TEST BANK: MEDICALSURGICAL NURSING IN CANADA, 3RD EDITION, SHARON L. LEWIS, LINDA BUCHER, MARGARET M. HEITKEMPER, MARIANN M. HARDING, MAUREEN A. BARRY, JANA LOK, JANE TYERMAN, SANDRA GOLDSWORTHY,

NCLEX (Test Bank I) Chapter 1: Contemporary Nursing Practice Test Bank MULTIPLE CHOICE 1. The nurse has admitted a patient with a new diagnosis of pneumonia and explained to the patient that together they will plan the patient’s care and set goals for discharge. The patient says, “How is that different from what the doctor does?” Which response by the nurse is most appropriate? a. “The role of the nurse is to administer medications and other treatments prescribed by your doctor.” b. “The nurse’s job is to help the doctor by collecting data and communicating when there are problems.” c. “Nurses perform many of the procedures done by physicians, but nurses are here in the hospital for a longer time than doctors.” d. “In addition to caring for you while you are sick, the nurses will assist you to develop an individualized plan to maintain your health.” ANS: D This response is consistent with the American Nurses Association (ANA) definition of nursing, which describes the role of nurses in promoting health. The other responses describe some of the dependent and collaborative functions of the nursing role but do not accurately describe the nurse’s role in the health care system. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 2. When providing patient care using evidence-based practice, the nurse uses a. clinical judgment based on experience. b. evidence from a clinical research study. c. evidence-based guidelines in addition to clinical expertise. d. evaluation of data showing that the patient outcomes are met. ANS: C Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician expertise. Clinical judgment based on the nurse’s clinical experience is part of EBP, but clinical decision making also should incorporate current research and research-based guidelines. Evidence from one clinical research study does not provide an adequate substantiation for interventions. Evaluation of patient outcomes is important, but interventions should be based on research from randomized control studies with a large number of subjects. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment 3. The nurse primarily uses the nursing process in the care of patients a. to explain nursing interventions to other health care professionals b. as a problem-solving tool to identify and treat patients’ health care needs c. as a scientific-based process of diagnosing the patient’s health care problems d. to establish nursing theory that incorporates the biopsychosocial nature of humansANS: B The nursing process is a problem-solving approach to the identification and treatment of patients’ problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing process is in patient care, not to establish nursing theory or explain nursing interventions to other health care professionals. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 4. The nurse plans an every 2-hour turning schedule to prevent skin breakdown for a critically ill patient in the intensive care unit. In this case, the nursing action is considered to be a. dependent. b. cooperative. c. independent. d. collaborative. ANS: D When implementing collaborative nursing actions, the nurse is responsible primarily for monitoring for complications of acute illness or providing care to prevent or treat complications. Independent nursing actions are focused on health promotion, illness prevention, and patient advocacy. A dependent action would require a physician order to implement. Cooperative nursing functions are not described as one of the formal nursing functions. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment