TEST BANK For Medical-Surgical Nursing
m m m m m
10th Edition Concepts for Interprofessional
m m m m
m Collaborative Care, by Donna D. Ignatavicius,
m m m m m m
All chapters 1 – 69
m m m m
,Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
m m m m m m m m m
m Ignatavicius: Medical-Surgical Nursing, 10th Edition
m m m m
MULTIPLE CHOICE m
1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises the
m m m m m m m m m m m m m m m
m new nurse that which is the priority when working as a professional nurse?
m m m m m m m m m m m m
a. Attending to holistic client needs m m m m
b. Ensuring client safety m m
c. Not making medication errors m m m
d. Providing client-focused care m m
CORRECT ANSWER: B m m
All actions are appropriate for the professional nurse. However, ensuring client safety is the
m m m m m m m m m m m m m
m priority. Health care errors have been widely reported for 25 years, many of which result in
m m m m m m m m m m m m m m m
m client injury, death, and increased health care costs. There are several national and
m m m m m m m m m m m m
m international organizations that have either recommended or mandated safety initiatives.
m m m m m m m m m
Every nurse has the responsibility to guard the client’s safety. The other actions are important
m m m m m m m m m m m m m m
m for quality nursing, but they are not as vital as providing safety. Not making medication errors
m m m m m m m m m m m m m m m
m does provide safety, but is too narrow in scope to be the best answer.
m m m m m m m m m m m m m
DIF: Understanding TOP: Integrated Process: Nursing Process: Intervention
m m m m m
m KEY: Client safety
m m
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
m m m m m m m m m m m m
2. A nurse is orienting a new client and family to the medical-surgical unit. What information
m m m m m m m m m m m m m m
m does the nurse provide to best help the client promote his or her own safety?
m m m m m m m m m m m m m m
a. Encourage the client and family to be active partners. m m m m m m m m
b. Have the client monitor hand hygiene in caregivers.
m m m m m m m
c. Offer the family the opportunity to stay with the client.
m m m m m m m m m
d. Tell the client to always wear his or her armband.
m m m m m m m m m
CORRECT ANSWER: A m m
Each action could be important for the client or family to perform. However, encouraging the
m m m m m m m m m m m m m m
m client to be active in his or her health care as a safety partner is the most critical. The other
m m m m m m m m m m m m m m m m m m m
, m actions are very limited in scope and do not provide the broad protection that being active and
m m m m m m m m m m m m m m m m
m involved does. m
DIF: Understanding TOP: Integrated Process: Teaching/Learning
m m m
m KEY: Client safety
m m
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
m m m m m m m m m m m m
3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
m m m m m m m m m m m m m m m
m was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nurse
m m m m m m m m m m m m m m m m m
m take first?
m
a. Call the Rapid Response Team.
m m m m
b. Document and continue to monitor. m m m m
c. Notify the primary health care provider.
m m m m m
d. Repeat the blood pressure in 15 minutes.
m m m m m m
, CORRECT ANSWER: A m m
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
m m m m m m m m m m m m m m
m before they suffer either respiratory or cardiac arrest. Since the client has manifested a
m m m m m m m m m m m m m
m significant change, the nurse would call the RRT. Changes in blood pressure, mental status,
m m m m m m m m m m m m m
m heart rate, temperature, oxygen saturation, and last 2 hours’ urine output are particularly
m m m m m m m m m m m m
m significant and are part of the Modified Early Warning System guide. Documentation is vital,
m m m m m m m m m m m m m
m but the nurse must do more than document. The primary health care provider would be
m m m m m m m m m m m m m m
m notified, but this is not more important than calling the RRT. The client’s blood pressure would
m m m m m m m m m m m m m m m
m be reassessed frequently, but the priority is getting the rapid care to the client.
m m m m m m m m m m m m m
DIF: Applying TOP: Integrated Process: Communication and Documentation
m m m m m
m KEY: Rapid Response Team (RRT), Clinical judgment
m m m m m m
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
m m m m m m m
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
m m m m m m m m m m m m m m
best demonstrates this concept?
m m m
a. Assesses for cultural influences affecting health care. m m m m m m
b. Ensures that all the client’s basic needs are met. m m m m m m m m
c. Tells the client and family about all upcoming tests.
m m m m m m m m
d. Thoroughly orients the client and family to the room. m m m m m m m m
CORRECT ANSWER: A m m
Showing respect for the client and family’s preferences and needs is essential to ensure a
m m m m m m m m m m m m m m
m holistic or “whole-person” approach to care. By assessing the effect of the client’s culture on
m m m m m m m m m m m m m m
m health care, this nurse is practicing client-focused care. Providing for basic needs does not
m m m m m m m m m m m m m
m demonstrate this competence. Simply telling the client about all upcoming tests is not
m m m m m m m m m m m m
m providing empowering education. Orienting the client and family to the room is an important
m m m m m m m m m m m m m
m safety measure, but not directly related to demonstrating client-centered care.
m m m m m m m m m
DIF: Understanding TOP: Integrated Process: Culture and Spirituality KEY:
m m m m m m
m Client-centered care, Culture m m MSC: Client Needs Category: Psychosocial Integrity
m m m m m
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
m m m m m m m m m m m m m m m
m nurse explain is the most important thing the client can do to protect against errors?
m m m m m m m m m m m m m m
a. Bring a list of all medications and what they are for.
m m m m m m m m m m
b. Keep the provider’s phone number by the telephone.
m m m m m m m
c. Make sure that all providers wash hands before entering the room.
m m m m m m m m m m
d. Write down the name of each caregiver who comes in the room.
m m m m m m m m m m m
m m m m m
10th Edition Concepts for Interprofessional
m m m m
m Collaborative Care, by Donna D. Ignatavicius,
m m m m m m
All chapters 1 – 69
m m m m
,Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
m m m m m m m m m
m Ignatavicius: Medical-Surgical Nursing, 10th Edition
m m m m
MULTIPLE CHOICE m
1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises the
m m m m m m m m m m m m m m m
m new nurse that which is the priority when working as a professional nurse?
m m m m m m m m m m m m
a. Attending to holistic client needs m m m m
b. Ensuring client safety m m
c. Not making medication errors m m m
d. Providing client-focused care m m
CORRECT ANSWER: B m m
All actions are appropriate for the professional nurse. However, ensuring client safety is the
m m m m m m m m m m m m m
m priority. Health care errors have been widely reported for 25 years, many of which result in
m m m m m m m m m m m m m m m
m client injury, death, and increased health care costs. There are several national and
m m m m m m m m m m m m
m international organizations that have either recommended or mandated safety initiatives.
m m m m m m m m m
Every nurse has the responsibility to guard the client’s safety. The other actions are important
m m m m m m m m m m m m m m
m for quality nursing, but they are not as vital as providing safety. Not making medication errors
m m m m m m m m m m m m m m m
m does provide safety, but is too narrow in scope to be the best answer.
m m m m m m m m m m m m m
DIF: Understanding TOP: Integrated Process: Nursing Process: Intervention
m m m m m
m KEY: Client safety
m m
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
m m m m m m m m m m m m
2. A nurse is orienting a new client and family to the medical-surgical unit. What information
m m m m m m m m m m m m m m
m does the nurse provide to best help the client promote his or her own safety?
m m m m m m m m m m m m m m
a. Encourage the client and family to be active partners. m m m m m m m m
b. Have the client monitor hand hygiene in caregivers.
m m m m m m m
c. Offer the family the opportunity to stay with the client.
m m m m m m m m m
d. Tell the client to always wear his or her armband.
m m m m m m m m m
CORRECT ANSWER: A m m
Each action could be important for the client or family to perform. However, encouraging the
m m m m m m m m m m m m m m
m client to be active in his or her health care as a safety partner is the most critical. The other
m m m m m m m m m m m m m m m m m m m
, m actions are very limited in scope and do not provide the broad protection that being active and
m m m m m m m m m m m m m m m m
m involved does. m
DIF: Understanding TOP: Integrated Process: Teaching/Learning
m m m
m KEY: Client safety
m m
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
m m m m m m m m m m m m
3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
m m m m m m m m m m m m m m m
m was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nurse
m m m m m m m m m m m m m m m m m
m take first?
m
a. Call the Rapid Response Team.
m m m m
b. Document and continue to monitor. m m m m
c. Notify the primary health care provider.
m m m m m
d. Repeat the blood pressure in 15 minutes.
m m m m m m
, CORRECT ANSWER: A m m
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
m m m m m m m m m m m m m m
m before they suffer either respiratory or cardiac arrest. Since the client has manifested a
m m m m m m m m m m m m m
m significant change, the nurse would call the RRT. Changes in blood pressure, mental status,
m m m m m m m m m m m m m
m heart rate, temperature, oxygen saturation, and last 2 hours’ urine output are particularly
m m m m m m m m m m m m
m significant and are part of the Modified Early Warning System guide. Documentation is vital,
m m m m m m m m m m m m m
m but the nurse must do more than document. The primary health care provider would be
m m m m m m m m m m m m m m
m notified, but this is not more important than calling the RRT. The client’s blood pressure would
m m m m m m m m m m m m m m m
m be reassessed frequently, but the priority is getting the rapid care to the client.
m m m m m m m m m m m m m
DIF: Applying TOP: Integrated Process: Communication and Documentation
m m m m m
m KEY: Rapid Response Team (RRT), Clinical judgment
m m m m m m
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
m m m m m m m
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
m m m m m m m m m m m m m m
best demonstrates this concept?
m m m
a. Assesses for cultural influences affecting health care. m m m m m m
b. Ensures that all the client’s basic needs are met. m m m m m m m m
c. Tells the client and family about all upcoming tests.
m m m m m m m m
d. Thoroughly orients the client and family to the room. m m m m m m m m
CORRECT ANSWER: A m m
Showing respect for the client and family’s preferences and needs is essential to ensure a
m m m m m m m m m m m m m m
m holistic or “whole-person” approach to care. By assessing the effect of the client’s culture on
m m m m m m m m m m m m m m
m health care, this nurse is practicing client-focused care. Providing for basic needs does not
m m m m m m m m m m m m m
m demonstrate this competence. Simply telling the client about all upcoming tests is not
m m m m m m m m m m m m
m providing empowering education. Orienting the client and family to the room is an important
m m m m m m m m m m m m m
m safety measure, but not directly related to demonstrating client-centered care.
m m m m m m m m m
DIF: Understanding TOP: Integrated Process: Culture and Spirituality KEY:
m m m m m m
m Client-centered care, Culture m m MSC: Client Needs Category: Psychosocial Integrity
m m m m m
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
m m m m m m m m m m m m m m m
m nurse explain is the most important thing the client can do to protect against errors?
m m m m m m m m m m m m m m
a. Bring a list of all medications and what they are for.
m m m m m m m m m m
b. Keep the provider’s phone number by the telephone.
m m m m m m m
c. Make sure that all providers wash hands before entering the room.
m m m m m m m m m m
d. Write down the name of each caregiver who comes in the room.
m m m m m m m m m m m