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 — Professional Nursing
Practice
Stem: A newly graduated RN is assigned to a med–surg unit and
is asked to admit a postop patient with diabetes. The RN notes
the primary nurse is juggling two admissions and a medication
administration round. Which action best demonstrates
professional nursing practice while ensuring patient safety and
continuity of care?
,Options:
A. Accept the admission and postpone the medication round
until both admissions are complete.
B. Ask the charge nurse to reassign one admission so
medication times and admission assessments are completed
safely.
C. Admit the patient quickly and rely on the primary nurse to
complete teaching later during nights.
D. Delegate the medication round to a nursing assistant so the
RN can focus on admissions.
Correct answer: B
Rationale — Correct: Asking the charge nurse to reassign
balances workload and supports safe, timely medication
administration and thorough admission assessment. This
follows Lewis’s emphasis on professional responsibility, safe
staffing, and advocacy for necessary resources; it uses clinical
judgment to recognize risk and plan (Recognize → Analyze →
Plan). Reassignment reduces error risk and preserves patient-
centered care and continuity.
Rationale — A: Postponing medication risks missed or delayed
therapy and is unsafe per Lewis’s standards.
Rationale — C: Relying on later teaching may delay essential
education and overlooks immediate safety and assessment
needs.
Rationale — D: Delegating medications to a nursing assistant is
outside scope of practice and unsafe.
Teaching point: Advocate for safe staffing and timely
,medication administration.
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference: Ch. 1 — Professional Nursing — Domain of Nursing
Practice
Stem: A hospital adopts a new protocol requiring RNs to triage
emergency department (ED) admissions at the unit front. A
med-surg RN is asked to apply triage principles during surge.
Which RN action best reflects appropriate domain practice and
patient safety?
Options:
A. Use a brief focused assessment to identify unstable patients
and notify the ED provider immediately.
B. Perform full head-to-toe assessments on all arrivals before
notifying ED staff.
C. Send stable patients to a waiting room and document only
vitals.
D. Rotate triage duties exclusively to the most junior RN to gain
experience.
Correct answer: A
Rationale — Correct: A focused assessment to identify
instability and immediate notification aligns with the nursing
domain of prioritization and early recognition of deterioration
per Lewis and the NCSBN CJM (Recognize → Analyze →
, Intervene). This balances rapid identification of red flags with
scope and system needs.
Rationale — B: Full head-to-toe assessments on all arrivals
delays care for unstable patients and is inefficient in triage.
Rationale — C: Only documenting vitals without assessing for
red flags risks missing critical cues.
Rationale — D: Assigning complex triage only to novice staff
risks safety and inconsistent decision making.
Teaching point: Triage requires focused assessment to detect
instability and prompt escalation.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Definitions of
Nursing
Stem: During interdisciplinary rounds, a nurse is asked to define
the unique role of nursing versus other professions for a care
plan. Which statement best captures the nursing definition in a
way that clarifies responsibilities?
Options:
A. Nursing focuses primarily on prescribing and adjusting
medications.
B. Nursing integrates assessment, clinical judgment, and
individualized interventions to promote safety and function.
C. Nursing primarily documents physician plans without
independent assessment.
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 — Professional Nursing
Practice
Stem: A newly graduated RN is assigned to a med–surg unit and
is asked to admit a postop patient with diabetes. The RN notes
the primary nurse is juggling two admissions and a medication
administration round. Which action best demonstrates
professional nursing practice while ensuring patient safety and
continuity of care?
,Options:
A. Accept the admission and postpone the medication round
until both admissions are complete.
B. Ask the charge nurse to reassign one admission so
medication times and admission assessments are completed
safely.
C. Admit the patient quickly and rely on the primary nurse to
complete teaching later during nights.
D. Delegate the medication round to a nursing assistant so the
RN can focus on admissions.
Correct answer: B
Rationale — Correct: Asking the charge nurse to reassign
balances workload and supports safe, timely medication
administration and thorough admission assessment. This
follows Lewis’s emphasis on professional responsibility, safe
staffing, and advocacy for necessary resources; it uses clinical
judgment to recognize risk and plan (Recognize → Analyze →
Plan). Reassignment reduces error risk and preserves patient-
centered care and continuity.
Rationale — A: Postponing medication risks missed or delayed
therapy and is unsafe per Lewis’s standards.
Rationale — C: Relying on later teaching may delay essential
education and overlooks immediate safety and assessment
needs.
Rationale — D: Delegating medications to a nursing assistant is
outside scope of practice and unsafe.
Teaching point: Advocate for safe staffing and timely
,medication administration.
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference: Ch. 1 — Professional Nursing — Domain of Nursing
Practice
Stem: A hospital adopts a new protocol requiring RNs to triage
emergency department (ED) admissions at the unit front. A
med-surg RN is asked to apply triage principles during surge.
Which RN action best reflects appropriate domain practice and
patient safety?
Options:
A. Use a brief focused assessment to identify unstable patients
and notify the ED provider immediately.
B. Perform full head-to-toe assessments on all arrivals before
notifying ED staff.
C. Send stable patients to a waiting room and document only
vitals.
D. Rotate triage duties exclusively to the most junior RN to gain
experience.
Correct answer: A
Rationale — Correct: A focused assessment to identify
instability and immediate notification aligns with the nursing
domain of prioritization and early recognition of deterioration
per Lewis and the NCSBN CJM (Recognize → Analyze →
, Intervene). This balances rapid identification of red flags with
scope and system needs.
Rationale — B: Full head-to-toe assessments on all arrivals
delays care for unstable patients and is inefficient in triage.
Rationale — C: Only documenting vitals without assessing for
red flags risks missing critical cues.
Rationale — D: Assigning complex triage only to novice staff
risks safety and inconsistent decision making.
Teaching point: Triage requires focused assessment to detect
instability and prompt escalation.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Definitions of
Nursing
Stem: During interdisciplinary rounds, a nurse is asked to define
the unique role of nursing versus other professions for a care
plan. Which statement best captures the nursing definition in a
way that clarifies responsibilities?
Options:
A. Nursing focuses primarily on prescribing and adjusting
medications.
B. Nursing integrates assessment, clinical judgment, and
individualized interventions to promote safety and function.
C. Nursing primarily documents physician plans without
independent assessment.
