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: During shift report, the RN learns about four
adult patients on a medical-surgical unit.
Question stem: Which patient should the RN assess first?
Answer options:
A. A 2-day postoperative hip replacement patient reporting
pain 7/10, vital signs stable
B. A patient with COPD on 2 L/min oxygen with SpO₂ 92%,
which is the patient’s baseline
C. A 6-hour postoperative abdominal surgery patient who is
restless, with HR 122/min, BP 86/50 mm Hg, cool clammy skin
D. A patient scheduled for discharge teaching in 30 minutes
Correct answer: C
Detailed rationale:
This patient has cues consistent with acute hemodynamic
instability and possible hemorrhage or shock. Restlessness,
tachycardia, hypotension, and cool clammy skin are red flags
that require immediate assessment and intervention. In clinical
judgment, the nurse prioritizes the patient with the greatest
risk for deterioration.
Incorrect option analysis:
• A: Pain needs treatment, but the patient is currently
stable. This is not the most urgent threat.
• B: The oxygen saturation is at the patient’s baseline and
does not suggest acute decline.
, • D: Discharge teaching is important, but it is not a priority
over an unstable patient.
Nursing process linkage: Assessment
Clinical Judgment Competencies (NCJMM): Recognize Cues,
Analyze Cues, Prioritize Hypotheses, Take Action
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX Client Needs Category: Physiological Adaptation
Key Learning Objective: Prioritize assessment of unstable
patients using abnormal cues that signal deterioration.
2) MCQ
Clinical scenario: A nurse leader wants to revise a unit protocol
to reduce pressure injuries.
Question stem: Which action best reflects evidence-based
nursing care?
Answer options:
A. Change the turning schedule based on the most experienced
nurse’s opinion
B. Review a current clinical practice guideline and unit outcome
data before changing the protocol
C. Wait until several patients develop pressure injuries before
making changes
, D. Use the same protocol because it has always been used on
the unit
Correct answer: B
Detailed rationale:
Evidence-based practice integrates the best available research,
clinical expertise, and patient values/preferences. Reviewing a
current guideline and unit outcomes supports a safe, informed
practice change.
Incorrect option analysis:
• A: Expert opinion alone is not the strongest basis for
system-level change.
• C: This is reactive and unsafe; prevention should occur
before harm.
• D: Tradition is not evidence and may ignore updated best
practices.
Nursing process linkage: Planning
Clinical Judgment Competencies (NCJMM): Analyze Cues,
Generate Solutions, Take Action
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX Client Needs Category: Management of Care
Key Learning Objective: Identify the best evidence-informed
approach to practice change.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
1) MCQ
,Clinical scenario: During shift report, the RN learns about four
adult patients on a medical-surgical unit.
Question stem: Which patient should the RN assess first?
Answer options:
A. A 2-day postoperative hip replacement patient reporting
pain 7/10, vital signs stable
B. A patient with COPD on 2 L/min oxygen with SpO₂ 92%,
which is the patient’s baseline
C. A 6-hour postoperative abdominal surgery patient who is
restless, with HR 122/min, BP 86/50 mm Hg, cool clammy skin
D. A patient scheduled for discharge teaching in 30 minutes
Correct answer: C
Detailed rationale:
This patient has cues consistent with acute hemodynamic
instability and possible hemorrhage or shock. Restlessness,
tachycardia, hypotension, and cool clammy skin are red flags
that require immediate assessment and intervention. In clinical
judgment, the nurse prioritizes the patient with the greatest
risk for deterioration.
Incorrect option analysis:
• A: Pain needs treatment, but the patient is currently
stable. This is not the most urgent threat.
• B: The oxygen saturation is at the patient’s baseline and
does not suggest acute decline.
, • D: Discharge teaching is important, but it is not a priority
over an unstable patient.
Nursing process linkage: Assessment
Clinical Judgment Competencies (NCJMM): Recognize Cues,
Analyze Cues, Prioritize Hypotheses, Take Action
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX Client Needs Category: Physiological Adaptation
Key Learning Objective: Prioritize assessment of unstable
patients using abnormal cues that signal deterioration.
2) MCQ
Clinical scenario: A nurse leader wants to revise a unit protocol
to reduce pressure injuries.
Question stem: Which action best reflects evidence-based
nursing care?
Answer options:
A. Change the turning schedule based on the most experienced
nurse’s opinion
B. Review a current clinical practice guideline and unit outcome
data before changing the protocol
C. Wait until several patients develop pressure injuries before
making changes
, D. Use the same protocol because it has always been used on
the unit
Correct answer: B
Detailed rationale:
Evidence-based practice integrates the best available research,
clinical expertise, and patient values/preferences. Reviewing a
current guideline and unit outcomes supports a safe, informed
practice change.
Incorrect option analysis:
• A: Expert opinion alone is not the strongest basis for
system-level change.
• C: This is reactive and unsafe; prevention should occur
before harm.
• D: Tradition is not evidence and may ignore updated best
practices.
Nursing process linkage: Planning
Clinical Judgment Competencies (NCJMM): Analyze Cues,
Generate Solutions, Take Action
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX Client Needs Category: Management of Care
Key Learning Objective: Identify the best evidence-informed
approach to practice change.
