Davis Advantage for
Understanding Medical-
Surgical Nursing, 7th Edition
by Linda S. Williams and
Paula D. Hopper all 57
chapters Questions and
correct answers
Unit 1: Understanding Health Care Issues (Chapters 1-5)
1. Critical Thinking and the Nursing Process
Question: A nurse is caring for a client with heart failure. Which phase of the nursing
process involves establishing a database by interviewing the client and reviewing their
medical record?
Answer: Assessment.
Rationale: Assessment is the systematic collection of data from various sources,
including the client interview, physical examination, and health record, to establish a
baseline database.
2. Evidence-Based Practice
Question: When integrating evidence-based practice (EBP) into clinical care, what is the
primary initial step the nurse should take?
Answer: Formulate a clear, clinical, searchable question (e.g., using the PICO format).
Rationale: The first step of EBP is transforming clinical uncertainty into an answerable,
well-structured clinical question.
3. Issues in Nursing Practice
Question: A nurse notes a colleague documenting nursing tasks before they are
performed. Which ethical and legal principle is being violated?
Answer: Veracity and professional accountability.
Rationale: Documenting care before completion falsifies the medical record and
breaches legal and ethical standards of truthful reporting.
,4. Cultural Influences on Nursing Care
Question: A nurse is caring for a client from a culture with differing health beliefs.
Which action best demonstrates culturally competent nursing care?
Answer: Assessing the client's individual cultural beliefs, practices, and preferences
regarding health and healing.
Rationale: Cultural competence requires understanding and respecting individual
variations within cultural groups rather than stereotyping.
5. Complementary and Alternative Modalities
Question: A client scheduled for surgery states they regularly use St. John's wort for
mild depression. Why should the nurse report this to the surgical team?
Answer: St. John's wort induces hepatic enzymes, which can accelerate the metabolism
of anesthetics and other medications.
Rationale: Herbal supplements can significantly alter the pharmacokinetics and
pharmacodynamics of perioperative medications.
Unit 2: Understanding Health and Illness (Chapters 6-10)
6. Fluid, Electrolyte, and Acid-Base Imbalances
Question: A client is admitted with severe vomiting and diarrhea. Which laboratory
value should the nurse monitor closely for signs of extracellular fluid volume deficit?
Answer: Elevated hematocrit and specific gravity.
Rationale: Fluid volume deficit causes hemoconcentration, resulting in elevated
hematocrit and an increased urine specific gravity.
7. Acid-Base Imbalances
Question: An arterial blood gas (ABG) report shows pH=7.28 , PaC O2=52 mmHg , and
HC O−¿=24
3
mEq/L¿
. How should the nurse interpret these results?
Answer: Respiratory acidosis, uncompensated.
Rationale: A low pH indicates acidosis. A high PaC O2points to a respiratory cause, and
normal bicarbonate indicates no renal compensation.
8. Potassium Regulation
Question: What is the priority nursing intervention when administering intravenous
potassium chloride to a client with hypokalemia?
Answer: Administer the solution via an infusion pump and never as an IV push.
Rationale: IV potassium can cause fatal cardiac arrhythmias if administered rapidly; it
must always be infused slowly via an infusion pump.
,9. Perioperative Care: Preoperative
Question: During the preoperative assessment, a client states they take garlic
supplements daily. Why is it crucial to report this?
Answer: Garlic has anticoagulant properties that increase the risk of intraoperative and
postoperative bleeding.
Rationale: Many herbal supplements alter blood coagulation and must be stopped prior
to major surgical procedures.
10. Perioperative Care: Intraoperative and Postoperative
Question: What is the primary purpose of performing deep-breathing and coughing
exercises in the immediate postoperative period?
Answer: To prevent atelectasis and promote optimal gas exchange.
Rationale: General anesthesia and immobility cause alveolar collapse; coughing and
deep breathing re-expand alveoli and mobilize secretions.
Unit 3: Pain, Oncology, and Emergency Care (Chapters 11-17)
11. Pain Management
Question: A client with terminal cancer reports breakthrough pain despite being on a
scheduled long-acting opioid. What is the most appropriate initial nursing action?
Answer: Administer the prescribed short-acting rescue opioid medication.
Rationale: Breakthrough pain requires immediate intervention using a rapid-onset, short-
acting opioid analgesic.
12. Oncological Care
Question: A client undergoing external radiation therapy for neck cancer reports skin
dryness and redness. What instruction should the nurse provide?
Answer: Avoid applying commercial lotions, powders, or perfumes to the area unless
specifically prescribed.
Rationale: Chemical irritants can intensify skin reactions on fragile, irradiated skin
tissues.
13. Shock and Emergency Care
Question: A client presents with cold, clammy skin, tachycardia, and a dropping blood
pressure following severe trauma. Which type of shock does the nurse suspect?
Answer: Hypovolemic shock.
Rationale: Hypovolemic shock results from acute loss of intravascular volume,
triggering compensatory sympathetic vasoconstriction and tachycardia.
, 14. Inflammation and Immunity
Question: Which white blood cell type is primarily elevated during an acute bacterial
infection?
Answer: Neutrophils (specifically segmented and band neutrophils).
Rationale: Neutrophils are the primary phagocytic defense cells that surge during acute
bacterial invasions.
15. HIV and AIDS Care
Question: When monitoring a client with HIV, which laboratory test is the most direct
indicator of immune system destruction?
Answer: CD4+ T-lymphocyte cell count.
Rationale: HIV specifically targets and destroys CD4+ T-cells, making this count the
primary marker of immune competence.
Unit 4: Integumentary System (Chapters 18-21)
16. Common Skin Disorders
Question: A client is diagnosed with impetigo. What key education point should the
nurse emphasize to prevent transmission?
Answer: Perform meticulous hand hygiene and avoid sharing towels or personal items.
Rationale: Impetigo is a highly contagious bacterial skin infection spread through direct
contact and fomites.
17. Burn Injuries
Question: A client has partial-thickness burns covering 20 % of their total body surface
area (TBSA). Which fluid resuscitation formula is standard for the first 24 hours?
Answer: The Parkland formula (4 mL × weight in kg ×% TBSA ).
Rationale: The Parkland formula calculates crystalloid replacement needs following
major burns to prevent hypovolemic shock.
18. Wound Healing
Question: What nutritional component is essential to promote collagen synthesis and
wound healing in a client with pressure injuries?
Answer: Protein and Vitamin C.
Rationale: Protein provides the structural building blocks for tissue repair, while Vitamin
C is an essential cofactor in collagen synthesis.
19. Dermatological Diagnostics
Understanding Medical-
Surgical Nursing, 7th Edition
by Linda S. Williams and
Paula D. Hopper all 57
chapters Questions and
correct answers
Unit 1: Understanding Health Care Issues (Chapters 1-5)
1. Critical Thinking and the Nursing Process
Question: A nurse is caring for a client with heart failure. Which phase of the nursing
process involves establishing a database by interviewing the client and reviewing their
medical record?
Answer: Assessment.
Rationale: Assessment is the systematic collection of data from various sources,
including the client interview, physical examination, and health record, to establish a
baseline database.
2. Evidence-Based Practice
Question: When integrating evidence-based practice (EBP) into clinical care, what is the
primary initial step the nurse should take?
Answer: Formulate a clear, clinical, searchable question (e.g., using the PICO format).
Rationale: The first step of EBP is transforming clinical uncertainty into an answerable,
well-structured clinical question.
3. Issues in Nursing Practice
Question: A nurse notes a colleague documenting nursing tasks before they are
performed. Which ethical and legal principle is being violated?
Answer: Veracity and professional accountability.
Rationale: Documenting care before completion falsifies the medical record and
breaches legal and ethical standards of truthful reporting.
,4. Cultural Influences on Nursing Care
Question: A nurse is caring for a client from a culture with differing health beliefs.
Which action best demonstrates culturally competent nursing care?
Answer: Assessing the client's individual cultural beliefs, practices, and preferences
regarding health and healing.
Rationale: Cultural competence requires understanding and respecting individual
variations within cultural groups rather than stereotyping.
5. Complementary and Alternative Modalities
Question: A client scheduled for surgery states they regularly use St. John's wort for
mild depression. Why should the nurse report this to the surgical team?
Answer: St. John's wort induces hepatic enzymes, which can accelerate the metabolism
of anesthetics and other medications.
Rationale: Herbal supplements can significantly alter the pharmacokinetics and
pharmacodynamics of perioperative medications.
Unit 2: Understanding Health and Illness (Chapters 6-10)
6. Fluid, Electrolyte, and Acid-Base Imbalances
Question: A client is admitted with severe vomiting and diarrhea. Which laboratory
value should the nurse monitor closely for signs of extracellular fluid volume deficit?
Answer: Elevated hematocrit and specific gravity.
Rationale: Fluid volume deficit causes hemoconcentration, resulting in elevated
hematocrit and an increased urine specific gravity.
7. Acid-Base Imbalances
Question: An arterial blood gas (ABG) report shows pH=7.28 , PaC O2=52 mmHg , and
HC O−¿=24
3
mEq/L¿
. How should the nurse interpret these results?
Answer: Respiratory acidosis, uncompensated.
Rationale: A low pH indicates acidosis. A high PaC O2points to a respiratory cause, and
normal bicarbonate indicates no renal compensation.
8. Potassium Regulation
Question: What is the priority nursing intervention when administering intravenous
potassium chloride to a client with hypokalemia?
Answer: Administer the solution via an infusion pump and never as an IV push.
Rationale: IV potassium can cause fatal cardiac arrhythmias if administered rapidly; it
must always be infused slowly via an infusion pump.
,9. Perioperative Care: Preoperative
Question: During the preoperative assessment, a client states they take garlic
supplements daily. Why is it crucial to report this?
Answer: Garlic has anticoagulant properties that increase the risk of intraoperative and
postoperative bleeding.
Rationale: Many herbal supplements alter blood coagulation and must be stopped prior
to major surgical procedures.
10. Perioperative Care: Intraoperative and Postoperative
Question: What is the primary purpose of performing deep-breathing and coughing
exercises in the immediate postoperative period?
Answer: To prevent atelectasis and promote optimal gas exchange.
Rationale: General anesthesia and immobility cause alveolar collapse; coughing and
deep breathing re-expand alveoli and mobilize secretions.
Unit 3: Pain, Oncology, and Emergency Care (Chapters 11-17)
11. Pain Management
Question: A client with terminal cancer reports breakthrough pain despite being on a
scheduled long-acting opioid. What is the most appropriate initial nursing action?
Answer: Administer the prescribed short-acting rescue opioid medication.
Rationale: Breakthrough pain requires immediate intervention using a rapid-onset, short-
acting opioid analgesic.
12. Oncological Care
Question: A client undergoing external radiation therapy for neck cancer reports skin
dryness and redness. What instruction should the nurse provide?
Answer: Avoid applying commercial lotions, powders, or perfumes to the area unless
specifically prescribed.
Rationale: Chemical irritants can intensify skin reactions on fragile, irradiated skin
tissues.
13. Shock and Emergency Care
Question: A client presents with cold, clammy skin, tachycardia, and a dropping blood
pressure following severe trauma. Which type of shock does the nurse suspect?
Answer: Hypovolemic shock.
Rationale: Hypovolemic shock results from acute loss of intravascular volume,
triggering compensatory sympathetic vasoconstriction and tachycardia.
, 14. Inflammation and Immunity
Question: Which white blood cell type is primarily elevated during an acute bacterial
infection?
Answer: Neutrophils (specifically segmented and band neutrophils).
Rationale: Neutrophils are the primary phagocytic defense cells that surge during acute
bacterial invasions.
15. HIV and AIDS Care
Question: When monitoring a client with HIV, which laboratory test is the most direct
indicator of immune system destruction?
Answer: CD4+ T-lymphocyte cell count.
Rationale: HIV specifically targets and destroys CD4+ T-cells, making this count the
primary marker of immune competence.
Unit 4: Integumentary System (Chapters 18-21)
16. Common Skin Disorders
Question: A client is diagnosed with impetigo. What key education point should the
nurse emphasize to prevent transmission?
Answer: Perform meticulous hand hygiene and avoid sharing towels or personal items.
Rationale: Impetigo is a highly contagious bacterial skin infection spread through direct
contact and fomites.
17. Burn Injuries
Question: A client has partial-thickness burns covering 20 % of their total body surface
area (TBSA). Which fluid resuscitation formula is standard for the first 24 hours?
Answer: The Parkland formula (4 mL × weight in kg ×% TBSA ).
Rationale: The Parkland formula calculates crystalloid replacement needs following
major burns to prevent hypovolemic shock.
18. Wound Healing
Question: What nutritional component is essential to promote collagen synthesis and
wound healing in a client with pressure injuries?
Answer: Protein and Vitamin C.
Rationale: Protein provides the structural building blocks for tissue repair, while Vitamin
C is an essential cofactor in collagen synthesis.
19. Dermatological Diagnostics
