Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical scenario:
A postoperative patient who received IV hydromorphone 20
minutes ago is resting in bed. The nurse enters the room and
notes the patient is difficult to arouse.
Question stem:
Which finding requires the nurse’s immediate follow-up?
Answer options:
A. Pain rating of 6/10
B. Respiratory rate of 10/min
C. Scant serosanguineous drainage at the incision
D. Requests ice chips
Correct answer: B
Detailed rationale:
A respiratory rate of 10/min after opioid administration
suggests opioid-related respiratory depression, which is an
urgent safety concern because decreased ventilation can
rapidly lead to hypoxemia, hypercapnia, and cardiac arrest. The
nurse must assess airway, breathing, oxygenation, and level of
sedation immediately and prepare to intervene per protocol.
Incorrect option analysis:
• A. Pain rating of 6/10 — Pain matters, but it is not as
immediately life-threatening as respiratory depression.
, o Common misconception: Any pain complaint must be
addressed first.
o Safety risk: Delaying response to respiratory
compromise.
• C. Scant serosanguineous drainage — Expected early
postoperative finding.
o Common misconception: Any drainage is abnormal.
o Safety risk: Overprioritizing a routine finding.
• D. Requests ice chips — Indicates comfort needs, not
instability.
o Common misconception: Patient requests signal
deterioration.
o Safety risk: Missing a true airway/breathing issue.
Nursing process linkage: Assessment
NCJMM competency: Recognize Cues; Prioritize Hypotheses
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX client needs: Physiological Adaptation
Key learning objective: Prioritize an abnormal assessment
finding that suggests acute deterioration.
2) MCQ
, Clinical scenario:
A medical-surgical unit is revising its wound care protocol to
reduce infection rates.
Question stem:
Which source best supports evidence-based nursing care for
this practice change?
Answer options:
A. A blog written by a wound care nurse
B. The opinion of one experienced staff nurse
C. A current clinical practice guideline or systematic review
D. A single patient’s positive outcome after a dressing change
Correct answer: C
Detailed rationale:
Evidence-based practice is built on the best available research
evidence, clinical expertise, and patient preferences. A current
clinical practice guideline or systematic review provides a
stronger foundation than opinion, anecdote, or one patient’s
result.
Incorrect option analysis:
• A. Blog written by a wound care nurse — May be
informative but is not necessarily rigorously reviewed.
o Misconception: Online information is equivalent to
evidence.
o Safety risk: Adopting unsupported practices.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical scenario:
A postoperative patient who received IV hydromorphone 20
minutes ago is resting in bed. The nurse enters the room and
notes the patient is difficult to arouse.
Question stem:
Which finding requires the nurse’s immediate follow-up?
Answer options:
A. Pain rating of 6/10
B. Respiratory rate of 10/min
C. Scant serosanguineous drainage at the incision
D. Requests ice chips
Correct answer: B
Detailed rationale:
A respiratory rate of 10/min after opioid administration
suggests opioid-related respiratory depression, which is an
urgent safety concern because decreased ventilation can
rapidly lead to hypoxemia, hypercapnia, and cardiac arrest. The
nurse must assess airway, breathing, oxygenation, and level of
sedation immediately and prepare to intervene per protocol.
Incorrect option analysis:
• A. Pain rating of 6/10 — Pain matters, but it is not as
immediately life-threatening as respiratory depression.
, o Common misconception: Any pain complaint must be
addressed first.
o Safety risk: Delaying response to respiratory
compromise.
• C. Scant serosanguineous drainage — Expected early
postoperative finding.
o Common misconception: Any drainage is abnormal.
o Safety risk: Overprioritizing a routine finding.
• D. Requests ice chips — Indicates comfort needs, not
instability.
o Common misconception: Patient requests signal
deterioration.
o Safety risk: Missing a true airway/breathing issue.
Nursing process linkage: Assessment
NCJMM competency: Recognize Cues; Prioritize Hypotheses
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX client needs: Physiological Adaptation
Key learning objective: Prioritize an abnormal assessment
finding that suggests acute deterioration.
2) MCQ
, Clinical scenario:
A medical-surgical unit is revising its wound care protocol to
reduce infection rates.
Question stem:
Which source best supports evidence-based nursing care for
this practice change?
Answer options:
A. A blog written by a wound care nurse
B. The opinion of one experienced staff nurse
C. A current clinical practice guideline or systematic review
D. A single patient’s positive outcome after a dressing change
Correct answer: C
Detailed rationale:
Evidence-based practice is built on the best available research
evidence, clinical expertise, and patient preferences. A current
clinical practice guideline or systematic review provides a
stronger foundation than opinion, anecdote, or one patient’s
result.
Incorrect option analysis:
• A. Blog written by a wound care nurse — May be
informative but is not necessarily rigorously reviewed.
o Misconception: Online information is equivalent to
evidence.
o Safety risk: Adopting unsupported practices.
