!! !! !!
UNDERSTANDING
MEDICAL-SURGICAL
NURSING
5TH EDITION BY
!! !!
HOPPER ,WILLIAMS !!
,Chapter 1. Critical Thinking and the Nursing Process
!! !! !! !! !! !! !!
MULTIPLE !!CHOICE
1. The !!nurse !!is !!caring !!for !!a !!group !!of !!patients !!on !!a !!medical-surgical !!unit. !!Which !!patient
!!should !!the !!licensed !!practical !!nurse/licensed !!vocational !!nurse !!(LPN/LVN) !!assess
!!first?
1. A !!patient !!with !!a !!blood !!glucose !!of !!42 !!mg/dL
2. A !!patient !!who !!reports !!a !!pain !!level !!of !!2
3. A !!patient !!who !!has !!just !!received !!a !!diagnosis !!of !!cancer
4. A !!patient !!who !!has !!a !!respiratory !!rate !!of !!22
ANS: ! ! ! ! 1
Chapter: !!Chapter !!1 !!Critical !!Thinking !!and !!the !!Nursing !!Process
Objective: !!7. !!Prioritize !!patient !!care !!activities !!based !!on !!the !!Maslow !!hierarchy !!of
!!human !!needs.
Pages: !!6–7
Heading: !!Prioritize !!Care
Integrated !!Process: !!Clinical !!Problem-Solving !!Process !!(Nursing !!Process)
!!Client !!Need: !!SECE—Coordinated !!Care
Cognitive !!Level: !!Application !![Applying]
!!Concept: !!Patient-Centered !!Care
!!Difficulty: !!Difficult
Feedback
1 This !!patient !!has !!a !!dangerously !!low !!blood !!glucose !!level !!and !!requires
!!immediate
intervention.
2 This !!patient !!will !!need !!to !!be !!assessed, !!but !!is !!not !!as !!high !!a !!priority.
3 According !!to !!Maslow, !!psychosocial !!needs !!are !!not !!as !!high !!of !!a !!priority !!as
physiological !!needs.
4 A !!respiratory !!rate !!of !!22 !!is !!within !!normal !!range.
PTS: 1 CON: ! ! Patient-Centered !!Care
2. The !!LPN/LVN !!enters !!the !!room !!of !!a !!patient !!who !!is !!angry !!and !!yells, !!“I !!asked !!5
!!minutes !!ago !!for !!my !!pain !!medication. !!I’m !!going !!to !!call !!the !!CEO !!of !!the !!hospital !!if
!!you !!don’t !!get !!it !!for !!me !!now.” !!Which !! statement !!by !!the !!nurse !!demonstrates
!!intellectual !!empathy?
1. “We !!are !!short-staffed !!today, !!so !!it !!will !!take !!me !!longer !!to !!meet !!your !!needs.”
2. “I !!am !!sorry !!you !!had !!to !!wait, !!I !!know !!you !!must !!be !!in !!a !!lot !!of !!pain.”
3. “I !!had !!another !!patient !!who !!had !!severe !!pain, !!and !!I !!had !!to !!get !!to !!them !!first.”
4. “I !!will !!get !!you !!the !!number !!for !!the !!CEO, !!but !!he !!is !!aware !!of !!how !!busy !!we !!are.”
ANS: ! ! ! ! 2
Chapter: !!Chapter !!1 !!Critical !!Thinking !!and !!the !!Nursing !!Process
Objective: !!2. !!Describe !!attitudes !!and !!skills !!that !!promote !!good !!critical
!!thinking !!Page: !!2
Heading: !!Intellectual !!Empathy
Integrated !!Process: !!Communication !!and
!!Documentation !! Client !!Need: !!Psychosocial !!Integrity
, Cognitive !!Level: !!Application !![Applying]
!!Concept: !!Communication
Difficulty: !!Moderate
Feedback
1 This !!statement !!does !!not !!consider !!an !!individual’s !!situation.
2 This !!statement !!demonstrates !!intellectual !!empathy !!by !!considering !!this !!patient’s
!!situation !!and !!will !!likely !!alleviate !!the !!patient’s !!anger.
3 This !!statement !!does !!not !!consider !!a !!patient’s !!situation !!and !!does !!not
!!demonstrate
intellectual !!empathy.
4 This !!statement !!addresses !!the !!patient’s !!statement !!of !!wanting !!to !!call !!the
!!CEO, !!but !!does !!not !!demonstrate !!intellectual !!empathy !!by !!considering !!the
!!patient’s !!situation.
PTS: 1 CON: ! ! Communication
3. The !!nurse !!is !!collecting !!data !!on !!a !!patient. !!Which !!data !!are !!described !!as !!subjective?
1. Respiratory !!rate !!of !!26 !!per !!minute
2. Patient !!report !!of !!shortness !!of !!breath
3. Coarse !!lung !!sounds !!bilaterally
4. Cough !!producing !!green !!sputum
ANS: ! ! ! ! 2
Chapter: !!Chapter !!1 !!Critical !!Thinking !!and !!the !!Nursing !!Process
!!Objective: !!5. !!Differentiate !!between !!objective !!and !!subjective
!!data. !!Page: !!4
Heading: !!Subjective !!Data
Integrated !!Process: !!Communication !!and
!!Documentation !! Client !!Need: !!Communication !!and
!!Documentation !!Cognitive !!Level: !!Application
!!(Applying)
Concept: !!Communication
!!Difficulty: !!Moderate
Feedback
1 Respiratory !!rate !!of !!26 !!per !!minute !!is !!an !!example !!of !!objective !!data.
2 A !!patient !!reporting !!symptoms !!to !!the !!nurse !!is !!an !!example !!of !!subjective !!data.
3 Coarse !!lung !!sounds !!is !!an !!example !!of !!objective !!data.
4 A !!productive !!cough !!is !!an !!example !!of !!objective !!data.
PTS: 1 CON: ! ! Communication
4. A !!patient !!with !!a !!newly !!fractured !!femur !!reports !!a !!pain !!level !!of !!8/10 !!and !!analgesic
!!medication !!is !!not !!due !!for !!another !!50 !!minutes. !!Which !!action !!should !!the !!nurse !!take
!!first?
1. Reposition !!the !!patient.
2. Give !!the !!medication !!in !!30 !!minutes.
3. Notify !!the !!registered !!nurse !!(RN) !!or !!physician.
4. Tell !!the !!patient !!it !!is !!too !!early !!for !!pain
!! medication. !!ANS: ! ! 3
, Chapter: !!Chapter !!1 !!Critical !!Thinking !!and !!the !!Nursing !!Process
Objective: !!4. !!Identify !!the !!role !!of !!a !!licensed !!practical !!nurse/licensed !!vocational !!nurse !!in
!!using !!the !!nursing !!process.
Page: !!3
Heading: !!Clinical !!Judgement
Integrated !!Process: !!Clinical !!Problem-solving !!Process !!(Nursing !!Process)
!!Client !!Need: !!SECE—Coordinated !!Care
Cognitive !!Level: !!Application !![Applying]
!!Concept: !!Patient-Centered !!Care
!!Difficulty: !!Moderate
Feedback
1 The !!patient !!who !!has !!a !!fractured !!femur !!is !!having !!acute !!pain. !!Repositioning
!!a
patient !!with !!a !!new !!fracture !!is !!not !!likely !!to !!relieve !!pain.
2 Giving !!the !!medication !!before !!the !!prescribed !!time !!is !!beyond !!the !!nurse’s
!!scope !!of !!practice.
3 The !!patient !!should !!not !!have !!to !!wait !!for !!pain !!relief, !!so !!the !!LPN !!should
!!inform
the !!RN !!or !!physician !!so !!new !!pain !!relief !!orders !!can !!be !!obtained.
4 The !!nurse !!needs !!to !!do !!more !!than !!expect !!the !!patient !!to !!wait !!for !!pain !!relief.
PTS: 1 CON: ! ! Patient-Centered !!Care
5. The !!nurse !!is !!prioritizing !!care !!based !!on !!Maslow !!hierarchy !!of !!needs. !!Which !!need
!!does !!the !!nurse !!identify !!as !!having !!the !!highest !! priority?
1. Job-related !!stress
2. Feeling !!of !!loneliness
3. Pain !!level !!of !!9 !!on !!0-to-10 !!scale
4. Lack !!of !!confidence
ANS: ! ! ! ! 3
Chapter: !!Chapter !!1 !!Critical !!Thinking !!and !!the !!Nursing !!Process
Objective: !!7. !!Prioritize !!patient !!care !!activities !!based !!on !!the !!Maslow !!hierarchy !!of
!!human !!needs
Page: !!7
Heading: !!Prioritize !!Care
!!Integrated !!Process: !!Caring
Client !!Need: !!SECE !!– !!Coordinated
!!Care !!Cognitive !!Level: !!Application
!![Applying] !!Concept: !!Patient-Centered
!!Care !!Difficulty: !!Moderate
Feedback
1 Job-related !!stress !!falls !!under !!safety !!according !!to !!Maslow !!and !!is !!addressed
!!after
physiological !!needs.
2 According !!to !!Maslow, !!loneliness !!is !!addressed !!under !!social !!needs !!following
!!physiological !!and !!safety.
3 Pain !!is !!a !!physiological !!need !!and !!is !!the !!highest !!priority.
4 Lack !!of !!confidence !!falls !!under !!esteem !!according !!to !!Maslow !!and !!is
!!addressed !!following !!physiological, !!safety, !!and !! social !!needs.