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 nurse is receiving report on four adult patients on a medical-
surgical unit.
Question Stem:
Which patient should the nurse assess first?
Answer Options:
A. A patient reporting pain 7/10 after ambulation
B. A patient with a new oxygen saturation of 88% after
receiving an opioid
C. A patient requesting discharge teaching about anticoagulants
D. A patient whose blood pressure is 156/92 mm Hg before a
morning antihypertensive
Correct Answer:
B
Detailed Rationale:
A new oxygen saturation of 88% after an opioid suggests
possible respiratory depression and impaired oxygenation,
which is an immediate threat to safety. Airway and breathing
problems take priority over pain, education, and stable
hypertension. This reflects clinical judgment by recognizing
cues and responding to the most urgent physiologic risk first.
Incorrect Option Analysis:
, • A: Pain needs intervention, but it is not higher priority
than compromised oxygenation.
Misconception: Pain scores always come first.
Safety risk: Delaying assessment of respiratory depression.
• C: Important, but discharge teaching is not emergent.
Misconception: Education should always be completed
immediately.
Safety risk: Missed deterioration while teaching.
• D: Elevated blood pressure is concerning but less urgent
than hypoxemia.
Misconception: Any abnormal vital sign is a priority.
Safety risk: Failure to address breathing compromise.
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 a patient with potential
respiratory compromise.
2) MCQ
Clinical Scenario:
A unit educator is revising a pressure-injury prevention
protocol.
, Question Stem:
Which source provides the strongest evidence for updating the
protocol?
Answer Options:
A. A single nurse’s opinion based on experience
B. A recent systematic review or evidence-based guideline
C. A blog post written by a wound-care patient
D. A commercial brochure from a skin-care product company
Correct Answer:
B
Detailed Rationale:
Systematic reviews and evidence-based guidelines synthesize
multiple studies and are stronger sources than opinions,
testimonials, or marketing materials. Evidence-based nursing
care uses the best available research, clinical expertise, and
patient values to improve outcomes and safety.
Incorrect Option Analysis:
• A: Experience matters, but it is not the strongest evidence
alone.
Misconception: Expert opinion equals evidence.
Safety risk: Protocols may not reflect current best
practice.
• C: Patient perspective is valuable but not sufficient to
guide protocol design.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario:
A nurse is receiving report on four adult patients on a medical-
surgical unit.
Question Stem:
Which patient should the nurse assess first?
Answer Options:
A. A patient reporting pain 7/10 after ambulation
B. A patient with a new oxygen saturation of 88% after
receiving an opioid
C. A patient requesting discharge teaching about anticoagulants
D. A patient whose blood pressure is 156/92 mm Hg before a
morning antihypertensive
Correct Answer:
B
Detailed Rationale:
A new oxygen saturation of 88% after an opioid suggests
possible respiratory depression and impaired oxygenation,
which is an immediate threat to safety. Airway and breathing
problems take priority over pain, education, and stable
hypertension. This reflects clinical judgment by recognizing
cues and responding to the most urgent physiologic risk first.
Incorrect Option Analysis:
, • A: Pain needs intervention, but it is not higher priority
than compromised oxygenation.
Misconception: Pain scores always come first.
Safety risk: Delaying assessment of respiratory depression.
• C: Important, but discharge teaching is not emergent.
Misconception: Education should always be completed
immediately.
Safety risk: Missed deterioration while teaching.
• D: Elevated blood pressure is concerning but less urgent
than hypoxemia.
Misconception: Any abnormal vital sign is a priority.
Safety risk: Failure to address breathing compromise.
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 a patient with potential
respiratory compromise.
2) MCQ
Clinical Scenario:
A unit educator is revising a pressure-injury prevention
protocol.
, Question Stem:
Which source provides the strongest evidence for updating the
protocol?
Answer Options:
A. A single nurse’s opinion based on experience
B. A recent systematic review or evidence-based guideline
C. A blog post written by a wound-care patient
D. A commercial brochure from a skin-care product company
Correct Answer:
B
Detailed Rationale:
Systematic reviews and evidence-based guidelines synthesize
multiple studies and are stronger sources than opinions,
testimonials, or marketing materials. Evidence-based nursing
care uses the best available research, clinical expertise, and
patient values to improve outcomes and safety.
Incorrect Option Analysis:
• A: Experience matters, but it is not the strongest evidence
alone.
Misconception: Expert opinion equals evidence.
Safety risk: Protocols may not reflect current best
practice.
• C: Patient perspective is valuable but not sufficient to
guide protocol design.
