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Medical-
Surgical Nursing in Canada 5th Edition Lewi Test Bank
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, Medical-
Chapter 01: Introduction
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Surgical Nursing in Canada 5th Edition Lewi Test Bank
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Surgical Nursing Practice in Canada Lewis: Medical-
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Surgical Nursing in Canada, 5th Canadian Edition
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MULTIPLE CHOICE Gt




1. When caring for clients using evidence-
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informed practice, which of the following does the nurse use?
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a. Clinical judgement based on experience Gt Gt Gt Gt


b. Evidence from a clinical research study Gt Gt Gt Gt Gt


c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the client outcomes are met Gt Gt Gt Gt Gt Gt Gt Gt Gt




ANS: C G t


Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscie
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ntious, and judicious consideration of the best available evidence to provide care. Four prima
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ry elements are: (a) clinical state, setting, and circumstances; (b) client preferences and acti
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ons; (c) best research evidence; and (d) health care resources. Clinical judgement based on t
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he nurse‘s clinical experience is part of EIP, but clinical decision making also should incor
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porate current research and research-
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based guidelines. Evidence from one clinical research study does not provide an adequate s
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ubstantiation for interventions. Evaluation of client outcomes is important, but interventions
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should be based on research from randomized control studies with a large number of subj
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ects.

DIF: Cognitive Level: Comprehension Gt Gt TOP: G t Nursing Process: Planning Gt Gt




2. Which of the following best e xp l a i n s the n u r s e s ‘ primary use of the nursing process wh
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N R I G B . C M
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en providing care to clients? U S N T
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a. To explain nursing interventions to other health care professionals
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b. As a problem-solving tool to identify and treat clients‘ health care needs
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c. As a scientific-based process of diagnosing the client‘s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
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ANS: B G t


The nursing process is an assertive problem-
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solving approach to the identification and treatment of clients‘ problems. Diagnosis is only
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one phase of the nursing process. The primary use of the nursing process is in client care, n
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ot to establish nursing theory or explain nursing interventions to other health care professio
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nals.

DIF: Cognitive Level: Comprehension Gt Gt TOP: G t Nursing Process: Implementation Gt Gt




3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-
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hour turning schedule to prevent skin breakdown. Which type of nursing function is demon
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strated with this turning schedule?
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a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D G t




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, Medical-
Surgical Nursing in Canada 5th Edition Lewi Test Bank
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When implementing collaborative nursing actions, the nurse is responsible primarily for mo
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nitoring for complications of acute illness or providing care to prevent or treat complicatio
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ns. Independent nursing actions are focused on health promotion, illness prevention, and cli
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ent advocacy. A dependent action would require a physician order to implement. Cooperati
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ve nursing functions are not described as one of the formal nursing functions.
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DIF: Cognitive Level: Application Gt Gt TOP: G t Nursing Process: Implementation Gt Gt




4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells t
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he nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which acti
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on should the nurse take next?
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a. Reassure the client that these feelings are common for parents.
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b. Have the client call the children to ensure that they are doing well.
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c. Call the neighbour to determine whether adequate childcare is being provided.
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d. Gather more data about the client‘s feelings about the childcare arrangements.
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ANS: D G t


Since a complete assessment is necessary in order to identify a problem and choose an app
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ropriate intervention, the nurse‘s first action should be to obtain more information. The oth
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er actions may be appropriate, but more assessment is needed before the best intervention ca
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n be chosen.
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DIF: Cognitive Level: Application Gt Gt TOP: G t Nursing Process: Assessment Gt Gt




5. The nurse is caring for a client who has left-
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sided paralysis as the result of a stroke and assesses a pressure injury on the clie nt‘s
N R I is theGmost
B.appropriate
C M nursing diagnosis f Uo r t Sh i s c
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left h i p . W hich of the following
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Nl i e nTt ?
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a. Impaired physical mobility related to decrease in muscle control (left-sided
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paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge abo
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ut protecting tissue integrity
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c. Impaired skin integrity related to pressure over bony prominence (impaire
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d circulation) Gt


d. Ineffective tissue perfusion related to sedentary lifestyle Gt Gt Gt Gt Gt Gt




ANS: C G t


The client‘s major problem is the impaired skin integrity as demonstrated by the presence of
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a pressure injury. The nurse is able to treat the cause of altered circulation and pressure by
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frequently repositioning the client. Although left-
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sided weakness is a problem for the client, the nurse cannot treat the weakness. The ―risk f
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or‖ diagnosis is not appropriate for this client, who already has impaired tissue integrity. The
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client does have ineffective tissue perfusion, but the impaired skin integrity diagnosis indi
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cates more clearly what the health problem is.
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DIF: Cognitive Level: Application Gt Gt TOP: G t Nursing Process: Diagnosis Gt Gt




6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fl
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uid volume related to excessive diaphoresis. Which of the following is an appropriate
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client outcome?
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a. Client has a balanced intake and output. Gt Gt Gt Gt Gt Gt


b. Client‘s bedding is changed when it becomes damp. Gt Gt Gt Gt Gt Gt Gt




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, Medical-
Surgical Nursing in Canada 5th Edition Lewi Test Bank
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c. Client understands the need for increased fluid intake.
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d. Client‘s skin remains cool and dry throughout hospitalization.
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ANS: A G t


This statement gives measurable data showing resolution of the problem of deficient fluid
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volume that was identified in the nursing diagnosis statement. The other statements would no
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t indicate that the problem of deficient fluid volume was resolved.
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DIF: Cognitive Level: Application Gt Gt TOP: G t Nursing Process: Planning Gt Gt




7. Which of the following represents a nursing activity that is carried out during the evaluati
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on phase of the nursing process?
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a. Determining if interventions have been effective in meeting client outcomes
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b. Documenting the nursing care plan in the progress notes in the medical record
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c. Deciding whether the client‘s health problems have been completely resolved
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d. Asking the client to evaluate whether the nursing care provided was satisfactory
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ANS: A G t


Evaluation consists of determining whether the desired client outcomes have been met and
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whether the nursing interventions were appropriate. The other responses do not describe the
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evaluation phase. Gt




DIF: Cognitive Level: Comprehension Gt Gt TOP: G t Nursing Process: Evaluation Gt Gt




8. Which of the following would the nurse perform during the assessment phase of the nursi
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ng process?
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a. Obtains data with which to diagnose client problems
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b. Uses client data to develoNp p R
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Uri oSriNIt T
y nGursB
in.
gC
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c. Teaches interventions to relieve client health problems
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d. Assists the client to identify realistic outcomes to health problems
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ANS: A G t


During the assessment phase, the nurse gathers information about the client. The other resp
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onses are examples of the intervention, diagnosis, and planning phases of the nursing process
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.

DIF: Cognitive Level: Knowledge Gt Gt TOP: G t Nursing Process: Assessment Gt Gt




9. Which of the following is an example of a correctly written nursing diagnosis statement?
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a. Altered tissue perfusion related to heart failure
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b. Risk for impaired tissue integrity related to sacral redness
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c. Ineffective coping related to insufficient sense of control.Gt Gt Gt Gt Gt Gt Gt


d. Altered urinary elimination related to urinary tract infection
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ANS: C G t


This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describ
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es a client‘s response to a health problem that can be treated by nursing. The use of a me
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dical diagnosis (as in the responses beginning ―Altered tissue perfusion‖ and ―Altered uri
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nary elimination‖) is not appropriate. The response beginning ―Risk for impaired tissue in
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tegrity‖ uses the defining characteristics as the etiology.
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DIF: Cognitive Level: Comprehension Gt Gt TOP: G t Nursing Process: Diagnosis Gt Gt





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