TEST BANKS FOR LEWIS'S MEDICAL-SURGICAL NURSING 12TH
EDITION COMPLETE (1-69 CHAPTERS)
,TABLE OF CONTENTS
SECTION 1: Foundations of Nursing Practice
Chapter 1: Professional Nursing
Chapter 2: Social Determinants of Health
Chapter 3: Health History and Physical Examination
Chapter 4: Patient and Caregiver Teaching
Chapter 5: Chronic Illness and Older Adults
Chapter 6: Caring for Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, and Gender Diverse Patients
SECTION 2: Problems Related to Comfort and Coping
Chapter 7: Stress Management
Chapter 8: Sleep and Sleep Disorders
Chapter 9: Pain
Chapter 10: Palliative and End-of-Life Care
Chapter 11: Substance Use Disorders in Acute Care
SECTION 3: Problems Related to Homeostasis and Protection
Chapter 12: Inflammation and Healing
Chapter 13: Genetics
Chapter 14: Immune Responses and Transplantation
Chapter 15: Infection
Chapter 16: Cancer
Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances
SECTION 4: Perioperative and Emergency Care
Chapter 18: Preoperative Care
Chapter 19: Intraoperative Care
Chapter 20: Postoperative Care
Chapter 21: Emergency and Disaster Nursing
SECTION 5: Problems Related to Altered Sensory Input
Chapter 22: Assessment and Management: Visual Problems
Chapter 23: Assessment and Management: Auditory Problems
Chapter 24: Assessment: Integumentary System
,Chapter 25: Integumentary Problems
Chapter 26: Burns
SECTION 6: Problems of Oxygenation – Ventilation
Chapter 27: Assessment: Respiratory System
Chapter 28: Supporting Ventilation
Chapter 29: Upper Respiratory Problems
Chapter 30: Lower Respiratory Problems
Chapter 31: Obstructive Pulmonary Diseases
Chapter 32: Acute Respiratory Failure and Acute Respiratory Distress Syndrome (ARDS)
SECTION 7: Problems of Oxygenation – Transport
Chapter 33: Assessment: Hematologic System
Chapter 34: Hematologic Problems
SECTION 8: Problems of Oxygenation – Perfusion
Chapter 35: Assessment: Cardiovascular System
Chapter 36: Hypertension
Chapter 37: Coronary Artery Disease and Acute Coronary Syndrome
Chapter 38: Heart Failure
Chapter 39: Dysrhythmias
Chapter 40: Inflammatory and Structural Heart Disorders
Chapter 41: Vascular Disorders
Chapter 42: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome (MODS)
SECTION 9: Problems of Ingestion, Digestion, Absorption, and Elimination
Chapter 43: Assessment: Gastrointestinal System
Chapter 44: Nutrition Problems
Chapter 45: Obesity
Chapter 46: Upper Gastrointestinal Problems
Chapter 47: Lower Gastrointestinal Problems
Chapter 48: Liver, Biliary Tract, and Pancreas Problems
SECTION 10: Problems of Urinary Function
,Chapter 49: Assessment: Urinary System
Chapter 50: Renal and Urologic Problems
Chapter 51: Acute Kidney Injury and Chronic Kidney Disease
SECTION 11: Problems Related to Regulatory and Reproductive Mechanisms
Chapter 52: Assessment: Endocrine System
Chapter 53: Diabetes
Chapter 54: Endocrine Problems
Chapter 55: Assessment: Reproductive System
Chapter 56: Breast Problems
Chapter 57: Sexually Transmitted Infections (STIs)
Chapter 58: Female Reproductive Problems
Chapter 59: Male Reproductive Problems
SECTION 12: Problems Related to Movement and Coordination
Chapter 60: Assessment: Nervous System
Chapter 61: Acute Intracranial Problems
Chapter 62: Stroke
Chapter 63: Chronic Neurologic Problems
Chapter 64: Dementia and Delirium
Chapter 65: Spinal Cord and Peripheral Nerve Problems
Chapter 66: Assessment: Musculoskeletal System
Chapter 67: Musculoskeletal Trauma and Orthopedic Surgery
Chapter 68: Musculoskeletal Problems
Chapter 69: Arthritis and Connective Tissue Diseases
Document Summary
• Total Sections: 12
• Total Chapters: 69
• Question Range: 1–1380
• Format: Advanced NCLEX-RN Style
• Includes: NGN Clinical Judgment Cases, SATA Questions, Priority Nursing Care, Detailed Rationales,
Patient Safety Concepts, Evidence-Based Practice, and Adult Health Nursing Content.
,Chapter 1: professional nursing
Question 1
A newly licensed nurse is caring for a client admitted with acute pancreatitis. Which action best demonstrates
professional accountability?
A. Performing interventions based on previous experiences only
B. Consulting current evidence-based guidelines before implementing care
C. Following the care plan without evaluating patient outcomes
D. Delegating all routine assessments to assistive personnel
Correct answer: b
Rationale: professional accountability requires nurses to integrate evidence-based practice, clinical expertise,
and patient preferences into care decisions. Consulting current evidence ensures that interventions are safe,
effective, and aligned with professional standards. Accountable nurses continually update their knowledge and
apply current best practices to improve patient outcomes.
Why not a: experience alone may not reflect current best practices.
Why not c: nurses must evaluate patient responses and outcomes.
Why not d: assessment is a nursing responsibility.
Keywords: accountability, evidence-based practice, professional standards, quality care
Question 2
A nurse receives a verbal order for a medication dosage that appears unusually high. Which action is most
appropriate?
A. Administer the medication as prescribed
B. Ask another nurse to administer it
C. Clarify the order with the provider before administration
D. Document the order and administer later
Correct answer: c
Rationale: nurses have a professional and legal responsibility to question any order that appears unsafe or
inconsistent with patient needs. Clarification helps prevent medication errors and protects patient safety. The
nurse serves as the final safeguard before medication administration.
Why not a: blindly following questionable orders may harm the patient.
Why not b: responsibility cannot be transferred to another nurse.
,Why not d: delaying clarification may jeopardize patient care.
Keywords: patient safety, medication error prevention, advocacy, professional responsibility
Question 3
A nurse identifies a recent research article supporting a new intervention for pressure injury prevention. Which
action reflects evidence-based nursing practice?
A. Implementing the intervention immediately for all patients
B. Evaluating the evidence and discussing implementation with the healthcare team
C. Ignoring the research because current practice has worked previously
D. Waiting several years before considering the intervention
Correct answer: b
Rationale: evidence-based practice requires critical appraisal of research, collaboration with stakeholders, and
evaluation of applicability before implementation. A systematic approach ensures safe adoption of new
interventions.
Why not a: practice changes require evaluation and planning.
Why not c: nursing care should evolve with emerging evidence.
Why not d: delayed adoption may prevent patients from receiving better care.
Keywords: research utilization, evidence-based practice, quality improvement
Question 4
The nurse is assigned four clients. Which client should be assessed first?
A. A client with chronic osteoarthritis reporting pain of 4/10
B. A client with pneumonia whose oxygen saturation decreased from 95% to 87%
C. A client awaiting discharge instructions
D. A client requesting assistance to the bathroom
Correct answer: b
Rationale: airway and breathing problems take priority according to the abc framework. A significant drop in
oxygen saturation suggests worsening respiratory compromise requiring immediate assessment and
intervention.
Why not a: chronic pain is important but not immediately life-threatening.
Why not c: discharge teaching can safely wait.
Why not d: assistance is needed but is not the highest priority.
,Keywords: priority setting, abcs, oxygenation, clinical judgment
Question 5
A nurse demonstrates patient advocacy when performing which action?
A. Convincing the patient to follow the nurse's preferred treatment
B. Reporting the patient's concerns regarding a proposed procedure to the provider
C. Making treatment decisions independently
D. Withholding information that may increase anxiety
Correct answer: b
Rationale: advocacy involves protecting patient rights, ensuring informed decision-making, and communicating
patient concerns to the healthcare team. Nurses serve as patient representatives when concerns arise.
Why not a: advocacy supports patient choices, not nurse preferences.
Why not c: treatment decisions require collaboration.
Why not d: patients deserve complete information.
Keywords: advocacy, patient rights, communication, ethics
Question 6
A nurse notices a colleague documenting assessments that were not completed. What is the nurse's priority
action?
A. Ignore the situation
B. Discuss concerns directly with the colleague according to organizational policy
C. Inform other staff members
D. Rewrite the colleague's documentation
Correct answer: b
Rationale: professional nursing standards require addressing unsafe practices through appropriate channels.
Direct communication may clarify the issue and promote accountability while protecting patient safety.
Why not a: ignoring misconduct jeopardizes patient care.
Why not c: gossip does not resolve safety concerns.
Why not d: altering another nurse's documentation is inappropriate.
Keywords: professional conduct, accountability, documentation, ethics
Question 7
,A nurse participates in a quality improvement project aimed at reducing catheter-associated urinary tract
infections. This activity primarily supports which nursing role?
A. Caregiver only
B. Educator only
C. Quality improvement advocate
D. Financial manager
Correct answer: c
Rationale: quality improvement initiatives focus on enhancing patient outcomes, reducing complications, and
improving healthcare processes. Participation demonstrates commitment to professional excellence.
Why not a: the role extends beyond direct patient care.
Why not b: education may occur but is not the primary focus.
Why not d: financial management is unrelated.
Keywords: quality improvement, patient safety, outcomes, professional nursing
Question 8
A nurse caring for a culturally diverse population demonstrates cultural humility by:
A. Assuming all patients from the same culture share beliefs
B. Asking patients about individual healthcare preferences and values
C. Using stereotypes to guide care
D. Avoiding discussions about cultural practices
Correct answer: b
Rationale: cultural humility involves self-reflection, openness, and respect for each patient's unique beliefs and
experiences. Individualized assessment improves culturally competent care.
Why not a: cultural groups are diverse.
Why not c: stereotypes create bias.
Why not d: open discussion improves understanding.
Keywords: cultural humility, diversity, patient-centered care
Question 9
The nurse is evaluating whether a nursing intervention was effective. This action corresponds to which step of
the nursing process?
A. Assessment
,B. Diagnosis
C. Planning
D. Evaluation
Correct answer: d
Rationale: evaluation determines whether goals have been met and whether interventions achieved desired
outcomes. Findings guide future care decisions.
Why not a: assessment gathers data.
Why not b: diagnosis identifies problems.
Why not c: planning establishes goals.
Keywords: nursing process, evaluation, outcomes
Question 10
A nurse is mentoring a new graduate nurse. Which statement best reflects professional nursing leadership?
A. "you should do exactly what i do."
B. "ask questions and use evidence to guide your decisions."
C. "avoid questioning provider orders."
D. "experience is more important than evidence."
Correct answer: b
Rationale: effective nursing leaders encourage critical thinking, evidence-based practice, and lifelong learning.
These qualities strengthen clinical judgment and patient safety.
Why not a: leadership promotes independent thinking.
Why not c: unsafe orders must be questioned.
Why not d: evidence and experience work together.
Keywords: leadership, critical thinking, mentorship
Question 11
A charge nurse is assigning patients. Which patient is most appropriate for a newly licensed rn?
A. A patient with septic shock receiving vasopressors
B. A patient 24 hours after uncomplicated appendectomy
C. A patient requiring continuous cardiac titration
D. A patient with multiple organ failure
, Correct answer: b
Rationale: stable patients with predictable outcomes are appropriate assignments for newly licensed nurses.
Complex unstable patients require experienced clinicians.
Why not a: requires advanced critical care skills.
Why not c: involves high-risk monitoring.
Why not d: requires expert clinical judgment.
Keywords: assignment, delegation, staffing
Question 12
A nurse identifies a medication error before administration. What is the first action?
A. Complete an incident report
B. Notify risk management
C. Prevent administration of the medication
D. Inform the patient's family
Correct answer: c
Rationale: patient safety is the immediate priority. Preventing harm takes precedence before reporting or
documentation procedures.
Why not a: reporting occurs after ensuring safety.
Why not b: not the first action.
Why not d: family notification follows appropriate assessment.
Keywords: medication safety, error prevention, priority
Question 13
A nurse manager encourages staff participation in shared governance. What is the primary goal?
A. Reducing nursing autonomy
B. Increasing administrative control
C. Promoting nurse involvement in decision-making
D. Eliminating interdisciplinary collaboration
Correct answer: c
Rationale: shared governance empowers nurses to participate in decisions affecting practice, quality
improvement, and patient outcomes.
Why not a: it increases autonomy.
EDITION COMPLETE (1-69 CHAPTERS)
,TABLE OF CONTENTS
SECTION 1: Foundations of Nursing Practice
Chapter 1: Professional Nursing
Chapter 2: Social Determinants of Health
Chapter 3: Health History and Physical Examination
Chapter 4: Patient and Caregiver Teaching
Chapter 5: Chronic Illness and Older Adults
Chapter 6: Caring for Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, and Gender Diverse Patients
SECTION 2: Problems Related to Comfort and Coping
Chapter 7: Stress Management
Chapter 8: Sleep and Sleep Disorders
Chapter 9: Pain
Chapter 10: Palliative and End-of-Life Care
Chapter 11: Substance Use Disorders in Acute Care
SECTION 3: Problems Related to Homeostasis and Protection
Chapter 12: Inflammation and Healing
Chapter 13: Genetics
Chapter 14: Immune Responses and Transplantation
Chapter 15: Infection
Chapter 16: Cancer
Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances
SECTION 4: Perioperative and Emergency Care
Chapter 18: Preoperative Care
Chapter 19: Intraoperative Care
Chapter 20: Postoperative Care
Chapter 21: Emergency and Disaster Nursing
SECTION 5: Problems Related to Altered Sensory Input
Chapter 22: Assessment and Management: Visual Problems
Chapter 23: Assessment and Management: Auditory Problems
Chapter 24: Assessment: Integumentary System
,Chapter 25: Integumentary Problems
Chapter 26: Burns
SECTION 6: Problems of Oxygenation – Ventilation
Chapter 27: Assessment: Respiratory System
Chapter 28: Supporting Ventilation
Chapter 29: Upper Respiratory Problems
Chapter 30: Lower Respiratory Problems
Chapter 31: Obstructive Pulmonary Diseases
Chapter 32: Acute Respiratory Failure and Acute Respiratory Distress Syndrome (ARDS)
SECTION 7: Problems of Oxygenation – Transport
Chapter 33: Assessment: Hematologic System
Chapter 34: Hematologic Problems
SECTION 8: Problems of Oxygenation – Perfusion
Chapter 35: Assessment: Cardiovascular System
Chapter 36: Hypertension
Chapter 37: Coronary Artery Disease and Acute Coronary Syndrome
Chapter 38: Heart Failure
Chapter 39: Dysrhythmias
Chapter 40: Inflammatory and Structural Heart Disorders
Chapter 41: Vascular Disorders
Chapter 42: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome (MODS)
SECTION 9: Problems of Ingestion, Digestion, Absorption, and Elimination
Chapter 43: Assessment: Gastrointestinal System
Chapter 44: Nutrition Problems
Chapter 45: Obesity
Chapter 46: Upper Gastrointestinal Problems
Chapter 47: Lower Gastrointestinal Problems
Chapter 48: Liver, Biliary Tract, and Pancreas Problems
SECTION 10: Problems of Urinary Function
,Chapter 49: Assessment: Urinary System
Chapter 50: Renal and Urologic Problems
Chapter 51: Acute Kidney Injury and Chronic Kidney Disease
SECTION 11: Problems Related to Regulatory and Reproductive Mechanisms
Chapter 52: Assessment: Endocrine System
Chapter 53: Diabetes
Chapter 54: Endocrine Problems
Chapter 55: Assessment: Reproductive System
Chapter 56: Breast Problems
Chapter 57: Sexually Transmitted Infections (STIs)
Chapter 58: Female Reproductive Problems
Chapter 59: Male Reproductive Problems
SECTION 12: Problems Related to Movement and Coordination
Chapter 60: Assessment: Nervous System
Chapter 61: Acute Intracranial Problems
Chapter 62: Stroke
Chapter 63: Chronic Neurologic Problems
Chapter 64: Dementia and Delirium
Chapter 65: Spinal Cord and Peripheral Nerve Problems
Chapter 66: Assessment: Musculoskeletal System
Chapter 67: Musculoskeletal Trauma and Orthopedic Surgery
Chapter 68: Musculoskeletal Problems
Chapter 69: Arthritis and Connective Tissue Diseases
Document Summary
• Total Sections: 12
• Total Chapters: 69
• Question Range: 1–1380
• Format: Advanced NCLEX-RN Style
• Includes: NGN Clinical Judgment Cases, SATA Questions, Priority Nursing Care, Detailed Rationales,
Patient Safety Concepts, Evidence-Based Practice, and Adult Health Nursing Content.
,Chapter 1: professional nursing
Question 1
A newly licensed nurse is caring for a client admitted with acute pancreatitis. Which action best demonstrates
professional accountability?
A. Performing interventions based on previous experiences only
B. Consulting current evidence-based guidelines before implementing care
C. Following the care plan without evaluating patient outcomes
D. Delegating all routine assessments to assistive personnel
Correct answer: b
Rationale: professional accountability requires nurses to integrate evidence-based practice, clinical expertise,
and patient preferences into care decisions. Consulting current evidence ensures that interventions are safe,
effective, and aligned with professional standards. Accountable nurses continually update their knowledge and
apply current best practices to improve patient outcomes.
Why not a: experience alone may not reflect current best practices.
Why not c: nurses must evaluate patient responses and outcomes.
Why not d: assessment is a nursing responsibility.
Keywords: accountability, evidence-based practice, professional standards, quality care
Question 2
A nurse receives a verbal order for a medication dosage that appears unusually high. Which action is most
appropriate?
A. Administer the medication as prescribed
B. Ask another nurse to administer it
C. Clarify the order with the provider before administration
D. Document the order and administer later
Correct answer: c
Rationale: nurses have a professional and legal responsibility to question any order that appears unsafe or
inconsistent with patient needs. Clarification helps prevent medication errors and protects patient safety. The
nurse serves as the final safeguard before medication administration.
Why not a: blindly following questionable orders may harm the patient.
Why not b: responsibility cannot be transferred to another nurse.
,Why not d: delaying clarification may jeopardize patient care.
Keywords: patient safety, medication error prevention, advocacy, professional responsibility
Question 3
A nurse identifies a recent research article supporting a new intervention for pressure injury prevention. Which
action reflects evidence-based nursing practice?
A. Implementing the intervention immediately for all patients
B. Evaluating the evidence and discussing implementation with the healthcare team
C. Ignoring the research because current practice has worked previously
D. Waiting several years before considering the intervention
Correct answer: b
Rationale: evidence-based practice requires critical appraisal of research, collaboration with stakeholders, and
evaluation of applicability before implementation. A systematic approach ensures safe adoption of new
interventions.
Why not a: practice changes require evaluation and planning.
Why not c: nursing care should evolve with emerging evidence.
Why not d: delayed adoption may prevent patients from receiving better care.
Keywords: research utilization, evidence-based practice, quality improvement
Question 4
The nurse is assigned four clients. Which client should be assessed first?
A. A client with chronic osteoarthritis reporting pain of 4/10
B. A client with pneumonia whose oxygen saturation decreased from 95% to 87%
C. A client awaiting discharge instructions
D. A client requesting assistance to the bathroom
Correct answer: b
Rationale: airway and breathing problems take priority according to the abc framework. A significant drop in
oxygen saturation suggests worsening respiratory compromise requiring immediate assessment and
intervention.
Why not a: chronic pain is important but not immediately life-threatening.
Why not c: discharge teaching can safely wait.
Why not d: assistance is needed but is not the highest priority.
,Keywords: priority setting, abcs, oxygenation, clinical judgment
Question 5
A nurse demonstrates patient advocacy when performing which action?
A. Convincing the patient to follow the nurse's preferred treatment
B. Reporting the patient's concerns regarding a proposed procedure to the provider
C. Making treatment decisions independently
D. Withholding information that may increase anxiety
Correct answer: b
Rationale: advocacy involves protecting patient rights, ensuring informed decision-making, and communicating
patient concerns to the healthcare team. Nurses serve as patient representatives when concerns arise.
Why not a: advocacy supports patient choices, not nurse preferences.
Why not c: treatment decisions require collaboration.
Why not d: patients deserve complete information.
Keywords: advocacy, patient rights, communication, ethics
Question 6
A nurse notices a colleague documenting assessments that were not completed. What is the nurse's priority
action?
A. Ignore the situation
B. Discuss concerns directly with the colleague according to organizational policy
C. Inform other staff members
D. Rewrite the colleague's documentation
Correct answer: b
Rationale: professional nursing standards require addressing unsafe practices through appropriate channels.
Direct communication may clarify the issue and promote accountability while protecting patient safety.
Why not a: ignoring misconduct jeopardizes patient care.
Why not c: gossip does not resolve safety concerns.
Why not d: altering another nurse's documentation is inappropriate.
Keywords: professional conduct, accountability, documentation, ethics
Question 7
,A nurse participates in a quality improvement project aimed at reducing catheter-associated urinary tract
infections. This activity primarily supports which nursing role?
A. Caregiver only
B. Educator only
C. Quality improvement advocate
D. Financial manager
Correct answer: c
Rationale: quality improvement initiatives focus on enhancing patient outcomes, reducing complications, and
improving healthcare processes. Participation demonstrates commitment to professional excellence.
Why not a: the role extends beyond direct patient care.
Why not b: education may occur but is not the primary focus.
Why not d: financial management is unrelated.
Keywords: quality improvement, patient safety, outcomes, professional nursing
Question 8
A nurse caring for a culturally diverse population demonstrates cultural humility by:
A. Assuming all patients from the same culture share beliefs
B. Asking patients about individual healthcare preferences and values
C. Using stereotypes to guide care
D. Avoiding discussions about cultural practices
Correct answer: b
Rationale: cultural humility involves self-reflection, openness, and respect for each patient's unique beliefs and
experiences. Individualized assessment improves culturally competent care.
Why not a: cultural groups are diverse.
Why not c: stereotypes create bias.
Why not d: open discussion improves understanding.
Keywords: cultural humility, diversity, patient-centered care
Question 9
The nurse is evaluating whether a nursing intervention was effective. This action corresponds to which step of
the nursing process?
A. Assessment
,B. Diagnosis
C. Planning
D. Evaluation
Correct answer: d
Rationale: evaluation determines whether goals have been met and whether interventions achieved desired
outcomes. Findings guide future care decisions.
Why not a: assessment gathers data.
Why not b: diagnosis identifies problems.
Why not c: planning establishes goals.
Keywords: nursing process, evaluation, outcomes
Question 10
A nurse is mentoring a new graduate nurse. Which statement best reflects professional nursing leadership?
A. "you should do exactly what i do."
B. "ask questions and use evidence to guide your decisions."
C. "avoid questioning provider orders."
D. "experience is more important than evidence."
Correct answer: b
Rationale: effective nursing leaders encourage critical thinking, evidence-based practice, and lifelong learning.
These qualities strengthen clinical judgment and patient safety.
Why not a: leadership promotes independent thinking.
Why not c: unsafe orders must be questioned.
Why not d: evidence and experience work together.
Keywords: leadership, critical thinking, mentorship
Question 11
A charge nurse is assigning patients. Which patient is most appropriate for a newly licensed rn?
A. A patient with septic shock receiving vasopressors
B. A patient 24 hours after uncomplicated appendectomy
C. A patient requiring continuous cardiac titration
D. A patient with multiple organ failure
, Correct answer: b
Rationale: stable patients with predictable outcomes are appropriate assignments for newly licensed nurses.
Complex unstable patients require experienced clinicians.
Why not a: requires advanced critical care skills.
Why not c: involves high-risk monitoring.
Why not d: requires expert clinical judgment.
Keywords: assignment, delegation, staffing
Question 12
A nurse identifies a medication error before administration. What is the first action?
A. Complete an incident report
B. Notify risk management
C. Prevent administration of the medication
D. Inform the patient's family
Correct answer: c
Rationale: patient safety is the immediate priority. Preventing harm takes precedence before reporting or
documentation procedures.
Why not a: reporting occurs after ensuring safety.
Why not b: not the first action.
Why not d: family notification follows appropriate assessment.
Keywords: medication safety, error prevention, priority
Question 13
A nurse manager encourages staff participation in shared governance. What is the primary goal?
A. Reducing nursing autonomy
B. Increasing administrative control
C. Promoting nurse involvement in decision-making
D. Eliminating interdisciplinary collaboration
Correct answer: c
Rationale: shared governance empowers nurses to participate in decisions affecting practice, quality
improvement, and patient outcomes.
Why not a: it increases autonomy.
