Test Bank Lewis Medical-Surgical Nursing: Assessment
and Management of Clinical Problems 12th Edition By
Harding & Kwong
SECTION I: PROFESSIONAL NURSING & FOUNDATIONS (Questions 1–20)
1. A nurse explains to a patient that the plan of care and discharge goals will be developed
with the patient's input. The patient asks, "How is this different from what the physician
does?" Which response by the nurse best reflects the unique role of nursing?
A. "The nurse administers medications and treatments prescribed by your physician."
B. "In addition to caring for you while you are sick, nurses help you plan to maintain your
health."
C. "The nurse collects information and communicates any problems to the physician."
D. "Nurses perform many of the same procedures as physicians but spend more time with
patients."
Correct Answer: B
Rationale: The American Nurses Association (ANA) defines nursing as the protection,
promotion, and optimization of health and abilities, prevention of illness and injury, and
advocacy in care. Option B accurately captures this unique health-promotion focus. Option A
describes dependent functions, Option C describes collaborative functions, and Option D
focuses on task performance rather than nursing's distinctive contribution .
2. A nurse is teaching a student about evidence-based practice (EBP). Which statement by the
student indicates correct understanding?
A. "Patient care should be based primarily on clinical judgment and traditions."
B. "EBP means using all published research articles to guide care decisions."
C. "Recommendations integrate research evidence, clinical expertise, and patient preferences."
D. "Data should be analyzed retrospectively to confirm outcomes were met."
Correct Answer: C
Rationale: EBP is the integration of the best research evidence with clinician expertise and
patient preferences and values . Not all published articles provide credible evidence;
randomized controlled trials carry greater weight. Clinical judgment alone without current
research is insufficient. Evaluation of outcomes is important but does not define EBP.
,3. A patient with a bacterial infection is hypovolemic due to fever and excessive diaphoresis.
Which expected outcome best indicates resolution of the fluid volume deficit?
A. Patient's bedding remains clean and dry.
B. Patient has balanced intake and output.
C. Patient verbalizes understanding of increased fluid needs.
D. Patient's skin remains cool throughout hospitalization.
Correct Answer: B
Rationale: Balanced intake and output provides measurable, objective data demonstrating
resolution of deficient fluid volume . The other options are supportive measures or patient
education goals, not direct indicators that the physiologic problem has resolved.
4. During which phase of the nursing process does the nurse obtain data to diagnose patient
strengths and problems?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
Correct Answer: B
Rationale: The assessment phase involves gathering information about the patient to
identify actual and potential health problems . Planning involves setting outcomes,
implementation involves interventions, and evaluation determines whether outcomes were
met.
5. A nurse is evaluating whether pain medication administered 30 minutes ago was effective.
This activity represents which phase of the nursing process?
A. Assessment
B. Planning
C. Evaluation
D. Implementation
Correct Answer: C
, Rationale: Evaluation consists of determining whether the desired patient outcomes have
been met and whether nursing interventions were appropriate . Reassessing pain after an
intervention is a classic evaluation activity.
6. A patient is admitted with an acute exacerbation of heart failure. Which type of assessment
should the nurse prioritize initially?
A. Comprehensive admission assessment
B. Focused assessment of cardiovascular and respiratory systems
C. Emergency assessment
D. Functional assessment
Correct Answer: B
Rationale: A focused assessment targets the specific body systems affected by the patient's
presenting problem. While an admission database is needed, the immediate priority is assessing
the cardiovascular and respiratory systems to identify life-threatening manifestations such as
pulmonary edema.
7. Which nursing action best demonstrates the principle of nonmaleficence?
A. Discussing a DNR order with a terminally ill patient
B. Refusing to administer a prescribed pain medication
C. Providing more care to one patient than another based on insurance status
D. Administering a medication without verifying the dose
Correct Answer: B
Rationale: Nonmaleficence is the duty to do no harm. Refusing to administer prescribed
pain medication (when not contraindicated) would constitute harm through unnecessary
suffering. Discussing DNR orders and assisting with ADLs are ethical actions . Administering
medication without verification is negligence.
8. A nurse is preparing to delegate tasks to assistive personnel (AP). Which task is most
appropriate to delegate?
A. Assessing a patient reporting new chest pain
B. Measuring vital signs for a stable postoperative patient
, C. Administering a newly prescribed antihypertensive
D. Evaluating the effectiveness of patient teaching
Correct Answer: B
Rationale: Measuring vital signs for a stable patient is within the AP scope of practice and
does not require nursing judgment . Assessment, medication administration, and evaluation of
teaching are nursing responsibilities that cannot be delegated.
9. A patient asks the nurse about the purpose of a living will. Which statement by the nurse is
most accurate?
A. "A living will is always honored regardless of circumstances."
B. "A living will specifies your wishes for medical treatment if you become terminally ill."
C. "A living will is binding for the duration of your life."
D. "A living will is drawn up by your family to determine DNR status."
Correct Answer: B
Rationale: A living will is an advance directive that specifies a patient's wishes for medical
treatment in terminal conditions . It is not always honored in every circumstance, is not binding
for the patient's entire life, and is created by the patient, not the family.
10. Which statement by a nurse demonstrates understanding of the purpose of the evaluation
phase?
A. "To document the care plan in the medical record"
B. "To determine if interventions were effective in meeting outcomes"
C. "To decide whether the patient's health problems are completely resolved"
D. "To establish if the patient is satisfied with nursing care"
Correct Answer: B
Rationale: Evaluation determines whether desired patient outcomes have been met and
whether nursing interventions were appropriate . Documentation occurs throughout the
process, and evaluation is not solely about patient satisfaction or complete problem resolution.
11. A nurse is developing a plan of care for a patient with chronic illness. Which principle
should guide the nurse's approach?
and Management of Clinical Problems 12th Edition By
Harding & Kwong
SECTION I: PROFESSIONAL NURSING & FOUNDATIONS (Questions 1–20)
1. A nurse explains to a patient that the plan of care and discharge goals will be developed
with the patient's input. The patient asks, "How is this different from what the physician
does?" Which response by the nurse best reflects the unique role of nursing?
A. "The nurse administers medications and treatments prescribed by your physician."
B. "In addition to caring for you while you are sick, nurses help you plan to maintain your
health."
C. "The nurse collects information and communicates any problems to the physician."
D. "Nurses perform many of the same procedures as physicians but spend more time with
patients."
Correct Answer: B
Rationale: The American Nurses Association (ANA) defines nursing as the protection,
promotion, and optimization of health and abilities, prevention of illness and injury, and
advocacy in care. Option B accurately captures this unique health-promotion focus. Option A
describes dependent functions, Option C describes collaborative functions, and Option D
focuses on task performance rather than nursing's distinctive contribution .
2. A nurse is teaching a student about evidence-based practice (EBP). Which statement by the
student indicates correct understanding?
A. "Patient care should be based primarily on clinical judgment and traditions."
B. "EBP means using all published research articles to guide care decisions."
C. "Recommendations integrate research evidence, clinical expertise, and patient preferences."
D. "Data should be analyzed retrospectively to confirm outcomes were met."
Correct Answer: C
Rationale: EBP is the integration of the best research evidence with clinician expertise and
patient preferences and values . Not all published articles provide credible evidence;
randomized controlled trials carry greater weight. Clinical judgment alone without current
research is insufficient. Evaluation of outcomes is important but does not define EBP.
,3. A patient with a bacterial infection is hypovolemic due to fever and excessive diaphoresis.
Which expected outcome best indicates resolution of the fluid volume deficit?
A. Patient's bedding remains clean and dry.
B. Patient has balanced intake and output.
C. Patient verbalizes understanding of increased fluid needs.
D. Patient's skin remains cool throughout hospitalization.
Correct Answer: B
Rationale: Balanced intake and output provides measurable, objective data demonstrating
resolution of deficient fluid volume . The other options are supportive measures or patient
education goals, not direct indicators that the physiologic problem has resolved.
4. During which phase of the nursing process does the nurse obtain data to diagnose patient
strengths and problems?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
Correct Answer: B
Rationale: The assessment phase involves gathering information about the patient to
identify actual and potential health problems . Planning involves setting outcomes,
implementation involves interventions, and evaluation determines whether outcomes were
met.
5. A nurse is evaluating whether pain medication administered 30 minutes ago was effective.
This activity represents which phase of the nursing process?
A. Assessment
B. Planning
C. Evaluation
D. Implementation
Correct Answer: C
, Rationale: Evaluation consists of determining whether the desired patient outcomes have
been met and whether nursing interventions were appropriate . Reassessing pain after an
intervention is a classic evaluation activity.
6. A patient is admitted with an acute exacerbation of heart failure. Which type of assessment
should the nurse prioritize initially?
A. Comprehensive admission assessment
B. Focused assessment of cardiovascular and respiratory systems
C. Emergency assessment
D. Functional assessment
Correct Answer: B
Rationale: A focused assessment targets the specific body systems affected by the patient's
presenting problem. While an admission database is needed, the immediate priority is assessing
the cardiovascular and respiratory systems to identify life-threatening manifestations such as
pulmonary edema.
7. Which nursing action best demonstrates the principle of nonmaleficence?
A. Discussing a DNR order with a terminally ill patient
B. Refusing to administer a prescribed pain medication
C. Providing more care to one patient than another based on insurance status
D. Administering a medication without verifying the dose
Correct Answer: B
Rationale: Nonmaleficence is the duty to do no harm. Refusing to administer prescribed
pain medication (when not contraindicated) would constitute harm through unnecessary
suffering. Discussing DNR orders and assisting with ADLs are ethical actions . Administering
medication without verification is negligence.
8. A nurse is preparing to delegate tasks to assistive personnel (AP). Which task is most
appropriate to delegate?
A. Assessing a patient reporting new chest pain
B. Measuring vital signs for a stable postoperative patient
, C. Administering a newly prescribed antihypertensive
D. Evaluating the effectiveness of patient teaching
Correct Answer: B
Rationale: Measuring vital signs for a stable patient is within the AP scope of practice and
does not require nursing judgment . Assessment, medication administration, and evaluation of
teaching are nursing responsibilities that cannot be delegated.
9. A patient asks the nurse about the purpose of a living will. Which statement by the nurse is
most accurate?
A. "A living will is always honored regardless of circumstances."
B. "A living will specifies your wishes for medical treatment if you become terminally ill."
C. "A living will is binding for the duration of your life."
D. "A living will is drawn up by your family to determine DNR status."
Correct Answer: B
Rationale: A living will is an advance directive that specifies a patient's wishes for medical
treatment in terminal conditions . It is not always honored in every circumstance, is not binding
for the patient's entire life, and is created by the patient, not the family.
10. Which statement by a nurse demonstrates understanding of the purpose of the evaluation
phase?
A. "To document the care plan in the medical record"
B. "To determine if interventions were effective in meeting outcomes"
C. "To decide whether the patient's health problems are completely resolved"
D. "To establish if the patient is satisfied with nursing care"
Correct Answer: B
Rationale: Evaluation determines whether desired patient outcomes have been met and
whether nursing interventions were appropriate . Documentation occurs throughout the
process, and evaluation is not solely about patient satisfaction or complete problem resolution.
11. A nurse is developing a plan of care for a patient with chronic illness. Which principle
should guide the nurse's approach?
