Test Bank for Lewis's Medical-Surgical Nursing in Canada, 5th Edition(Tyerman, 2023), Chapter 1-72 | All Chapters

Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
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Chapter 01: Introduction to Medical-
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Surgical Nursing Practice in Canada Lewis: Medical-
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Surgical Nursing in Canada, 5th Canadian Edition
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MULTIPLE CHOICE /[




1. When caring for clients using evidence-
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informed practice, which of the following does the nurse use? /[ /[ /[ /[ /[ /[ /[ /[ /[


a. Clinical judgement based on experience /[ /[ /[ /[


b. Evidence from a clinical research study /[ /[ /[ /[ /[


c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the client outcomes are met /[ /[ /[ /[ /[ /[ /[ /[ /[




ANS: C / [


Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscientio
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us, and judicious consideration of the best available evidence to provide care Four primary elem
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ents are: (a) clinical state, setting, and circumstances; (b) client preferences and actions; (c) best
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research evidence; and (d) health care resources Clinical judgement based on the nurse‘s clinic
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al experience is part of EIP, but clinical decision making also should incorporate current resear
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ch and research-
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based guidelines Evidence from one clinical research study does not provide an adequate subst
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antiation for interventions Evaluation of client outcomes is important, but interventions should
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be based on research from randomized control studies with a large number of subjects
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DIF: Cognitive Level: Comprehension /[ /[ TOP: Nursing Process: Planning/ [ /[ /[




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
N R I G B C M
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x
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providing care to clients? USNT O /[ /[ /[ /[ /[ /[


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: B / [


The nursing process is an assertive problem-solving approach to the identification and
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treatment of clients‘ problems Diagnosis is only one phase of the nursing process The primary
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use of the nursing process is in client care, not to establish nursing theory or explain nursing inte
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rventions to other health care professionals /[ /[ /[ /[ /[ x




DIF: Cognitive Level: Comprehension /[ /[ TOP: 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 2-
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hour turning schedule to prevent skin breakdown Which type of nursing function is demonstrat
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ed with this turning schedule?
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a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D / [




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When implementing collaborative nursing actions, the nurse is responsible primarily for monit
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oring for complications of acute illness or providing care to prevent or treat complications Inde
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pendent nursing actions are focused on health promotion, illness prevention, and client advocac
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y A dependent action would require a physician order to implement Cooperative nursing functi
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ons are not described as one of the formal nursing functions
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DIF: Cognitive Level: Application /[ /[ TOP: Nursing Process: Implementation / [ /[ /[




4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the nu
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rse, ―I do not feel right about leaving my children with my neighbour ‖ Which action should th
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e nurse take next?
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a. Reassure the client that these feelings are common for parents /[ /[ /[ /[ /[ /[ /[ /[ /[ x


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: D / [


Since a complete assessment is necessary in order to identify a problem and choose an appropri
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ate intervention, the nurse‘s first action should be to obtain more information The other actions
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may be appropriate, but more assessment is needed before the best intervention can be chosen
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DIF: Cognitive Level: Application /[ /[ TOP: Nursing Process: Assessment / [ /[ /[




5. The nurse is caring for a client who has left-sided paralysis as the result of a stroke and
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assesses a pressure injury on the clie nt‘s left hip W hich of the following is the most
N fUoRr tShIi s cNGl i e nTBt ? CO M
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x
appropriate nursing diagnosis /[ /[ /[ /[ /[


a. Impaired physical mobility related to decrease in muscle control (left- /[ /[ /[ /[ /[ /[ /[ /[ /[


sided paralysis) /[


b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about p
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rotecting tissue integrity /[ /[


c. Impaired skin integrity related to pressure over bony prominence (impaired c
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irculation)
d. Ineffective tissue perfusion related to sedentary lifestyle /[ /[ /[ /[ /[ /[




ANS: C / [


The client‘s major problem is the impaired skin integrity as demonstrated by the presence of a pr
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essure injury The nurse is able to treat the cause of altered circulation and pressure by frequentl
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y repositioning the client Although left-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 client, wh
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o already has impaired tissue integrity The client does have ineffective tissue perfusion, but the
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impaired skin integrity diagnosis indicates more clearly what the health problem is
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DIF: Cognitive Level: Application /[ /[ TOP: Nursing Process: Diagnosis / [ /[ /[




6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid v
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olume related to excessive diaphoresis Which of the following is an appropriate client out
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come?
a. Client has a balanced intake and output /[ /[ /[ /[ /[ /[ x


b. Client‘s bedding is changed when it becomes damp /[ /[ /[ /[ /[ /[ /[ x




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c. Client understands the need for increased fluid intake /[ /[ /[ /[ /[ /[ /[ x


d. Client‘s skin remains cool and dry throughout hospitalization /[ /[ /[ /[ /[ /[ /[ x




ANS: A / [


This statement gives measurable data showing resolution of the problem of deficient fluid volu
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me that was identified in the nursing diagnosis statement The other statements would not indicat
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e that the problem of deficient fluid volume was resolved
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DIF: Cognitive Level: Application /[ /[ TOP: Nursing Process: Planning / [ /[ /[




7. Which of the following represents a nursing activity that is carried out during the evaluation p
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hase of the nursing process?
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a. Determining if interventions have been effective in meeting client outcomes /[ /[ /[ /[ /[ /[ /[ /[ /[


b. Documenting the nursing care plan in the progress notes in the medical record /[ /[ /[ /[ /[ /[ /[ /[ /[ /[ /[ /[


c. Deciding whether the client‘s health problems have been completely resolved /[ /[ /[ /[ /[ /[ /[ /[ /[


d. Asking the client to evaluate whether the nursing care provided was satisfactory
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ANS: A / [


Evaluation consists of determining whether the desired client outcomes have been met and whe
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ther the nursing interventions were appropriate The other responses do not describe the evaluati
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on phase
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DIF: Cognitive Level: Comprehension /[ /[ TOP: Nursing Process: Evaluation/ [ /[ /[




8. Which of the following would the nurse perform during the assessment phase of the nursing pr
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ocess?
a. Obtains data with which to diagnose client problems /[ /[ /[ /[ /[ /[ /[


b. Uses client data to develoNp pR
U SINt yTnGursB
riori /[ ing C OMnoses
d iag
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: A / [


During the assessment phase, the nurse gathers information about the client The other response
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s are examples of the intervention, diagnosis, and planning phases of the nursing process
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DIF: Cognitive Level: Knowledge /[ /[ TOP: Nursing Process: Assessment/ [ /[ /[




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 /[ /[ /[ /[ /[ /[


b. Risk for impaired tissue integrity related to sacral redness
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c. Ineffective coping related to insufficient sense of control /[ /[ /[ /[ /[ /[ /[ x


d. Altered urinary elimination related to urinary tract infection /[ /[ /[ /[ /[ /[ /[




ANS: C / [


This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes a
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client‘s response to a health problem that can be treated by nursing The use of a medical diagn
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osis (as in the responses beginning ―Altered tissue perfusion‖ and ―Altered urinary
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elimination‖) is not appropriate The response beginning ―Risk for impaired tissue integrity‖
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uses the defining characteristics as the etiology
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DIF: Cognitive Level: Comprehension /[ /[ TOP: Nursing Process: Diagnosis / [ /[ /[




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