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UNDERSTANDING
MEDICAL-SURGICAL
NURSING
5THEDITIONBY
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HOPPER,WILLIAMS 33
,Chapter1. CriticalThinking and the Nursing Process
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MULTIPLECHOICE 3
1. The nurse is caring for a group of patients on a medical-surgical unit.Which patient should the
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licensed practical nurse/licensed vocational nurse (LPN/LVN) assess first?
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1. Apatient with a blood glucose of 42 mg/dL
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2. Apatient who reports a pain level of 2
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3. Apatient who has just received a diagnosis of cancer
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4. Apatient who has a respiratory rate of 22
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ANS: 1 3 3 3 3
Chapter: Chapter 1 CriticalThinking and the Nursing Process 33 33 33 33 33 33 33 33
Objective: 7. Prioritize patient care activities based on the Maslow hierarchy of human 33 33 33 33 33 33 33 33 33 33 33 33
needs.
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Pages: 6–7 33
Heading:Prioritize Care 33 33
IntegratedProcess:ClinicalProblem-Solving Process(Nursing Process) Client 33 33 33 33 33 33 33
Need: SECE—Coordinated Care
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CognitiveLevel:Application[Applying] 3 3 3
Concept: Patient-Centered Care
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Difficulty: Difficult
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Feedback
1 Thispatient has a dangerously low blood glucose level and requires immediate
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intervention.
2 This patient will need to be assessed, but is not as high a priority.
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3 Accordingto Maslow, psychosocial needs are not as high of a priority as 33 33 33 33 33 33 33 33 33 33 33 33
physiologicalneeds. 33
4 Arespiratory rate of 22 is within normal range.
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PTS: 1 CON: Patient-Centered Care 3 3 33
2. The LPN/LVN enters the room of a patient who is angry and yells, “I asked 5 minutes ago for my
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pain medication. I’m going to call the CEO of the hospital if you don’t get it for me now.” Which
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statement by the nurse demonstrates intellectual empathy?
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1. “Weareshort-staffed today, so it will takeme longer tomeetyour needs.”
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2. “I am sorry you had to wait, I know you must be in a lot of pain.”
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3. “I had another patient who had severe pain, and I had to get to them first.”
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4. “I will get you the number for the CEO, but he is aware of how busy we are.”
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ANS: 2 3 3 3 3
Chapter: Chapter 1 CriticalThinking and the Nursing Process 33 33 33 33 33 33 33 33
Objective: 2. Describeattitudes and skills that promotegood criticalthinking 33 33 33 33 33 33 33 33 33 33
Page: 2
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Heading:Intellectual Empathy 33 33
IntegratedProcess:CommunicationandDocumentation 3 3 3 3
Client Need: Psychosocial Integrity
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, CognitiveLevel:Application[Applying] 3 3 3
Concept: Communication
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Difficulty: Moderate 33
Feedback
1 Thisstatement doesnot consider anindividual’s situation.
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2 Thisstatementdemonstratesintellectual empathybyconsideringthispatient’s
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situation and will likely alleviate the patient’s anger.
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3 This statement does not consider apatient’s situation and does not demonstrate
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intellectual empathy. 33
4 This statement addresses thepatient’s statementof wanting to call theCEO, but does
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not demonstrate intellectual empathy by considering the patient’s situation.
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PTS: 1 CON: Communication 3 3
3. The nurse is collecting data on a patient.Which data are described as subjective?
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1. Respiratory rate of 26 per minute 33 33 33 33 33
2. Patient report of shortness of breath 33 33 33 33 33
3. Coarse lung sounds bilaterally 33 33 33
4. Cough producing green sputum 33 33 33
ANS: 2 3 3 3 3
Chapter: Chapter 1 Critical Thinking and the Nursing Process
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Objective:5.Differentiate betweenobjective andsubjective data.
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Page: 4
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Heading:Subjective Data 33 33
IntegratedProcess:CommunicationandDocumentation 3 3 3 3
Client Need: Communication and Documentation
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Cognitive Level: Application (Applying)
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Concept:Communication 3
Difficulty: Moderate
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Feedback
1 Respiratory rate of 26 per minute is an example of objective data. 33 33 33 33 33 33 33 33 33 33 33
2 Apatient reporting symptoms to the nurse is an example of subjective data.
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3 Coarse lung sounds is an example of objective data. 33 33 33 33 33 33 33 33
4 Aproductive cough is an example of objective data.
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PTS: 1 CON: Communication 3 3
4. Apatient with a newly fractured femur reports a pain level of 8/10 and analgesic medication is not
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due for another 50 minutes. Which action should the nurse take first?
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1. Reposition the patient. 33 33
2. Give the medication in 30 minutes. 33 33 33 33 33
3. Notify the registered nurse (RN) or physician. 33 33 33 33 33 33
4. Tellthepatientitistooearlyfor painmedication.
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33 ANS: 3 3 3
, Chapter: Chapter 1 CriticalThinking and the Nursing Process
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Objective: 4. Identify the role of a licensed practical nurse/licensed vocational nurse in using the
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nursing process.
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Page: 3 33
Heading: Clinical Judgement 33 33
IntegratedProcess: ClinicalProblem-solving Process(Nursing Process) Client 33 33 33 33 33 33 33
Need: SECE—Coordinated Care
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CognitiveLevel:Application[Applying] 3 3 3
Concept: Patient-Centered Care
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Difficulty: Moderate
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Feedback
1 The patient who has a fractured femur is having acute pain. Repositioning a
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patient with a new fracture is not likely to relieve pain. 33 33 33 33 33 33 33 33 33 33
2 Giving the medication beforethe prescribed time isbeyond the nurse’s scope of 33 33 33 33 33 33 33 33 33 33 33 33
practice.
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3 The patient should not have to wait for pain relief, so the LPN should inform
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the RN or physician so new pain relief orders can be obtained.
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4 The nurse needs to do more than expect the patient to wait for pain relief.
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PTS: 1 CON: Patient-Centered Care 3 3 33
5. The nurse is prioritizing care based on Maslow hierarchy of needs.Which need does the nurse
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identify as having the highest priority?
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1. Job-relatedstress 33
2. Feeling of loneliness 33 33
3. Pain level of 9 on 0-to-10 scale 33 33 33 33 33 33
4. Lack of confidence 33 33
ANS: 3 3 3 3 3
Chapter: Chapter 1 CriticalThinking and the Nursing Process
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Objective: 7. Prioritize patient care activities based on the Maslow hierarchy of human needs
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Page: 7 33
Heading: Prioritize Care 33 33
IntegratedProcess:Caring
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Client Need: SECE – Coordinated Care
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CognitiveLevel:Application[Applying]
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Concept: Patient-Centered Care
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Difficulty: Moderate
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Feedback
1 Job-related stress falls under safety according to Maslow and is addressed after 33 33 33 33 33 33 33 33 33 33 33
physiologicalneeds. 33
2 AccordingtoMaslow, lonelinessisaddressed undersocialneedsfollowing 33 33 33 33 33 33 33 33 33
physiological and safety.
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3 Pain is a physiological need and is the highest priority.
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4 Lack of confidence falls under esteem according to Maslow and isaddressed
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following physiological, safety, and social needs.
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