STUDY GUIDE
B B
Davis Advantage for Understanding
B B B B
Medical-Surgical Nursing 7th Edition
B B B B
By Hopper, Williams, All Chapter's 1 - 57
B B B B B B B B
1
,(Davis Advantage for Understanding Medical-Surgical Nursing, 7e Linda Williams, Paula Hopper)
B B B B B B B B B B
Answers
CHAPTER 1 B
to collect appropriate data, identify a patient problem, and
B B
determine the best possible plan of action. Clinicaljudgment is
B B B B B B
CRITICAL THINKING,
B B B B B B B B B B
B
based on good critical thinking.
B B B B B
CLINICAL JUDGMENT, ANDTHE B B B
Cue
B
NURSING PROCESS
B B
Definition: Significant or relevant data. Not all data are
B B B B B B B B
cues (relevant), but all cues are data.
B B B B B B
AUDIO CASE STUDY B B
Collaboration
Jane Practices Clinical Judgment
B B B
Definition: Working together with the health team B B B B B B
toimprove patient outcomes.
B B B B
1. Identify and analyze cues; prioritize hypotheses;
B B B B B
generatesolutions; take action; evaluate outcomes; repeat.
B B B B B B B
Intervention
2. Jane was exhausted, failed a test, and was pulled in too many
B B B B B B B B B B B Definition: Taking action to carry out a plan. B B B B B B B
directions. She was also crying in her car and hadpoor study
Evaluation
B B B B B B B B B B B B
habits and not enough sleep.
B B B B B
3. Jane’s resources included a good friend, sick time fromwork,
B B B B B B B B B
Definition: Comparing the outcomes you expected withactual
B B B B B B B
and wasted time between classes that she could better utilize.
B B B B B B B B B B
outcomes. Did the plan work? Were expected outcomes
B B B B B B B B
Your resources will be different, but theyexist!
B B B B B B B B
met?
B
4. Critical thinking—the why: Jane uses critical thinking to
B B B B B B B Vigilance
determine why her current plan isn’t working. She thinks
B B B B B B B B B
Definition: The act of being attentive, alert, and watchful.
B B B B B B B B
honestly about her poor study habits, her time- management
B B B B B B B B B
problems, and the impact this is having onher and her family.
B B B B B B B B B B B B
CRITICAL THINKING AND CLINICALJUDGMENT B B B B
Clinical judgment—the do: Jane uses her thinking to develop and
B B B B B B B B B
carry out a plan that uses her resources and provides more
B B B B B B B B B B B
Critical thinking and clinical judgment both follow a similar format.
B B B B B B B B B
productive study time and more quality time with her kids.
B B B B B B B B B B
Both follow steps from collecting data to determin- ing problems
B B B B B B B B B B
and outcomes, developing and taking actions, and evaluating
B B B B B B B B
VOCABULARY outcomes. However, critical thinking helps you think about the
B B B B B B B B B
problem: What is it? Why is it happen- ing? And clinical judgment
B B B B B B B B B B B B
Sample sentences will vary for the Vocabulary problems.
B B B B B B B
leads you to do something to manage the problem.
B B B B B B B B B
Nursing process B
Definition: An organizing framework that links thinking with
B B B B B B B
CUE RECOGNITION B
nursing actions. Steps include assessment/data collection,
B B B B B B You will do many things for each individual, but the FIRST thing is listed
B B B B B B B B B B B B B
nursing diagnosis, planning, implementation,and evaluation.
B B B B B B below.
B
Critical thinking B
1. Sit the patient upright.
B B B
Definition: The use of those cognitive (knowledge) skills or
B B B B B B B B 2. Call 911 while running across the street.
B B B B B B
strategies that increase the probability of a desirable outcome.
B B B B B B B B B
3. Elevate the feet off the bed by placing a pillow under thecalves
B B B B B B B B B B B B
Also involves reflection, problem-solving, andrelated thinking
B B B B B B B
and allowing the feet to hang off the edge of the pillow.
B B B B B B B B B B B B
skills.
B
4. Check blood glucose and have a glucose source ready.
B B B B B B B B
Clinical judgment B
5. Turn the patient to the side to prevent aspiration.
B B B B B B B B
Definition: The observed outcome of critical thinking and decision
B B B B B B B B
making. A process that uses nursing knowledge
B B B B B B B
,2 Chapter 1 B Answers
CRITICAL THINKING B
This is just one possible way to complete a cognitive map.
B B B B B B B B B B
Could it be low B B B Am I diabetic? B B Frontal area B "Sick" feeling
B Hard Tylenol helps B Hunger makes B
blood sugar? B it worse B
Patient's Where is it? B B Quality Aggravating and
perception
B
alleviating factors B
Food helps B
Headache
Useful other B Severity Timing
data
Sometimes Mother is B
7–8 on 0–10 Lasts 1–2 hours Before meals B Early in the B B
feel
B B B B
B
diabetic scale once starts morning
sick to stomach
B
B B
REVIEW QUESTIONS B taking vital signs; data collection is the first step in the nursing
B B B B B B B B B B B
process. (2, 3, 4) are all steps in the nursing process, for which
The correct answers are in boldface.
B B B B B B B B B B B B B
the registered nurse is responsible; the LPN/LVN may assist
B B B B B
B B B B B B B B B
1. (2) Critical thinking can lead to better outcomes for the patient.
B B B B B B B B B B the registered nurse with these. Nitroglycerin should not be
B B B B B B B B B
(1, 3, 4) may be true but are not the best answer.
B B B B B B B B B B B B administered withoutfirst knowing the patient’s blood
B B B B B B B
2. (4) is correct. The nurse who can admit to not
B B B B B B B B B
pressure.
B
knowing something is exhibiting intellectual humility. (1)
B B B B B B B 7. (2) indicates that the patient is concerned about freedomfrom
B B B B B B B B B
showsexpertise but not necessarily intellectual humility;
B B B B B B B injury and harm. (1) relates to basic needs such as air, oxygen,
B B B B B B B B B B B B
(2) reporting an error shows intellectual integrity; B B B B B
and water. (3) relates to feeling loved. (4) isrelated to having
B B B B B B B B B B B B
(3) empathizing is positive but does is not evidence of B B B B B B B B
positive self-esteem.
B B
humility.
B
8. (3, 1, 2, 4) is the correct order according to Maslow.
B B B B B B B B B B
3. (3, 4, 5, 1, 2) is the correct order.
B B B B B B B B
9. (5, 2, 1, 4, 6, 3) is the correct order.
B B B B B B B B B
4. (1) is the best definition. (2, 3, 4) do not define
B B B B B B B B B B
10. (3) shows the patient is actually taking action. (1, 2, 4)are all
B B B B B B B B B B B B
criticalthinking but are examples of good thinking.
B B B B B B B B
positive but do not show intent to take action.
B B B B B B B B B
5. (4) is correct. Evaluation determines whether goals are achieved
B B B B B B B B
11. (4) is the nurse’s analysis of the situation. (1, 2) aredata; (3)
B B B B B B B B B B B B
and interventions effective. (2) is the role of thephysician. (1, 3)
B B B B B B B B B B B B
is a recommendation.
B B B
encompass data collection and imple- mentation, which are
B B B B B B B B 12. (1, 2, 3, 4) should be present. Since the data providesonly hip
B B B B B B B B B B B B
earlier steps in the nursing process.
B B B B B B replacement as the patient’s problem, (5) the dietitian is not
B B B B B B B B B B
6. (1) is correct. The licensed practical nurse/licensed voca-tional
B B B B B B B B
necessary.
B
nurse (LPN/LVN) can collect data, which includes
B B B B B B B
1
, Answers
CHAPTER 2 B
EVIDENCE-BASED B PRACTICE
EVIDENCE-BASED PRACTICE B
1. proof
2. context
AUDIO CASE STUDY B B
3. quality
4. care
Marie and Evidence-Based Practice
B B B
5. randomized
1. Thirdhand smoke is the dangerous toxins of smoke thatlinger B B B B B B B B B
6. outcomes
on hair, clothing, furniture, and other surfaces inan area after a
B B B B B B B B B B B B 7. gold
cigarette is put out. Marie learned that exposure to these
B B B B B B B B B B 8. nursing
toxins can be neurotoxic to children and can trigger asthma
B B B B B B B B B B
9. patient’s
attacks in sensitive people.
B B B B
10. information
2. Evidence-based practice is considered the gold standardof B B B B B B B
health care.
B B CLINICAL JUDGMENT B
3. Step 1: Ask the burning question. Step 2: Search and collect
B B B B B B B B B B
the most relevant and best evidence available.Step 3: Think
B B B B B B B B B B
1. By questioning the existing way of doing things to ensure
B B B B B B B B B
critically. Appraise the evidence for validity, relevance to the
B B B B B B B B B
that the patient receives the best care possible
B B B B B B B B
situation, and applicability.
B B B
2. A thorough search of the literature, with the assistance ofthe
B B B B B B B B B B
Step 4: Measure the outcomes before and after institutingthe
B B B B B B B B B
medical librarian, in the area of their burning ques- tion
B B B B B B B B B B
change. Step 5: Make it happen. Step 6: Evaluate the practice
B B B B B B B B B B B
regarding music reducing preoperative anxiety.
B B B B B
decision or change.
B B B
3. Cumulative Index to Nursing and Allied Health Literature B B B B B B B
4. Combination therapy with a nicotine patch and nicotine lozenges B B B B B B B B
(CINAHL) Database, Joanna Briggs Instituteevidence-based
B B B B B B
worked best, although bupropion (Zyban) or varenicline
B B B B B B B
resources, Cochrane Reviews, Medline/PubMed
B B B B B
(Chantix) and nicotine lozenges worked well,too. A Cochrane
B B B B B B B B B
4. Measure patient outcomes before instituting the evidence-
B B B B B B
Review found that advice and support from nursing staff can
B B B B B B B B B B
based change in practice so comparisons canbe made after
B B B B B B B B B
increase patients’ success in quit- ting smoking, especially in a
B B B B B B B B B B
implementation to determine if the inter-vention worked
B B B B B B B B
hospital setting.
B B
5. Evaluate the results to determine whether the changemade a
B B B B B B B B B
significant difference and if it was valuable interms of cost and
B B B B B B B B B B B B
VOCABULARY time
B
Sample sentences will vary for the Vocabulary problems.
B B B B B B B
REVIEW QUESTIONS B
1. Evidence-based practice: A systematic process that usescurrent B B B B B B B
The correct answers are in boldface.
B B B B B
evidence in making decisions about patient care.
B B B B B B B
2. Evidence-informed practice: Consideration of patient factors B B B B B
1. (3) is correct. Providing an explanation of why some- thing is
B B B B B B B B B B
along with the use of evidence for shared decisionmaking
B B B B B B B B B B
done promotes the understanding for why it is important to be
B B B B B B B B B B B
between the health-care provider and the patient.
B B B B B B B
done and therefore will more likely be done. (1, 2, 4) only
B B B B B B B B B B B B
3. Randomized controlled trials: True experimental studiesin B B B B B B
communicate the need to perform atask. They do not provide
B B B B B B B B B B B
which as many factors as possible that could falsely change the
B B B B B B B B B B B
rationale for the task to pro- mote understanding of the
B B B B B B B B B B
results are controlled.
B B B
importance of the task.
B B B B
4. Research: Scientific study, investigation, or experimenta-tion to
B B B B B B B
2. (3) is correct. Evidence-based nursing care that has been
B B B B B B B B
establish facts and analyze their significance.
B B B B B B
evaluated as appropriate for an agency provides the best and
B B B B B B B B B B
5. Systematic review: A review of relevant research B B B B B B
safest patient care. (1) Opinions may not be based on
B B B B B B B B B B
usingguidelines.
B B
B B
Davis Advantage for Understanding
B B B B
Medical-Surgical Nursing 7th Edition
B B B B
By Hopper, Williams, All Chapter's 1 - 57
B B B B B B B B
1
,(Davis Advantage for Understanding Medical-Surgical Nursing, 7e Linda Williams, Paula Hopper)
B B B B B B B B B B
Answers
CHAPTER 1 B
to collect appropriate data, identify a patient problem, and
B B
determine the best possible plan of action. Clinicaljudgment is
B B B B B B
CRITICAL THINKING,
B B B B B B B B B B
B
based on good critical thinking.
B B B B B
CLINICAL JUDGMENT, ANDTHE B B B
Cue
B
NURSING PROCESS
B B
Definition: Significant or relevant data. Not all data are
B B B B B B B B
cues (relevant), but all cues are data.
B B B B B B
AUDIO CASE STUDY B B
Collaboration
Jane Practices Clinical Judgment
B B B
Definition: Working together with the health team B B B B B B
toimprove patient outcomes.
B B B B
1. Identify and analyze cues; prioritize hypotheses;
B B B B B
generatesolutions; take action; evaluate outcomes; repeat.
B B B B B B B
Intervention
2. Jane was exhausted, failed a test, and was pulled in too many
B B B B B B B B B B B Definition: Taking action to carry out a plan. B B B B B B B
directions. She was also crying in her car and hadpoor study
Evaluation
B B B B B B B B B B B B
habits and not enough sleep.
B B B B B
3. Jane’s resources included a good friend, sick time fromwork,
B B B B B B B B B
Definition: Comparing the outcomes you expected withactual
B B B B B B B
and wasted time between classes that she could better utilize.
B B B B B B B B B B
outcomes. Did the plan work? Were expected outcomes
B B B B B B B B
Your resources will be different, but theyexist!
B B B B B B B B
met?
B
4. Critical thinking—the why: Jane uses critical thinking to
B B B B B B B Vigilance
determine why her current plan isn’t working. She thinks
B B B B B B B B B
Definition: The act of being attentive, alert, and watchful.
B B B B B B B B
honestly about her poor study habits, her time- management
B B B B B B B B B
problems, and the impact this is having onher and her family.
B B B B B B B B B B B B
CRITICAL THINKING AND CLINICALJUDGMENT B B B B
Clinical judgment—the do: Jane uses her thinking to develop and
B B B B B B B B B
carry out a plan that uses her resources and provides more
B B B B B B B B B B B
Critical thinking and clinical judgment both follow a similar format.
B B B B B B B B B
productive study time and more quality time with her kids.
B B B B B B B B B B
Both follow steps from collecting data to determin- ing problems
B B B B B B B B B B
and outcomes, developing and taking actions, and evaluating
B B B B B B B B
VOCABULARY outcomes. However, critical thinking helps you think about the
B B B B B B B B B
problem: What is it? Why is it happen- ing? And clinical judgment
B B B B B B B B B B B B
Sample sentences will vary for the Vocabulary problems.
B B B B B B B
leads you to do something to manage the problem.
B B B B B B B B B
Nursing process B
Definition: An organizing framework that links thinking with
B B B B B B B
CUE RECOGNITION B
nursing actions. Steps include assessment/data collection,
B B B B B B You will do many things for each individual, but the FIRST thing is listed
B B B B B B B B B B B B B
nursing diagnosis, planning, implementation,and evaluation.
B B B B B B below.
B
Critical thinking B
1. Sit the patient upright.
B B B
Definition: The use of those cognitive (knowledge) skills or
B B B B B B B B 2. Call 911 while running across the street.
B B B B B B
strategies that increase the probability of a desirable outcome.
B B B B B B B B B
3. Elevate the feet off the bed by placing a pillow under thecalves
B B B B B B B B B B B B
Also involves reflection, problem-solving, andrelated thinking
B B B B B B B
and allowing the feet to hang off the edge of the pillow.
B B B B B B B B B B B B
skills.
B
4. Check blood glucose and have a glucose source ready.
B B B B B B B B
Clinical judgment B
5. Turn the patient to the side to prevent aspiration.
B B B B B B B B
Definition: The observed outcome of critical thinking and decision
B B B B B B B B
making. A process that uses nursing knowledge
B B B B B B B
,2 Chapter 1 B Answers
CRITICAL THINKING B
This is just one possible way to complete a cognitive map.
B B B B B B B B B B
Could it be low B B B Am I diabetic? B B Frontal area B "Sick" feeling
B Hard Tylenol helps B Hunger makes B
blood sugar? B it worse B
Patient's Where is it? B B Quality Aggravating and
perception
B
alleviating factors B
Food helps B
Headache
Useful other B Severity Timing
data
Sometimes Mother is B
7–8 on 0–10 Lasts 1–2 hours Before meals B Early in the B B
feel
B B B B
B
diabetic scale once starts morning
sick to stomach
B
B B
REVIEW QUESTIONS B taking vital signs; data collection is the first step in the nursing
B B B B B B B B B B B
process. (2, 3, 4) are all steps in the nursing process, for which
The correct answers are in boldface.
B B B B B B B B B B B B B
the registered nurse is responsible; the LPN/LVN may assist
B B B B B
B B B B B B B B B
1. (2) Critical thinking can lead to better outcomes for the patient.
B B B B B B B B B B the registered nurse with these. Nitroglycerin should not be
B B B B B B B B B
(1, 3, 4) may be true but are not the best answer.
B B B B B B B B B B B B administered withoutfirst knowing the patient’s blood
B B B B B B B
2. (4) is correct. The nurse who can admit to not
B B B B B B B B B
pressure.
B
knowing something is exhibiting intellectual humility. (1)
B B B B B B B 7. (2) indicates that the patient is concerned about freedomfrom
B B B B B B B B B
showsexpertise but not necessarily intellectual humility;
B B B B B B B injury and harm. (1) relates to basic needs such as air, oxygen,
B B B B B B B B B B B B
(2) reporting an error shows intellectual integrity; B B B B B
and water. (3) relates to feeling loved. (4) isrelated to having
B B B B B B B B B B B B
(3) empathizing is positive but does is not evidence of B B B B B B B B
positive self-esteem.
B B
humility.
B
8. (3, 1, 2, 4) is the correct order according to Maslow.
B B B B B B B B B B
3. (3, 4, 5, 1, 2) is the correct order.
B B B B B B B B
9. (5, 2, 1, 4, 6, 3) is the correct order.
B B B B B B B B B
4. (1) is the best definition. (2, 3, 4) do not define
B B B B B B B B B B
10. (3) shows the patient is actually taking action. (1, 2, 4)are all
B B B B B B B B B B B B
criticalthinking but are examples of good thinking.
B B B B B B B B
positive but do not show intent to take action.
B B B B B B B B B
5. (4) is correct. Evaluation determines whether goals are achieved
B B B B B B B B
11. (4) is the nurse’s analysis of the situation. (1, 2) aredata; (3)
B B B B B B B B B B B B
and interventions effective. (2) is the role of thephysician. (1, 3)
B B B B B B B B B B B B
is a recommendation.
B B B
encompass data collection and imple- mentation, which are
B B B B B B B B 12. (1, 2, 3, 4) should be present. Since the data providesonly hip
B B B B B B B B B B B B
earlier steps in the nursing process.
B B B B B B replacement as the patient’s problem, (5) the dietitian is not
B B B B B B B B B B
6. (1) is correct. The licensed practical nurse/licensed voca-tional
B B B B B B B B
necessary.
B
nurse (LPN/LVN) can collect data, which includes
B B B B B B B
1
, Answers
CHAPTER 2 B
EVIDENCE-BASED B PRACTICE
EVIDENCE-BASED PRACTICE B
1. proof
2. context
AUDIO CASE STUDY B B
3. quality
4. care
Marie and Evidence-Based Practice
B B B
5. randomized
1. Thirdhand smoke is the dangerous toxins of smoke thatlinger B B B B B B B B B
6. outcomes
on hair, clothing, furniture, and other surfaces inan area after a
B B B B B B B B B B B B 7. gold
cigarette is put out. Marie learned that exposure to these
B B B B B B B B B B 8. nursing
toxins can be neurotoxic to children and can trigger asthma
B B B B B B B B B B
9. patient’s
attacks in sensitive people.
B B B B
10. information
2. Evidence-based practice is considered the gold standardof B B B B B B B
health care.
B B CLINICAL JUDGMENT B
3. Step 1: Ask the burning question. Step 2: Search and collect
B B B B B B B B B B
the most relevant and best evidence available.Step 3: Think
B B B B B B B B B B
1. By questioning the existing way of doing things to ensure
B B B B B B B B B
critically. Appraise the evidence for validity, relevance to the
B B B B B B B B B
that the patient receives the best care possible
B B B B B B B B
situation, and applicability.
B B B
2. A thorough search of the literature, with the assistance ofthe
B B B B B B B B B B
Step 4: Measure the outcomes before and after institutingthe
B B B B B B B B B
medical librarian, in the area of their burning ques- tion
B B B B B B B B B B
change. Step 5: Make it happen. Step 6: Evaluate the practice
B B B B B B B B B B B
regarding music reducing preoperative anxiety.
B B B B B
decision or change.
B B B
3. Cumulative Index to Nursing and Allied Health Literature B B B B B B B
4. Combination therapy with a nicotine patch and nicotine lozenges B B B B B B B B
(CINAHL) Database, Joanna Briggs Instituteevidence-based
B B B B B B
worked best, although bupropion (Zyban) or varenicline
B B B B B B B
resources, Cochrane Reviews, Medline/PubMed
B B B B B
(Chantix) and nicotine lozenges worked well,too. A Cochrane
B B B B B B B B B
4. Measure patient outcomes before instituting the evidence-
B B B B B B
Review found that advice and support from nursing staff can
B B B B B B B B B B
based change in practice so comparisons canbe made after
B B B B B B B B B
increase patients’ success in quit- ting smoking, especially in a
B B B B B B B B B B
implementation to determine if the inter-vention worked
B B B B B B B B
hospital setting.
B B
5. Evaluate the results to determine whether the changemade a
B B B B B B B B B
significant difference and if it was valuable interms of cost and
B B B B B B B B B B B B
VOCABULARY time
B
Sample sentences will vary for the Vocabulary problems.
B B B B B B B
REVIEW QUESTIONS B
1. Evidence-based practice: A systematic process that usescurrent B B B B B B B
The correct answers are in boldface.
B B B B B
evidence in making decisions about patient care.
B B B B B B B
2. Evidence-informed practice: Consideration of patient factors B B B B B
1. (3) is correct. Providing an explanation of why some- thing is
B B B B B B B B B B
along with the use of evidence for shared decisionmaking
B B B B B B B B B B
done promotes the understanding for why it is important to be
B B B B B B B B B B B
between the health-care provider and the patient.
B B B B B B B
done and therefore will more likely be done. (1, 2, 4) only
B B B B B B B B B B B B
3. Randomized controlled trials: True experimental studiesin B B B B B B
communicate the need to perform atask. They do not provide
B B B B B B B B B B B
which as many factors as possible that could falsely change the
B B B B B B B B B B B
rationale for the task to pro- mote understanding of the
B B B B B B B B B B
results are controlled.
B B B
importance of the task.
B B B B
4. Research: Scientific study, investigation, or experimenta-tion to
B B B B B B B
2. (3) is correct. Evidence-based nursing care that has been
B B B B B B B B
establish facts and analyze their significance.
B B B B B B
evaluated as appropriate for an agency provides the best and
B B B B B B B B B B
5. Systematic review: A review of relevant research B B B B B B
safest patient care. (1) Opinions may not be based on
B B B B B B B B B B
usingguidelines.
B B
