Complete Test Bank for Timby’s Fundamental
Nursing Skills and Concepts by Donnelly-Moreno,
13th Edition Chapters 1-38
, ◦ Timby'slIntroductorylMedical-SurgicallNursingl13thlEditionlMorenolTestlBank
Chapterl 1 Conceptsl andl Trendsl inl Healthcare
◦ Alnewlnurselislworkinglwithlalpreceptorlonlanlinpatientlmedical-
surgicallunit.lThelpreceptorladviseslthelstudentlthatlwhichlislthelprioritylwhenlwork
inglaslalprofessionallnurse?
◦ Attendingl tol holisticl clientl needs
◦ Ensuringl clientl safety
◦ Notl makingl medicationl errors
◦ Providinglclient-
lfocusedlcarel AN
S:lB
◦ Alllactionslarelappropriatelforlthelprofessionallnurse.lHowever,l ensuringl c
lientl safetyl isl thel priority.l Upl tol 98,000l deathsl resultl eachl yearl froml errorslinlhospitallcare
,laccordingltolthel2000lInstituteloflMedicinelreport.lManylmorelclientslhavelsufferedlinjurie
slandllesslseriousloutcomes.lEverylnurselhaslthelresponsibilityltolguardlthelclientslsafety.
◦ DIF:lUnderstanding/ComprehensionlREF:l2l
KEY:lPatientlsafetylMSC:lIntegratedlProcess:lNursinglProces
s:lIntervention
◦ NOT:lClientlNeedslCategory:lSafelandlEffectivelCarelEn
vironment:lSafetylandlInfectionlControl
◦ Alnurselislorientinglalnewlclientlandlfamilyltolthelinpatientlunit.lWhatlinformatio
nldoeslthelnurselprovideltolhelplthelclientlpromotelhislorlherlownlsafety?
◦ Encouragel thel clientl andl familyl tol bel activel partners.
◦ Havel thel clientl monitorl handl hygienel inl caregivers.
◦ Offerl thel familyl thel opportunityl tol stayl withl thel client.
◦ Telllthelclientltolalwayslwearlhislorlhe
rlarmband.lANS:lA
◦ Eachlactionlcouldlbelimportantlforlthelclientlorlfamilyltolperform.lHowe
ver,lencouraginglthelclientltolbelactivelinlhislorlherlhealthlcarelaslalpartnerlislthelmostlcriti
cal.lThelotherlactionslare
◦
◦ veryllimitedlinlscopelandldolnotlprovidelthelbroadlprotectionlthatlbein
glactivelandlinvolvedldoes.
◦ DIF:lUnderstanding/ComprehensionlREF:l3l
KEY:lPatientlsafetylMSC:lIntegratedlProcess:lTeaching/lLear
ning
◦ NOT:l Clientl Needsl Category:l Safel andl Effectivel Care
,Environment:l Safetyl andl Infectionl Control
◦ Alnurselislcaringlforlalpostoperativelclientlonlthelsurgicallunit.lThelclientslbloodlpress
urelwasl142/76lmmlHgl30lminuteslago,landlnowlisl88/50lmmlHg.lWhatlactionlbyltheln
urselislbest?
◦ Calll thel Rapidl Responsel Team.
◦ Documentl andl continuel tol monitor.
◦ Notifyl thel primaryl carel provider.
◦ Repeatlbloodlpressurelmeasurementli
nl15lminutes.lANS:lA
◦ ThelpurposeloflthelRapidlResponselTeaml(RRT)lisltolintervenelwhenlclientsl
areldeterioratinglbeforeltheylsufferleitherlrespiratorylorlcardiaclarrest.lSincelthelclientlhaslm
anifestedlalsignificantlchange,lthelnurselshouldlcalllthelRRT.lChangeslinlbloodlpressure,lme
ntallstatus,lheartlrate,landlpainlarelparticularlylsignificant.lDocumentationlislvital,lbutlthelnu
rselmustldolmorelthanldocument.lThelprimarylcarelproviderlshouldlbelnotified,lbutlthislislnot
lthelpriorityl overlcallingl thelRRT.lThel clientslbloodlpressurelshouldlbelreassessedlfrequent
ly,lbutlthelprioritylislgetting
thelrapidlcareltolthelclient.
◦ DIF:lApplying/Applicationl REF:l 3
◦ KEY:lRapidlResponselTeaml(RRT)|l
medicallemergencieslMSC:lIntegratedlProcess:
Communicationl andl Documentation
◦ NOT:l Clientl Needsl Category:l Physiologicall Integrity:l PhysiologicallAdaptation
◦
◦ Alnurselwishesltolprovidelclient-
centeredlcarelinlalllinteractions.lWhichlactionlbylthelnurselbestldemonstrates
lthislconcept?
◦ Assessesl forl culturall influencesl affectingl healthl care
◦ Ensureslthatlalll thelclientsl basicl needsl arel met
◦ Tellslthel clientl andl familyl aboutl alll upcomingl tests
◦ Thoroughlylorientslthelclientlandlf
amilyltolthelroomlANS:lA
◦ Competencylinlclient-
focusedlcarelisldemonstratedlwhenlthelnurselfocuseslonlcommunication,lculture,lrespe
ct,lcompassion,lclientleducation,landlempowerment.lBylassessingltheleffectloflthe
◦
◦ clientslculturelonlhealthlcare,lthislnurselislpracticinglclient-
focusedlcare.lProvidinglforlbasicl needsldoeslnotldemonstratelthislcompetence.lSimplyltelli
nglthelclientlaboutlalllupcomingltestslislnotlprovidinglempoweringleducation.lOrientinglth
elclientlandlfamilyltolthelroomlislanlimportantlsafetylmeasure,lbutlnotldirectlyl relatedltolde
monstratinglclient-centeredl care.
◦ DIF:l Understanding/Comprehensionl REF:l 3
, ◦ KEY:lPatient-
centeredlcare|lculturelMSC:lIntegratedlProcess:lCaringlNO
T:lClientlNeedslCategory:
Psychosociall Integrity
◦ Alclientlislgoingltolbeladmittedlforlalscheduledlsurgicallprocedure.lWhichlactio
nldoeslthelnurselexplainlislthelmostlimportantlthinglthelclientlcanldol tolprotectla
gainstlerrors?
◦ Bringl al listl ofl alll medicationsl andl whatl theyl arel for.
◦ Keepl thel doctorsl phonel numberl byl thel telephone.
◦ Makel surel alll providersl washl handsl beforel enteringl thel room.
◦ Writeldownlthelnamelofleachlcaregiverlwholco
meslinlthelroom.lANS:lA
◦ Medicationlerrorslarelthelmostlcommonltypeloflhealthlcarelmistake.lThelJo
intlCommissionslSpeaklUplcampaignlencourageslclientsltolhelplensureltheirlsafety.lOnelre
commendationlislforlclientsltolknowlallltheirlmedicationslandlwhyltheyltakelthem.lThislwil
llhelplpreventlmedicationlerrors.
◦ DIF:lApplying/Applicationl REF:l 4
◦ KEY:lSpeaklUplcampaign|lpatientlsafetylMSC:lIntegratedlProces
s:lTeaching/LearninglNOT:lClientlNeedslCategory:lSafelandlEffectivelCarelEnvi
ronment:lSafetylandlInfectionlControl
◦ Whichlactionlbylthelnurselworkinglwithlalclientlbestldemonstrateslrespectlforl auton
omy?
◦ Asksl ifl thel clientl hasl questionsl beforel signingl al consent
◦ Givesl thel clientl accuratel informationl whenl questioned
◦ Keepsl thel promisesl madel tol thel clientl andl family
◦ Treatslthelclientlfairlylcom
paredltolotherlclientslANS
:lA
◦ Autonomylislself-
determination.lThelclientlshouldlmakeldecisionslregardinglcare.lWhenlthelnurselobtainslals
ignaturelonlthelconsentlform,lassessinglifl thelclientlstilllhaslquestionslislvital,lbecauselwith
outlfulllinformationlthelclientlcannotlpracticelautonomy.lGivinglaccuratelinformationlislpra
cticinglwithlveracity.lKeepinglpromiseslislupholdinglfidelity.lTreatinglthe
◦
◦ clientl fairlyl isl providingl sociall justice.
◦
◦ DIF:lApplying/Applicationl REF:l 4
◦ KEY:lAutonomy|l ethicall principlesl MSC:l Integratedl Process:l Caring
◦ NOT:l Clientl Needsl Category:l Safel andl Effectivel Carel Environment:l Management
oflCare
Nursing Skills and Concepts by Donnelly-Moreno,
13th Edition Chapters 1-38
, ◦ Timby'slIntroductorylMedical-SurgicallNursingl13thlEditionlMorenolTestlBank
Chapterl 1 Conceptsl andl Trendsl inl Healthcare
◦ Alnewlnurselislworkinglwithlalpreceptorlonlanlinpatientlmedical-
surgicallunit.lThelpreceptorladviseslthelstudentlthatlwhichlislthelprioritylwhenlwork
inglaslalprofessionallnurse?
◦ Attendingl tol holisticl clientl needs
◦ Ensuringl clientl safety
◦ Notl makingl medicationl errors
◦ Providinglclient-
lfocusedlcarel AN
S:lB
◦ Alllactionslarelappropriatelforlthelprofessionallnurse.lHowever,l ensuringl c
lientl safetyl isl thel priority.l Upl tol 98,000l deathsl resultl eachl yearl froml errorslinlhospitallcare
,laccordingltolthel2000lInstituteloflMedicinelreport.lManylmorelclientslhavelsufferedlinjurie
slandllesslseriousloutcomes.lEverylnurselhaslthelresponsibilityltolguardlthelclientslsafety.
◦ DIF:lUnderstanding/ComprehensionlREF:l2l
KEY:lPatientlsafetylMSC:lIntegratedlProcess:lNursinglProces
s:lIntervention
◦ NOT:lClientlNeedslCategory:lSafelandlEffectivelCarelEn
vironment:lSafetylandlInfectionlControl
◦ Alnurselislorientinglalnewlclientlandlfamilyltolthelinpatientlunit.lWhatlinformatio
nldoeslthelnurselprovideltolhelplthelclientlpromotelhislorlherlownlsafety?
◦ Encouragel thel clientl andl familyl tol bel activel partners.
◦ Havel thel clientl monitorl handl hygienel inl caregivers.
◦ Offerl thel familyl thel opportunityl tol stayl withl thel client.
◦ Telllthelclientltolalwayslwearlhislorlhe
rlarmband.lANS:lA
◦ Eachlactionlcouldlbelimportantlforlthelclientlorlfamilyltolperform.lHowe
ver,lencouraginglthelclientltolbelactivelinlhislorlherlhealthlcarelaslalpartnerlislthelmostlcriti
cal.lThelotherlactionslare
◦
◦ veryllimitedlinlscopelandldolnotlprovidelthelbroadlprotectionlthatlbein
glactivelandlinvolvedldoes.
◦ DIF:lUnderstanding/ComprehensionlREF:l3l
KEY:lPatientlsafetylMSC:lIntegratedlProcess:lTeaching/lLear
ning
◦ NOT:l Clientl Needsl Category:l Safel andl Effectivel Care
,Environment:l Safetyl andl Infectionl Control
◦ Alnurselislcaringlforlalpostoperativelclientlonlthelsurgicallunit.lThelclientslbloodlpress
urelwasl142/76lmmlHgl30lminuteslago,landlnowlisl88/50lmmlHg.lWhatlactionlbyltheln
urselislbest?
◦ Calll thel Rapidl Responsel Team.
◦ Documentl andl continuel tol monitor.
◦ Notifyl thel primaryl carel provider.
◦ Repeatlbloodlpressurelmeasurementli
nl15lminutes.lANS:lA
◦ ThelpurposeloflthelRapidlResponselTeaml(RRT)lisltolintervenelwhenlclientsl
areldeterioratinglbeforeltheylsufferleitherlrespiratorylorlcardiaclarrest.lSincelthelclientlhaslm
anifestedlalsignificantlchange,lthelnurselshouldlcalllthelRRT.lChangeslinlbloodlpressure,lme
ntallstatus,lheartlrate,landlpainlarelparticularlylsignificant.lDocumentationlislvital,lbutlthelnu
rselmustldolmorelthanldocument.lThelprimarylcarelproviderlshouldlbelnotified,lbutlthislislnot
lthelpriorityl overlcallingl thelRRT.lThel clientslbloodlpressurelshouldlbelreassessedlfrequent
ly,lbutlthelprioritylislgetting
thelrapidlcareltolthelclient.
◦ DIF:lApplying/Applicationl REF:l 3
◦ KEY:lRapidlResponselTeaml(RRT)|l
medicallemergencieslMSC:lIntegratedlProcess:
Communicationl andl Documentation
◦ NOT:l Clientl Needsl Category:l Physiologicall Integrity:l PhysiologicallAdaptation
◦
◦ Alnurselwishesltolprovidelclient-
centeredlcarelinlalllinteractions.lWhichlactionlbylthelnurselbestldemonstrates
lthislconcept?
◦ Assessesl forl culturall influencesl affectingl healthl care
◦ Ensureslthatlalll thelclientsl basicl needsl arel met
◦ Tellslthel clientl andl familyl aboutl alll upcomingl tests
◦ Thoroughlylorientslthelclientlandlf
amilyltolthelroomlANS:lA
◦ Competencylinlclient-
focusedlcarelisldemonstratedlwhenlthelnurselfocuseslonlcommunication,lculture,lrespe
ct,lcompassion,lclientleducation,landlempowerment.lBylassessingltheleffectloflthe
◦
◦ clientslculturelonlhealthlcare,lthislnurselislpracticinglclient-
focusedlcare.lProvidinglforlbasicl needsldoeslnotldemonstratelthislcompetence.lSimplyltelli
nglthelclientlaboutlalllupcomingltestslislnotlprovidinglempoweringleducation.lOrientinglth
elclientlandlfamilyltolthelroomlislanlimportantlsafetylmeasure,lbutlnotldirectlyl relatedltolde
monstratinglclient-centeredl care.
◦ DIF:l Understanding/Comprehensionl REF:l 3
, ◦ KEY:lPatient-
centeredlcare|lculturelMSC:lIntegratedlProcess:lCaringlNO
T:lClientlNeedslCategory:
Psychosociall Integrity
◦ Alclientlislgoingltolbeladmittedlforlalscheduledlsurgicallprocedure.lWhichlactio
nldoeslthelnurselexplainlislthelmostlimportantlthinglthelclientlcanldol tolprotectla
gainstlerrors?
◦ Bringl al listl ofl alll medicationsl andl whatl theyl arel for.
◦ Keepl thel doctorsl phonel numberl byl thel telephone.
◦ Makel surel alll providersl washl handsl beforel enteringl thel room.
◦ Writeldownlthelnamelofleachlcaregiverlwholco
meslinlthelroom.lANS:lA
◦ Medicationlerrorslarelthelmostlcommonltypeloflhealthlcarelmistake.lThelJo
intlCommissionslSpeaklUplcampaignlencourageslclientsltolhelplensureltheirlsafety.lOnelre
commendationlislforlclientsltolknowlallltheirlmedicationslandlwhyltheyltakelthem.lThislwil
llhelplpreventlmedicationlerrors.
◦ DIF:lApplying/Applicationl REF:l 4
◦ KEY:lSpeaklUplcampaign|lpatientlsafetylMSC:lIntegratedlProces
s:lTeaching/LearninglNOT:lClientlNeedslCategory:lSafelandlEffectivelCarelEnvi
ronment:lSafetylandlInfectionlControl
◦ Whichlactionlbylthelnurselworkinglwithlalclientlbestldemonstrateslrespectlforl auton
omy?
◦ Asksl ifl thel clientl hasl questionsl beforel signingl al consent
◦ Givesl thel clientl accuratel informationl whenl questioned
◦ Keepsl thel promisesl madel tol thel clientl andl family
◦ Treatslthelclientlfairlylcom
paredltolotherlclientslANS
:lA
◦ Autonomylislself-
determination.lThelclientlshouldlmakeldecisionslregardinglcare.lWhenlthelnurselobtainslals
ignaturelonlthelconsentlform,lassessinglifl thelclientlstilllhaslquestionslislvital,lbecauselwith
outlfulllinformationlthelclientlcannotlpracticelautonomy.lGivinglaccuratelinformationlislpra
cticinglwithlveracity.lKeepinglpromiseslislupholdinglfidelity.lTreatinglthe
◦
◦ clientl fairlyl isl providingl sociall justice.
◦
◦ DIF:lApplying/Applicationl REF:l 4
◦ KEY:lAutonomy|l ethicall principlesl MSC:l Integratedl Process:l Caring
◦ NOT:l Clientl Needsl Category:l Safel andl Effectivel Carel Environment:l Management
oflCare
