Linton and Matteson's Medical-Surgical
Practical Nursing in Canada, 1st Edition
Authors:
Katherine Poser,Adrianne Dill Linton,Mary
Ann Matteson
TEST BANK.
Linton & Matteson’s Medical-Surgical Practical Nursing in
Canada, 1st ed. — Chapter 1: Aspects of Medical-Surgical
Nursing
(20 advanced MCQs — PN level)
1. (Standard) A 72-year-old post-op patient is confused,
mildly hypotensive, and has warm, flushed skin 2 hours
after an abdominal surgery. As the PN, which assessment
finding most strongly suggests the early development of
hypovolemic shock rather than medication effect or
delirium?
, A. Patient reports lightheadedness when sitting up.
B. Urine output 20 mL in the last hour.
C. Pupils equal and reactive.
D. Orientation to person but not place.
Answer: B
Rationale: Low urine output (<30 mL/hr) is an early objective
sign of reduced renal perfusion from hypovolemia; combined
with hypotension and confusion it suggests volume loss rather
than isolated delirium or medication effect. (Chapter 1: Roles,
patient safety & assessment)
Citation: Linton & Matteson — Chapter 1: Aspects of Medical-
Surgical Nursing.
2. (Priority) During change-of-shift report on a medical-
surgical unit, which patient should the PN assess first?
A. Stable COPD patient due for nebulizer treatment.
B. Post-op patient 3 hrs after surgery with steady drains
and pain 4/10.
C. Newly admitted patient with symmetrical lower-
extremity edema and clear lungs.
D. Patient with type 1 diabetes whose capillary glucose is
2.8 mmol/L (50 mg/dL) and is drowsy.
Answer: D
Rationale: Hypoglycemia is immediately life-threatening and
can rapidly progress to decreased consciousness; it requires
immediate intervention and is the highest priority. (Chapter 1:
,Prioritization, safety)
Citation: Linton & Matteson — Chapter 1.
3. (SATA) Which actions are within the PN’s scope when
receiving a telephone order for a PRN analgesic for a
postoperative client? (Select all that apply.)
A. Write the order on the provider’s order sheet, sign the
order with name and “PN.”
B. Clarify dosage and route if unclear before giving
medication.
C. Administer the medication per unit policy once the
order is transcribed and verified.
D. Change the frequency of the PRN order based on
personal judgment without contacting the prescriber.
E. Document the call source, time, content of order, and
your name.
Answer: A, B, C, E
Rationale: PNs may transcribe and carry out telephone orders
per facility policy after clarification; they must document call
details. Changing orders unilaterally is not within PN scope.
(Chapter 1: Legal/ethical considerations, documentation,
medication safety)
Citation: Linton & Matteson — Chapter 1.
4. (Standard) A PN is delegating bathing of a stable patient to
a nursing assistant (NA). Which instruction most clearly
communicates a safety-focused delegation?
A. “Bathe Mr. K. quickly.”
, B. “Help him bathe; he can do whatever he wants.”
C. “Use a draw sheet for repositioning, monitor his oxygen
saturation, and stop if he becomes dizzy.”
D. “Give him a full bath and report when done.”
Answer: C
Rationale: Clear delegation includes specific safety instructions
(transfer technique, monitoring, stop criteria). Vague
commands risk harm. (Chapter 1: Delegation & teamwork)
Citation: Linton & Matteson — Chapter 1.
5. (Scenario) A client’s family insists on withholding a
treatment recommended for pain control because of
cultural beliefs. The client is alert and asks for the
medication. As PN, what is the most appropriate
immediate action?
A. Respect family wishes and withhold medication.
B. Explain to the family that the client has the right to
decide and offer to mediate discussion.
C. Administer medication covertly to prevent family
conflict.
D. Refuse to give medication until the family signs consent.
Answer: B
Rationale: The adult client’s autonomous choice takes
precedence; the PN should support the client, clarify roles, and
mediate culturally sensitive discussion—covert administration
or deferring to family violates autonomy/ethics. (Chapter 1:
Practical Nursing in Canada, 1st Edition
Authors:
Katherine Poser,Adrianne Dill Linton,Mary
Ann Matteson
TEST BANK.
Linton & Matteson’s Medical-Surgical Practical Nursing in
Canada, 1st ed. — Chapter 1: Aspects of Medical-Surgical
Nursing
(20 advanced MCQs — PN level)
1. (Standard) A 72-year-old post-op patient is confused,
mildly hypotensive, and has warm, flushed skin 2 hours
after an abdominal surgery. As the PN, which assessment
finding most strongly suggests the early development of
hypovolemic shock rather than medication effect or
delirium?
, A. Patient reports lightheadedness when sitting up.
B. Urine output 20 mL in the last hour.
C. Pupils equal and reactive.
D. Orientation to person but not place.
Answer: B
Rationale: Low urine output (<30 mL/hr) is an early objective
sign of reduced renal perfusion from hypovolemia; combined
with hypotension and confusion it suggests volume loss rather
than isolated delirium or medication effect. (Chapter 1: Roles,
patient safety & assessment)
Citation: Linton & Matteson — Chapter 1: Aspects of Medical-
Surgical Nursing.
2. (Priority) During change-of-shift report on a medical-
surgical unit, which patient should the PN assess first?
A. Stable COPD patient due for nebulizer treatment.
B. Post-op patient 3 hrs after surgery with steady drains
and pain 4/10.
C. Newly admitted patient with symmetrical lower-
extremity edema and clear lungs.
D. Patient with type 1 diabetes whose capillary glucose is
2.8 mmol/L (50 mg/dL) and is drowsy.
Answer: D
Rationale: Hypoglycemia is immediately life-threatening and
can rapidly progress to decreased consciousness; it requires
immediate intervention and is the highest priority. (Chapter 1:
,Prioritization, safety)
Citation: Linton & Matteson — Chapter 1.
3. (SATA) Which actions are within the PN’s scope when
receiving a telephone order for a PRN analgesic for a
postoperative client? (Select all that apply.)
A. Write the order on the provider’s order sheet, sign the
order with name and “PN.”
B. Clarify dosage and route if unclear before giving
medication.
C. Administer the medication per unit policy once the
order is transcribed and verified.
D. Change the frequency of the PRN order based on
personal judgment without contacting the prescriber.
E. Document the call source, time, content of order, and
your name.
Answer: A, B, C, E
Rationale: PNs may transcribe and carry out telephone orders
per facility policy after clarification; they must document call
details. Changing orders unilaterally is not within PN scope.
(Chapter 1: Legal/ethical considerations, documentation,
medication safety)
Citation: Linton & Matteson — Chapter 1.
4. (Standard) A PN is delegating bathing of a stable patient to
a nursing assistant (NA). Which instruction most clearly
communicates a safety-focused delegation?
A. “Bathe Mr. K. quickly.”
, B. “Help him bathe; he can do whatever he wants.”
C. “Use a draw sheet for repositioning, monitor his oxygen
saturation, and stop if he becomes dizzy.”
D. “Give him a full bath and report when done.”
Answer: C
Rationale: Clear delegation includes specific safety instructions
(transfer technique, monitoring, stop criteria). Vague
commands risk harm. (Chapter 1: Delegation & teamwork)
Citation: Linton & Matteson — Chapter 1.
5. (Scenario) A client’s family insists on withholding a
treatment recommended for pain control because of
cultural beliefs. The client is alert and asks for the
medication. As PN, what is the most appropriate
immediate action?
A. Respect family wishes and withhold medication.
B. Explain to the family that the client has the right to
decide and offer to mediate discussion.
C. Administer medication covertly to prevent family
conflict.
D. Refuse to give medication until the family signs consent.
Answer: B
Rationale: The adult client’s autonomous choice takes
precedence; the PN should support the client, clarify roles, and
mediate culturally sensitive discussion—covert administration
or deferring to family violates autonomy/ethics. (Chapter 1:
