Grand Canyon University –
Medical-Surgical Nursing Test
Bank
Practice Questions and Answers
1. The nurse completes an admission database and explains
that the plan of care and discharge goals will be developed
with the patient's input. The patient states, "How is this
different from what the doctor does?" Which response would
be most appropriate for the nurse to make?
a. "The role of the nurse is to administer medications and other
treatments prescribed by your doctor."
b. "The nurse's job is to help the doctor by collecting information
and communicating any problems that occur."
c. "Nurses perform many of the same procedures as the doctor, but
nurses are with the patients for a longer time than the doctor."
d. "In addition to caring for you while you are sick, the nurses will
assist you to develop an individualized plan to maintain your
health."
Answer: D
Rationale: This response is consistent with the American
Nurses Association (ANA) definition of nursing, which
describes the role of nurses in promoting health. The other
responses describe some of the dependent and collaborative
functions of the nursing role but do not accurately describe
the nurse's role in the health care system.
2. The nurse describes to a student nurse how to use
evidence-based practice guidelines when caring for patients.
Which statement, if made by the nurse, would be the most
accurate?
a. "Inferences from clinical research studies are used as a guide."
b. "Patient care is based on clinical judgment, experience, and
traditions."
c. "Data are evaluated to show that the patient outcomes are
consistently met."
1
,d. "Recommendations are based on research, clinical expertise, and
patient preferences."
Answer: D
Rationale: Evidence-based practice (EBP) is the use of the
best research-based evidence combined with clinician
expertise. Clinical judgment based on the nurse's clinical
experience is part of EBP, but clinical decision making
should also incorporate current research and research-based
guidelines. Evaluation of patient outcomes is important, but
interventions should be based on research from randomized
control studies with a large number of subjects.
3. The nurse teaches a student nurse about how to apply the
nursing process when providing patient care. Which
statement, if made by the student nurse, indicates that
teaching was successful?
a. "The nursing process is a scientific-based method of diagnosing
the patient's health care problems."
b. "The nursing process is a problem-solving tool used to identify
and treat patients' health care needs."
c. "The nursing process is used primarily to explain nursing
interventions to other health care professionals."
d. "The nursing process is based on nursing theory that incorporates
the biopsychosocial nature of humans."
Answer: B
Rationale: The nursing process is a problem-solving
approach to the identification and treatment of patients'
problems. Diagnosis is only one phase of the nursing
process. The primary use of the nursing process is in patient
care, not to establish nursing theory or explain nursing
interventions to other health care professionals.
4. A patient has been admitted to the hospital for surgery
and tells the nurse, "I do not feel comfortable leaving my
children with my parents." Which action should the nurse
take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing
well.
c. Gather more data about the patient's feelings about the child-
care arrangements.
2
,d. Call the patient's parents to determine whether adequate child
care is being provided.
Answer: C
Rationale: Because a complete assessment is necessary in
order to identify a problem and choose an appropriate
intervention, the nurse's first action should be to obtain
more information. The other actions may be appropriate, but
more assessment is needed before the best intervention can
be chosen.
5. A patient who is paralyzed on the left side of the body
after a stroke develops a pressure ulcer on the left hip.
Which nursing diagnosis is most appropriate?
a. Impaired physical mobility related to left-sided paralysis
b. Risk for impaired tissue integrity related to left-sided weakness
c. Impaired skin integrity related to altered circulation and pressure
d. Ineffective tissue perfusion related to inability to move
independently
Answer: C
Rationale: The patient's major problem is the impaired skin
integrity as demonstrated by the presence of a pressure
ulcer. The nurse is able to treat the cause of altered
circulation and pressure by frequently repositioning the
patient. Although left-sided weakness is a problem for the
patient, the nurse cannot treat the weakness. The "risk for"
diagnosis is not appropriate for this patient, who already
has impaired tissue integrity. The patient does have
ineffective tissue perfusion, but the impaired skin integrity
diagnosis indicates more clearly what the health problem is.
6. A patient with a bacterial infection has a nursing
diagnosis of deficient fluid volume related to excessive
diaphoresis. Which outcome would the nurse recognize as
appropriate for this patient?
a. Patient has a balanced intake and output.
b. Patient's bedding is changed when it becomes damp.
c. Patient understands the need for increased fluid intake.
d. Patient's skin remains cool and dry throughout hospitalization.
Answer: A
3
, Rationale: This statement gives measurable data showing
resolution of the problem of deficient fluid volume that was
identified in the nursing diagnosis statement. The other
statements would not indicate that the problem of deficient
fluid volume was resolved.
7. A nurse asks the patient if pain was relieved after
receiving medication. What is the purpose of the evaluation
phase of the nursing process?
a. To determine if interventions have been effective in meeting
patient outcomes
b. To document the nursing care plan in the progress notes of the
medical record
c. To decide whether the patient's health problems have been
completely resolved
d. To establish if the patient agrees that the nursing care provided
was satisfactory
Answer: A
Rationale: Evaluation consists of determining whether the
desired patient outcomes have been met and whether the
nursing interventions were appropriate. The other
responses do not describe the evaluation phase.
8. The nurse interviews a patient while completing the
health history and physical examination. What is the
purpose of the assessment phase of the nursing process?
a. To teach interventions that relieve health problems
b. To use patient data to evaluate patient care outcomes
c. To obtain data with which to diagnose patient problems
d. To help the patient identify realistic outcomes for health problems
Answer: C
Rationale: During the assessment phase, the nurse gathers
information about the patient to diagnose patient problems.
The other responses are examples of the planning,
intervention, and evaluation phases of the nursing process.
9. Which nursing diagnosis statement is written correctly?
4
Medical-Surgical Nursing Test
Bank
Practice Questions and Answers
1. The nurse completes an admission database and explains
that the plan of care and discharge goals will be developed
with the patient's input. The patient states, "How is this
different from what the doctor does?" Which response would
be most appropriate for the nurse to make?
a. "The role of the nurse is to administer medications and other
treatments prescribed by your doctor."
b. "The nurse's job is to help the doctor by collecting information
and communicating any problems that occur."
c. "Nurses perform many of the same procedures as the doctor, but
nurses are with the patients for a longer time than the doctor."
d. "In addition to caring for you while you are sick, the nurses will
assist you to develop an individualized plan to maintain your
health."
Answer: D
Rationale: This response is consistent with the American
Nurses Association (ANA) definition of nursing, which
describes the role of nurses in promoting health. The other
responses describe some of the dependent and collaborative
functions of the nursing role but do not accurately describe
the nurse's role in the health care system.
2. The nurse describes to a student nurse how to use
evidence-based practice guidelines when caring for patients.
Which statement, if made by the nurse, would be the most
accurate?
a. "Inferences from clinical research studies are used as a guide."
b. "Patient care is based on clinical judgment, experience, and
traditions."
c. "Data are evaluated to show that the patient outcomes are
consistently met."
1
,d. "Recommendations are based on research, clinical expertise, and
patient preferences."
Answer: D
Rationale: Evidence-based practice (EBP) is the use of the
best research-based evidence combined with clinician
expertise. Clinical judgment based on the nurse's clinical
experience is part of EBP, but clinical decision making
should also incorporate current research and research-based
guidelines. Evaluation of patient outcomes is important, but
interventions should be based on research from randomized
control studies with a large number of subjects.
3. The nurse teaches a student nurse about how to apply the
nursing process when providing patient care. Which
statement, if made by the student nurse, indicates that
teaching was successful?
a. "The nursing process is a scientific-based method of diagnosing
the patient's health care problems."
b. "The nursing process is a problem-solving tool used to identify
and treat patients' health care needs."
c. "The nursing process is used primarily to explain nursing
interventions to other health care professionals."
d. "The nursing process is based on nursing theory that incorporates
the biopsychosocial nature of humans."
Answer: B
Rationale: The nursing process is a problem-solving
approach to the identification and treatment of patients'
problems. Diagnosis is only one phase of the nursing
process. The primary use of the nursing process is in patient
care, not to establish nursing theory or explain nursing
interventions to other health care professionals.
4. A patient has been admitted to the hospital for surgery
and tells the nurse, "I do not feel comfortable leaving my
children with my parents." Which action should the nurse
take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing
well.
c. Gather more data about the patient's feelings about the child-
care arrangements.
2
,d. Call the patient's parents to determine whether adequate child
care is being provided.
Answer: C
Rationale: Because a complete assessment is necessary in
order to identify a problem and choose an appropriate
intervention, the nurse's first action should be to obtain
more information. The other actions may be appropriate, but
more assessment is needed before the best intervention can
be chosen.
5. A patient who is paralyzed on the left side of the body
after a stroke develops a pressure ulcer on the left hip.
Which nursing diagnosis is most appropriate?
a. Impaired physical mobility related to left-sided paralysis
b. Risk for impaired tissue integrity related to left-sided weakness
c. Impaired skin integrity related to altered circulation and pressure
d. Ineffective tissue perfusion related to inability to move
independently
Answer: C
Rationale: The patient's major problem is the impaired skin
integrity as demonstrated by the presence of a pressure
ulcer. The nurse is able to treat the cause of altered
circulation and pressure by frequently repositioning the
patient. Although left-sided weakness is a problem for the
patient, the nurse cannot treat the weakness. The "risk for"
diagnosis is not appropriate for this patient, who already
has impaired tissue integrity. The patient does have
ineffective tissue perfusion, but the impaired skin integrity
diagnosis indicates more clearly what the health problem is.
6. A patient with a bacterial infection has a nursing
diagnosis of deficient fluid volume related to excessive
diaphoresis. Which outcome would the nurse recognize as
appropriate for this patient?
a. Patient has a balanced intake and output.
b. Patient's bedding is changed when it becomes damp.
c. Patient understands the need for increased fluid intake.
d. Patient's skin remains cool and dry throughout hospitalization.
Answer: A
3
, Rationale: This statement gives measurable data showing
resolution of the problem of deficient fluid volume that was
identified in the nursing diagnosis statement. The other
statements would not indicate that the problem of deficient
fluid volume was resolved.
7. A nurse asks the patient if pain was relieved after
receiving medication. What is the purpose of the evaluation
phase of the nursing process?
a. To determine if interventions have been effective in meeting
patient outcomes
b. To document the nursing care plan in the progress notes of the
medical record
c. To decide whether the patient's health problems have been
completely resolved
d. To establish if the patient agrees that the nursing care provided
was satisfactory
Answer: A
Rationale: Evaluation consists of determining whether the
desired patient outcomes have been met and whether the
nursing interventions were appropriate. The other
responses do not describe the evaluation phase.
8. The nurse interviews a patient while completing the
health history and physical examination. What is the
purpose of the assessment phase of the nursing process?
a. To teach interventions that relieve health problems
b. To use patient data to evaluate patient care outcomes
c. To obtain data with which to diagnose patient problems
d. To help the patient identify realistic outcomes for health problems
Answer: C
Rationale: During the assessment phase, the nurse gathers
information about the patient to diagnose patient problems.
The other responses are examples of the planning,
intervention, and evaluation phases of the nursing process.
9. Which nursing diagnosis statement is written correctly?
4
