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UNDERSTANDING
MEDICAL-SURGICAL
NURSING
5THEDITIONBY
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HOPPER,WILLIAMS ji
,Chapter1.CriticalThinking and theNursing Process
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MULTIPLECHOICE ji
1. Thenurseiscaringforagroupofpatientsonamedical-surgicalunit.Whichpatientshould the
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licensed practical nurse/licensed vocational nurse (LPN/LVN) assess first?
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1. Apatientwith ablood glucose of 42 mg/dL
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2. Apatientwho reports a painlevelof 2
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3. Apatientwho has just receiveda diagnosis of cancer
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4. Apatientwho has arespiratory rate of22
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ANS: 1 j i j i
Chapter:Chapter1CriticalThinkingandthe Nursing Process ji ji ji ji ji ji ji ji
Objective:7.PrioritizepatientcareactivitiesbasedontheMaslowhierarchyofhuman needs. ji ji ji ji ji ji ji ji ji ji ji ji ji
Pages:6–7 ji
Heading:PrioritizeCare ji ji
IntegratedProcess:ClinicalProblem-SolvingProcess(NursingProcess) Client ji ji ji ji ji ji ji
Need: SECE—Coordinated Care
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CognitiveLevel:Application[Applying] ji ji ji
Concept: Patient-Centered Care
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Difficulty: Difficult
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Feedback
1 Thispatienthasadangerouslylowblood glucoselevelandrequiresimmediate ji ji ji ji ji ji ji ji ji ji ji
intervention.
2 Thispatient willneed to be assessed, but isnot ashigh a priority. ji ji ji ji ji ji ji ji ji ji ji ji ji
3 AccordingtoMaslow,psychosocialneedsarenotashighofapriorityas ji ji ji ji ji ji ji ji ji ji ji ji
physiologicalneeds. ji
4 Arespiratoryrateof 22 is within normalrange.
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PTS: 1 CON: Patient-CenteredCare j i ji
2. The LPN/LVN enters the room of a patient who is angry and yells, “I asked 5 minutes ago formy
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painmedication.I’m going tocalltheCEOof thehospitalifyou don’tgetitfor me now.” Which
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statement by the nurse demonstrates intellectual empathy?
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1. “Weareshort-staffedtoday,soitwilltakemelongertomeetyourneeds.” ji ji ji ji ji ji ji ji ji ji ji ji ji
2. “Iam sorry you had to wait, I know you mustbe in a lot of pain.”
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3. “Ihad anotherpatient whohad severe pain,and I had to get to themfirst.”
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4. “Iwill getyou the number for the CEO, but he is awareof how busy we are.”
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ANS: 2 j i j i
Chapter:Chapter1CriticalThinkingandthe Nursing Process ji ji ji ji ji ji ji ji
Objective:2.Describeattitudesandskillsthatpromotegoodcriticalthinking Page: ji ji ji ji ji ji ji ji ji ji ji
2
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Heading:IntellectualEmpathy ji ji
IntegratedProcess:CommunicationandDocumentation ji ji ji ji
Client Need: Psychosocial Integrity
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, CognitiveLevel:Application[Applying] ji ji ji
Concept: Communication
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Difficulty:Moderate ji
Feedback
1 Thisstatementdoesnotconsideranindividual’ssituation.
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2 Thisstatementdemonstratesintellectualempathybyconsideringthispatient’s
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situation and will likely alleviate the patient’s anger.
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3 Thisstatementdoesnotconsiderapatient’ssituationanddoesnotdemonstrate
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intellectualempathy. ji
4 Thisstatementaddressesthepatient’sstatementofwantingtocalltheCEO,but does
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not demonstrate intellectual empathy by considering the patient’s situation.
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PTS: 1 CON: Communication j i
3. Thenurseis collectingdata onapatient.Which dataaredescribedas subjective?
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1. Respiratoryrateof 26 per minute ji ji ji ji ji
2. Patientreportof shortnessof breath ji ji ji ji ji
3. Coarselungsounds bilaterally ji ji ji
4. Coughproducinggreen sputum ji ji ji
ANS: 2 j i j i
Chapter: Chapter 1 Critical Thinking and the Nursing Process ji ji ji ji ji ji ji ji
Objective:5.Differentiatebetweenobjectiveandsubjectivedata.
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Page: 4
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Heading:SubjectiveData ji ji
IntegratedProcess:CommunicationandDocumentation ji ji ji ji
Client Need: Communication and Documentation
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Cognitive Level: Application (Applying)
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Concept:Communication ji
Difficulty: Moderate
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Feedback
1 Respiratoryrateof 26 per minute isanexample ofobjectivedata. ji ji ji ji ji ji ji ji ji ji ji
2 Apatientreportingsymptoms tothenurseisan exampleof subjectivedata.
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3 Coarselung soundsis an exampleof objectivedata. ji ji ji ji ji ji ji ji
4 Aproductivecough isanexampleof objective data.
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PTS: 1 CON: Communication j i
4. Apatientwithanewly fracturedfemurreports apainlevelof8/10andanalgesicmedication is not
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due for another 50 minutes. Which action should the nurse take first?
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1. Repositionthepatient. ji ji
2. Givethe medication in30 minutes. ji ji ji ji ji
3. Notifythe registerednurse (RN) or physician. ji ji ji ji ji ji
4. Tellthepatientitistooearlyforpainmedication. ji ji ji ji ji ji ji ji ji
ANS:
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, Chapter:Chapter1CriticalThinkingandthe Nursing Process ji ji ji ji ji ji ji ji
Objective:4.Identifytheroleofalicensedpracticalnurse/licensedvocationalnursein using the ji ji ji ji ji ji ji ji ji ji ji ji ji ji
nursing process.
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Page:3 ji
Heading:ClinicalJudgement ji ji
IntegratedProcess:ClinicalProblem-solvingProcess(NursingProcess) Client ji ji ji ji ji ji ji
Need: SECE—Coordinated Care
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CognitiveLevel:Application[Applying] ji ji ji
Concept: Patient-Centered Care
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Difficulty: Moderate
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Feedback
1 Thepatientwhohasa fracturedfemurishaving acutepain.Repositioning a
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patientwitha newfractureisnotlikelyto relievepain. ji ji ji ji ji ji ji ji ji ji
2 Givingthemedicationbeforetheprescribedtimeisbeyondthenurse’sscope of ji ji ji ji ji ji ji ji ji ji ji ji
practice.
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3 Thepatient shouldnothave towait for painrelief,so the LPN should inform
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theRNor physician so newpain relieforderscan beobtained.
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4 Thenurseneeds to do morethan expectthe patientto waitfor pain relief.
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PTS: 1 CON: Patient-CenteredCare j i ji
5. ThenurseisprioritizingcarebasedonMaslowhierarchyofneeds.Whichneeddoesthe nurse
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identify as having the highest priority?
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1. Job-relatedstress ji
2. Feelingof loneliness ji ji
3. Painlevel of 9 on 0-to-10 scale ji ji ji ji ji ji
4. Lack of confidence ji ji
ANS: 3 j i j i
Chapter:Chapter1CriticalThinkingandthe Nursing Process ji ji ji ji ji ji ji ji
Objective:7.PrioritizepatientcareactivitiesbasedontheMaslowhierarchyofhuman needs ji ji ji ji ji ji ji ji ji ji ji ji ji
Page:7 ji
Heading: Prioritize Care ji ji
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-relatedstressfallsundersafetyaccordingtoMaslowandisaddressedafter ji ji ji ji ji ji ji ji ji ji ji
physiologicalneeds. ji
2 AccordingtoMaslow,lonelinessisaddressedundersocialneedsfollowing ji ji ji ji ji ji ji ji ji
physiological and safety.
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3 Painisa physiologicalneed and is thehighest priority.
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4 LackofconfidencefallsunderesteemaccordingtoMaslowandisaddressed following
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physiological, safety, and social needs.
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