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Medical-
Surgical Nursing in Canada 5th Edition Lewi Test Bank




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, Medical-
Surgical Nursing in Canada 5th Edition Lewi Test Bank
Chapter 01: Introduction to Medical-
sx sx sx sx


Surgical Nursing Practice in Canada Lewis: Medical-
sx sx sx sx sx sx


Surgical Nursing in Canada, 5th Canadian Edition
sx sx sx sx sx sx




MULTIPLE CHOICE sx




1. When caring for clients using evidence-
sx sx sx sx sx


informed practice, which of the following does the nurse use?
sx sx sx sx sx sx sx sx sx


a. Clinical judgement based on experience sx sx sx sx


b. Evidence from a clinical research study sx sx sx sx sx


c. The best available evidence to guide clinical expertise
sx sx sx sx sx sx sx


d. Evaluation of data showing that the client outcomes are met sx sx sx sx sx sx sx sx sx




ANS: C s x


Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscien
sx sx sx sx sx sx sx sx sx sx sx


tious, and judicious consideration of the best available evidence to provide care. Four primar
sx sx sx sx sx sx sx sx sx sx sx sx sx


y elements are: (a) clinical state, setting, and circumstances; (b) client preferences and actio
sx sx sx sx sx sx sx sx sx sx sx sx sx


ns; (c) best research evidence; and (d) health care resources. Clinical judgement based on the
sx sx sx sx sx sx sx sx sx sx sx sx sx sx s


xnurse‘s clinical experience is part of EIP, but clinical decision making also should incorpora
sx sx sx sx sx sx sx sx sx sx sx sx sx


te current research and research-
sx sx sx sx


based guidelines. Evidence from one clinical research study does not provide an adequate su
sx sx sx sx sx sx sx sx sx sx sx sx sx


bstantiation for interventions. Evaluation of client outcomes is important, but interventions s
sx sx sx sx sx sx sx sx sx sx sx


hould be based on research from randomized control studies with a large number of subjects
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


.

DIF: Cognitive Level: Comprehension sx sx TOP: s x Nursing Process: Planning sx sx




2. Which of the following best e x p l a i n s t h e n u r s e s ‘ primary use of the nursing process when
sx sx sx sx sx
N R I G B.C M sx sx sx sx sx sx sx



providing care to clients sx sx sx USNT O sx sx sx


?
a. To explain nursing interventions to other health care professionals
sx sx sx sx sx sx sx sx


b. As a problem-solving tool to identify and treat clients‘ health care needs
sx sx sx sx sx sx sx sx sx sx sx


c. As a scientific-based process of diagnosing the client‘s health care problems
sx sx sx sx sx sx sx sx sx sx


d. To establish nursing theory that incorporates the biopsychosocial nature of humans
sx sx sx sx sx sx sx sx sx sx




ANS: B s x


The nursing process is an assertive problem-solving approach to the identification and
sx sx sx sx sx sx sx sx sx sx sx


treatment of clients‘ problems. Diagnosis is only one phase of the nursing process. The prim
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


ary use of the nursing process is in client care, not to establish nursing theory or explain nurs
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


ing interventions to other health care professionals.
sx sx sx sx sx sx




DIF: Cognitive Level: Comprehension sx sx TOP: s x Nursing Process: Implementation sx sx




3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


hour turning schedule to prevent skin breakdown. Which type of nursing function is demonst
sx sx sx sx sx sx sx sx sx sx sx sx sx


rated with this turning schedule?
sx sx sx sx


a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D s x




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, Medical-
Surgical Nursing in Canada 5th Edition Lewi Test Bank
When implementing collaborative nursing actions, the nurse is responsible primarily for mo
sx sx sx sx sx sx sx sx sx sx sx


nitoring for complications of acute illness or providing care to prevent or treat complications
sx sx sx sx sx sx sx sx sx sx sx sx sx


. Independent nursing actions are focused on health promotion, illness prevention, and client
sx sx sx sx sx sx sx sx sx sx sx sx s


xadvocacy. A dependent action would require a physician order to implement. Cooperative n
sx sx sx sx sx sx sx sx sx sx sx sx


ursing functions are not described as one of the formal nursing functions.
sx sx sx sx sx sx sx sx sx sx sx




DIF: Cognitive Level: Application sx sx TOP: s x Nursing Process: Implementation sx sx




4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells th
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


e nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which action s
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


hould the nurse take next?
sx sx sx sx


a. Reassure the client that these feelings are common for parents.
sx sx sx sx sx sx sx sx sx


b. Have the client call the children to ensure that they are doing well.
sx sx sx sx sx sx sx sx sx sx sx sx


c. Call the neighbour to determine whether adequate childcare is being provided.
sx sx sx sx sx sx sx sx sx sx


d. Gather more data about the client‘s feelings about the childcare arrangements.
sx sx sx sx sx sx sx sx sx sx




ANS: D s x


Since a complete assessment is necessary in order to identify a problem and choose an appr
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


opriate intervention, the nurse‘s first action should be to obtain more information. The other
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


actions may be appropriate, but more assessment is needed before the best intervention can b
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


e chosen.
sx




DIF: Cognitive Level: Application sx sx TOP: s x Nursing Process: Assessment sx sx




5. The nurse is caring for a client who has left-sided paralysis as the result of a stroke and
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


assesses a pressure injury on the clie nt‘s left h ip . W hich of the following is the most
appropriate nursing diagnosisNfUoR hI Gl i e nT
Bt ?. OC M
sx sx sx sx sx sx sx sx sx sx sx


r tS i s cN sx sx sx sx sx


a. Impaired physical mobility related to decrease in muscle control (left-
sx sx sx sx sx sx sx sx sx


sided paralysis) sx


b. Risk for impaired tissue integrity as evidenced by insufficient knowledge abou
sx sx sx sx sx sx sx sx sx sx


t protecting tissue integrity
sx sx sx


c. Impaired skin integrity related to pressure over bony prominence (impaire
sx sx sx sx sx sx sx sx sx


d circulation) sx


d. Ineffective tissue perfusion related to sedentary lifestyle sx sx sx sx sx sx




ANS: C s x


The client‘s major problem is the impaired skin integrity as demonstrated by the presence of
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


a pressure injury. The nurse is able to treat the cause of altered circulation and pressure by f
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


requently repositioning the client. Although left-sided weakness is a problem for the client,
sx sx sx sx sx sx sx sx sx sx sx sx


the nurse cannot treat the weakness. The ―risk for‖ diagnosis is not appropriate for this client,
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


who already has impaired tissue integrity. The client does have ineffective tissue perfusion,
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


but the impaired skin integrity diagnosis indicates more clearly what the health problem is.
sx sx sx sx sx sx sx sx sx sx sx sx sx




DIF: Cognitive Level: Application sx sx TOP: s x Nursing Process: Diagnosis sx sx




6. The nurse caring for a client with an infection has a nursing diagnosis of deficient flui
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


d volume related to excessive diaphoresis. Which of the following is an appropriate cli
sx sx sx sx sx sx sx sx sx sx sx sx sx


ent outcome?
sx


a. Client has a balanced intake and output. sx sx sx sx sx sx


b. Client‘s bedding is changed when it becomes damp. sx sx sx sx sx sx sx




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, Medical-
Surgical Nursing in Canada 5th Edition Lewi Test Bank
c. Client understands the need for increased fluid intake.
sx sx sx sx sx sx sx


d. Client‘s skin remains cool and dry throughout hospitalization.
sx sx sx sx sx sx sx




ANS: A s x


This statement gives measurable data showing resolution of the problem of deficient fluid v
sx sx sx sx sx sx sx sx sx sx sx sx sx


olume that was identified in the nursing diagnosis statement. The other statements would not
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


indicate that the problem of deficient fluid volume was resolved.
sx sx sx sx sx sx sx sx sx




DIF: Cognitive Level: Application sx sx TOP: s x Nursing Process: Planning sx sx




7. Which of the following represents a nursing activity that is carried out during the evaluatio
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


n phase of the nursing process?
sx sx sx sx sx


a. Determining if interventions have been effective in meeting client outcomes
sx sx sx sx sx sx sx sx sx


b. Documenting the nursing care plan in the progress notes in the medical record sx sx sx sx sx sx sx sx sx sx sx sx


c. Deciding whether the client‘s health problems have been completely resolved
sx sx sx sx sx sx sx sx sx


d. Asking the client to evaluate whether the nursing care provided was satisfactory
sx sx sx sx sx sx sx sx sx sx sx




ANS: A s x


Evaluation consists of determining whether the desired client outcomes have been met and
sx sx sx sx sx sx sx sx sx sx sx sx sx


whether the nursing interventions were appropriate. The other responses do not describe the e
sx sx sx sx sx sx sx sx sx sx sx sx sx


valuation phase. sx




DIF: Cognitive Level: Comprehension sx sx TOP: s x Nursing Process: Evaluation sx sx




8. Which of the following would the nurse perform during the assessment phase of the nursin
sx sx sx sx sx sx sx sx sx sx sx sx sx sx


g process?
sx


a. Obtains data with which to diagnose client problems
sx sx sx sx sx sx sx


b. Uses client data to develoNp pR
S NItyT nGursB
Uriori
sx in.
gC iagMnoses
dO
c. Teaches interventions to relieve client health problems
sx
sx sx sx


sx sx
sx
sx sx
sx
sx
sx


sx
sx


sx


d. Assists the client to identify realistic outcomes to health problems
sx sx sx sx sx sx sx sx sx




ANS: A s x


During the assessment phase, the nurse gathers information about the client. The other respo
sx sx sx sx sx sx sx sx sx sx sx sx sx


nses are examples of the intervention, diagnosis, and planning phases of the nursing process.
sx sx sx sx sx sx sx sx sx sx sx sx sx




DIF: Cognitive Level: Knowledge sx sx TOP: s x Nursing Process: Assessment sx sx




9. Which of the following is an example of a correctly written nursing diagnosis statement?
sx sx sx sx sx sx sx sx sx sx sx sx sx


a. Altered tissue perfusion related to heart failure
sx sx sx sx sx sx


b. Risk for impaired tissue integrity related to sacral redness
sx sx sx sx sx sx sx sx


c. Ineffective coping related to insufficient sense of control. sx sx sx sx sx sx sx


d. Altered urinary elimination related to urinary tract infection
sx sx sx sx sx sx sx




ANS: C s x


This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describe
sx sx sx sx sx sx sx sx sx sx sx sx


s a client‘s response to a health problem that can be treated by nursing. The use of a medic
sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx sx


al diagnosis (as in the responses beginning ―Altered tissue perfusion‖ and ―Altered urinary
sx sx sx sx sx sx sx sx sx sx sx sx


elimination‖) is not appropriate. The response beginning ―Risk for impaired tissue integrity‖
sx sx sx sx sx sx sx sx sx sx sx


uses the defining characteristics as the etiology.
sx sx sx sx sx sx




DIF: Cognitive Level: Comprehension sx sx TOP: s x Nursing Process: Diagnosis sx sx




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