Lewis's Medical-Surgical Nursing in Canada
Assessment and Management of Clinical
Problems
• 5th Edition - June 15, 2022
• Latest edition
• Authors: Jane Tyerman, Shelley Cobbett,
Mariann M. Harding, Jeffrey Kwong, Dottie
Roberts, Debra Hagler, Courtney Reinisch
TEST BANK
1. A nurse is caring for four clients on a medical-surgical unit.
Which client should the nurse assess first?
A. A client with COPD who reports increased dyspnea and has
an SpO₂ of 88%
B. A client with diabetes reporting polyuria and polydipsia
C. A client awaiting discharge teaching for hypertension
D. A client with stable angina requesting pain medication
Correct Answer: A
,Rationale:
Airway and breathing take priority according to clinical
judgment and ABC principles. An SpO₂ of 88% with increased
dyspnea indicates impaired oxygenation and requires
immediate assessment.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Clinical Judgment and Prioritization in Medical-
Surgical Nursing Practice.
2. The nurse uses clinical judgment when caring for a
deteriorating patient. Which action best reflects the “noticing”
component of clinical judgment?
A. Administering prescribed oxygen
B. Recognizing a change in vital signs from baseline
C. Evaluating the response to medication
D. Documenting findings in the health record
Correct Answer: B
Rationale:
“Noticing” involves recognizing cues and changes from baseline.
Identifying abnormal vital signs represents cue recognition.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Clinical Judgment Model.
,3. A nurse advocates for a patient whose pain is inadequately
treated despite repeated requests. This action demonstrates
which professional role?
A. Care provider
B. Educator
C. Advocate
D. Researcher
Correct Answer: C
Rationale:
Advocacy involves protecting patient rights and ensuring
appropriate care when needs are unmet.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Professional Roles in Medical-Surgical Nursing.
4. Which statement by a nurse best reflects evidence-informed
practice?
A. “I perform care the way I was taught in school.”
B. “I follow unit routines for consistency.”
C. “I use current research findings along with clinical expertise
and patient preferences.”
D. “I rely on physician direction for treatment decisions.”
Correct Answer: C
, Rationale:
Evidence-informed practice integrates best research evidence,
clinical expertise, and patient values.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Evidence-Informed Practice.
5. A client refuses a blood transfusion based on religious
beliefs. What is the nurse’s priority action?
A. Notify the physician immediately
B. Respect the client’s autonomy and document the refusal
C. Persuade the client to accept treatment
D. Contact the ethics committee before proceeding
Correct Answer: B
Rationale:
Respecting autonomy is foundational in Canadian nursing
ethics. Competent adults have the right to refuse treatment.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Ethical and Legal Foundations of Practice.
6. A newly licensed nurse asks how to reduce medical errors.
Which response by the preceptor is most appropriate?
A. “Work quickly to manage your workload.”
B. “Rely on memory for medication doses.”
Assessment and Management of Clinical
Problems
• 5th Edition - June 15, 2022
• Latest edition
• Authors: Jane Tyerman, Shelley Cobbett,
Mariann M. Harding, Jeffrey Kwong, Dottie
Roberts, Debra Hagler, Courtney Reinisch
TEST BANK
1. A nurse is caring for four clients on a medical-surgical unit.
Which client should the nurse assess first?
A. A client with COPD who reports increased dyspnea and has
an SpO₂ of 88%
B. A client with diabetes reporting polyuria and polydipsia
C. A client awaiting discharge teaching for hypertension
D. A client with stable angina requesting pain medication
Correct Answer: A
,Rationale:
Airway and breathing take priority according to clinical
judgment and ABC principles. An SpO₂ of 88% with increased
dyspnea indicates impaired oxygenation and requires
immediate assessment.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Clinical Judgment and Prioritization in Medical-
Surgical Nursing Practice.
2. The nurse uses clinical judgment when caring for a
deteriorating patient. Which action best reflects the “noticing”
component of clinical judgment?
A. Administering prescribed oxygen
B. Recognizing a change in vital signs from baseline
C. Evaluating the response to medication
D. Documenting findings in the health record
Correct Answer: B
Rationale:
“Noticing” involves recognizing cues and changes from baseline.
Identifying abnormal vital signs represents cue recognition.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Clinical Judgment Model.
,3. A nurse advocates for a patient whose pain is inadequately
treated despite repeated requests. This action demonstrates
which professional role?
A. Care provider
B. Educator
C. Advocate
D. Researcher
Correct Answer: C
Rationale:
Advocacy involves protecting patient rights and ensuring
appropriate care when needs are unmet.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Professional Roles in Medical-Surgical Nursing.
4. Which statement by a nurse best reflects evidence-informed
practice?
A. “I perform care the way I was taught in school.”
B. “I follow unit routines for consistency.”
C. “I use current research findings along with clinical expertise
and patient preferences.”
D. “I rely on physician direction for treatment decisions.”
Correct Answer: C
, Rationale:
Evidence-informed practice integrates best research evidence,
clinical expertise, and patient values.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Evidence-Informed Practice.
5. A client refuses a blood transfusion based on religious
beliefs. What is the nurse’s priority action?
A. Notify the physician immediately
B. Respect the client’s autonomy and document the refusal
C. Persuade the client to accept treatment
D. Contact the ethics committee before proceeding
Correct Answer: B
Rationale:
Respecting autonomy is foundational in Canadian nursing
ethics. Competent adults have the right to refuse treatment.
Citation: Lewis’s Medical-Surgical Nursing in Canada, 5th ed.,
Chapter 1: Ethical and Legal Foundations of Practice.
6. A newly licensed nurse asks how to reduce medical errors.
Which response by the preceptor is most appropriate?
A. “Work quickly to manage your workload.”
B. “Rely on memory for medication doses.”
