Study Guide for Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems

Test Bank For Lewis's
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Medical-Surgical Nursing,
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12thEdition by Mariann M.
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Harding,JeffreyKwong,
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Debra Hagler Chapter 1- 69
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,Chapter 01: Professional Nursing
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Harding: Lewis’sMedical-SurgicalNursing,12thEdition
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MULTIPLE CHOICE n




1. The nurse completes an admission database and explains that the plan of care and discharge goals
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will be developed with the patient‘s input. The patient asks, “How is this different from what the
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physician does?” Which response would the nurse provide?
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a. “The role of the nurse is to administer medications and other treatments prescribed by your
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physician.”
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b. “In addition to caring for you while you are sick, the nurses will help you plan to
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maintain your health.”
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c. “The nurse‘s job is to collect information and communicate any problems that occur to the
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physician.”
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d. “Nurses perform many of the same procedures as the physician, but nurses are with the
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patients for a longer time than the physician.”
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ANS: B n




TheAmerican Nurses Association (ANA) definition of nursing describes the role of nurses in
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promoting health. The other responses describe dependent and collaborative functions of the
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nursing role but do not accurately describe the nurse‘s unique role in the health care system.
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DIF: Cognitive Level: Analyze (Analysis) n n n




TOP: Nursing Process: Implementation
n MSC: NCLEX: Safe and Effective Care Environment n n n n n n n n




2. Which statement by the nurse accurately describes the use of evidence-based practice (EBP)?
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a. “Patient care is based on clinical judgment, experience, and traditions.” n n n n n n n n n




b. “Data are analyzed later to show that the patient outcomes are consistently met.”
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c. “Research from all published articles are used as a guide for planning patient care.” n n n n n n n n n n n n n




d. “Recommendations are based on research, clinical expertise, and patient preferences.” n n n n n n n n n




ANS: D n




Evidence-based practice (EBP) is the use of the best research-based evidence combined with n n n n n n n n n n n n




clinician expertise and consideration of patient preferences. Clinical judgment based on the
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nurse‘s clinical experience is part of EBP, but clinical decision making should also incorporate
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current research and research-based guidelines. Evaluation of patient outcomes is important, but
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data analysis is not required to use EBP. All published articles do not provide research evidence;
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interventions should be based on credible research, preferably randomized controlled studies
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with a large number of subjects.
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, DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Planning MSC: n n n n n n n n




NCLEX: Safe and Effective Care Environment
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3. Which statement by the nurse provides a clear explanation of the nursing process?
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a. “The nursing process is a research method of diagnosing the patient‘s health care
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problems.”
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b. “The nursing process is used primarily to explain nursing interventions to other health care
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professionals.”
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c. “The nursing process is a problem-solving tool used to identify and manage the
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patients‘ health care needs.” n n n




d. “The nursing process is based on nursing theory that incorporates the biopsychosocial
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n nature of humans.” n n




ANS: C n




The nursing process is a problem-solving approach to the identification and treatment of
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patients‘ problems. Nursing process does not require research methods for diagnosis. The
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primary use of the nursing process is in patient care, not to establish nursing theory or explain
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nursing interventions to other health care professionals.
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DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: n n n n n n n n




NCLEX: Safe and Effective Care Environment
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4. A patient admitted to the hospital for surgery tells the nurse, “I do not feel comfortable leaving
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my children with my parents.” Which action would the nurse take next? a. Reassure the patient
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that these feelings are common for parents.
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b. Have the patient call the children to ensure that they are doing well.
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c. Gather information on the patient‘s concerns about the child care arrangements.
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d. Call the patient‘s parents to determine whether adequate child care is being
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n provided.
ANS: C n




Because a complete assessment is necessary in order to identify a problem and choose an
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appropriate intervention, the nurse‘s first action should be to obtain more information. The other
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actions may be appropriate, but more assessment is needed before the best intervention can be
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chosen.
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DIF: Cognitive Level: Analyze (Analysis) n n n




TOP: Nursing Process: Assessment
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5. A patient with a bacterial infection is hypovolemic due to a fever and excessive diaphoresis.
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Which expected outcome would the nurse select for this patient? a.
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Patient has a balanced intake and output.
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b. Patient‘s bedding is kept clean and free of moisture. n n n n n n n n




c. Patient understands the need for increased fluid intake. n n n n n n n




d. Patient‘s skin remains cool and dry throughout hospitalization. n n n n n n n

, ANS: A
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Balanced intake and output gives measurable data showing resolution of the problem of deficient
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fluid volume. The other statements would not indicate that the problem of hypovolemia was
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resolved.
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DIF: Cognitive Level: Apply (Application) n n n TOP: Nursing Process: Planning MSC: NCLEX:
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Physiological Integrity
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6. Which statement describes the purpose of the evaluation phase of the nursing process?
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a. To document the nursing care plan in the progress notes of the health record
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b. To determine if interventions have been effective in meeting patient outcomes
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c. To decide whether the patient‘s health problems have been completely resolved
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d. To establish if the patient agrees that the nursing care provided was satisfactory
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ANS: B n