Surgical Nursing 7th Edition by Williams and Hopper
, Chapter 1. Critical Thinking and the Nursing Process
MULTIPLE CHOICE
1. The nurse is assigned to care for several patients on a medical-surgical floor. Which patient should the
LPN/LVN see first?
A. A patient with a blood sugar reading of 42 mg/dL
B. A patient complaining of pain rated 2
C. A patient who was just told they have cancer
D. A patient breathing at a rate of 22 per minute
Answer: A
Rationale: A glucose of 42 mg/dL is critically low and places the patient at immediate risk for neurological
damage or death if not treated. This is a life-threatening emergency. The other options (mild pain, new cancer
diagnosis, slightly high-normal respirations) are lower priority according to Maslow’s hierarchy, which places
physiological stability first.
2. The LPN/LVN goes into the room of a patient who angrily says, “I asked for my pain meds 5 minutes ago.
I’m calling the CEO if you don’t bring it now.” Which response shows intellectual empathy?
A. “We are understaffed today, so you’ll have to wait longer.”
B. “I’m sorry you had to wait; I understand you must be hurting.”
C. “I had to help another patient in severe pain first.”
D. “I can give you the CEO’s number, but he knows how busy we are.”
Answer: B
Rationale: Intellectual empathy means understanding the patient’s feelings and seeing the situation from their
perspective. Option B validates the patient’s pain and frustration, showing understanding and compassion. The
,other responses either excuse the nurse’s delay, shift blame, or minimize the patient’s concern without addressing
their feelings.
3. The nurse is gathering data about a patient. Which of these is considered subjective?
A. Breathing rate of 26 per minute
B. The patient says they feel short of breath
C. Hearing coarse lung sounds on both sides
D. Coughing up green mucus
Answer: B
Rationale: Subjective data are what the patient tells you, describing their personal perception of symptoms. Saying
“I feel short of breath” is subjective. Breathing rate, lung sounds, and observing sputum are objective measurements
made by the nurse.
4. A patient with a new femur fracture reports pain at 8/10, and pain medicine is not due for 50 minutes. What
should the nurse do first?
A. Change the patient’s position
B. Give the medication 30 minutes early
C. Alert the RN or doctor
D. Tell the patient it is too soon for pain medicine
Answer: C
Rationale: Severe pain after a fresh fracture may signal complications such as compartment syndrome. The
LPN/LVN cannot give a medication early but must promptly report the uncontrolled pain to the RN or physician to
get new orders. Changing position will not fix fracture pain, and simply telling the patient to wait is inadequate.
, 5. While prioritizing care using Maslow’s hierarchy, which need should the nurse rank highest?
A. Work-related stress
B. Feeling isolated
C. Pain rated 9 on a scale of 0 to 10
D. Low self-confidence
Answer: C
Rationale: Pain is a basic physiological need that must be met before addressing safety, belonging, or esteem
issues per Maslow’s hierarchy. High pain levels can affect vital functions, making it the highest priority.
6. The nurse is making plans and setting goals for a newly admitted patient. Who should be involved in these
nursing decisions?
A. The patient
B. The nurse manager
C. The hospital chaplain
D. The patient’s doctor
Answer: A
Rationale: Nursing care planning must be collaborative with the patient to ensure patient-centered care and
adherence. The patient’s preferences and participation are crucial to successful outcomes. Others (manager,
chaplain, or HCP) may consult but do not replace the patient’s voice in their own care planning.
7. A patient 4 hours post-op has serosanguineous drainage on the dressing. How should the nurse document
this?