Medical-Surgical Nursing
11th Edition
• Author(s)Donna D. Ignatavicius; Cherie R. Rebar; Nicole
M. Heimgartner
PRACTICE QUESTIONS, DETAILED RATIONALES AND CLINICAL JUDGEMENT
Chapter 1: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Question 1
A medical-surgical nurse is caring for a patient who has several chronic health conditions and
expresses concern that the treatment plan does not reflect the patient's personal preferences.
Which nursing action best demonstrates patient-centered care?
A. Encourage the patient to follow the prescribed plan without modification
B. Ask the patient to identify personal goals and preferences before developing the plan of care
C. Explain that the healthcare team determines the most appropriate treatment plan
D. Ask the patient's family to select the treatment plan on the patient's behalf
Correct Answer: B
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in decisions concerning
care. The nurse should determine the patient's values, preferences, needs, and goals and
incorporate them into the plan of care. Patient-centered care promotes respect for autonomy
and individualized care rather than treating the patient as a passive recipient of treatment.
,Why the Other Options Are Incorrect:
A: Following a plan without considering patient preferences does not provide individualized,
patient-centered care.
B: Correct. Identifying the patient's goals and preferences supports shared decision-making and
individualized care.
C: The healthcare team should collaborate with the patient rather than make decisions
independently of the patient.
D: Family involvement may be appropriate when desired by the patient, but the patient's
autonomy should be respected.
Clinical Judgment Focus: Recognize Cues / Generate Solutions
Cognitive Level: Application
Question 2
During a safety assessment, the nurse identifies that a patient has repeatedly attempted to get
out of bed without assistance. Which nursing action is most appropriate?
A. Document the behavior at the end of the shift
B. Identify factors contributing to the patient's risk and implement appropriate safety measures
C. Tell the patient that getting out of bed independently is prohibited
D. Ask another patient to notify the nurse whenever the patient attempts to get out of bed
Correct Answer: B
Detailed Rationale:
Safety requires nurses to identify risks proactively and implement measures that reduce the
likelihood of patient harm. The nurse should assess contributing factors and use appropriate
interventions based on the patient's individual needs. Safety is an ongoing responsibility rather
than merely documenting an event after it occurs.
,Why the Other Options Are Incorrect:
A: Documentation is important but does not address the immediate safety risk.
B: Correct. Identifying risks and implementing appropriate preventive interventions promotes
patient safety.
C: Simply prohibiting the behavior does not address why the patient is attempting to get out of
bed.
D: Delegating responsibility for recognizing a patient's safety risk to another patient is
inappropriate.
Clinical Judgment Focus: Recognize Cues / Take Action
Cognitive Level: Application
Question 3
A nurse working with a multidisciplinary healthcare team notices that two team members have
different understandings of the patient's plan of care. What should the nurse do first?
A. Continue providing care according to the nurse's interpretation
B. Wait until the next staff meeting to discuss the discrepancy
C. Communicate with the team members to clarify the plan of care
D. Document that the other team members failed to communicate
Correct Answer: C
Detailed Rationale:
Effective teamwork and collaboration require clear communication among healthcare
professionals. A discrepancy in understanding can create a patient-safety risk. The nurse should
clarify the plan promptly with the appropriate team members so that care is coordinated and
consistent.
Why the Other Options Are Incorrect:
, A: Proceeding despite uncertainty can result in inconsistent or unsafe care.
B: Delaying clarification may expose the patient to unnecessary risk.
C: Correct. Direct communication helps resolve discrepancies and promotes coordinated care.
D: Documentation alone does not resolve the communication problem.
Clinical Judgment Focus: Analyze Cues / Take Action
Cognitive Level: Application
Question 4 — Select All That Apply
Which nursing behaviors demonstrate the Quality and Safety Education for Nurses (QSEN)
competency of patient-centered care? Select all that apply.
A. Incorporating patient preferences into care planning
B. Respecting the patient's values
C. Making all healthcare decisions without patient involvement
D. Encouraging patient participation in decisions
E. Providing identical interventions to every patient with the same diagnosis
F. Considering the patient's individual needs when planning care
Correct Answers: A, B, D, F
Detailed Rationale:
Patient-centered care involves recognizing the patient as an individual and incorporating the
patient's preferences, values, needs, and choices into care. Patients should participate in
decisions to the extent they desire and are able.
Why the Other Options Are Incorrect:
A: Correct. Patient preferences are an essential component of individualized care.
B: Correct. Respect for patient values supports patient-centered practice.
11th Edition
• Author(s)Donna D. Ignatavicius; Cherie R. Rebar; Nicole
M. Heimgartner
PRACTICE QUESTIONS, DETAILED RATIONALES AND CLINICAL JUDGEMENT
Chapter 1: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Question 1
A medical-surgical nurse is caring for a patient who has several chronic health conditions and
expresses concern that the treatment plan does not reflect the patient's personal preferences.
Which nursing action best demonstrates patient-centered care?
A. Encourage the patient to follow the prescribed plan without modification
B. Ask the patient to identify personal goals and preferences before developing the plan of care
C. Explain that the healthcare team determines the most appropriate treatment plan
D. Ask the patient's family to select the treatment plan on the patient's behalf
Correct Answer: B
Detailed Rationale:
Patient-centered care recognizes the patient as an active participant in decisions concerning
care. The nurse should determine the patient's values, preferences, needs, and goals and
incorporate them into the plan of care. Patient-centered care promotes respect for autonomy
and individualized care rather than treating the patient as a passive recipient of treatment.
,Why the Other Options Are Incorrect:
A: Following a plan without considering patient preferences does not provide individualized,
patient-centered care.
B: Correct. Identifying the patient's goals and preferences supports shared decision-making and
individualized care.
C: The healthcare team should collaborate with the patient rather than make decisions
independently of the patient.
D: Family involvement may be appropriate when desired by the patient, but the patient's
autonomy should be respected.
Clinical Judgment Focus: Recognize Cues / Generate Solutions
Cognitive Level: Application
Question 2
During a safety assessment, the nurse identifies that a patient has repeatedly attempted to get
out of bed without assistance. Which nursing action is most appropriate?
A. Document the behavior at the end of the shift
B. Identify factors contributing to the patient's risk and implement appropriate safety measures
C. Tell the patient that getting out of bed independently is prohibited
D. Ask another patient to notify the nurse whenever the patient attempts to get out of bed
Correct Answer: B
Detailed Rationale:
Safety requires nurses to identify risks proactively and implement measures that reduce the
likelihood of patient harm. The nurse should assess contributing factors and use appropriate
interventions based on the patient's individual needs. Safety is an ongoing responsibility rather
than merely documenting an event after it occurs.
,Why the Other Options Are Incorrect:
A: Documentation is important but does not address the immediate safety risk.
B: Correct. Identifying risks and implementing appropriate preventive interventions promotes
patient safety.
C: Simply prohibiting the behavior does not address why the patient is attempting to get out of
bed.
D: Delegating responsibility for recognizing a patient's safety risk to another patient is
inappropriate.
Clinical Judgment Focus: Recognize Cues / Take Action
Cognitive Level: Application
Question 3
A nurse working with a multidisciplinary healthcare team notices that two team members have
different understandings of the patient's plan of care. What should the nurse do first?
A. Continue providing care according to the nurse's interpretation
B. Wait until the next staff meeting to discuss the discrepancy
C. Communicate with the team members to clarify the plan of care
D. Document that the other team members failed to communicate
Correct Answer: C
Detailed Rationale:
Effective teamwork and collaboration require clear communication among healthcare
professionals. A discrepancy in understanding can create a patient-safety risk. The nurse should
clarify the plan promptly with the appropriate team members so that care is coordinated and
consistent.
Why the Other Options Are Incorrect:
, A: Proceeding despite uncertainty can result in inconsistent or unsafe care.
B: Delaying clarification may expose the patient to unnecessary risk.
C: Correct. Direct communication helps resolve discrepancies and promotes coordinated care.
D: Documentation alone does not resolve the communication problem.
Clinical Judgment Focus: Analyze Cues / Take Action
Cognitive Level: Application
Question 4 — Select All That Apply
Which nursing behaviors demonstrate the Quality and Safety Education for Nurses (QSEN)
competency of patient-centered care? Select all that apply.
A. Incorporating patient preferences into care planning
B. Respecting the patient's values
C. Making all healthcare decisions without patient involvement
D. Encouraging patient participation in decisions
E. Providing identical interventions to every patient with the same diagnosis
F. Considering the patient's individual needs when planning care
Correct Answers: A, B, D, F
Detailed Rationale:
Patient-centered care involves recognizing the patient as an individual and incorporating the
patient's preferences, values, needs, and choices into care. Patients should participate in
decisions to the extent they desire and are able.
Why the Other Options Are Incorrect:
A: Correct. Patient preferences are an essential component of individualized care.
B: Correct. Respect for patient values supports patient-centered practice.
