Medical-Surgical Nursing
11th Edition
Author(s)Donna D. Ignatavicius;
Cherie R. Rebar; Nicole M.
Heimgartner
Publisher Published by Elsevier
UK Copyright© 2024
Print ISBN: 9780323878265
TEST BANK
,Question 1 (MCQ)
Clinical Scenario
A nurse receives change-of-shift report on four patients.
Question Stem
Which patient should the nurse assess first?
Options
A. A patient with chronic heart failure requesting assistance to
the bathroom
B. A patient scheduled for discharge who needs medication
teaching
C. A patient with diabetes whose blood glucose is 54 mg/dL and
is diaphoretic
D. A patient waiting for transport to radiology
Correct Answer
C
Detailed Rationale
A symptomatic hypoglycemic patient is at immediate risk for
neurologic deterioration, seizures, and loss of consciousness.
Clinical judgment requires prioritizing unstable physiologic
needs before routine care activities.
Incorrect Option Analysis
A
, Not immediately life-threatening.
Misconception: Mobility requests always require
immediate response.
Safety concern: Delay is acceptable if assistance is
arranged.
B
Important but not urgent.
Misconception: Discharge tasks supersede acute
physiologic needs.
D
Transport delays rarely threaten life.
Nursing Process Linkage
Assessment
NCJMM Competencies
Recognize Cues
Analyze Cues
Prioritize Hypotheses
Difficulty
Moderate
Bloom's Level
Analyze
, NCLEX Client Needs
Physiological Adaptation
Learning Objective
Prioritize care using patient acuity and safety principles.
Question 2 (MCQ)
Clinical Scenario
A nurse is reviewing evidence before implementing a new fall-
prevention intervention.
Question Stem
Which action best demonstrates evidence-based practice?
Options
A. Using a strategy because another nurse prefers it
B. Following a unit tradition
C. Integrating current research findings, clinical expertise, and
patient preferences
D. Implementing the least expensive intervention
Correct Answer
C
Detailed Rationale
11th Edition
Author(s)Donna D. Ignatavicius;
Cherie R. Rebar; Nicole M.
Heimgartner
Publisher Published by Elsevier
UK Copyright© 2024
Print ISBN: 9780323878265
TEST BANK
,Question 1 (MCQ)
Clinical Scenario
A nurse receives change-of-shift report on four patients.
Question Stem
Which patient should the nurse assess first?
Options
A. A patient with chronic heart failure requesting assistance to
the bathroom
B. A patient scheduled for discharge who needs medication
teaching
C. A patient with diabetes whose blood glucose is 54 mg/dL and
is diaphoretic
D. A patient waiting for transport to radiology
Correct Answer
C
Detailed Rationale
A symptomatic hypoglycemic patient is at immediate risk for
neurologic deterioration, seizures, and loss of consciousness.
Clinical judgment requires prioritizing unstable physiologic
needs before routine care activities.
Incorrect Option Analysis
A
, Not immediately life-threatening.
Misconception: Mobility requests always require
immediate response.
Safety concern: Delay is acceptable if assistance is
arranged.
B
Important but not urgent.
Misconception: Discharge tasks supersede acute
physiologic needs.
D
Transport delays rarely threaten life.
Nursing Process Linkage
Assessment
NCJMM Competencies
Recognize Cues
Analyze Cues
Prioritize Hypotheses
Difficulty
Moderate
Bloom's Level
Analyze
, NCLEX Client Needs
Physiological Adaptation
Learning Objective
Prioritize care using patient acuity and safety principles.
Question 2 (MCQ)
Clinical Scenario
A nurse is reviewing evidence before implementing a new fall-
prevention intervention.
Question Stem
Which action best demonstrates evidence-based practice?
Options
A. Using a strategy because another nurse prefers it
B. Following a unit tradition
C. Integrating current research findings, clinical expertise, and
patient preferences
D. Implementing the least expensive intervention
Correct Answer
C
Detailed Rationale
