Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
-
TEST BANK
Question 1 (MCQ)
,Clinical Scenario
A nurse is caring for a 72-year-old patient admitted with
pneumonia. During morning rounds, the nurse notices the
patient is more confused than yesterday, has a respiratory rate
of 30/min, and oxygen saturation of 88% on room air.
Question Stem
Which action best demonstrates clinical judgment?
Answer Options
A. Document the findings and reassess in 4 hours.
B. Increase oral fluid intake and continue monitoring.
C. Recognize deterioration and notify the provider while
initiating oxygen therapy per protocol.
D. Wait for the provider to evaluate the patient during
scheduled rounds.
Correct Answer
C
Detailed Rationale
Clinical judgment requires recognizing significant changes,
analyzing their meaning, and taking timely action. Acute
confusion, tachypnea, and hypoxemia suggest worsening
respiratory status. Early intervention improves outcomes and
reduces risk of respiratory failure.
Incorrect Option Analysis
,A
• Incorrect: Delays intervention.
• Misconception: Documentation alone is sufficient.
• Safety Risk: Missed deterioration.
B
• Incorrect: Does not address hypoxia.
• Misconception: Fluids correct respiratory compromise.
• Safety Risk: Respiratory failure progression.
D
• Incorrect: Waiting may worsen patient status.
• Misconception: Provider assessment should always
precede nursing action.
• Safety Risk: Delayed treatment.
Nursing Process Linkage
Assessment
NCJMM Competencies
• Recognize Cues
• Analyze Cues
• Take Action
Difficulty
, Moderate
Bloom's Level
Analyze
NCLEX Category
Physiological Adaptation
Key Learning Objective
Apply clinical judgment to identify and respond to patient
deterioration.
Question 2 (MCQ)
Clinical Scenario
A nurse is reviewing evidence before implementing a new
pressure injury prevention protocol.
Question Stem
Which action best reflects evidence-based nursing practice?
Answer Options
A. Using only personal experience
B. Following a practice because it has always been done that
way
C. Integrating current research, clinical expertise, and patient
preferences
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
-
TEST BANK
Question 1 (MCQ)
,Clinical Scenario
A nurse is caring for a 72-year-old patient admitted with
pneumonia. During morning rounds, the nurse notices the
patient is more confused than yesterday, has a respiratory rate
of 30/min, and oxygen saturation of 88% on room air.
Question Stem
Which action best demonstrates clinical judgment?
Answer Options
A. Document the findings and reassess in 4 hours.
B. Increase oral fluid intake and continue monitoring.
C. Recognize deterioration and notify the provider while
initiating oxygen therapy per protocol.
D. Wait for the provider to evaluate the patient during
scheduled rounds.
Correct Answer
C
Detailed Rationale
Clinical judgment requires recognizing significant changes,
analyzing their meaning, and taking timely action. Acute
confusion, tachypnea, and hypoxemia suggest worsening
respiratory status. Early intervention improves outcomes and
reduces risk of respiratory failure.
Incorrect Option Analysis
,A
• Incorrect: Delays intervention.
• Misconception: Documentation alone is sufficient.
• Safety Risk: Missed deterioration.
B
• Incorrect: Does not address hypoxia.
• Misconception: Fluids correct respiratory compromise.
• Safety Risk: Respiratory failure progression.
D
• Incorrect: Waiting may worsen patient status.
• Misconception: Provider assessment should always
precede nursing action.
• Safety Risk: Delayed treatment.
Nursing Process Linkage
Assessment
NCJMM Competencies
• Recognize Cues
• Analyze Cues
• Take Action
Difficulty
, Moderate
Bloom's Level
Analyze
NCLEX Category
Physiological Adaptation
Key Learning Objective
Apply clinical judgment to identify and respond to patient
deterioration.
Question 2 (MCQ)
Clinical Scenario
A nurse is reviewing evidence before implementing a new
pressure injury prevention protocol.
Question Stem
Which action best reflects evidence-based nursing practice?
Answer Options
A. Using only personal experience
B. Following a practice because it has always been done that
way
C. Integrating current research, clinical expertise, and patient
preferences
