TEST BANK: Lewis's Medical Surgical Nursing in
Canada 5th Edition by Jane Tyerman & Shelley
Cobbett 2024-2025 Chapter 1-9
Chapter 01: Introduction to Medical-Surgical Nursing Practice in Canada Lewis:
Medical-Surgical Nursing in Canada, 5th Canadian Edition
MULTIPLE CHOICE
1. When caring for clients using evidence-informed practice, which of the
following does the nurse use?
a. Clinical judgement based on experience
b. Evidence from a clinical research study
c. The best available evidence to guide clinical expertise
d. Evaluation of data showing that the client outcomes are met
CORRECT ANSWER: C
Evidence-informed nursing practice is a continuous interactive process
involving the explicit, conscientious, and judicious consideration of the
best available evidence to provide care. Four primary elements are: (a)
clinical state, setting, and circumstances; (b) client preferences and
actions; (c) best research evidence; and (d) health care resources.
Clinical judgement based on the nurse’s clinical experience is part of EIP,
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 client outcomes is important, but interventions should be
based on research from randomized control studies with a large
number of subjects.
The nurse is caring for a client who has been admitted to the hospital
for surgery and tells the nurse, “I do not feel right about leaving my
children with my neighbour.” Which action should the nurse take next?
a. Reassure the client that these feelings are common for parents.
b. Have the client call the children to ensure that they are doing well.
c. Call the neighbour to determine whether adequate childcare is
being provided.
, d. Gather more data about the client’s feelings about the childcare
arrangements.
CORRECT ANSWER: D
Since a complete assessment is necessary in order to identify a problem
and choose an appropriate intervention, the nurse’s first action should
be to obtain more information. The other actions may be appropriate,
but more assessment is needed before the best intervention can be
chosen.
Which of the following represents a nursing activity that is carried out
during the evaluation phase of the nursing process?
a. Determining if interventions have been effective in meeting client
outcomes
b. Documenting the nursing care plan in the progress notes in the
medical record
c. Deciding whether the client’s health problems have been
completely resolved
d. Asking the client to evaluate whether the nursing care provided
was satisfactory
CORRECT ANSWER: A
Evaluation consists of determining whether the desired client
outcomes have been met and whether the nursing interventions
were appropriate. The other responses do not describe the
evaluation phase.
Which of the following includes the components required for a complete
nursing diagnosis statement?
a. A problem and the suggested client goals or outcomes
b. A problem, its cause, and objective data that support the problem
c. A problem with all its possible causes and the planned
interventions
d. A problem with its etiology and the signs and symptoms of the
problem
CORRECT ANSWER: D
The PES format is used when writing nursing diagnoses. The
subjective, as well as objective, data should be included in the
defining characteristics. Interventions and outcomes are not
included in the nursing diagnosis statement.
When using the Five Steps : Nursing Process: Evaluation practice (EIP) Process,
which of the
, of t e evidence informed
flowing elements is the final step when constructing a
clinical question? a. Comparison of interest
b. Population of interest
c. Outcome of interest
d. Timeframe of interest
CORRECT ANSWER: D
The order of the nurse’s statements follows the PICOT format with the
final step being the “T”, or timeframe of interest.
Which of the following refers to a situation that results in unintended
harm to the client and is related to the care or services provided
rather than the client’s medical condition? a. Negligence
b. Adverse event
c. Incident report
d. Nonmaleficence
CORRECT ANSWER: B
An adverse event is an event that results in unintended harm to the
client and is related to the care or services provided to the client
rather than to the client’s underlying medical condition.
. Which of the following would the nurse perform during the assessment
phase of the nursing process?
a. Obtains data with which to diagnose client problems
b. Uses client data to develop
c. Teaches interventions to relieve client health problems
d. Assists the client to identify realistic outcomes to health problems
CORRECT ANSWER: A
During the assessment phase, the nurse gathers information about
the client. The other responses are examples of the intervention,
diagnosis, and planning phases of the nursing process.
, The nurse is caring for a client who has left-sided paralysis as the result of
a stroke and assesses a pressure injury on the c lient ’ s le ft hip. W hich
of the following is the
most appropriate nursing diagnosis for this client?
a. Impaired physical mobility related to decrease in muscle control
(left-sided paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient
knowledge about protecting tissue integrity
c. Impaired skin integrity related to pressure over bony prominence
(impaired circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle
CORRECT ANSWER: C
The client’s major problem is the impaired skin integrity as
demonstrated by the presence of a pressure injury. The nurse is able to
treat the cause of altered circulation and pressure by frequently
repositioning the client. Although left-sided weakness is a problem for
the client, the nurse cannot treat the weakness. The “risk for” diagnosis
is not appropriate for this client, who already has impaired tissue
integrity. The client does have ineffective tissue perfusion, but the
impaired skin integrity diagnosis indicates more clearly what the health
problem is.
Which of the following best explains the nurses primary use of the
nursing process when providing care to vlients
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat clients’ health care
needs
c. As a scientific-based process of diagnosing the client’s health care
problems
d. To establish nursing theory that incorporates the biopsychosocial
nature of humans
CORRECT ANSWER: B
The nursing process is an assertive problem-solving approach to the
identification and treatment of clients’ problems. Diagnosis is only one
phase of the nursing process. The primary use of the nursing process is
in client care, not to establish nursing theory or explain nursing
interventions to other health care professionals.
Canada 5th Edition by Jane Tyerman & Shelley
Cobbett 2024-2025 Chapter 1-9
Chapter 01: Introduction to Medical-Surgical Nursing Practice in Canada Lewis:
Medical-Surgical Nursing in Canada, 5th Canadian Edition
MULTIPLE CHOICE
1. When caring for clients using evidence-informed practice, which of the
following does the nurse use?
a. Clinical judgement based on experience
b. Evidence from a clinical research study
c. The best available evidence to guide clinical expertise
d. Evaluation of data showing that the client outcomes are met
CORRECT ANSWER: C
Evidence-informed nursing practice is a continuous interactive process
involving the explicit, conscientious, and judicious consideration of the
best available evidence to provide care. Four primary elements are: (a)
clinical state, setting, and circumstances; (b) client preferences and
actions; (c) best research evidence; and (d) health care resources.
Clinical judgement based on the nurse’s clinical experience is part of EIP,
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 client outcomes is important, but interventions should be
based on research from randomized control studies with a large
number of subjects.
The nurse is caring for a client who has been admitted to the hospital
for surgery and tells the nurse, “I do not feel right about leaving my
children with my neighbour.” Which action should the nurse take next?
a. Reassure the client that these feelings are common for parents.
b. Have the client call the children to ensure that they are doing well.
c. Call the neighbour to determine whether adequate childcare is
being provided.
, d. Gather more data about the client’s feelings about the childcare
arrangements.
CORRECT ANSWER: D
Since a complete assessment is necessary in order to identify a problem
and choose an appropriate intervention, the nurse’s first action should
be to obtain more information. The other actions may be appropriate,
but more assessment is needed before the best intervention can be
chosen.
Which of the following represents a nursing activity that is carried out
during the evaluation phase of the nursing process?
a. Determining if interventions have been effective in meeting client
outcomes
b. Documenting the nursing care plan in the progress notes in the
medical record
c. Deciding whether the client’s health problems have been
completely resolved
d. Asking the client to evaluate whether the nursing care provided
was satisfactory
CORRECT ANSWER: A
Evaluation consists of determining whether the desired client
outcomes have been met and whether the nursing interventions
were appropriate. The other responses do not describe the
evaluation phase.
Which of the following includes the components required for a complete
nursing diagnosis statement?
a. A problem and the suggested client goals or outcomes
b. A problem, its cause, and objective data that support the problem
c. A problem with all its possible causes and the planned
interventions
d. A problem with its etiology and the signs and symptoms of the
problem
CORRECT ANSWER: D
The PES format is used when writing nursing diagnoses. The
subjective, as well as objective, data should be included in the
defining characteristics. Interventions and outcomes are not
included in the nursing diagnosis statement.
When using the Five Steps : Nursing Process: Evaluation practice (EIP) Process,
which of the
, of t e evidence informed
flowing elements is the final step when constructing a
clinical question? a. Comparison of interest
b. Population of interest
c. Outcome of interest
d. Timeframe of interest
CORRECT ANSWER: D
The order of the nurse’s statements follows the PICOT format with the
final step being the “T”, or timeframe of interest.
Which of the following refers to a situation that results in unintended
harm to the client and is related to the care or services provided
rather than the client’s medical condition? a. Negligence
b. Adverse event
c. Incident report
d. Nonmaleficence
CORRECT ANSWER: B
An adverse event is an event that results in unintended harm to the
client and is related to the care or services provided to the client
rather than to the client’s underlying medical condition.
. Which of the following would the nurse perform during the assessment
phase of the nursing process?
a. Obtains data with which to diagnose client problems
b. Uses client data to develop
c. Teaches interventions to relieve client health problems
d. Assists the client to identify realistic outcomes to health problems
CORRECT ANSWER: A
During the assessment phase, the nurse gathers information about
the client. The other responses are examples of the intervention,
diagnosis, and planning phases of the nursing process.
, The nurse is caring for a client who has left-sided paralysis as the result of
a stroke and assesses a pressure injury on the c lient ’ s le ft hip. W hich
of the following is the
most appropriate nursing diagnosis for this client?
a. Impaired physical mobility related to decrease in muscle control
(left-sided paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient
knowledge about protecting tissue integrity
c. Impaired skin integrity related to pressure over bony prominence
(impaired circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle
CORRECT ANSWER: C
The client’s major problem is the impaired skin integrity as
demonstrated by the presence of a pressure injury. The nurse is able to
treat the cause of altered circulation and pressure by frequently
repositioning the client. Although left-sided weakness is a problem for
the client, the nurse cannot treat the weakness. The “risk for” diagnosis
is not appropriate for this client, who already has impaired tissue
integrity. The client does have ineffective tissue perfusion, but the
impaired skin integrity diagnosis indicates more clearly what the health
problem is.
Which of the following best explains the nurses primary use of the
nursing process when providing care to vlients
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat clients’ health care
needs
c. As a scientific-based process of diagnosing the client’s health care
problems
d. To establish nursing theory that incorporates the biopsychosocial
nature of humans
CORRECT ANSWER: B
The nursing process is an assertive problem-solving approach to the
identification and treatment of clients’ problems. Diagnosis is only one
phase of the nursing process. The primary use of the nursing process is
in client care, not to establish nursing theory or explain nursing
interventions to other health care professionals.
