Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• PublisherPublished by F.A.
Davis Copyright© 2024
• Print ISBN: 9781719647366
TEST BANK
,Chapter 1: Foundations for Medical-Surgical Nursing
1) MCQ
Clinical scenario: A 78-year-old patient is 6 hours postoperative
after abdominal surgery. The patient is drowsy, has a
respiratory rate of 8/min, SpO₂ of 88% on 2 L/min nasal
cannula, and is difficult to arouse after receiving IV morphine
20 minutes ago.
Question stem: What is the nurse’s priority action?
Answer options:
A. Document the findings and reassess in 15 minutes
B. Give the next scheduled opioid to prevent pain escalation
C. Stimulate the patient, apply oxygen per policy, and activate
rapid response/notify the provider
D. Encourage incentive spirometry and ambulation
Correct answer: C
Detailed rationale: The patient shows signs of opioid-induced
respiratory depression and possible hypoxemia. The priority is
to address airway/breathing immediately and escalate care.
Stimulation, oxygen, and urgent help activation are appropriate
first actions.
Incorrect option analysis:
, • A: Incorrect. Delaying action risks severe hypoxia and
respiratory arrest.
Misconception: Thinking “reassess later” is acceptable for
a deteriorating patient.
Safety risk: Delayed intervention can lead to cardiac
arrest.
• B: Incorrect. Giving more opioid would worsen respiratory
depression.
Misconception: Treating pain before stabilizing
ventilation.
Safety risk: Further respiratory compromise.
• D: Incorrect. Incentive spirometry and ambulation are
helpful only when the patient is stable.
Misconception: Applying routine postop care to an
unstable patient.
Safety risk: Missed emergency response.
Nursing process linkage: Assessment / Implementation
Clinical Judgment Competencies (NCJMM): Recognize Cues,
Analyze Cues, Take Action
Difficulty level: Moderate
Bloom’s cognitive level: Apply
NCLEX Client Needs Category: Physiological Adaptation / Safety
and Infection Control
Key learning objective: Prioritize immediate interventions for
postoperative respiratory compromise.
, 2) MCQ
Clinical scenario: A nurse on a medical-surgical unit is told, “We
have always changed this wound dressing every shift.” New
evidence-based guidelines on the unit recommend dressing
changes based on wound condition and drainage, not an
automatic schedule.
Question stem: Which action best reflects evidence-based
nursing care?
Answer options:
A. Continue the old schedule because it has always been used
B. Ask the most experienced nurse what she prefers
C. Review the current guideline and assess the wound before
deciding on dressing frequency
D. Follow the patient’s preference only, without checking the
wound
Correct answer: C
Detailed rationale: Evidence-based care integrates best
available research, clinical expertise, and patient-specific
assessment. Dressing frequency should be based on the
wound’s condition and current guidance.
Incorrect option analysis:
• A: Incorrect. Tradition alone is not evidence-based.
Misconception: “If it worked before, it is best practice.”
Safety risk: Unnecessary dressing changes or missed
wound deterioration.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• PublisherPublished by F.A.
Davis Copyright© 2024
• Print ISBN: 9781719647366
TEST BANK
,Chapter 1: Foundations for Medical-Surgical Nursing
1) MCQ
Clinical scenario: A 78-year-old patient is 6 hours postoperative
after abdominal surgery. The patient is drowsy, has a
respiratory rate of 8/min, SpO₂ of 88% on 2 L/min nasal
cannula, and is difficult to arouse after receiving IV morphine
20 minutes ago.
Question stem: What is the nurse’s priority action?
Answer options:
A. Document the findings and reassess in 15 minutes
B. Give the next scheduled opioid to prevent pain escalation
C. Stimulate the patient, apply oxygen per policy, and activate
rapid response/notify the provider
D. Encourage incentive spirometry and ambulation
Correct answer: C
Detailed rationale: The patient shows signs of opioid-induced
respiratory depression and possible hypoxemia. The priority is
to address airway/breathing immediately and escalate care.
Stimulation, oxygen, and urgent help activation are appropriate
first actions.
Incorrect option analysis:
, • A: Incorrect. Delaying action risks severe hypoxia and
respiratory arrest.
Misconception: Thinking “reassess later” is acceptable for
a deteriorating patient.
Safety risk: Delayed intervention can lead to cardiac
arrest.
• B: Incorrect. Giving more opioid would worsen respiratory
depression.
Misconception: Treating pain before stabilizing
ventilation.
Safety risk: Further respiratory compromise.
• D: Incorrect. Incentive spirometry and ambulation are
helpful only when the patient is stable.
Misconception: Applying routine postop care to an
unstable patient.
Safety risk: Missed emergency response.
Nursing process linkage: Assessment / Implementation
Clinical Judgment Competencies (NCJMM): Recognize Cues,
Analyze Cues, Take Action
Difficulty level: Moderate
Bloom’s cognitive level: Apply
NCLEX Client Needs Category: Physiological Adaptation / Safety
and Infection Control
Key learning objective: Prioritize immediate interventions for
postoperative respiratory compromise.
, 2) MCQ
Clinical scenario: A nurse on a medical-surgical unit is told, “We
have always changed this wound dressing every shift.” New
evidence-based guidelines on the unit recommend dressing
changes based on wound condition and drainage, not an
automatic schedule.
Question stem: Which action best reflects evidence-based
nursing care?
Answer options:
A. Continue the old schedule because it has always been used
B. Ask the most experienced nurse what she prefers
C. Review the current guideline and assess the wound before
deciding on dressing frequency
D. Follow the patient’s preference only, without checking the
wound
Correct answer: C
Detailed rationale: Evidence-based care integrates best
available research, clinical expertise, and patient-specific
assessment. Dressing frequency should be based on the
wound’s condition and current guidance.
Incorrect option analysis:
• A: Incorrect. Tradition alone is not evidence-based.
Misconception: “If it worked before, it is best practice.”
Safety risk: Unnecessary dressing changes or missed
wound deterioration.
