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 licensed nurse is assigned a patient with COPD
who requires oxygen therapy, frequent respiratory assessments,
and inhaled bronchodilators. The charge nurse asks the new
nurse to accept an additional stable postop patient. The new
nurse is unsure whether she should accept both assignments.
What is the most appropriate action?
A. Accept both patients and ask the charge nurse for help if
,workload becomes unsafe.
B. Accept both patients because the postop patient is stable
and can be checked every 4 hours.
C. Inform the charge nurse that accepting both patients would
exceed safe scope and request reassignment.
D. Refuse both assignments and call the nurse manager
immediately.
Correct answer: C
Rationales — Correct (C): According to Lewis, safe staffing and
scope require nurses to recognize limits in competence and
workload. Recognize → Analyze → Plan: the nurse identifies risk
(high-acuity COPD plus new postop), analyzes safety, plans to
request reassignment, and intervenes by notifying the charge
nurse. This preserves patient safety and aligns with standards of
professional nursing practice.
Incorrect (A): Waiting to ask for help after overload risks unsafe
care; proactive communication is preferred.
Incorrect (B): Labeling the postop patient “stable” ignores the
new nurse’s workload and potential for rapid change.
Incorrect (D): Escalating immediately to the manager without
first discussing reassignment with the charge nurse is
unnecessarily adversarial.
Teaching point: Speak up early — request reassignment when
workload risks safe care.
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 — Nursing Core
Competencies
Stem: A nurse preparing discharge teaching for a patient with
new heart failure must prioritize education topics. Which
teaching topic should be prioritized to reduce readmission risk?
A. Cardiac anatomy and pathophysiology.
B. Daily weight measurement and when to call the provider.
C. Detailed review of hospital laboratory trends.
D. Long-term prognosis statistics for heart failure.
Correct answer: B
Rationales — Correct (B): Lewis emphasizes patient-centered
care and risk-reduction teaching relevant to self-management.
Recognize: fluid retention risk; Analyze: daily weights detect
early decompensation; Plan/Intervene: teach daily weights and
call thresholds; Evaluate: reduce readmissions. This is high-
yield, actionable education.
Incorrect (A): Anatomy is low priority for immediate risk
reduction and may overwhelm the patient.
Incorrect (C): Lab trends are clinician-focused information, not
immediate self-management education.
Incorrect (D): Prognosis statistics do not provide actionable
steps to prevent deterioration.
, Teaching point: Teach daily weights and call thresholds to
detect heart failure worsening early.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Standards of
Professional Nursing Practice
Stem: A nurse notices an RN colleague charted that a patient
received scheduled analgesia, but the MAR shows the dose was
omitted. What is the nurse’s best action?
A. Document in the chart that the MAR shows omission and
sign the colleague’s note.
B. Confront the colleague privately and do nothing else if they
admit the error.
C. Notify the charge nurse and initiate the facility’s incident
reporting process.
D. Ignore it because the patient later complained of pain and
received PRN medication.
Correct answer: C
Rationales — Correct (C): Lewis and professional standards
require reporting medication errors to protect patients and
support quality improvement. Recognize the safety event,
analyze potential harm, plan to escalate appropriately,
intervene by notifying leadership and completing incident
report, and evaluate system causes. This upholds accountability
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 licensed nurse is assigned a patient with COPD
who requires oxygen therapy, frequent respiratory assessments,
and inhaled bronchodilators. The charge nurse asks the new
nurse to accept an additional stable postop patient. The new
nurse is unsure whether she should accept both assignments.
What is the most appropriate action?
A. Accept both patients and ask the charge nurse for help if
,workload becomes unsafe.
B. Accept both patients because the postop patient is stable
and can be checked every 4 hours.
C. Inform the charge nurse that accepting both patients would
exceed safe scope and request reassignment.
D. Refuse both assignments and call the nurse manager
immediately.
Correct answer: C
Rationales — Correct (C): According to Lewis, safe staffing and
scope require nurses to recognize limits in competence and
workload. Recognize → Analyze → Plan: the nurse identifies risk
(high-acuity COPD plus new postop), analyzes safety, plans to
request reassignment, and intervenes by notifying the charge
nurse. This preserves patient safety and aligns with standards of
professional nursing practice.
Incorrect (A): Waiting to ask for help after overload risks unsafe
care; proactive communication is preferred.
Incorrect (B): Labeling the postop patient “stable” ignores the
new nurse’s workload and potential for rapid change.
Incorrect (D): Escalating immediately to the manager without
first discussing reassignment with the charge nurse is
unnecessarily adversarial.
Teaching point: Speak up early — request reassignment when
workload risks safe care.
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 — Nursing Core
Competencies
Stem: A nurse preparing discharge teaching for a patient with
new heart failure must prioritize education topics. Which
teaching topic should be prioritized to reduce readmission risk?
A. Cardiac anatomy and pathophysiology.
B. Daily weight measurement and when to call the provider.
C. Detailed review of hospital laboratory trends.
D. Long-term prognosis statistics for heart failure.
Correct answer: B
Rationales — Correct (B): Lewis emphasizes patient-centered
care and risk-reduction teaching relevant to self-management.
Recognize: fluid retention risk; Analyze: daily weights detect
early decompensation; Plan/Intervene: teach daily weights and
call thresholds; Evaluate: reduce readmissions. This is high-
yield, actionable education.
Incorrect (A): Anatomy is low priority for immediate risk
reduction and may overwhelm the patient.
Incorrect (C): Lab trends are clinician-focused information, not
immediate self-management education.
Incorrect (D): Prognosis statistics do not provide actionable
steps to prevent deterioration.
, Teaching point: Teach daily weights and call thresholds to
detect heart failure worsening early.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Standards of
Professional Nursing Practice
Stem: A nurse notices an RN colleague charted that a patient
received scheduled analgesia, but the MAR shows the dose was
omitted. What is the nurse’s best action?
A. Document in the chart that the MAR shows omission and
sign the colleague’s note.
B. Confront the colleague privately and do nothing else if they
admit the error.
C. Notify the charge nurse and initiate the facility’s incident
reporting process.
D. Ignore it because the patient later complained of pain and
received PRN medication.
Correct answer: C
Rationales — Correct (C): Lewis and professional standards
require reporting medication errors to protect patients and
support quality improvement. Recognize the safety event,
analyze potential harm, plan to escalate appropriately,
intervene by notifying leadership and completing incident
report, and evaluate system causes. This upholds accountability
