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TEST BANK FOR
MEDICAL SURGICAL NURSING 7TH
EDITION BY LINTON
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Chapter 1: Introduction to Medical-Surgical Nursing
Chapter 1: Introduction to Medical-Surgical Nursing
Test Bank
MULTIPLE CHOICE
1. Which action demonstrates that the nurse understands the purpose of the Rapid Response Team?
a. Monitoring the client for changes in postoperative status such as wound
infection
b. Documenting all changes observed in the client and maintaining a
postoperative flow sheet
c. Notifying the physician of the client’s change in blood pressure from
140 to 88 mm Hg systolic
d. Notifying the physician of the client’s increase in restlessness after
medication change
ANS: C
The Rapid Response Team (RRT) saves lives and decreases the risk for harm by providing care to
clients before a respiratory or cardiac arrest occurs. Although the RRT does not replace the Code
Team, which responds to client arrests, it intervenes rapidly for those who are beginning to decline
clinically. It would be appropriate for the RRT to intervene when the client has experienced a 52-
point drop in blood pressure. Monitoring the client’s postoperative status, maintaining a
postoperative flow sheet, and notifying the physician of a change in the client’s status after a
medication change would not be considered activities of the Rapid Response Team.
DIF: Cognitive Level: Comprehension/Understanding REF: pp. 2-3
TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Collaboration with
Interdisciplinary Team)
MSC: Integrated Process: Nursing Process (Assessment)
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2. The Joint Commission focuses on safety in health care. Which action by the nurse reflects The
Joint Commission’s main objective?
a. Performing range-of-motion exercises on the client three times each day
b. Ensuring that the client is eating 100% of the meals served to him or
her
c. Assessing the client’s respirations when administering opioids
d. Delegating to the nursing assistant to give the client a complete bath
daily
ANS: C
It is important for the nurse to assess respirations of the client when administering opioids because
of the possibility of respiratory depression. The other interventions may or may not be necessary in
the care of the client and do not focus on safety.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control)
MSC: Integrated Process: Nursing Process (Assessment)
3. Which oaction oby othe onurse oshows oan ounderstanding oof othe oprinciple oof oself-determination?
a. Allowing oa opostoperative oclient oto odecide oto otake omedication owith
ofruitojuice orather othan owater
b. Allowing oa oteenager oto odecide onot oto ogo oto oa oclinic owhen
othere oisoevidence othat oshe ois ohaving oprofuse ovaginal
obleeding
c. Allowing oa oparent oto odecide onot oto oproceed owith oa olifesaving
ooperationofor oa o12-year-old oclient
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d. Allowing oan oolder oclient owith odementia oto odecide onot oto otake
ocardiacomedication othroughout othe oshift
ANS: oA
Respect ofor opeople ois oone oof othree obasic oethical oprinciples othat onurses oand oother ohealth ocare
oprofessionals oshould ouse oas oa obasis ofor oclinical odecision omaking. oRespect oimplies othat oclients
oare otreated oas oautonomous oindividuals ocapable oof omaking oinformed odecisions oabout otheir
ocare. oThis oclient oautonomy ois oreferred oto oas oself-determination, oor oself-management, oand ois
obest oillustrated obyoallowing oa oclient oto odecide oto otake omedication owith ofruit ojuice orather othan
owater. oThe oother oanswer ochoices owould onot oillustrate oself-determination oappropriately oand
omight opossibly oendanger othe oclient’s olife.
DIF: oCognitive oLevel: oApplication/Applying oor ohigher oREF: oN/A
TOP: oClient oNeeds oCategory: oSafe oand oEffective oCare oEnvironment o(Management oof oCare—Ethical
oPractice)oMSC: oIntegrated oProcess: oNursing oProcess o(Assessment)
4. The onurse ois oinitiating oa oseries oof oteaching osessions owith oan oolder oclient. oWhat ois othe
nurse’sohighest-priority, oclient-centered oaction obefore obeginning othe osession?
o
a. Ensure othat othe oclient’s ofamily ois opresent oand owill oparticipate.
b. Make ocertain othat othe oclient ois owearing ohis oglasses.
c. Have oprinted ohandouts oready oto ouse oduring othe osession.
d. Schedule othe osession ofor oearly oevening oafter othe oclient’s omeal.
ANS: oB
The omost oimportant oclient-centered oaction ois oto oensure othat othe oclient ois owearing ohis oor oher
oglasses. oThe oability oto osee oadequately owill ooutweigh othe oneed ofor ofamily opresence, ouse oof
oprinted ohandouts,oand ohunger o(or olack othereof).
DIF: oCognitive oLevel: oApplication/Applying oor ohigher oREF: oN/A
TOP: oClient oNeeds oCategory: oHealth oPromotion oand oMaintenance o(Principles oof oTeaching/Learning)
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TEST BANK FOR
MEDICAL SURGICAL NURSING 7TH
EDITION BY LINTON
Downloaded by: Ariah |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
Chapter 1: Introduction to Medical-Surgical Nursing
Chapter 1: Introduction to Medical-Surgical Nursing
Test Bank
MULTIPLE CHOICE
1. Which action demonstrates that the nurse understands the purpose of the Rapid Response Team?
a. Monitoring the client for changes in postoperative status such as wound
infection
b. Documenting all changes observed in the client and maintaining a
postoperative flow sheet
c. Notifying the physician of the client’s change in blood pressure from
140 to 88 mm Hg systolic
d. Notifying the physician of the client’s increase in restlessness after
medication change
ANS: C
The Rapid Response Team (RRT) saves lives and decreases the risk for harm by providing care to
clients before a respiratory or cardiac arrest occurs. Although the RRT does not replace the Code
Team, which responds to client arrests, it intervenes rapidly for those who are beginning to decline
clinically. It would be appropriate for the RRT to intervene when the client has experienced a 52-
point drop in blood pressure. Monitoring the client’s postoperative status, maintaining a
postoperative flow sheet, and notifying the physician of a change in the client’s status after a
medication change would not be considered activities of the Rapid Response Team.
DIF: Cognitive Level: Comprehension/Understanding REF: pp. 2-3
TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Collaboration with
Interdisciplinary Team)
MSC: Integrated Process: Nursing Process (Assessment)
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2. The Joint Commission focuses on safety in health care. Which action by the nurse reflects The
Joint Commission’s main objective?
a. Performing range-of-motion exercises on the client three times each day
b. Ensuring that the client is eating 100% of the meals served to him or
her
c. Assessing the client’s respirations when administering opioids
d. Delegating to the nursing assistant to give the client a complete bath
daily
ANS: C
It is important for the nurse to assess respirations of the client when administering opioids because
of the possibility of respiratory depression. The other interventions may or may not be necessary in
the care of the client and do not focus on safety.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control)
MSC: Integrated Process: Nursing Process (Assessment)
3. Which oaction oby othe onurse oshows oan ounderstanding oof othe oprinciple oof oself-determination?
a. Allowing oa opostoperative oclient oto odecide oto otake omedication owith
ofruitojuice orather othan owater
b. Allowing oa oteenager oto odecide onot oto ogo oto oa oclinic owhen
othere oisoevidence othat oshe ois ohaving oprofuse ovaginal
obleeding
c. Allowing oa oparent oto odecide onot oto oproceed owith oa olifesaving
ooperationofor oa o12-year-old oclient
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d. Allowing oan oolder oclient owith odementia oto odecide onot oto otake
ocardiacomedication othroughout othe oshift
ANS: oA
Respect ofor opeople ois oone oof othree obasic oethical oprinciples othat onurses oand oother ohealth ocare
oprofessionals oshould ouse oas oa obasis ofor oclinical odecision omaking. oRespect oimplies othat oclients
oare otreated oas oautonomous oindividuals ocapable oof omaking oinformed odecisions oabout otheir
ocare. oThis oclient oautonomy ois oreferred oto oas oself-determination, oor oself-management, oand ois
obest oillustrated obyoallowing oa oclient oto odecide oto otake omedication owith ofruit ojuice orather othan
owater. oThe oother oanswer ochoices owould onot oillustrate oself-determination oappropriately oand
omight opossibly oendanger othe oclient’s olife.
DIF: oCognitive oLevel: oApplication/Applying oor ohigher oREF: oN/A
TOP: oClient oNeeds oCategory: oSafe oand oEffective oCare oEnvironment o(Management oof oCare—Ethical
oPractice)oMSC: oIntegrated oProcess: oNursing oProcess o(Assessment)
4. The onurse ois oinitiating oa oseries oof oteaching osessions owith oan oolder oclient. oWhat ois othe
nurse’sohighest-priority, oclient-centered oaction obefore obeginning othe osession?
o
a. Ensure othat othe oclient’s ofamily ois opresent oand owill oparticipate.
b. Make ocertain othat othe oclient ois owearing ohis oglasses.
c. Have oprinted ohandouts oready oto ouse oduring othe osession.
d. Schedule othe osession ofor oearly oevening oafter othe oclient’s omeal.
ANS: oB
The omost oimportant oclient-centered oaction ois oto oensure othat othe oclient ois owearing ohis oor oher
oglasses. oThe oability oto osee oadequately owill ooutweigh othe oneed ofor ofamily opresence, ouse oof
oprinted ohandouts,oand ohunger o(or olack othereof).
DIF: oCognitive oLevel: oApplication/Applying oor ohigher oREF: oN/A
TOP: oClient oNeeds oCategory: oHealth oPromotion oand oMaintenance o(Principles oof oTeaching/Learning)
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