidential.
Clinical Pearl
Patient confidentiality continues unless the patient authorizes disclosure or another legal exception applies.
Question 11
Shortly after receiving report, the nurse notices that a colleague is about to administer medication to the
wrong patient. Which action demonstrates professional accountability?
A. Immediately intervene to prevent the error and follow institutional reporting procedures if necessary.
B. Wait until after the medication is given before discussing the mistake privately.
C. Ignore the situation because every nurse is responsible only for assigned patients.
D. Document the incident before speaking to the colleague.
Correct Answer: A
Rationale
Patient safety requires immediate intervention whenever a preventable error is identified. Professional accountability
includes respectfully stopping unsafe actions and following organizational policies to promote a culture of safety.
Why the Other Options Are Less Appropriate
B. Waiting may allow patient harm to occur.
C. Every nurse has a professional obligation to protect patient safety.
D. Immediate intervention takes priority over documentation.
Clinical Pearl
A culture of safety encourages nurses to speak up immediately when patient harm can be prevented.
Question 12
While reviewing a patient's laboratory results, the nurse identifies a critical potassium level of 6.4 mEq/L.
The patient is asymptomatic. What is the nurse's priority action?
A. Document the laboratory value and continue routine care.
B. Encourage the patient to increase oral fluid intake.
C. Notify the healthcare provider immediately and assess the patient for manifestations of hyperkalemia.
D. Repeat the laboratory test during the next scheduled blood draw.
Correct Answer: C
Rationale
Hyperkalemia is a potentially life-threatening electrolyte imbalance that can rapidly cause fatal cardiac dysrhythmias.
Even without symptoms, the nurse should promptly assess the patient, verify cardiac monitoring if indicated, and
notify the healthcare provider without delay.
Why the Other Options Are Less Appropriate
A. Documentation does not replace immediate clinical intervention.
B. Oral fluids alone will not correct severe hyperkalemia.
Page 10 of 551
16th Edition
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Brunner & Suddarth's Medical-Surgical
Nursing
16th Edition — Corrected Chapter-Aligned
TestBank
Table of Contents
Use Word’s Navigation Pane to jump directly to any Unit or Chapter heading. The table below also shows the corrected 16th-
edition chapter structure and question ranges.
Chapter Coverage & Question Ranges
Chapter Official 16th-Edition Questions Range
Chapter Title
1 Professional Nursing Practice 16 1–16
2 Medical-Surgical Nursing 16 17–32
Health Education and Health
3 16 33–48
Promotion
Adult Health and Physical,
4 Nutritional, and Cultural 26 49–74
Assessment
Stress and Inflammatory
5 16 75–90
Responses
Genetics and Genomics in
6 16 91–106
Nursing
7 Disability and Chronic Illness 16 107–122
8 Care of the Older Adult 16 123–138
9 Pain Management 16 139–154
Principles of Fluid and
10 32 155–186
Electrolytes
Shock, Sepsis, and Multiple
11 26 187–212
Organ Dysfunction Syndrome
12 Oncologic Management 16 213–228
13 Palliative and End-of-Life Care 16 229–244
Preoperative Nursing
14 16 245–260
Management
Intraoperative Nursing
15 16 261–276
Management
Postoperative Nursing
16 8 277–284
Management
Assessment of Respiratory
17 16 285–300
Function
Management of Patients with
18 Upper Respiratory Tract 8 301–308
Disorders
Management of Patients with
19 Acute Disorders of the Chest and 10 309–318
Lower Respiratory Tract
Page 2 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Chapter Official 16th-Edition Questions Range
Chapter Title
Management of Patients with
Non-Acute Disorders of the
20 Chest and Lower Respiratory 19 319–337
Tract and Disorders of the
Pulmonary Vasculature
Management of Patients with
21 8 338–345
Chronic Pulmonary Disease
22 Assessment of Cardiac Function 18 346–363
Management of Patients with
23 Arrhythmias and Conduction 10 364–373
Disorders
Management of Patients with
24 10 374–383
Coronary Vascular Disorders
Management of Patients with
25 Structural, Infectious, and 15 384–398
Inflammatory Cardiac Disorders
Management of Patients with
26 9 399–407
Complications of Heart Disease
Assessment and Management of
Patients with Vascular Disorders
27 10 408–417
and Disorders of Peripheral
Circulation
Assessment and Management of
28 10 418–427
Patients with Hypertension
Assessment of Hematologic
29 Function and Treatment 8 428–435
Modalities
Management of Patients with
30 Nonmalignant Hematologic 8 436–443
Disorders
Management of Patients with
31 30 444–473
Hematologic Neoplasms
32 Assessment of Immune Function 8 474–481
Management of Patients with
33 24 482–505
Immune Deficiency Disorders
Assessment and Management of
34 8 506–513
Patients with Allergic Disorders
Assessment and Management of
35 Patients with Inflammatory 51 514–564
Rheumatic Disorders
Assessment of Musculoskeletal
36 8 565–572
Function
Management of Patients with
37 14 573–586
Musculoskeletal Disorders
Management of Patients with
38 15 587–601
Musculoskeletal Trauma
Assessment of Digestive and
39 15 602–616
Gastrointestinal Function
Management of Patients with
40 15 617–631
Oral and Esophageal Disorders
Management of Patients with
41 8 632–639
Gastric and Duodenal Disorders
Management of Patients with
42 12 640–651
Intestinal and Rectal Disorders
Assessment and Management of
43 13 652–664
Patients with Obesity
Page 3 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Chapter Official 16th-Edition Questions Range
Chapter Title
Assessment and Management of
44 8 665–672
Patients with Hepatic Disorders
Assessment and Management of
45 8 673–680
Patients with Biliary Disorders
Assessment and Management of
46 Patients with Endocrine 15 681–695
Disorders
Assessment and Management of
47 16 696–711
Patients with Diabetes
Assessment of Kidney and
48 14 712–725
Urinary Function
Management of Patients with
49 14 726–739
Kidney Disorders
Management of Patients with
50 14 740–753
Urinary Disorders
Assessment and Management of
51 Patients with Female Physiologic 8 754–761
Processes
Management of Patients with
52 23 762–784
Female Physiologic Disorders
Assessment and Management of
53 16 785–800
Patients with Breast Disorders
Assessment and Management of
54 Patients with Male Reproductive 18 801–818
Disorders
Assessment and Management of
55 20 819–838
Patients who are LGBTQ
Assessment of Integumentary
56 22 839–860
Function
Management of Patients with
57 Dermatologic Disorders and 18 861–878
Wounds
Management of Patients with
58 28 879–906
Burn Injury
Assessment and Management of
59 Patients with Eye and Vision 20 907–926
Disorders
Assessment and Management of
60 Patients with Hearing and 20 927–946
Balance Disorders
Assessment of Neurologic
61 20 947–966
Function
Management of Patients with
62 20 967–986
Neurologic Dysfunction
Management of Patients with
63 30 987–1016
Cerebrovascular Disorders
Management of Patients with
64 50 1017–1066
Neurologic Trauma
Management of Patients with
Neurologic Infections,
65 52 1067–1118
Autoimmune Disorders, and
Neuropathies
Management of Patients with
66 Oncologic or Degenerative 68 1119–1186
Neurologic Disorders
Management of Patients with
67 81 1187–1267
Infectious Diseases
Page 4 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Chapter Official 16th-Edition Questions Range
Chapter Title
68 Emergency Nursing 40 1268–1307
69 Disaster Nursing 50 1308–1357
Page 5 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
UNIT 1 — Principles of Nursing Practice
Chapter 1: Professional Nursing Practice
Question 1
During the morning handoff, the nurse receives reports on four patients. Which patient should the nurse
assess first?
A. A patient awaiting discharge who asks for clarification about home medications.
B. A patient with chronic heart failure who reports mild ankle swelling after missing one dose of furosemide.
C. A patient with type 2 diabetes requesting assistance with selecting meals from the lunch menu.
D. A postoperative patient who suddenly develops shortness of breath, restlessness, and an oxygen saturation of 86%
on room air.
Correct Answer: D
Rationale
The postoperative patient showing sudden hypoxemia, restlessness, and dyspnea may be experiencing a life-
threatening complication such as pulmonary embolism or acute respiratory compromise. Applying the ABC (Airway,
Breathing, Circulation) framework and prioritization principles, the nurse must assess and intervene immediately to
prevent further deterioration.
Why the Other Options Are Less Appropriate
A. Discharge teaching is appropriate after urgent patient needs have been addressed.
B. Mild peripheral edema requires follow-up but does not indicate immediate instability.
C. Dietary education is important but can safely be delayed until unstable patients have been evaluated.
Clinical Pearl
Always prioritize patients with acute changes in airway, breathing, circulation, or level of consciousness over stable patients
with routine care needs.
Question 2
While preparing morning medications, a nurse notices that a prescribed dose of insulin appears
significantly higher than the patient's usual dose. What is the nurse's most appropriate action?
A. Verify the prescription, review the patient's blood glucose results, and clarify the order with the healthcare provider
before administration.
B. Ask another nurse to administer the medication instead.
C. Withhold the medication permanently without notifying anyone.
D. Administer the medication because it has already been prescribed.
Correct Answer: A
Rationale
Nurses are professionally accountable for ensuring medication safety. When an order appears inconsistent with the
patient's condition or previous therapy, it must be verified before administration. Clarifying questionable prescriptions
helps prevent medication errors and protects patient safety.
Why the Other Options Are Less Appropriate
B. Delegating administration does not remove professional accountability.
C. Medication should not be permanently withheld without appropriate clinical communication.
D. Nurses remain responsible for questioning unsafe or unclear medication orders.
Clinical Pearl
Never administer a medication that seems unsafe or questionable. Stop, verify, and clarify before proceeding.
Page 6 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Question 3
Assessment of an older adult reveals new confusion, agitation, and difficulty following simple commands
several hours after surgery. Which nursing action is the priority?
A. Request a psychiatric consultation before further assessment.
B. Encourage the patient to sleep and reassess later.
C. Reorient the patient while immediately assessing oxygenation, vital signs, pain, and possible causes of the mental
status change.
D. Apply physical restraints to prevent injury.
Correct Answer: C
Rationale
Acute postoperative confusion may indicate hypoxia, infection, medication effects, metabolic disturbances, or
delirium. The nurse must first perform a focused assessment to identify and address reversible causes before
considering other interventions.
Why the Other Options Are Less Appropriate
A. Psychiatric consultation is inappropriate before evaluating potential physiological causes.
B. Delaying assessment may allow a serious condition to worsen.
D. Restraints are a last resort and should never replace assessment.
Clinical Pearl
Sudden confusion is a clinical symptom—not a diagnosis. Always assess for reversible physiological causes first.
Question 4
A newly licensed nurse asks why evidence-based practice is emphasized during patient care planning.
Which response by the experienced nurse is most accurate?
A. It eliminates the need for individualized nursing assessments.
B. It replaces clinical judgment with standardized treatment plans.
C. It integrates the best available evidence, clinical expertise, and patient preferences to improve outcomes.
D. It ensures that every patient receives identical nursing care.
Correct Answer: C
Rationale
Evidence-based practice combines current research, professional expertise, and patient values to guide clinical
decisions. This approach supports individualized, safe, and effective patient care rather than relying solely on tradition
or routine.
Why the Other Options Are Less Appropriate
A. Comprehensive assessment remains the foundation of safe nursing practice.
B. Clinical judgment remains essential in applying evidence appropriately.
D. Nursing care should always be individualized.
Clinical Pearl
Evidence-based practice is built on research evidence + clinical expertise + patient preferences.
Question 5
Following a busy shift, a nurse realizes that a scheduled medication was unintentionally omitted. What is
the nurse's priority action?
A. Inform the charge nurse and healthcare provider, assess the patient, document the omission accurately, and follow
institutional policy.
B. Administer a double dose at the next scheduled time.
C. Document the medication as administered to avoid disciplinary action.
D. Wait until the next shift and allow the incoming nurse to manage the situation.
Page 7 of 551
, BRUNNER & SUDDARTH’S MEDICAL-SURGICAL NURSING • 16TH EDITION • INDEPENDENT TESTBANK
Correct Answer: A
Rationale
Professional accountability requires prompt recognition, reporting, and documentation of medication errors or
omissions. The nurse should assess the patient for any adverse effects, notify appropriate personnel, and follow
organizational protocols to ensure patient safety.
Why the Other Options Are Less Appropriate
B. Administering a double dose without an order may cause harm.
C. Falsifying documentation is unethical and may have legal consequences.
D. Delaying intervention places the patient at unnecessary risk.
Clinical Pearl
When an error occurs, protect the patient first, report promptly, document truthfully, and learn from the event.
Question 6
During interdisciplinary rounds, the nurse disagrees with a proposed discharge plan because the patient
demonstrates unsafe medication management. What is the nurse's best course of action?
A. Remain silent because discharge decisions belong exclusively to the physician.
B. Delay the discharge paperwork without informing anyone.
C. Advocate for the patient by communicating the safety concerns and recommending further evaluation before
discharge.
D. Tell the patient's family that the discharge plan is unsafe without discussing it with the healthcare team.
Correct Answer: C
Rationale
Patient advocacy is a fundamental responsibility of professional nursing practice. Nurses should communicate
evidence-based concerns respectfully and collaborate with the healthcare team to promote safe, patient-centered
care.
Why the Other Options Are Less Appropriate
A. Nurses are responsible for advocating when patient safety is at risk.
B. Delaying care without communication is unprofessional and ineffective.
D. Concerns should first be addressed through appropriate professional communication.
Clinical Pearl
Advocacy means speaking up for patient safety, even when it requires respectfully questioning the current plan.
Question 7
During clinical rounds, a nurse is delegating tasks during a busy medical-surgical shift. Which assignment
is most appropriate for an experienced unlicensed assistive personnel (UAP)?
A. Measuring and documenting routine vital signs for a stable patient.
B. Assessing a patient who reports sudden chest pain.
C. Teaching a patient how to use an incentive spirometer.
D. Evaluating the effectiveness of intravenous pain medication.
Correct Answer: A
Rationale
Routine vital signs for stable patients are within the typical role of a trained UAP. Assessment, patient education,
evaluation, and clinical judgment remain the responsibility of the registered nurse.
Why the Other Options Are Less Appropriate
B. Assessment of acute symptoms must be performed by the RN.
C. Initial teaching is an RN responsibility.
D. Evaluation of patient response requires RN clinical judgment.
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Clinical Pearl
Delegate stable, predictable, routine tasks—never assessment, teaching, evaluation, or clinical decision-making.
Question 8
While reviewing quality improvement data, a nurse notices an increase in patient falls on the medical-
surgical unit over the past three months. Which nursing action best supports continuous quality
improvement?
A. Wait for management to implement changes before taking action.
B. Counsel only the nurses involved in previous fall incidents.
C. Focus only on documenting falls after they occur.
D. Participate in analyzing contributing factors and implementing evidence-based fall-prevention strategies.
Correct Answer: D
Rationale
Quality improvement focuses on identifying system issues, analyzing trends, and implementing evidence-based
interventions to improve patient outcomes. Collaborative efforts are more effective than assigning individual blame.
Why the Other Options Are Less Appropriate
A. All nurses share responsibility for quality improvement.
B. Quality improvement emphasizes system improvement rather than individual blame.
C. Documentation alone does not reduce future falls.
Clinical Pearl
Quality improvement asks "How can we improve the system?" rather than "Who is at fault?"
Question 9
During the shift, a nurse is preparing to administer a newly prescribed antibiotic when the patient states,
"I'm allergic to that medication." The electronic health record does not list any allergies. What should the
nurse do first?
A. Request that the pharmacist remove the medication from the medication administration record.
B. Administer the antibiotic because there is no documented allergy.
C. Ask the patient whether the previous reaction was severe after administering the medication.
D. Withhold the medication, further assess the reported allergy, and notify the healthcare provider before
administration.
Correct Answer: D
Rationale
Patient safety is the nurse's highest priority. Any reported allergy should be thoroughly assessed before medication
administration, even if it is not documented. The nurse should clarify the reaction, withhold the medication, and
collaborate with the healthcare provider to determine the safest course of action.
Why the Other Options Are Less Appropriate
A. Pharmacy involvement may be necessary later, but the immediate priority is protecting the patient.
B. Absence of documentation does not mean an allergy does not exist.
C. The medication should never be administered before verifying allergy information.
Clinical Pearl
Always investigate patient-reported allergies, even when documentation is incomplete.
Question 10
A patient's family requests detailed information about the patient's diagnosis while the patient is awake
and capable of making decisions. The patient has not given permission to share health information. What
is the nurse's best response?
A. Explain that patient information cannot be shared without the patient's permission and ask the patient how they
would like information communicated.
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B. Ask another nurse to speak with the family.
C. Provide the requested information because the family is directly involved in care.
D. Share only laboratory results because they are less confidential than the diagnosis.
Correct Answer: A
Rationale
Respect for patient autonomy and confidentiality requires the nurse to protect private health information. When the
patient has decision-making capacity, permission should be obtained before discussing medical information with
family members.
Why the Other Options Are Less Appropriate
B. Responsibility cannot be transferred to avoid an ethical obligation.
C. Family involvement does not override patient privacy rights.
D. All protected health information is confidential.
Clinical Pearl
Patient confidentiality continues unless the patient authorizes disclosure or another legal exception applies.
Question 11
Shortly after receiving report, the nurse notices that a colleague is about to administer medication to the
wrong patient. Which action demonstrates professional accountability?
A. Immediately intervene to prevent the error and follow institutional reporting procedures if necessary.
B. Wait until after the medication is given before discussing the mistake privately.
C. Ignore the situation because every nurse is responsible only for assigned patients.
D. Document the incident before speaking to the colleague.
Correct Answer: A
Rationale
Patient safety requires immediate intervention whenever a preventable error is identified. Professional accountability
includes respectfully stopping unsafe actions and following organizational policies to promote a culture of safety.
Why the Other Options Are Less Appropriate
B. Waiting may allow patient harm to occur.
C. Every nurse has a professional obligation to protect patient safety.
D. Immediate intervention takes priority over documentation.
Clinical Pearl
A culture of safety encourages nurses to speak up immediately when patient harm can be prevented.
Question 12
While reviewing a patient's laboratory results, the nurse identifies a critical potassium level of 6.4 mEq/L.
The patient is asymptomatic. What is the nurse's priority action?
A. Document the laboratory value and continue routine care.
B. Encourage the patient to increase oral fluid intake.
C. Notify the healthcare provider immediately and assess the patient for manifestations of hyperkalemia.
D. Repeat the laboratory test during the next scheduled blood draw.
Correct Answer: C
Rationale
Hyperkalemia is a potentially life-threatening electrolyte imbalance that can rapidly cause fatal cardiac dysrhythmias.
Even without symptoms, the nurse should promptly assess the patient, verify cardiac monitoring if indicated, and
notify the healthcare provider without delay.
Why the Other Options Are Less Appropriate
A. Documentation does not replace immediate clinical intervention.
B. Oral fluids alone will not correct severe hyperkalemia.
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