Test bank for medical-surgical nursing: concepts for clinical judgment and collaborative care 11th Edition by donna d. Ignatavicius. all chapters 1 - 74 Test Bank For Medical-Surgical Nursing: Concepts For Clinical Judgment And Collaborative Care (Evo

Test bank for medical-surgical nursing: concepts for
clinical judgment and collaborative care 11th
Edition by donna d. Ignatavicius,
all chapters 1 - 74

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, Chapter01:OverviewofProfessionalNursingConceptsforMedical- ax x
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Surgical Nursing ax




MULTIPLE CHOICE ax




1. A nurse wishes to provide client-
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centered care in all interactions. Which action by the nurse2best demonstrates this concept?
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a. Assesses for cultural influences affecting health care ax ax ax ax ax ax




b. Ensures that all the clients basic needs are met ax ax ax ax ax ax ax ax




c. Tells the client and family about all upcoming tests
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d. Thoroughly orients the client2 and family to the2room ax ax ax ax ax ax ax




CORRECT2ANSWER: A
Competency in client- ax ax




focused care is demonstrated when the nurse focuses on communication, culture, respect compassion, client educ ati
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on, and empowerment. By assessing the effect of the clients culture on health care, this nurse is practicing c lient-
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focused care. Providing for basic needs does not demonstrate this competence. Simply telling the client about a
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ll upcoming tests is not providing empowering education. Orienting the client and family to the room is an im porta
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nt safety measure, but not directly related to demonstrating client-centered care.
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DIF: Understanding/Comprehension REF: 3
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KEY: Patient- ax




centered care| culture MSC: Integrated Process: Caring NOT: Client Nee
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ds Category: Psychosocial Integrity
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2. A nurse is caring for a postoperative client on the surgical unit. The clients blood pressure was 142/76 mm H g 3
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0 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best?
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a. Call the Rapid Response Team. ax ax ax ax




b. Document and continue to monitor. ax ax ax ax




c. Notify the primary care provider. ax ax ax ax




d. Repeat blood pressure measurement in 15 minutes. ax ax ax ax ax ax




CORRECT2ANSWER: A
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they su f
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fer either respiratory or cardiac arrest. Since the client has manifested a significant change, the nurse should call t he
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RRT. Changes in blood pressure, mental status, heart rate, and pain are particularly significant.
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Documentation is vital, but the nurse must do more than document. The primary care provider should be notified, b ax ax ax ax ax ax ax ax ax ax ax ax ax ax ax ax ax ax




ut this is not the priority over calling the RRT. The clients blood pressure should be reassessed fre quently, but the p
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riority is getting the rapid care to the client.
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DIF: Applying/Application REF: 3
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KEY: Rapid Response Team (RRT)| medical emergencies MS
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