MEDICAL SURGICAL NURSING
PATIENT CENTERED
COLLABORATIVE CARE 8TH
EDITION DONNA-D,
IGNATAVICIUS TEST BANK
WITH RATIONALIZED
ANSWERS(CHAPTER 1 T0 74)
,Chapter 1: Introduction to Medical-Surgical Nursing Practice
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The
preceptor advises the student that which is the priority when working as a professional
nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
ANS: B
All actions are appropriate for the professional nurse. However, ensuring client safety is the
priority. Up to 98,000 deaths result each year from errors in hospital care, according to the
2000 Institute of Medicine report. Many more clients have suffered injuries and less serious
outcomes. Every nurse has the responsibility to guard the client’s safety.
DIF: Understanding/Comprehension REF: 2 KEY: Patient safety
MSC: Integrated Process: Nursing Process: Intervention
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
2. A nurse is orienting a new client and family to the inpatient unit. What information does the
nurse provide to help the client promote his or her own safety?
a. Encourage the client and family to be active partners.
b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the client.
d. Tell the client to always wear his or her armband.
ANS: A
Each action could be important for the client or family to perform. However, encouraging
the client to be active in his or her health care as a partner is the most critical. The other
actions are very limited in scope and do not provide the broad protection that being active
and involved does.
DIF: Understanding/Comprehension REF: 3 KEY: Patient safety
MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is
best?
a. Call the Rapid Response Team.
b. Document and continue to monitor.
c. Notify the primary care provider.
d. Repeat blood pressure measurement in 15 minutes.
, ANS: A
The purpose of the Rapid Response Team (RRT) is to intervene when clients are
deteriorating before they suffer either respiratory or cardiac arrest. Since the client has
manifested a significant change, the nurse should call the RRT. Changes in blood pressure,
mental status, heart rate, and pain are particularly significant. Documentation is vital, but the
nurse must do more than document. The primary care provider should be notified, but this is
not the priority over calling the RRT. The client’s blood pressure should be reassessed
frequently, but the priority is getting the rapid care to the client.
DIF: Applying/Application REF: 3
KEY: Rapid Response Team (RRT)| medical emergencies
MSC: Integrated Process: Communication and Documentation
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
best demonstrates this concept?
a. Assesses for cultural influences affecting health care
b. Ensures that all the clients’ basic needs are met
c. Tells the client and family about all upcoming tests
d. Thoroughly orients the client and family to the room
ANS: A
Competency in client-focused care is demonstrated when the nurse focuses on
communication, culture, respect, compassion, client education, and empowerment. By
assessing the effect of the client’s culture on health care, this nurse is practicing
client-focused care. Providing for basic needs does not demonstrate this competence.
Simply telling the client about all upcoming tests is not providing empowering education.
Orienting the client and family to the room is an important safety measure, but not directly
related to demonstrating client-centered care.
DIF: Understanding/Comprehension REF: 3
KEY: Patient-centered care| culture MSC: Integrated Process: Caring
NOT: Client Needs Category: Psychosocial Integrity
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
nurse explain is the most important thing the client can do to protect against errors?
a. Bring a list of all medications and what they are for.
b. Keep the doctor’s phone number by the telephone.
c. Make sure all providers wash hands before entering the room.
d. Write down the name of each caregiver who comes in the room.
ANS: A
Medication errors are the most common type of health care mistake. The Joint
Commission’s Speak Up campaign encourages clients to help ensure their safety. One
recommendation is for clients to know all their medications and why they take them. This
will help prevent medication errors.
DIF: Applying/Application REF: 4
KEY: Speak Up campaign| patient safety MSC: Integrated Process: Teaching/Learning
, NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
6. Which action by the nurse working with a client best demonstrates respect for autonomy?
a. Asks if the client has questions before signing a consent
b. Gives the client accurate information when questioned
c. Keeps the promises made to the client and family
d. Treats the client fairly compared to other clients
ANS: A
Autonomy is self-determination. The client should make decisions regarding care. When the
nurse obtains a signature on the consent form, assessing if the client still has questions is
vital, because without full information the client cannot practice autonomy. Giving accurate
information is practicing with veracity. Keeping promises is upholding fidelity. Treating the
client fairly is providing social justice.
DIF: Applying/Application REF: 4
KEY: Autonomy| ethical principles MSC: Integrated Process: Caring
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
7. A student nurse asks the faculty to explain best practices when communicating with a
person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)
community. What answer by the faculty is most accurate?
a. Avoid embarrassing the client by asking questions.
b. Don’t make assumptions about their health needs.
c. Most LGBTQ people do not want to share information.
d. No differences exist in communicating with this population.
ANS: B
Many members of the LGBTQ community have faced discrimination from health care
providers and may be reluctant to seek health care. The nurse should never make
assumptions about the needs of members of this population. Rather, respectful questions are
appropriate. If approached with sensitivity, the client with any health care need is more
likely to answer honestly.
DIF: Understanding/Comprehension REF: 4 KEY: LGBTQ| diversity
MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Psychosocial Integrity
8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago
and has pain that is unrelieved by the prescribed narcotic pain medication. Which statement
is part of the SBAR format for communication?
a. A: “I would like you to order a different pain medication.”
b. B: “This client has allergies to morphine and codeine.”
c. R: “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
d. S: “This client had a vaginal hysterectomy 2 days ago.”
ANS: B
PATIENT CENTERED
COLLABORATIVE CARE 8TH
EDITION DONNA-D,
IGNATAVICIUS TEST BANK
WITH RATIONALIZED
ANSWERS(CHAPTER 1 T0 74)
,Chapter 1: Introduction to Medical-Surgical Nursing Practice
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The
preceptor advises the student that which is the priority when working as a professional
nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
ANS: B
All actions are appropriate for the professional nurse. However, ensuring client safety is the
priority. Up to 98,000 deaths result each year from errors in hospital care, according to the
2000 Institute of Medicine report. Many more clients have suffered injuries and less serious
outcomes. Every nurse has the responsibility to guard the client’s safety.
DIF: Understanding/Comprehension REF: 2 KEY: Patient safety
MSC: Integrated Process: Nursing Process: Intervention
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
2. A nurse is orienting a new client and family to the inpatient unit. What information does the
nurse provide to help the client promote his or her own safety?
a. Encourage the client and family to be active partners.
b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the client.
d. Tell the client to always wear his or her armband.
ANS: A
Each action could be important for the client or family to perform. However, encouraging
the client to be active in his or her health care as a partner is the most critical. The other
actions are very limited in scope and do not provide the broad protection that being active
and involved does.
DIF: Understanding/Comprehension REF: 3 KEY: Patient safety
MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is
best?
a. Call the Rapid Response Team.
b. Document and continue to monitor.
c. Notify the primary care provider.
d. Repeat blood pressure measurement in 15 minutes.
, ANS: A
The purpose of the Rapid Response Team (RRT) is to intervene when clients are
deteriorating before they suffer either respiratory or cardiac arrest. Since the client has
manifested a significant change, the nurse should call the RRT. Changes in blood pressure,
mental status, heart rate, and pain are particularly significant. Documentation is vital, but the
nurse must do more than document. The primary care provider should be notified, but this is
not the priority over calling the RRT. The client’s blood pressure should be reassessed
frequently, but the priority is getting the rapid care to the client.
DIF: Applying/Application REF: 3
KEY: Rapid Response Team (RRT)| medical emergencies
MSC: Integrated Process: Communication and Documentation
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
best demonstrates this concept?
a. Assesses for cultural influences affecting health care
b. Ensures that all the clients’ basic needs are met
c. Tells the client and family about all upcoming tests
d. Thoroughly orients the client and family to the room
ANS: A
Competency in client-focused care is demonstrated when the nurse focuses on
communication, culture, respect, compassion, client education, and empowerment. By
assessing the effect of the client’s culture on health care, this nurse is practicing
client-focused care. Providing for basic needs does not demonstrate this competence.
Simply telling the client about all upcoming tests is not providing empowering education.
Orienting the client and family to the room is an important safety measure, but not directly
related to demonstrating client-centered care.
DIF: Understanding/Comprehension REF: 3
KEY: Patient-centered care| culture MSC: Integrated Process: Caring
NOT: Client Needs Category: Psychosocial Integrity
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
nurse explain is the most important thing the client can do to protect against errors?
a. Bring a list of all medications and what they are for.
b. Keep the doctor’s phone number by the telephone.
c. Make sure all providers wash hands before entering the room.
d. Write down the name of each caregiver who comes in the room.
ANS: A
Medication errors are the most common type of health care mistake. The Joint
Commission’s Speak Up campaign encourages clients to help ensure their safety. One
recommendation is for clients to know all their medications and why they take them. This
will help prevent medication errors.
DIF: Applying/Application REF: 4
KEY: Speak Up campaign| patient safety MSC: Integrated Process: Teaching/Learning
, NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
6. Which action by the nurse working with a client best demonstrates respect for autonomy?
a. Asks if the client has questions before signing a consent
b. Gives the client accurate information when questioned
c. Keeps the promises made to the client and family
d. Treats the client fairly compared to other clients
ANS: A
Autonomy is self-determination. The client should make decisions regarding care. When the
nurse obtains a signature on the consent form, assessing if the client still has questions is
vital, because without full information the client cannot practice autonomy. Giving accurate
information is practicing with veracity. Keeping promises is upholding fidelity. Treating the
client fairly is providing social justice.
DIF: Applying/Application REF: 4
KEY: Autonomy| ethical principles MSC: Integrated Process: Caring
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
7. A student nurse asks the faculty to explain best practices when communicating with a
person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)
community. What answer by the faculty is most accurate?
a. Avoid embarrassing the client by asking questions.
b. Don’t make assumptions about their health needs.
c. Most LGBTQ people do not want to share information.
d. No differences exist in communicating with this population.
ANS: B
Many members of the LGBTQ community have faced discrimination from health care
providers and may be reluctant to seek health care. The nurse should never make
assumptions about the needs of members of this population. Rather, respectful questions are
appropriate. If approached with sensitivity, the client with any health care need is more
likely to answer honestly.
DIF: Understanding/Comprehension REF: 4 KEY: LGBTQ| diversity
MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Psychosocial Integrity
8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago
and has pain that is unrelieved by the prescribed narcotic pain medication. Which statement
is part of the SBAR format for communication?
a. A: “I would like you to order a different pain medication.”
b. B: “This client has allergies to morphine and codeine.”
c. R: “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
d. S: “This client had a vaginal hysterectomy 2 days ago.”
ANS: B
