LEWIS'S MEDICAL-SURGICAL NURSING
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference: Ch. 1 — Professional Nursing Practice
Stem: A nurse on a med–surg unit is assigned a newly admitted
78-year-old with multiple comorbidities. The nurse recognizes
that balancing safety, patient-centered care, and evidence-
based practice is essential. Which action best reflects
professional nursing practice?
A. Follow the unit’s routine even if the patient’s preferences
differ.
,B. Integrate the patient’s goals into the plan while applying
current evidence and safety standards.
C. Defer all care decisions to the provider to avoid legal risk.
D. Prioritize tasks by speed to clear the assignment quickly.
Correct answer: B
Rationale — Correct: Integrating patient goals with current
evidence and safety standards embodies professional nursing
practice per Lewis: it balances patient-centered care, clinical
expertise, and best evidence. The nurse recognizes patterns
(CJM Recognize/Analyze), plans individualized care (Plan), and
intervenes consistent with evidence and safety. This approach
reduces risk, supports autonomy, and aligns with standards of
practice.
Rationale — Incorrect A: Rigidly following routines over a
patient’s preferences neglects patient-centered care and may
create unsafe or nontherapeutic outcomes.
Rationale — Incorrect C: Automatically deferring decisions
abdicates nursing responsibility and fails to utilize clinical
judgment and scope of practice.
Rationale — Incorrect D: Speed over safety increases risk for
errors and violates professional standards.
Teaching point: Combine patient goals, evidence, and safety for
professional nursing decisions.
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
,2
Reference: Ch. 1 — Domain of Nursing Practice
Stem: During handoff, a nurse is asked which activity falls within
the domain of nursing practice. Which response best
demonstrates accurate understanding?
A. Prescribing a new antibiotic for suspected pneumonia.
B. Teaching the patient about oxygen therapy and monitoring
response.
C. Diagnosing congestive heart failure and initiating therapy.
D. Interpreting complex radiographic studies independently.
Correct answer: B
Rationale — Correct: Teaching about therapy and monitoring
patient response are core nursing roles—assessment,
education, and evaluation—consistent with Lewis’s domain of
nursing practice. The nurse recognizes patient needs
(Recognize), analyzes responses, plans education, and
implements and evaluates interventions. This maintains scope
of practice and supports safe outcomes.
Rationale — Incorrect A: Prescribing is outside nursing scope
for RNs unless advanced practice privileges exist.
Rationale — Incorrect C: Diagnosing and initiating medical
therapy are provider roles; nursing contributes assessment and
monitoring.
Rationale — Incorrect D: Radiograph interpretation is a
specialized diagnostic skill; nurses collect data and collaborate,
but independent interpretation beyond scope is inappropriate.
, Teaching point: Nursing domain: assess, teach, implement,
monitor, and evaluate patient responses.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Definitions of Nursing
Stem: A new graduate asks what distinguishes nursing from
other health professions. Which statement best reflects Lewis’s
definition of nursing?
A. Nursing mainly carries out provider orders.
B. Nursing focuses on holistic care integrating biological,
psychosocial, and environmental factors.
C. Nursing is synonymous with administrative tasks on the unit.
D. Nursing replaces the role of primary providers in acute care.
Correct answer: B
Rationale — Correct: Lewis defines nursing as holistic care
integrating biological, psychosocial, and environmental aspects,
emphasizing patient-centered assessment and interventions.
This viewpoint drives clinical judgment (Recognize/Analyze) and
supports individualized planning/interventions to promote
health and safety.
Rationale — Incorrect A: Nursing involves more than executing
orders; it includes assessment, clinical reasoning, and
independent interventions.
Rationale — Incorrect C: Administrative tasks are part of
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference: Ch. 1 — Professional Nursing Practice
Stem: A nurse on a med–surg unit is assigned a newly admitted
78-year-old with multiple comorbidities. The nurse recognizes
that balancing safety, patient-centered care, and evidence-
based practice is essential. Which action best reflects
professional nursing practice?
A. Follow the unit’s routine even if the patient’s preferences
differ.
,B. Integrate the patient’s goals into the plan while applying
current evidence and safety standards.
C. Defer all care decisions to the provider to avoid legal risk.
D. Prioritize tasks by speed to clear the assignment quickly.
Correct answer: B
Rationale — Correct: Integrating patient goals with current
evidence and safety standards embodies professional nursing
practice per Lewis: it balances patient-centered care, clinical
expertise, and best evidence. The nurse recognizes patterns
(CJM Recognize/Analyze), plans individualized care (Plan), and
intervenes consistent with evidence and safety. This approach
reduces risk, supports autonomy, and aligns with standards of
practice.
Rationale — Incorrect A: Rigidly following routines over a
patient’s preferences neglects patient-centered care and may
create unsafe or nontherapeutic outcomes.
Rationale — Incorrect C: Automatically deferring decisions
abdicates nursing responsibility and fails to utilize clinical
judgment and scope of practice.
Rationale — Incorrect D: Speed over safety increases risk for
errors and violates professional standards.
Teaching point: Combine patient goals, evidence, and safety for
professional nursing decisions.
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
,2
Reference: Ch. 1 — Domain of Nursing Practice
Stem: During handoff, a nurse is asked which activity falls within
the domain of nursing practice. Which response best
demonstrates accurate understanding?
A. Prescribing a new antibiotic for suspected pneumonia.
B. Teaching the patient about oxygen therapy and monitoring
response.
C. Diagnosing congestive heart failure and initiating therapy.
D. Interpreting complex radiographic studies independently.
Correct answer: B
Rationale — Correct: Teaching about therapy and monitoring
patient response are core nursing roles—assessment,
education, and evaluation—consistent with Lewis’s domain of
nursing practice. The nurse recognizes patient needs
(Recognize), analyzes responses, plans education, and
implements and evaluates interventions. This maintains scope
of practice and supports safe outcomes.
Rationale — Incorrect A: Prescribing is outside nursing scope
for RNs unless advanced practice privileges exist.
Rationale — Incorrect C: Diagnosing and initiating medical
therapy are provider roles; nursing contributes assessment and
monitoring.
Rationale — Incorrect D: Radiograph interpretation is a
specialized diagnostic skill; nurses collect data and collaborate,
but independent interpretation beyond scope is inappropriate.
, Teaching point: Nursing domain: assess, teach, implement,
monitor, and evaluate patient responses.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Definitions of Nursing
Stem: A new graduate asks what distinguishes nursing from
other health professions. Which statement best reflects Lewis’s
definition of nursing?
A. Nursing mainly carries out provider orders.
B. Nursing focuses on holistic care integrating biological,
psychosocial, and environmental factors.
C. Nursing is synonymous with administrative tasks on the unit.
D. Nursing replaces the role of primary providers in acute care.
Correct answer: B
Rationale — Correct: Lewis defines nursing as holistic care
integrating biological, psychosocial, and environmental aspects,
emphasizing patient-centered assessment and interventions.
This viewpoint drives clinical judgment (Recognize/Analyze) and
supports individualized planning/interventions to promote
health and safety.
Rationale — Incorrect A: Nursing involves more than executing
orders; it includes assessment, clinical reasoning, and
independent interventions.
Rationale — Incorrect C: Administrative tasks are part of
