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Test Bank Medical-Surgical Nursing Concepts for Interprofessional Collaborative Care 10th Edition by Donna D. Ignatavicius Chapter 1-69 |Complete Guide A+

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Test Bank Medical-Surgical Nursing Concepts for Interprofessional Collaborative Care 10th Edition by Donna D. Ignatavicius Chapter 1-69 |Complete Guide A+ lOMoARcPSD| Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing Ignatavicius: Medical-Surgical Nursing, 10th Edition MULTIPLE CHOICE 1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises the new nurse that which is the priority when working as a professional nurse? a. Attending to holistic client needs b. Ensuring client safety c. Not making medication errors d. Providing client-focused care - CORRECT ANS>> B All actions are appropriate for the professional nurse. However, ensuring client safety is the priority. Health care errors have been widely reported for 25 years, many of which result in client injury, death, and increased health care costs. There are several national and international organizations that have either recommended or mandated safety initiatives. Every nurse has the responsibility to guard the client9s safety. The other actions are important for quality nursing, but they are not as vital as providing safety. Not making medication errors does provide safety, but is too narrow in scope to be the best answer. 2. A nurse is orienting a new client and family to the medical-surgical unit. What information does the nurse provide to best help the client promote his or her own safety? a. Encourage the client and family to be active partners. b. Have the client monitor hand hygiene in caregivers. c. Offer the family the opportunity to stay with the client. d. Tell the client to always wear his or her armband. - CORRECT ANS>> A Each action could be important for the client or family to perform. However, encouraging the client to be active in his or her health care as a safety partner is the most critical. The other actions are very limited in scope and do not provide the broad protection that being active and involved does. 3. A nurse is caring for a postoperative client on the surgical unit. The client9s blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nurse take first? a. Call the Rapid Response Team. b. Document and continue to monitor. c. Notify the primary health care provider. d. Repeat the blood pressure in 15 minutes. - CORRECT ANS>> A lOMoARcPSD| The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the client has manifested a significant change, the nurse would call the RRT. Changes in blood pressure, mental status, heart rate, temperature, oxygen saturation, and last 2 hours9 urine output are particularly significant and are part of the Modified Early Warning System guide. Documentation is vital, but the nurse must do more than document. The primary health care provider would be notified, but this is not more important than calling the RRT. The client9s blood pressure would be reassessed frequently, but the priority is getting the rapid care to the client. DIF: Applying TOP: Integrated Process: Communication and Documentation KEY: Rapid Response Team (RRT), Clinical judgment MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation 4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept? a. Assesses for cultural influences affecting health care. b. Ensures that all the client9s basic needs are met. c. Tells the client and family about all upcoming tests. d. Thoroughly orients the client and family to the room. - CORRECT ANS>> A Showing respect for the client and family9s preferences and needs is essential to ensure a holistic or <whole-person= approach to care. By assessing the effect of the client9s culture on health care, this nurse is practicing client-focused care. Providing for basic needs does not demonstrate this competence. Simply telling the client about all upcoming tests is not providing empowering education. Orienting the client and family to the room is an important safety measure, but not directly related to demonstrating client-centered care. 5. A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors? a. Bring a list of all medications and what they are for. b. Keep the provider9s phone number by the telephone. c. Make sure that all providers wash hands before entering the room. d. Write down the name of each caregiver who comes in the room. - CORRECT ANS>> A Medication reconciliation is a formal process in which the client9s actual current medications are compared to the prescribed medications at the time of admission, transfer, or discharge. This National client Safety Goal is important to reduce medication errors. The client would not have to be responsible for providers washing their hands, and even if the client does so, this is too narrow to be the most important action to prevent errors. Keeping the provider9s phone number nearby and documenting everyone who enters the room also do not guarantee safety. lOMoARcPSD| 6. Which action by the nurse working with a client best demonstrates respect for autonomy? a. Asks if the client has questions before signing a consent. b. Gives the client accurate information when questioned. c. Keeps the promises made to the client and family. d. Treats the client fairly compared to other clients. - CORRECT ANS>> A Autonomy is self-determination. The client would make decisions regarding care. When the nurse obtains a signature on the consent form, assessing if the client still has questions is vital, because without full information the client cannot practice autonomy. Giving accurate information is practicing with veracity. Keeping promises is upholding fidelity. Treating the client fairly is providing social justice. 7. A nurse asks a more seasoned colleague to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) community. What answer by the faculty is most accurate? a. Avoid embarrassing the client by asking questions. b. Don9t make assumptions about his or her health needs. c. Most LGBTQ people do not want to share information. d. No differences exist in communicating with this population. - CORRECT ANS>> B Many members of the LGBTQ community have faced discrimination from health care providers and may be reluctant to seek health care. The nurse would never make assumptions about the needs of members of this population. Rather, respectful questions are appropriate. If approached with sensitivity, the client with any health care need is more likely to answer honestly. 8. A nurse is calling the on-call health care provider about a client who had a hysterectomy 2 days ago and has pain that is unrelieved by the prescribed opioid pain medication. Which statement comprises the background portion of the SBAR format for communication? a. <I would like you to order a different pain medication.= b. <This client has allergies to morphine and codeine.= c. <Dr. Smith doesn9t like nonsteroidal anti-inflammatory meds.= d. <This client had a vaginal hysterectomy 2 days ago.= - CORRECT ANS>> B lOMoARcPSD| SBAR is a recommended form of communication, and the acronym stands for Situation, Background, Assessment, and Recommendation. Appropriate background information includes allergies to medications the on-call health care provider might order. Situation describes what is happening right now that must be communicated; the client9s surgery 2 days ago would be considered background. Assessment would include an analysis of the client9s problem; none of the options has assessment information. Asking for a different pain medication is a recommendation. Recommendation is a statement of what is needed or what outcome is desired. 9. A nurse working on a cardiac unit delegated taking vital signs to an experienced assistive personnel (AP). Four hours later, the nurse notes that the client9s blood pressure taken by the AP was much higher than previous readings, and the client9s mental status has changed. What action by the nurse would most likely have prevented this negative outcome? a. Determining if the AP knew how to take blood pressure b. Double-checking the AP by taking another blood pressure c. Providing more appropriate supervision of the AP d. Taking the blood pressure instead of delegating the task - CORRECT ANS>> C Supervision is one of the five rights of delegation and includes directing, evaluating, and following up on delegated tasks. The nurse would either have asked the AP about the vital signs or instructed the AP to report them right away. An experienced AP would know how to take vital signs and the nurse would not have to assess this at this point. Double-checking the work defeats the purpose of delegation. Vital signs are within the scope of practice for a AP and are permissible to delegate. The only appropriate answer is that the nurse did not provide adequate instruction to the AP. 10. A newly graduated nurse in the hospital states that because of being so new, participation in quality improvement (QI) projects is not wise. What response by the precepting nurse is best? a. <All staff nurses are required to participate in quality improvement here.= b. <Even being new, you can implement activities designed to improve care.= c. <It9s easy to identify what indicators would be used to measure quality.= d. <You should ask to be assigned to the research and quality committee.= - CORRECT ANS>> B The preceptor would try to reassure the nurse that implementing QI measures is not out of line for a newly licensed nurse. Simply stating that all nurses are required to participate does not help the nurse understand how that is possible and is dismissive. Identifying indicators of quality is not an easy, quick process and would not be the best place to suggest a new nurse to start. Asking to be assigned to the QI committee does not give the nurse information about how to implement QI in daily practice. workerwhoist 11. Anurseist talkingwitha co- toanewstateandt needstot findt newemployment there. Whatadvicet movingt bythet a. nurseis best? Askthehospitalsthereaboutstandardnurse3clientratios. b. Chooset thehospitalthathasthenewesttechnology. c. Findt at hospitalt thatt hast achievedt Magnett status. d. Workint afacilityaffiliatedwithamedicalornursingschool. - CORRECT ANS>> C Client Magnet statust isawardedbyThe Jointt Commissiont (TJC)t andcertifiesthatnurses can demo nstratehowbest currentt evidencet guidestheirpractice. Newtechnologydoesn9tt necessarilymea nthatthehospitalist safe. Affiliationwithahealtht professionschool hasseveraladvantages, butsa fetyismost important. MULTIPLERESPONSE lOMoARcPSD| 1. Anursemanagerwishestoensuret thatthenursesonthet unitaret practicing at theirhighest levelsof competency. Which areaswouldt themanagerassesstodetermineifthet nursingstaffdemonstratet competencyaccordingtothe Institutet of Medicinet (IOM) reportt Health Professions Education: Quality? (Select all thatapply.) ABridgetot a. Collaboratingt witht ant interprofessionalt team b. Implementingt evidence-basedt care c. Providingfamily-focusedcare d. Routinelyt usingt informaticst int practice e. Usingt qualityt improvementt f. int clientt care Formalizingsystemsthinkingwhenimplementingt care basedt- CORRECT ANS>> A, B,t D, E The IOMreportlistst fivet broadcorecompetenciesthatt allhealtht careproviderst shouldpractice. Theseincludecollaboratingt withtheinterprofessional team, implementingevidence- practice, providingt patient- focusedcare, usinginformaticsinclient care, andusingt qualityimprovementint clientcare. Syste msthinkingisrequiredforqualityimprovementbutisnotaspecifiedpartofthe IOMreport. DIF: Remembering TOP: IntegratedProcess:Nursingt Process:Assessmentt KEY: Competencies, Institutet of Medic ine (IOM) MSC: Client Needs Category: SafeandEffectiveCaret Environment: Safetyand Infection Control 2. Anurseist interestedt inmakingt interprofessionalworkat highpriority. Whicht actionst bythenurs e best demonstratethisskill? (Select all thatapply.) a. Consultst witht othert disciplinest ont clientt care. b. Coordinatest discharget planningt fort homet safety. c. Participatest int comprehensivet clientt rounding. d. Routinelyt askst othert disciplinest aboutt clientt progress. lOMoARcPSD| e. f. Showsthenursingt careplanstoother disciplines. Delegatet taskst tot unlicensedt ientt caret as at personnelt appropriately. - CORRECT ANS>> A,t B, C, D, F Collaboratingt withtheinterprofessional teaminvolvesplanning, implementing, andevaluatingt cl teamwithallotherinvolveddisciplinest included. Simplyshowingothercaregiverst th enursingcaret plant isnotactivelyinvolvingthemorcollaboratingwitht them. DIF: Applying TOP: IntegratedProcess:CommunicationandDocumentationt KEY: Teamwor kand collaboration, Interprofessional team MSC: Client Needst Category: Safet andEffectiveCareEnvironment: Management ofCare 3. Thenurseutilizingt evidence- basedpractice(EBP) considerst whichfactorswhenplanningcare? (Select all thatapply.) a. Cost-savingt measures b. Nurse9st expertise c. Clientt preferences d. Researcht findings e. Valuest oft thet f. client Plan-do-study-actmodel ertisewhent- CORRECT ANS>> B, C, D, E EBPconsistsofutilizingcurrentevidence, thet client9svaluest andpreferences, andt thenurse9sexp includecost- planningt savingt care. Itt does nott measures. The PDSAmodelist asystematic modelforqualityimprovement, but isnotaspe cifict componentof EBP. DIF: Remembering TOP: IntegratedProcess:Nursingt Process:Planningt KEY: Evidence-based practice (EBP) MSC: Client Needst Category: Safet andEffectivet CareEnvironment: Management ofCare 4. Anursemanagerwantstoimprovet hand- offcommunicationamongt thestaff. What actionst bythet managerwould best helpachievethisgoa l? (Select allthatapply.) a. Attendt hand-offt roundst tot coacht andt mentor. b. Createt at templatet oft suggestedt topicst tot includet int report. c. Encouraget stafft tot askt questionst duringt hand-off. d. Giveraisesbasedoncompliancewithreporting. e. Providet educationt ont thet SBARt- CORRECT ANS>> A, B, C, E nt methodt oft communication The SBARmethodofcommunicationhasbeenidentified as an excellent methodofcommunicatio betweenhealtht careprofessionals. It is at formalizedstructureconsistingoft Situation, Backgroun d, Assessment, and Recommendation/Request. Usingaformalizedt mechanismt forcommunicatio nt helpsensuresuccessfult hand- ythet offandfewerclient errors. Whenestablishingt thisnewformatforreport, themost helpfulactionsb managerwouldbetoprovideinitial education on theprocess, developt atemplatewithsuggest ed topicsunder each heading, attendroundstocoachandmentor, andencouraget stafftoaskt questio nstoclarifyinformation. Basingraisesoncompliancewouldt not bethemosthelpfulmethodt becau set raisesareoftendeterminedt onlyoncea yearandt aret basedonmultiplecriteria. DIF: Applying TOP: IntegratedProcess:CommunicationandDocumentationt KEY: Teamwor kand collaboration, Communication lOMoARcPSD| MSC: Client Needs Category: Safet andEffectiveCareEnvironment: Management ofCare lOMoARcPSD| Chapter 02: Clinical JudgmentandSystems Thinking Ignata vicius: Medical-Surgical Nursing, 10th Edition MULTIPLECHOICE 1. Anurseasksthechargenurset toexplainthet differencebetweencriticalthinkingandclinical judg ment. Whatstatementbythet chargenurseis best? a. <Clinicaljudgmentisoftencloudedbyerroneoushypotheses.= b. <Clinicaljudgmentisthet observableoutcomet ofcriticalthinking.= c. <Criticalthinkingrequiressynthesizingt interactionswithinasituation.= d. <Criticalthinkingist thehighestt levelofnursingt judgment.= - CORRECT ANS>> B tmostt oftent Clinical judgmentist theobservableoutcomet ofcriticalthinkinganddecisionmaking. It can be, bu is not, cloudedbyerroneoushypotheses. Recognizing, understanding, andsynthesizi nginteractionst andinterdependenciesinasett ofcomponentst designedforaspecificpurposeissyst emsthinking. Critical thinkingisnotthehighestlevelofnursingjudgment. DIF: Understanding TOP:IntegratedProcess:Teaching/Learning KEY: Clinicaljudgment MSC: Client Needs Category: Safet andEffectivet CareEnvironment: Management ofCare 2. Thenurset understandswhicht informationregardingpatient-centeredt care? a. Acompetencyrecognizingt thet clientt as thet sourceofcontrolofhisor her care b. Aprojectaddressingt challengesinimplementingpatient-centeredcare c. Purposeful, informed,t andoutcome-focusedcareofclientsorfamilies d. Theabilitytot usebest evidencet andpracticewhenmakingcare-relateddecisions - CORRECT ANS>> A Patient- uret centeredcareisa QSENcompetencythat recognizes thepatien

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lOMoARcPSD|240 059 64




Test Bank Medical-Surgical Nursing Concepts
for Interprofessional Collaborative Care 10th
Edition by Donna D. Ignatavicius Chapter 1-69
|Complete Guide A+

, lOMoARcPSD|240 059 64




Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Ignatavicius: Medical-Surgical Nursing, 10th Edition


MULTIPLE CHOICE

1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises the
new nurse that which is the priority when working as a professional nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
- CORRECT ANS>> B
All actions are appropriate for the professional nurse. However, ensuring client safety is the
priority. Health care errors have been widely reported for 25 years, many of which result in
client injury, death, and increased health care costs. There are several national and
international organizations that have either recommended or mandated safety initiatives.
Every nurse has the responsibility to guard the client9s safety. The other actions are important
for quality nursing, but they are not as vital as providing safety. Not making medication errors
does provide safety, but is too narrow in scope to be the best answer.


2. A nurse is orienting a new client and family to the medical-surgical unit. What information
does the nurse provide to best help the client promote his or her own safety?
a. Encourage the client and family to be active partners.
b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the client.
d. Tell the client to always wear his or her armband.
- CORRECT ANS>> A
Each action could be important for the client or family to perform. However, encouraging the
client to be active in his or her health care as a safety partner is the most critical. The other
actions are very limited in scope and do not provide the broad protection that being active and
involved does.

3. A nurse is caring for a postoperative client on the surgical unit. The client9s blood pressure
was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nurse
take first?
a. Call the Rapid Response Team.
b. Document and continue to monitor.
c. Notify the primary health care provider.
d. Repeat the blood pressure in 15 minutes.

, lOMoARcPSD|240 059 64




- CORRECT ANS>> A
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
before they suffer either respiratory or cardiac arrest. Since the client has manifested a
significant change, the nurse would call the RRT. Changes in blood pressure, mental status,
heart rate, temperature, oxygen saturation, and last 2 hours9 urine output are particularly
significant and are part of the Modified Early Warning System guide. Documentation is vital,
but the nurse must do more than document. The primary health care provider would be
notified, but this is not more important than calling the RRT. The client9s blood pressure
would be reassessed frequently, but the priority is getting the rapid care to the client.

DIF: Applying TOP: Integrated Process: Communication and Documentation
KEY: Rapid Response Team (RRT), Clinical judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation

4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
best demonstrates this concept?
a. Assesses for cultural influences affecting health care.
b. Ensures that all the client9s basic needs are met.
c. Tells the client and family about all upcoming tests.
d. Thoroughly orients the client and family to the room.
- CORRECT ANS>> A
Showing respect for the client and family9s preferences and needs is essential to ensure a
holistic or <whole-person= approach to care. By assessing the effect of the client9s culture on
health care, this nurse is practicing client-focused care. Providing for basic needs does not
demonstrate this competence. Simply telling the client about all upcoming tests is not
providing empowering education. Orienting the client and family to the room is an important
safety measure, but not directly related to demonstrating client-centered care.

5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
nurse explain is the most important thing the client can do to protect against errors?
a. Bring a list of all medications and what they are for.
b. Keep the provider9s phone number by the telephone.
c. Make sure that all providers wash hands before entering the room.
d. Write down the name of each caregiver who comes in the room.
- CORRECT ANS>> A
Medication reconciliation is a formal process in which the client9s actual current medications
are compared to the prescribed medications at the time of admission, transfer, or discharge.
This National client Safety Goal is important to reduce medication errors. The client would
not have to be responsible for providers washing their hands, and even if the client does so,
this is too narrow to be the most important action to prevent errors. Keeping the provider9s
phone number nearby and documenting everyone who enters the room also do not guarantee
safety.

, lOMoARcPSD|240 059 64




6. Which action by the nurse working with a client best demonstrates respect for autonomy?
a. Asks if the client has questions before signing a consent.
b. Gives the client accurate information when questioned.
c. Keeps the promises made to the client and family.
d. Treats the client fairly compared to other clients.
- CORRECT ANS>> A
Autonomy is self-determination. The client would make decisions regarding care. When the
nurse obtains a signature on the consent form, assessing if the client still has questions is vital,
because without full information the client cannot practice autonomy. Giving accurate
information is practicing with veracity. Keeping promises is upholding fidelity. Treating the
client fairly is providing social justice.

7. A nurse asks a more seasoned colleague to explain best practices when communicating with a
person from the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ)
community. What answer by the faculty is most accurate?
a. Avoid embarrassing the client by asking questions.
b. Don9t make assumptions about his or her health needs.
c. Most LGBTQ people do not want to share information.
d. No differences exist in communicating with this population.
- CORRECT ANS>> B
Many members of the LGBTQ community have faced discrimination from health care
providers and may be reluctant to seek health care. The nurse would never make assumptions
about the needs of members of this population. Rather, respectful questions are appropriate. If
approached with sensitivity, the client with any health care need is more likely to answer
honestly.

8. A nurse is calling the on-call health care provider about a client who had a hysterectomy 2
days ago and has pain that is unrelieved by the prescribed opioid pain medication. Which
statement comprises the background portion of the SBAR format for communication?
a. <I would like you to order a different pain medication.=
b. <This client has allergies to morphine and codeine.=
c. <Dr. Smith doesn9t like nonsteroidal anti-inflammatory meds.=
d. <This client had a vaginal hysterectomy 2 days ago.=
- CORRECT ANS>> B

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