Test Bank Medical-Surgical Nursing Concepts for Interprofessional Collaborative Care 10th Edition by Donna D. Ignatavicius Chapter 1-69 |Complete Guide A+

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Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
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Ignatavicius: Medical-Surgical Nursing, 10th Edition
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MULTIPLE CHOICE l




1. A new nurse is working with a preceptor on a medical-surgicalVunit.VTheVpreceptor
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l advises the new nurse that which is the priority whenVworkingVasVaVprofessionalVnurse?
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a. Attending to holistic client needs l l l l


b. Ensuring client safety l l


c. Not making medication errors l l l


d. Providing client-focused care l l




ANS: B l


All actions are appropriate for the professional nurse. However,VensuringVclientVsafetyVis
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the priority. Health care errors have been widely reportedVforV25Vyears,VmanyVofVwhich
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result in client injury, death, and increased health careVcosts.VThereVareVseveralVnational
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and international organizations that have eitherVrecommendedVorVmandatedVsafety
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initiatives.
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Every nurse has the responsibility to Vguard the client‘s Vsafety. VThe Vother Vactions Vare
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important for quality nursing, but they are Vnot Vas vital Vas Vproviding Vsafety. VNot Vmaking
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medication errors does provide safety, Vbut is Vtoo narrow in scope to be the best
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lanswer.

DIF: Understanding TOP: Integrated Process: Nursing Process: l l l l


lIntervention KEY: Client safety l l l


MSC: Client Needs Category:VSafeVandVEffective Care Environment: Safety and Infection Control
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2. A nurse is orientingVaVnewVclient and family to the medical-surgical unit. What
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information does the nurseVprovide to best help the client promote his or her
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lown safety? l


a. Encourage theVclientVand family to be active partners. l l l l l l l l


b. Have theVclientVmonitor hand hygiene in caregivers. l l l l l l


c. OfferVtheVfamily the opportunity to stay with the client. l l l l l l l l


d. Tell theVclient to always wear his or her armband.
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ANS: V A l l


EachVaction could be important for the client or family to perform. However,
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encouraging the client to be active in his or her health care as a safety partner is
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the most critical. The other actions are very limited in scope and do not provide the
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broad protection that being active and involved does.
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DIF: Understanding TOP: Integrated Process: l l


lTeaching/Learning KEY: Client safety l l l


MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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3. A nurse is caring for a postoperative client on the surgical unit. The client‘s
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lblood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg.
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lWhat action would the nurse take first?
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a. Call the Rapid Response Team. l l l l


b. Document and continue to monitor. l l l l


c. Notify the primary health care provider. l l l l l


d. Repeat the blood pressure in 15 minutes. l l l l l l

,Test bank Medical-Surgical Nursing Concepts for Interprofessional Collaborative Care 10th
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ANS: A l


The purpose of the Rapid Response Team (RRT) is to intervene when clients are
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ldeteriorating before they suffer either respiratory or cardiac arrest. Since the client l l l l l l l l l l l


lhas manifested a significant change, the nurse would call the RRT. Changes in
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lblood pressure, mental status, heart rate, temperature, oxygen saturation, and last 2
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lhours‘ urine output are particularly significant and are part of the Modified Early
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lWarning System guide. Documentation is vital, but the nurse must do more than
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ldocument. The primary health care provider would be notified, but this is not more l l l l l l l l l l l l l


limportant than calling the RRT. The client‘s blood pressure would be reassessedl l l l l l l l l l l


lfrequently, but the priority is getting the rapid care to the client. l l l l l l l l l l l




DIF: Applying TOP: Integrated Process: Communication and l l l l


lDocumentation KEY: Rapid Response Team (RRT), Clinical l l l l l l


ljudgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
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4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
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best demonstrates this concept?
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a. Assesses for cultural influences affecting health care. l l l l l l


b. Ensures that all the client‘s basic needs are met. l l l l l l l l


c. Tells the client and family about all upcoming tests. l l l l l l l l


d. Thoroughly orients the client and family to the room. l l l l l l l l




ANS: A l


Showing respect for the client and family‘s preferences and needs is essential to
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lensure a holistic or ―whole-person‖ approach to care. By assessing the effect of the
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lclient‘s culture on health care, this nurse is practicing client-focused care. Providing
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lfor basic needs does not demonstrate this competence. Simply telling the client
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labout all upcoming tests is not providing empowering education. Orienting the client
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land family to the room is an important safety measure, but not directly related to
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ldemonstrating client-centered care. l l




DIF: Understanding TOP: Integrated Process: Culture and l l l l l


lSpirituality KEY: Client-centered care, Culture MSC: Client Needs Category: l l l l l l l


lPsychosocial Integrity l




5. A client is going to be admitted for a scheduled surgical procedure. Which
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l action does the nurse explain is the most important thing the client can do
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l to protect against errors?
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a. Bring a list of all medications and what they are for. l l l l l l l l l l


b. Keep the provider‘s phone number by the telephone. l l l l l l l


c. Make sure that all providers wash hands before entering the room.l l l l l l l l l l


d. Write down the name of each caregiver who comes in the room. l l l l l l l l l l l




ANS: A l


Medication reconciliation is a formal process in which the client‘s actual current l l l l l l l l l l l


medications are compared to the prescribed medications at the time of admission,
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transfer, or discharge. This National client Safety Goal is important to reduce
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medication errors. The client would not have to be responsible for providers
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lwashing their hands, and even if the client does so, this is too narrow to be the
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lmost important action to prevent errors. Keeping the provider‘s phone number nearby
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land documenting everyone who enters the room also do not guarantee safety.
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DIF: Applying TOP: Integrated Process: l l


Teaching/Learning KEY: Client safety, Informatics l l l l


MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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,Test bank Medical-Surgical Nursing Concepts for Interprofessional Collaborative Care 10th
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6. Which action by the nurse working with a client best demonstrates respect for autonomy?
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a. Asks if the client has questions before signing a consent.
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b. Gives the client accurate information when questioned.
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c. Keeps the promises made to the client and family. l l l l l l l l


d. Treats the client fairly compared to other clients. l l l l l l l




ANS: A l


Autonomy is self-determination. The client would make decisions regarding care. When the
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lnurse obtains a signature on the consent form, assessing if the client still has questions is
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lvital, because without full information the client cannot practice autonomy. Giving accurate
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linformation is practicing with veracity. Keeping promises is upholding fidelity. Treating
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the client fairly is providing social justice.
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DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, l l l


lAutonomy MSC: Client Needs Category: Safe and Effective Care l l l l l l l l


lEnvironment: Management of Care l l l




7. A nurse asks a more seasoned colleague to explain best practices when
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l communicating with a person from the lesbian, gay, bisexual, transgender,Vand l l l l l l l l l l


l questioning/queer (LGBTQ) community. What answer by the faculty is l l l l l l l l


l mostVaccurate? l


a. Avoid embarrassing the client by asking questions. l l l l l l


b. Don‘t make assumptions about his or her health needs.
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c. Most LGBTQ people do not want to share information.
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d. No differences exist in communicating withVthisVpopulation.
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ANS: B l


Many members of the LGBTQ communityVhave faced discrimination from health
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lcare providers and may be reluctant to seek health care. The nurse would never
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lmake assumptions about the needs of members of this population. Rather, respectful
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questions are appropriate. If approachedVwithVsensitivity, the client with any health
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lcare need is more likely to answer honestly.
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DIF: Understanding TOP: Integrated Process: Teaching/Learning l l l


KEY: Health care disparities,VLGBTQ
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8. A nurse is callingVthe on-call health care provider about a client who had a
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lhysterectomy 2VdaysVago and has pain that is unrelieved by the prescribed l l l l l l l l l l l l


l opioid pain medication. Which statement comprises the background portion of
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l the SBAR formatVforVcommunication?
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a. ―IVwouldVlike you to order a different pain medication.‖ l l l l l l l l


b. ―ThisVclient has allergies to morphine and codeine.‖
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c. ―Dr.VSmith doesn‘t like nonsteroidal anti-inflammatory meds.‖ l l l l l


d. ―This client had a vaginal hysterectomy 2 days ago.‖
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ANS: B l

, SBAR is a recommended form of communication, and the acronym stands for
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lSituation, Background, Assessment, and Recommendation. Appropriate background
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linformation includes allergies to medications the on-call health care provider might
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lorder. Situation describes what is happening right now that must be communicated; the
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lclient‘s surgery 2 days ago would be considered background. Assessment would include
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lan analysis of the client‘s problem; none of the options has assessment information.
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lAsking for a different pain medication is a recommendation. Recommendation is a
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lstatement of what is needed or what outcome is desired.
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DIF: Applying TOP: Integrated Process: Communication and l l l l


lDocumentation KEY: Teamwork and collaboration, SBARl l l l l


MSC: Client Needs Category: Safe and Effective Care Environment: Management of Care
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