Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
s s s s s s s s
Medical Surgical Nursing 10th EditionIgnatavicius s s s s s
Workman Test Bank
s s s
Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
s s s s s s s s s
Ignatavicius: Medical-Surgical Nursing, 10th Edition
s s s s s
MULTIPLE CHOICE s
1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises thenew
s s s s s s s s s s s s s s s
nurse that which is the priority when working as a professional nurse?
s s s s s s s s s s s s
a. Attending to holistic client needs s s s s
b. Ensuring client safety s s
c. Not making medication errors s s s
d. Providing client-focused care s s
ANS: B s
All actions are appropriate for the professional nurse. However, ensuring client safety is thepriority.
s s s s s s s s s s s s s
Health care errors have been widely reported for 25 years, many of which result inclient injury, death,
s s s s s s s s s s s s s s s s s
and increased health care costs. There are several national and international organizations that have
s s s s s s s s s s s s s s
either recommended or mandated safety initiatives.
s s s s s s
Every nurse has the responsibility to guard the client‘s safety. The other actions are important for quality
s s s s s s s s s s s s s s s s
nursing, but they are not as vital as providing safety. Not making medication errorsdoes provide safety,
s s s s s s s s s s s s s s s s
but is too narrow in scope to be the best answer.
s s s s s s s s s s s
DIF: Understanding TOP: Integrated Process: Nursing Process: s s s s
InterventionKEY:Client safety
s s s
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
s s s s s s s s s s s s
2. A nurse is orienting a new client and family to the medical-surgical unit. What informationdoes the
s s s s s s s s s s s s s s s
nurse provide to best help the client promote his or her own safety?
s s s s s s s s s s s s s
a. Encourage the client and family to be active partners. s s s s s s s s
b. Have the client monitor hand hygiene in caregivers.
s s s s s s s
c. Offer the family the opportunity to stay with the client.
s s s s s s s s s
d. Tell the client to always wear his or her armband.
s s s s s s s s s
ANS: A s
Each action could be important for the client or family to perform. However, encouraging theclient to be
s s s s s s s s s s s s s s s s
active in his or her health care as a safety partner is the most critical. The other actions are very
s s s s s s s s s s s s s s s s s s s s
limited in scope and do not provide the broad protection that being active andinvolved does.
s s s s s s s s s s s s s s s
DIF: Understanding TOP: Integrated Process: s s
Teaching/LearningKEY: Client safety
s s s s
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
s s s s s s s s s s s s
,Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
s s s s s s s s
3. A nurse is caring for a postoperative client on the surgical unit. The client‘s blood pressure was 142/76
s s s s s s s s s s s s s s s s s
mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nursetake first?
s s s s s s s s s s s s s s s s s
a. Call the Rapid Response Team.
s s s s
b. Document and continue to monitor. s s s s
c. Notify the primary health care provider.
s s s s s
d. Repeat the blood pressure in 15 minutes.
s s s s s s
,Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
s s s s s s s s
ANS: A s
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deterioratingbefore
s s s s s s s s s s s s s s
they suffer either respiratory or cardiac arrest. Since the client has manifested a significant change,
s s s s s s s s s s s s s s s
the nurse would call the RRT. Changes in blood pressure, mental status, heart rate, temperature,
s s s s s s s s s s s s s s s
oxygen saturation, and last 2 hours‘ urine output are particularly significant and are part of the Modified
s s s s s s s s s s s s s s s s s
Early Warning System guide. Documentation is vital,but the nurse must do more than document. The
s s s s s s s s s s s s s s s
primary health care provider would be notified, but this is not more important than calling the RRT. The
s s s s s s s s s s s s s s s s s s
client‘s blood pressure would be reassessed frequently, but the priority is getting the rapid care to the
s s s s s s s s s s s s s s s s s
client.
s
DIF: Applying TOP: Integrated Process: Communication and DocumentationKEY: s s s s s
Rapid Response Team (RRT), Clinical judgment
s s s s s s
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
s s s s s s s
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
s s s s s s s s s s s s s s
best demonstrates this concept?
s s s
a. Assesses for cultural influences affecting health care. s s s s s s
b. Ensures that all the client‘s basic needs are met. s s s s s s s s
c. Tells the client and family about all upcoming tests.
s s s s s s s s
d. Thoroughly orients the client and family to the room. s s s s s s s s
ANS: A s
Showing respect for the client and family‘s preferences and needs is essential to ensure a holistic or
s s s s s s s s s s s s s s s s
―whole-person‖ approach to care. By assessing the effect of the client‘s culture onhealth care, this nurse
s s s s s s s s s s s s s s s
is practicing client-focused care. Providing for basic needs does not demonstrate this competence.
s s s s s s s s s s s s s
Simply telling the client about all upcoming tests is not providing empowering education. Orienting
s s s s s s s s s s s s s
the client and family to the room is an importantsafety measure, but not directly related to
s s s s s s s s s s s s s s s s
demonstrating client-centered care.
s s s
DIF: Understanding TOP: Integrated Process: Culture and Spirituality
s s s s s
KEY:Client-centered care, Culture
s s s s MSC: Client Needs Category: Psychosocial Integrity
s s s s s
5. A client is going to be admitted for a scheduled surgical procedure. Which action does
s s s s s s s s s s s s s s
thenurse explain is the most important thing the client can do to protect against errors?
s s s s s s s s s s s s s s s
a. Bring a list of all medications and what they are for.
s s s s s s s s s s
b. Keep the provider‘s phone number by the telephone.
s s s s s s s
c. Make sure that all providers wash hands before entering the room.
s s s s s s s s s s
d. Write down the name of each caregiver who comes in the room.
s s s s s s s s s s s
ANS: A s
Medication reconciliation is a formal process in which the client‘s actual current medicationsare
s s s s s s s s s s s s
compared to the prescribed medications at the time of admission, transfer, or discharge. This National
s s s s s s s s s s s s s s s
client Safety Goal is important to reduce medication errors. The client would not have to be
s s s s s s s s s s s s s s s s
responsible for providers washing their hands, and even if the client does so, this is too narrow to be
s s s s s s s s s s s s s s s s s s s
the most important action to prevent errors. Keeping the provider‘s phone number nearby and
s s s s s s s s s s s s s s
documenting everyone who enters the room also do not guaranteesafety.
s s s s s s s s s s
DIF: Applying TOP: Integrated Process: s s
Teaching/LearningKEY: Client safety, Informatics
s s s s s
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
s s s s s s s s s s s s
, Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
s s s s s s s s
6. Which action by the nurse working with a client best demonstrates respect for autonomy?
s s s s s s s s s s s s s
a. Asks if the client has questions before signing a consent.
s s s s s s s s s
b. Gives the client accurate information when questioned.s s s s s s
c. Keeps the promises made to the client and family. s s s s s s s s
d. Treats the client fairly compared to other clients. s s s s s s s
ANS: A s
Autonomy is self-determination. The client would make decisions regarding care. When the nurse
s s s s s s s s s s s s
obtains a signature on the consent form, assessing if the client still has questions is vital,because without
s s s s s s s s s s s s s s s s s
full information the client cannot practice autonomy. Giving accurate information is practicing with
s s s s s s s s s s s s s
veracity.
s
Keeping promises is upholding fidelity. Treating the client fairly is providing social justice.
s s s s s s s s s s s s
DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, s s s s
AutonomyMSC: Client Needs Category: Safe and Effective Care Environment: Management of
s s s s s s s s s s s s
Care
s
7. A nurse asks a more seasoned colleague to explain best practices when communicating with aperson
s s s s s s s s s s s s s s
from the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) community. What
s s s s s s s s s s s
answer by the faculty is most accurate?
s s s s s s s
a. Avoid embarrassing the client by asking questions.s s s s s s
b. Don‘t make assumptions about his or her health needs.
s s s s s s s s
c. Most LGBTQ people do not want to share information.
s s s s s s s s
d. No differences exist in communicating with this population.
s s s s s s s
ANS: B s
Many members of the LGBTQ community have faced discrimination from health care providers and
s s s s s s s s s s s s s
may be reluctant to seek health care. The nurse would never make assumptionsabout the needs of
s s s s s s s s s s s s s s s s
members of this population. Rather, respectful questions are appropriate. Ifapproached with
s s s s s s s s s s s
sensitivity, the client with any health care need is more likely to answer honestly.
s s s s s s s s s s s s s s
DIF: Understanding TOP: Integrated Process: Teaching/Learning
s s s
KEY: Health care disparities, LGBTQ
s s s s MSC: Client Needs Category: Psychosocial Integrity
s s s s s
8. A nurse is calling the on-call health care provider about a client who had a hysterectomy 2days ago
s s s s s s s s s s s s s s s s s
and has pain that is unrelieved by the prescribed opioid pain medication. Which statement
s s s s s s s s s s s s s s
comprises the background portion of the SBAR format for communication?
s s s s s s s s s s
a. ―I would like you to order a different pain medication.‖
s s s s s s s s s
b. ―This client has allergies to morphine and codeine.‖ s s s s s s s
c. ―Dr. Smith doesn‘t like nonsteroidal anti-inflammatory meds.‖
s s s s s s
d. ―This client had a vaginal hysterectomy 2 days ago.‖ s s s s s s s s
ANS: B s
s s s s s s s s
Medical Surgical Nursing 10th EditionIgnatavicius s s s s s
Workman Test Bank
s s s
Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
s s s s s s s s s
Ignatavicius: Medical-Surgical Nursing, 10th Edition
s s s s s
MULTIPLE CHOICE s
1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises thenew
s s s s s s s s s s s s s s s
nurse that which is the priority when working as a professional nurse?
s s s s s s s s s s s s
a. Attending to holistic client needs s s s s
b. Ensuring client safety s s
c. Not making medication errors s s s
d. Providing client-focused care s s
ANS: B s
All actions are appropriate for the professional nurse. However, ensuring client safety is thepriority.
s s s s s s s s s s s s s
Health care errors have been widely reported for 25 years, many of which result inclient injury, death,
s s s s s s s s s s s s s s s s s
and increased health care costs. There are several national and international organizations that have
s s s s s s s s s s s s s s
either recommended or mandated safety initiatives.
s s s s s s
Every nurse has the responsibility to guard the client‘s safety. The other actions are important for quality
s s s s s s s s s s s s s s s s
nursing, but they are not as vital as providing safety. Not making medication errorsdoes provide safety,
s s s s s s s s s s s s s s s s
but is too narrow in scope to be the best answer.
s s s s s s s s s s s
DIF: Understanding TOP: Integrated Process: Nursing Process: s s s s
InterventionKEY:Client safety
s s s
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
s s s s s s s s s s s s
2. A nurse is orienting a new client and family to the medical-surgical unit. What informationdoes the
s s s s s s s s s s s s s s s
nurse provide to best help the client promote his or her own safety?
s s s s s s s s s s s s s
a. Encourage the client and family to be active partners. s s s s s s s s
b. Have the client monitor hand hygiene in caregivers.
s s s s s s s
c. Offer the family the opportunity to stay with the client.
s s s s s s s s s
d. Tell the client to always wear his or her armband.
s s s s s s s s s
ANS: A s
Each action could be important for the client or family to perform. However, encouraging theclient to be
s s s s s s s s s s s s s s s s
active in his or her health care as a safety partner is the most critical. The other actions are very
s s s s s s s s s s s s s s s s s s s s
limited in scope and do not provide the broad protection that being active andinvolved does.
s s s s s s s s s s s s s s s
DIF: Understanding TOP: Integrated Process: s s
Teaching/LearningKEY: Client safety
s s s s
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
s s s s s s s s s s s s
,Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
s s s s s s s s
3. A nurse is caring for a postoperative client on the surgical unit. The client‘s blood pressure was 142/76
s s s s s s s s s s s s s s s s s
mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nursetake first?
s s s s s s s s s s s s s s s s s
a. Call the Rapid Response Team.
s s s s
b. Document and continue to monitor. s s s s
c. Notify the primary health care provider.
s s s s s
d. Repeat the blood pressure in 15 minutes.
s s s s s s
,Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
s s s s s s s s
ANS: A s
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deterioratingbefore
s s s s s s s s s s s s s s
they suffer either respiratory or cardiac arrest. Since the client has manifested a significant change,
s s s s s s s s s s s s s s s
the nurse would call the RRT. Changes in blood pressure, mental status, heart rate, temperature,
s s s s s s s s s s s s s s s
oxygen saturation, and last 2 hours‘ urine output are particularly significant and are part of the Modified
s s s s s s s s s s s s s s s s s
Early Warning System guide. Documentation is vital,but the nurse must do more than document. The
s s s s s s s s s s s s s s s
primary health care provider would be notified, but this is not more important than calling the RRT. The
s s s s s s s s s s s s s s s s s s
client‘s blood pressure would be reassessed frequently, but the priority is getting the rapid care to the
s s s s s s s s s s s s s s s s s
client.
s
DIF: Applying TOP: Integrated Process: Communication and DocumentationKEY: s s s s s
Rapid Response Team (RRT), Clinical judgment
s s s s s s
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
s s s s s s s
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
s s s s s s s s s s s s s s
best demonstrates this concept?
s s s
a. Assesses for cultural influences affecting health care. s s s s s s
b. Ensures that all the client‘s basic needs are met. s s s s s s s s
c. Tells the client and family about all upcoming tests.
s s s s s s s s
d. Thoroughly orients the client and family to the room. s s s s s s s s
ANS: A s
Showing respect for the client and family‘s preferences and needs is essential to ensure a holistic or
s s s s s s s s s s s s s s s s
―whole-person‖ approach to care. By assessing the effect of the client‘s culture onhealth care, this nurse
s s s s s s s s s s s s s s s
is practicing client-focused care. Providing for basic needs does not demonstrate this competence.
s s s s s s s s s s s s s
Simply telling the client about all upcoming tests is not providing empowering education. Orienting
s s s s s s s s s s s s s
the client and family to the room is an importantsafety measure, but not directly related to
s s s s s s s s s s s s s s s s
demonstrating client-centered care.
s s s
DIF: Understanding TOP: Integrated Process: Culture and Spirituality
s s s s s
KEY:Client-centered care, Culture
s s s s MSC: Client Needs Category: Psychosocial Integrity
s s s s s
5. A client is going to be admitted for a scheduled surgical procedure. Which action does
s s s s s s s s s s s s s s
thenurse explain is the most important thing the client can do to protect against errors?
s s s s s s s s s s s s s s s
a. Bring a list of all medications and what they are for.
s s s s s s s s s s
b. Keep the provider‘s phone number by the telephone.
s s s s s s s
c. Make sure that all providers wash hands before entering the room.
s s s s s s s s s s
d. Write down the name of each caregiver who comes in the room.
s s s s s s s s s s s
ANS: A s
Medication reconciliation is a formal process in which the client‘s actual current medicationsare
s s s s s s s s s s s s
compared to the prescribed medications at the time of admission, transfer, or discharge. This National
s s s s s s s s s s s s s s s
client Safety Goal is important to reduce medication errors. The client would not have to be
s s s s s s s s s s s s s s s s
responsible for providers washing their hands, and even if the client does so, this is too narrow to be
s s s s s s s s s s s s s s s s s s s
the most important action to prevent errors. Keeping the provider‘s phone number nearby and
s s s s s s s s s s s s s s
documenting everyone who enters the room also do not guaranteesafety.
s s s s s s s s s s
DIF: Applying TOP: Integrated Process: s s
Teaching/LearningKEY: Client safety, Informatics
s s s s s
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
s s s s s s s s s s s s
, Medical Surgical Nursing 10th Edition Ignatavicius Workman Test Bank
s s s s s s s s
6. Which action by the nurse working with a client best demonstrates respect for autonomy?
s s s s s s s s s s s s s
a. Asks if the client has questions before signing a consent.
s s s s s s s s s
b. Gives the client accurate information when questioned.s s s s s s
c. Keeps the promises made to the client and family. s s s s s s s s
d. Treats the client fairly compared to other clients. s s s s s s s
ANS: A s
Autonomy is self-determination. The client would make decisions regarding care. When the nurse
s s s s s s s s s s s s
obtains a signature on the consent form, assessing if the client still has questions is vital,because without
s s s s s s s s s s s s s s s s s
full information the client cannot practice autonomy. Giving accurate information is practicing with
s s s s s s s s s s s s s
veracity.
s
Keeping promises is upholding fidelity. Treating the client fairly is providing social justice.
s s s s s s s s s s s s
DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, s s s s
AutonomyMSC: Client Needs Category: Safe and Effective Care Environment: Management of
s s s s s s s s s s s s
Care
s
7. A nurse asks a more seasoned colleague to explain best practices when communicating with aperson
s s s s s s s s s s s s s s
from the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) community. What
s s s s s s s s s s s
answer by the faculty is most accurate?
s s s s s s s
a. Avoid embarrassing the client by asking questions.s s s s s s
b. Don‘t make assumptions about his or her health needs.
s s s s s s s s
c. Most LGBTQ people do not want to share information.
s s s s s s s s
d. No differences exist in communicating with this population.
s s s s s s s
ANS: B s
Many members of the LGBTQ community have faced discrimination from health care providers and
s s s s s s s s s s s s s
may be reluctant to seek health care. The nurse would never make assumptionsabout the needs of
s s s s s s s s s s s s s s s s
members of this population. Rather, respectful questions are appropriate. Ifapproached with
s s s s s s s s s s s
sensitivity, the client with any health care need is more likely to answer honestly.
s s s s s s s s s s s s s s
DIF: Understanding TOP: Integrated Process: Teaching/Learning
s s s
KEY: Health care disparities, LGBTQ
s s s s MSC: Client Needs Category: Psychosocial Integrity
s s s s s
8. A nurse is calling the on-call health care provider about a client who had a hysterectomy 2days ago
s s s s s s s s s s s s s s s s s
and has pain that is unrelieved by the prescribed opioid pain medication. Which statement
s s s s s s s s s s s s s s
comprises the background portion of the SBAR format for communication?
s s s s s s s s s s
a. ―I would like you to order a different pain medication.‖
s s s s s s s s s
b. ―This client has allergies to morphine and codeine.‖ s s s s s s s
c. ―Dr. Smith doesn‘t like nonsteroidal anti-inflammatory meds.‖
s s s s s s
d. ―This client had a vaginal hysterectomy 2 days ago.‖ s s s s s s s s
ANS: B s
