TEST BANK FOR Lewis's Medical-Surgical Nursing in Canada 5th edition by Jane Tyerman , Shelley Cobbett , Mariann M. Harding , Jeffrey Kwong, Dottie Roberts , Debra Hagler , Courtney Reinisch ISBN:978-0323791571 COMPLETE GUIDE WITH RATIONALES 100%

Medical-


Chapter 01: Introduction to Medical-
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Surgical Nursing Practice in Canada Lewis: Medical- Surgical
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Nursing in Canada, 5th Canadian Edition
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MULTIPLE CHOICE
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, Medical-
1. When caring for clients using evidence-
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informed practice, which of the following does the nurse use?
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a. Clinical judgement based on experience
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, Medical-
b. Evidence from a clinical research study n n n n n



c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the client outcomes are met n n n n n n n n n




ANS: C
Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscient
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ious, and judicious consideration of the best available evidence to provide care. Four primary
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elements are: (a) clinical state, setting, and circumstances; (b) client preferences and actions;
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(c) best research evidence; and (d) health care resources. Clinical judgement based on the nurs
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e‘s clinical experience is part of EIP, but clinical decision making also should incorporate cur
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rent research and research-
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based guidelines. Evidence from one clinical research study does not provide an adequate sub
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stantiation for interventions. Evaluation of client outcomes is important, but interventions sho
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uld be based on research from randomized control studies with a large number of subjects.
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DIF: n n Cognitive Level: Comprehension n n n n n TOP: n n Nursing Process: Planning n n




2. Which of the following best N
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explRa insItheGnu Br s . imary use of the nursing process when
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providing care to clients USNT O n n n n n n



?
a. To explain nursing interventions to other health care professionals
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b. As a problem-solving tool to identify and treat clients‘ health care needs
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c. As a scientific-based process of diagnosing the client‘s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
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ANS: B
The nursing process is an assertive problem-
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solving approach to the identification and treatment of clients‘ problems. Diagnosis is only on e
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phase of the nursing process. The
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primary use of the nursing process is in client care, not to establish nursing theory or explain n ursing
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interventions to other health care professionals. n n n n n




DIF: Cognitive Level: Comprehension n n TOP: Nursing Process: Implementation n n




3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2- hour
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turning schedule to prevent skin breakdown. Which type of nursing function is demonst rated
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with this turning schedule?
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a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D




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When implementing collaborative nursing actions, the nurse is responsible primarily for mon
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itoring for complications of acute illness or providing care to prevent or treat complications.
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Independent nursing actions are focused on health promotion, illness prevention, and client a
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dvocacy. A dependent action would require a physician order to implement. Cooperative nur
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sing functions are not described as one of the formal nursing functions.
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DIF: Cognitive Level: Application n n TOP: Nursing Process: Implementation n n




4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells th e
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nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which action sh
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ould the nurse take next?
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a. Reassure the client that these feelings are common for parents. n n n n n n n n n



b. Have the client call the children to ensure that they are doing well.
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c. Call the neighbour to determine whether adequate childcare is being provided.
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d. Gather more data about the client‘s feelings about the childcare arrangements.
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ANS: D
Since a complete assessment is necessary in order to identify a problem and choose an appro
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priate intervention, the nurse‘s first action should be to obtain more information. The other ac
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tions may be appropriate, but more assessment is needed before the best intervention can be c
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hosen.

DIF: Cognitive Level: Application n n TOP: Nursing Process: Assessment n n




5. The nurse is caring for a client who has left-
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sided paralysis as the result of a stroke and assesses a pressure injuryon the cl i e n t‘s l ef t h
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N R I G
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ip . Which of the following is the most
B.C M
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appropriate nursing diagnosis fUo r t Sh is cNlienTt? O
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a. Impaired physical mobility related to decrease in muscle control (left- n n n n n n n n n



sided paralysis) n



b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
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protecting tissue integrity n n



c. Impaired skin integrity related to pressure over bony prominence (impaired n n n n n n n n n n



circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle n n n n n n




ANS: C
The client‘s major problem is the impaired skin integrity as demonstrated by the presence of a
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pressure injury. The nurse is able to treat the cause of altered circulation and pressure by fre
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quently repositioning the client. Although left-sided weakness is a problem for the client,
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the nurse cannot treat the weakness. The ―risk for‖ diagnosis is not appropriate for this client,
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who already has impaired tissue integrity. The client does have ineffective tissue perfusion, b ut
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the impaired skin integrity diagnosis indicates more clearly what the health problem is.
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DIF: n n Cognitive Level: Application n n TOP: n n Nursing Process: Diagnosis n n




6. The nurse caring for a client with an infection has a nursing diagnosis of deficient flui d
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volume related to excessive diaphoresis. Which of the following is an appropriate clie nt
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outcome?
a. Client has a balanced intake and output. n n n n n n



b. Client‘s bedding is changed when it becomes damp. n n n n n n n





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