TEST BANK Lewis's Medical Surgical Nursing in Canada, 4th Edition by Jane Tyerman, Shelley Cobbett Chapters 1 - 72 Complete

Medical-
Surgical Nursing in Canada 4th Edition Lewi Test Bank




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, Medical-
Surgical Nursing in Canada 4th Edition Lewi Test Bank
Chapter 01: Introduction to Medical-
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Surgical Nursing Practice in Canada Lewis: Medical-
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Surgical Nursing in Canada, 4th Canadian Edition
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MULTIPLE CHOICE Wi




1. When caring for clients using evidence-
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informed practice, which of the following does the nurse use?
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a. Clinical judgement based on experience Wi Wi Wi Wi


b. Evidence from a clinical research study Wi Wi Wi Wi Wi


c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the client outcomes are met
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ANS: W i C
Evidence-
informed nursing practice is a continuous interactive process involving the explicit, consc
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ientious, and judicious consideration of the best available evidence to provide care. Four p
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rimary elements are: (a) clinical state, setting, and circumstances; (b) client preferences a
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nd actions; (c) best research evidence; and (d) health care resources. Clinical judgement b
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ased on the nurse‘s clinical experience is part of EIP, but clinical decision making also s
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hould incorporate current research and research-
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based guidelines. Evidence from one clinical research study does not provide an adequate
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substantiation for interventions. Evaluation of client outcomes is important, but interventi
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ons should be based on research from randomized control studies with a large number of
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subjects.
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DIF: Cognitive Level: Comprehension Wi Wi TOP: W i Nursing Process: Planning Wi Wi




2. Which of the following best e x p l a i n s t h e n u r s e s ‘ primary use of the nursing process when
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providing care to clients Wi Wi Wi USNT O Wi Wi Wi


?
a. To explain nursing interventions to other health care professionals
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b. As a problem-solving tool to identify and treat clients‘ health care needs
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c. As a scientific-based process of diagnosing the client‘s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
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ANS: W i B
The nursing process is an assertive problem-
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solving approach to the identification and treatment of clients‘ problems. Diagnosis is onl
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y one phase of the nursing process. The
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primary use of the nursing process is in client care, not to establish nursing theory or exp
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lain nursing interventions to other health care professionals.
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DIF: Cognitive Level: Comprehension Wi Wi TOP: W i Nursing Process: Implementation
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3. The nurse is caring for a critically ill client in the intensive care unit and plans an every
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2-
hour turning schedule to prevent skin breakdown. Which type of nursing function is dem
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onstrated with this turning schedule?
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a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: W i D
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, Medical-
Surgical Nursing in Canada 4th Edition Lewi Test Bank
When implementing collaborative nursing actions, the nurse is responsible primarily for
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monitoring for complications of acute illness or providing care to prevent or treat compli
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cations. Independent nursing actions are focused on health promotion, illness prevention,
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and client advocacy. A dependent action would require a physician order to implement.
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Cooperative nursing functions are not described as one of the formal nursing functions.
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DIF: Cognitive Level: Application Wi Wi TOP: W i Nursing Process: ImplementationWi Wi




4. The nurse is caring for a client who has been admitted to the hospital for surgery and te
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lls the nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which
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action should the nurse take next?
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a. Reassure the client that these feelings are common for parents.
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b. Have the client call the children to ensure that they are doing well.
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c. Call the neighbour to determine whether adequate childcare is being provided.
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d. Gather more data about the client‘s feelings about the childcare arrangements.
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ANS: W i D
Since a complete assessment is necessary in order to identify a problem and choose an a
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ppropriate intervention, the nurse‘s first action should be to obtain more information. The
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other actions may be appropriate, but more assessment is needed before the best interven
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tion can be chosen.
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DIF: Cognitive Level: Application Wi Wi TOP: W i Nursing Process: Assessment Wi Wi




5. The nurse is caring for a client who has left-
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sided paralysis as the result of a stroke and assesses a pressure injury on t h e cl i e n t
N R I
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‘s l eft h i p . W hich of the following is the most
G B. C M
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appropriate nursing diagnosis fUo r t S
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a. Impaired physical mobility related to decrease in muscle control (left-
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sided paralysis) Wi


b. Risk for impaired tissue integrity as evidenced by insufficient knowledge ab
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out protecting tissue integrity
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c. Impaired skin integrity related to pressure over bony prominence (impai
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red circulation) Wi


d. Ineffective tissue perfusion related to sedentary lifestyle
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ANS: W i C
The client‘s major problem is the impaired skin integrity as demonstrated by the presence
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of a pressure injury. The nurse is able to treat the cause of altered circulation and press
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ure by frequently repositioning the client. Although left-
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sided weakness is a problem for the client,
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the nurse cannot treat the weakness. The ―risk for‖ diagnosis is not appropriate for this cl
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ient, who already has impaired tissue integrity. The client does have ineffective tissue pe
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rfusion, but the impaired skin integrity diagnosis indicates more clearly what the health p
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roblem is. Wi




DIF: Cognitive Level: Application Wi Wi TOP: W i Nursing Process: Diagnosis Wi Wi




6. The nurse caring for a client with an infection has a nursing diagnosis of deficient
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fluid volume related to excessive diaphoresis. Which of the following is an approp
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riate client outcome?
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a. Client has a balanced intake and output.
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b. Client‘s bedding is changed when it becomes damp.
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, Medical-
Surgical Nursing in Canada 4th Edition Lewi Test Bank
c. Client understands the need for increased fluid intake.
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d. Client‘s skin remains cool and dry throughout hospitalization.
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ANS: W i A
This statement gives measurable data showing resolution of the problem of deficient fluid
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volume that was identified in the nursing diagnosis statement. The other statements woul
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d not indicate that the problem of deficient fluid volume was resolved.
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DIF: Cognitive Level: Application Wi Wi TOP: W i Nursing Process: Planning Wi Wi




7. Which of the following represents a nursing activity that is carried out during the evalu
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ation phase of the nursing process?
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a. Determining if interventions have been effective in meeting client outcomes
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b. Documenting the nursing care plan in the progress notes in the medical record
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c. Deciding whether the client‘s health problems have been completely resolved
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d. Asking the client to evaluate whether the nursing care provided was satisfactory
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ANS: W i A
Evaluation consists of determining whether the desired client outcomes have been met an
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d whether the nursing interventions were appropriate. The other responses do not describe
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the evaluation phase.
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DIF: Cognitive Level: Comprehension Wi Wi TOP: W i Nursing Process: Evaluation Wi Wi




8. Which of the following would the nurse perform during the assessment phase of the nu
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rsing process? Wi


a. Obtains data with which to diagnose client problems
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b. Uses client data to develoNp pR
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U rior t y nGursB
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d iagMnoses
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c. Teaches interventions to relieve client health problems
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d. Assists the client to identify realistic outcomes to health problems
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ANS: W i A
During the assessment phase, the nurse gathers information about the client. The other re
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sponses are examples of the intervention, diagnosis, and planning phases of the nursing pr
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ocess.

DIF: Cognitive Level: Knowledge Wi Wi TOP: W i Nursing Process: Assessment Wi Wi




9. Which of the following is an example of a correctly written nursing diagnosis statement?
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a. Altered tissue perfusion related to heart failure
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b. Risk for impaired tissue integrity related to sacral redness
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c. Ineffective coping related to insufficient sense of control.
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d. Altered urinary elimination related to urinary tract infection
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ANS: W i C
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that descr
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ibes a client‘s response to a health problem that can be treated by nursing. The use of a
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medical diagnosis (as in the responses beginning ―Altered tissue perfusion‖ and ―Altere
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d urinary
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elimination‖) is not appropriate. The response beginning ―Risk for impaired tissue integrit
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y‖ uses the defining characteristics as the etiology.
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DIF: Cognitive Level: Comprehension Wi Wi TOP: W i Nursing Process: Diagnosis Wi Wi




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