◦ Timby'sweIntroductoryweMedical-
SurgicalweNursingwe13thweEditionweMorenoweTestweBank
Chapterw e 1 Conceptswe andwe Trendswe inwe Healthcare
◦ Awenewwenurseweisweworkingwewithweawepreceptorweonweanweinpatientwemedical-
surgicalweunit.weThewepreceptorweadviseswethewestudentwethatwewhichweiswethewepriorityw
ewhenweworkingweasweaweprofessionalwenurse?
◦ Attendingw e tow e holisticw e clientw e needs
◦ Ensuringw e clientw e safety
◦ Notw e makingw e medicationw e errors
◦ Providingweclient
-
wefocusedwecarewe
ANS:weB
◦ Allweactionsweareweappropriateweforwetheweprofessionalwenurse.weHowever,w e e
nsuringw e clientw e safetyw e isw e thew e priority.w e Upw e tow e 98,000w e deathsw e resultw e eachw e yearw e fr
omw e errorsweinwehospitalwecare,weaccordingwetowethewe2000weInstituteweofweMedicinewereport.we
Manywemoreweclientswehavewesufferedweinjuriesweandwelessweseriousweoutcomes.weEverywenurse
wehaswetheweresponsibilitywetoweguardwetheweclientswesafety.
◦ DIF:weUnderstanding/ComprehensionweREF:we
2weKEY:wePatientwesafetyweMSC:weIntegratedweProcess:weNursin
gweProcess:weIntervention
◦ NOT:weClientweNeedsweCategory:weSafeweandweEffectivewe
CareweEnvironment:weSafetyweandweInfectionweControl
◦ Awenurseweisweorientingweawenewweclientweandwefamilywetowetheweinpatientweunit.weWh
atweinformationwedoeswethewenurseweprovidewetowehelpwetheweclientwepromotewehisweor
weherweownwesafety?
◦ Encouragewe thewe clientwe andwe familywe towe bewe activew e partners.
◦ Havewe thewe clientwe monitorw e handwe hygienewe inw e caregivers.
◦ Offerwe thewe familywe thewe opportunitywe towe staywe withwe thew e client.
◦ Tellwetheweclientwetowealwayswewearwehi
sweorweherwearmband.weANS:weA
◦ Eachweactionwecouldwebeweimportantweforwetheweclientweorwefamilywetoweperf
orm.weHowever,weencouragingwetheweclientwetowebeweactiveweinwehisweorweherwehealthwecarewea
sweawepartnerweiswethewemostwecritical.weTheweotherweactionsweare
◦
◦ verywelimitedweinwescopeweandwedowenotweprovidewethewebroadweprotectio
nwethatwebeingweactiveweandweinvolvedwedoes.
◦ DIF:weUnderstanding/ComprehensionweREF:we
3weKEY:wePatientwesafetyweMSC:weIntegratedweProcess:weTeachi
ng/weLearning
◦ NOT:we Clientwe Needswe Category:we Safewe andwe Effectivewe Care
,Environment:w e Safetyw e andw e Infectionw e Control
◦ Awenurseweiswecaringweforweawepostoperativeweclientweonwethewesurgicalweunit.weTheweclient
swebloodwepressurewewaswe142/76wemmweHgwe30weminutesweago,weandwenowweiswe88/50wem
mweHg.weWhatweactionwebywethewenurseweiswebest?
◦ Callwe thewe Rapidw e Responsew e Team.
◦ Documentw e andw e continuewe tow e monitor.
◦ Notifywe thewe primarywe carew e provider.
◦ Repeatwebloodwepressurewemeasureme
ntweinwe15weminutes.weANS:weA
◦ ThewepurposeweofwetheweRapidweResponseweTeamwe(RRT)weiswetoweintervenewew
henweclientswearewedeterioratingwebeforewetheywesufferweeitherwerespiratoryweorwecardiacwearrest.
weSincewetheweclientwehaswemanifestedweawesignificantwechange,wethewenurseweshouldwecallwethewe
RRT.weChangesweinwebloodwepressure,wementalwestatus,weheartwerate,weandwepainweareweparticula
rlywesignificant.weDocumentationweiswevital,webutwethewenursewemustwedowemorewethanwedocume
nt.weTheweprimarywecareweproviderweshouldwebewenotified,webutwethisweiswenotwethewepriorityweover
wecallingw e theweRRT.weThew e clientswebloodwepressureweshouldwebewereassessedwefrequently,we
butwethewepriorityweiswegetting
thewerapidwecarewetowetheweclient.
◦ DIF:weApplying/Applicationw e REF:w e 3
◦ KEY:weRapidweResponseweTeamwe(RR
T)|wemedicalweemergenciesweMSC:weIntegratedweProce
ss:
Communicationw e andw e Documentation
◦ NOT:w e Clientw e Needsw e Category:w e Physiologicalw e Integrity:w e PhysiologicalweAdaptatio
n
◦
◦ Awenursewewisheswetoweprovideweclient-
centeredwecareweinweallweinteractions.weWhichweactionwebywethewenursewebestwede
monstrateswethisweconcept?
◦ Assesseswe forw e culturalwe influenceswe affectingwe healthw e care
◦ Ensureswethatwe allwe theweclientswe basicwe needswe arew e met
◦ Tellswe thewe clientwe andwe familywe aboutwe allwe upcomingw e tests
◦ Thoroughlyweorientswetheweclientwea
ndwefamilywetowetheweroomweANS:we
A
◦ Competencyweinweclient-
focusedwecareweiswedemonstratedwewhenwethewenursewefocusesweonwecommunication,wecult
ure,werespect,wecompassion,weclientweeducation,weandweempowerment.weByweassessingwet
heweeffectweofwethe
◦
◦ clientswecultureweonwehealthwecare,wethiswenurseweiswepracticingweclient-
focusedwecare.weProvidingweforwebasicw e needswedoeswenotwedemonstratewethiswecompetence.we
Simplywetellingwetheweclientweaboutweallweupcomingwetestsweiswenotweprovidingweempoweringwe
education.weOrientingwetheweclientweandwefamilywetowetheweroomweisweanweimportantwesafetywem
easure,webutwenotwedirectlyw e relatedwetowedemonstratingweclient-centeredw e care.
,◦ DIF:w e Understanding/Comprehensionw e REF:w e 3
, ◦ KEY:wePatient-
centeredwecare|wecultureweMSC:weIntegratedweProcess:weCarin
gweNOT:weClientweNeedsweCategory:
Psychosocialw e Integrity
◦ Aweclientweiswegoingwetowebeweadmittedweforweawescheduledwesurgicalweprocedure.we
Whichweactionwedoeswethewenurseweexplainweiswethewemostweimportantwethingwethewe
clientwecanwedow e toweprotectweagainstweerrors?
◦ Bringweawe listwe ofwe allwe medicationswe andwe whatwe theywearew e for.
◦ Keepwe thewe doctorswe phonewe numberwe bywe thew e telephone.
◦ Makewe surewe allwe providerswe washwe handswe beforewe enteringwe thew e room.
◦ Writewedownwethewenameweofweeachwecaregiverwe
whowecomesweinwetheweroom.weANS:weA
◦ Medicationweerrorswearewethewemostwecommonwetypeweofwehealthwecarewemista
ke.weTheweJointweCommissionsweSpeakweUpwecampaignweencouragesweclientswetowehelpweensu
rewetheirwesafety.weOnewerecommendationweisweforweclientswetoweknowweallwetheirwemedications
weandwewhywetheywetakewethem.weThiswewillwehelpwepreventwemedicationweerrors.
◦ DIF:weApplying/Applicationw e REF:w e 4
◦ KEY:weSpeakweUpwecampaign|wepatientwesafetyweMSC:weIntegrated
Process:weTeaching/LearningweNOT:weClientweNeedsweCategory:weSafeweandweEff
we
ectiveweCareweEnvironment:weSafetyweandweInfectionweControl
◦ Whichweactionwebywethewenurseweworkingwewithweaweclientwebestwedemonstrateswerespe
ctweforw e autonomy?
◦ Askswe ifwe thewe clientwe haswequestionswe beforewe signingwe aw e consent
◦ Givesw e thew e clientwe accuratew e informationw e whenw e questioned
◦ Keepswe thewe promiseswe madewe towe theweclientwe andw e family
◦ Treatswetheweclientwefairlywe
comparedwetoweotherweclien
tsweANS:weA
◦ Autonomyweisweself-
determination.weTheweclientweshouldwemakewedecisionsweregardingwecare.weWhenwethewenursew
eobtainsweawesignatureweonwetheweconsentweform,weassessingweifw e theweclientwestillwehaswequesti
onsweiswevital,webecausewewithoutwefullweinformationwetheweclientwecannotwepracticeweautonom
y.weGivingweaccurateweinformationweiswepracticingwewithweveracity.weKeepingwepromisesweiswe
upholdingwefidelity.weTreatingwethe
◦
◦ clientwe fairlywe iswe providingw e socialwe justice.
◦
◦ DIF:weApplying/Applicationw e REF:w e 4
◦ KEY:weAutonomy|w e ethicalwe principleswe MSC:we Integratedwe Process:we Caring
◦ NOT:we Clientwe Needsw e Category:we Safewe andwe Effectivewe Carew e Environment:we Manage
ment
ofweCare
SurgicalweNursingwe13thweEditionweMorenoweTestweBank
Chapterw e 1 Conceptswe andwe Trendswe inwe Healthcare
◦ Awenewwenurseweisweworkingwewithweawepreceptorweonweanweinpatientwemedical-
surgicalweunit.weThewepreceptorweadviseswethewestudentwethatwewhichweiswethewepriorityw
ewhenweworkingweasweaweprofessionalwenurse?
◦ Attendingw e tow e holisticw e clientw e needs
◦ Ensuringw e clientw e safety
◦ Notw e makingw e medicationw e errors
◦ Providingweclient
-
wefocusedwecarewe
ANS:weB
◦ Allweactionsweareweappropriateweforwetheweprofessionalwenurse.weHowever,w e e
nsuringw e clientw e safetyw e isw e thew e priority.w e Upw e tow e 98,000w e deathsw e resultw e eachw e yearw e fr
omw e errorsweinwehospitalwecare,weaccordingwetowethewe2000weInstituteweofweMedicinewereport.we
Manywemoreweclientswehavewesufferedweinjuriesweandwelessweseriousweoutcomes.weEverywenurse
wehaswetheweresponsibilitywetoweguardwetheweclientswesafety.
◦ DIF:weUnderstanding/ComprehensionweREF:we
2weKEY:wePatientwesafetyweMSC:weIntegratedweProcess:weNursin
gweProcess:weIntervention
◦ NOT:weClientweNeedsweCategory:weSafeweandweEffectivewe
CareweEnvironment:weSafetyweandweInfectionweControl
◦ Awenurseweisweorientingweawenewweclientweandwefamilywetowetheweinpatientweunit.weWh
atweinformationwedoeswethewenurseweprovidewetowehelpwetheweclientwepromotewehisweor
weherweownwesafety?
◦ Encouragewe thewe clientwe andwe familywe towe bewe activew e partners.
◦ Havewe thewe clientwe monitorw e handwe hygienewe inw e caregivers.
◦ Offerwe thewe familywe thewe opportunitywe towe staywe withwe thew e client.
◦ Tellwetheweclientwetowealwayswewearwehi
sweorweherwearmband.weANS:weA
◦ Eachweactionwecouldwebeweimportantweforwetheweclientweorwefamilywetoweperf
orm.weHowever,weencouragingwetheweclientwetowebeweactiveweinwehisweorweherwehealthwecarewea
sweawepartnerweiswethewemostwecritical.weTheweotherweactionsweare
◦
◦ verywelimitedweinwescopeweandwedowenotweprovidewethewebroadweprotectio
nwethatwebeingweactiveweandweinvolvedwedoes.
◦ DIF:weUnderstanding/ComprehensionweREF:we
3weKEY:wePatientwesafetyweMSC:weIntegratedweProcess:weTeachi
ng/weLearning
◦ NOT:we Clientwe Needswe Category:we Safewe andwe Effectivewe Care
,Environment:w e Safetyw e andw e Infectionw e Control
◦ Awenurseweiswecaringweforweawepostoperativeweclientweonwethewesurgicalweunit.weTheweclient
swebloodwepressurewewaswe142/76wemmweHgwe30weminutesweago,weandwenowweiswe88/50wem
mweHg.weWhatweactionwebywethewenurseweiswebest?
◦ Callwe thewe Rapidw e Responsew e Team.
◦ Documentw e andw e continuewe tow e monitor.
◦ Notifywe thewe primarywe carew e provider.
◦ Repeatwebloodwepressurewemeasureme
ntweinwe15weminutes.weANS:weA
◦ ThewepurposeweofwetheweRapidweResponseweTeamwe(RRT)weiswetoweintervenewew
henweclientswearewedeterioratingwebeforewetheywesufferweeitherwerespiratoryweorwecardiacwearrest.
weSincewetheweclientwehaswemanifestedweawesignificantwechange,wethewenurseweshouldwecallwethewe
RRT.weChangesweinwebloodwepressure,wementalwestatus,weheartwerate,weandwepainweareweparticula
rlywesignificant.weDocumentationweiswevital,webutwethewenursewemustwedowemorewethanwedocume
nt.weTheweprimarywecareweproviderweshouldwebewenotified,webutwethisweiswenotwethewepriorityweover
wecallingw e theweRRT.weThew e clientswebloodwepressureweshouldwebewereassessedwefrequently,we
butwethewepriorityweiswegetting
thewerapidwecarewetowetheweclient.
◦ DIF:weApplying/Applicationw e REF:w e 3
◦ KEY:weRapidweResponseweTeamwe(RR
T)|wemedicalweemergenciesweMSC:weIntegratedweProce
ss:
Communicationw e andw e Documentation
◦ NOT:w e Clientw e Needsw e Category:w e Physiologicalw e Integrity:w e PhysiologicalweAdaptatio
n
◦
◦ Awenursewewisheswetoweprovideweclient-
centeredwecareweinweallweinteractions.weWhichweactionwebywethewenursewebestwede
monstrateswethisweconcept?
◦ Assesseswe forw e culturalwe influenceswe affectingwe healthw e care
◦ Ensureswethatwe allwe theweclientswe basicwe needswe arew e met
◦ Tellswe thewe clientwe andwe familywe aboutwe allwe upcomingw e tests
◦ Thoroughlyweorientswetheweclientwea
ndwefamilywetowetheweroomweANS:we
A
◦ Competencyweinweclient-
focusedwecareweiswedemonstratedwewhenwethewenursewefocusesweonwecommunication,wecult
ure,werespect,wecompassion,weclientweeducation,weandweempowerment.weByweassessingwet
heweeffectweofwethe
◦
◦ clientswecultureweonwehealthwecare,wethiswenurseweiswepracticingweclient-
focusedwecare.weProvidingweforwebasicw e needswedoeswenotwedemonstratewethiswecompetence.we
Simplywetellingwetheweclientweaboutweallweupcomingwetestsweiswenotweprovidingweempoweringwe
education.weOrientingwetheweclientweandwefamilywetowetheweroomweisweanweimportantwesafetywem
easure,webutwenotwedirectlyw e relatedwetowedemonstratingweclient-centeredw e care.
,◦ DIF:w e Understanding/Comprehensionw e REF:w e 3
, ◦ KEY:wePatient-
centeredwecare|wecultureweMSC:weIntegratedweProcess:weCarin
gweNOT:weClientweNeedsweCategory:
Psychosocialw e Integrity
◦ Aweclientweiswegoingwetowebeweadmittedweforweawescheduledwesurgicalweprocedure.we
Whichweactionwedoeswethewenurseweexplainweiswethewemostweimportantwethingwethewe
clientwecanwedow e toweprotectweagainstweerrors?
◦ Bringweawe listwe ofwe allwe medicationswe andwe whatwe theywearew e for.
◦ Keepwe thewe doctorswe phonewe numberwe bywe thew e telephone.
◦ Makewe surewe allwe providerswe washwe handswe beforewe enteringwe thew e room.
◦ Writewedownwethewenameweofweeachwecaregiverwe
whowecomesweinwetheweroom.weANS:weA
◦ Medicationweerrorswearewethewemostwecommonwetypeweofwehealthwecarewemista
ke.weTheweJointweCommissionsweSpeakweUpwecampaignweencouragesweclientswetowehelpweensu
rewetheirwesafety.weOnewerecommendationweisweforweclientswetoweknowweallwetheirwemedications
weandwewhywetheywetakewethem.weThiswewillwehelpwepreventwemedicationweerrors.
◦ DIF:weApplying/Applicationw e REF:w e 4
◦ KEY:weSpeakweUpwecampaign|wepatientwesafetyweMSC:weIntegrated
Process:weTeaching/LearningweNOT:weClientweNeedsweCategory:weSafeweandweEff
we
ectiveweCareweEnvironment:weSafetyweandweInfectionweControl
◦ Whichweactionwebywethewenurseweworkingwewithweaweclientwebestwedemonstrateswerespe
ctweforw e autonomy?
◦ Askswe ifwe thewe clientwe haswequestionswe beforewe signingwe aw e consent
◦ Givesw e thew e clientwe accuratew e informationw e whenw e questioned
◦ Keepswe thewe promiseswe madewe towe theweclientwe andw e family
◦ Treatswetheweclientwefairlywe
comparedwetoweotherweclien
tsweANS:weA
◦ Autonomyweisweself-
determination.weTheweclientweshouldwemakewedecisionsweregardingwecare.weWhenwethewenursew
eobtainsweawesignatureweonwetheweconsentweform,weassessingweifw e theweclientwestillwehaswequesti
onsweiswevital,webecausewewithoutwefullweinformationwetheweclientwecannotwepracticeweautonom
y.weGivingweaccurateweinformationweiswepracticingwewithweveracity.weKeepingwepromisesweiswe
upholdingwefidelity.weTreatingwethe
◦
◦ clientwe fairlywe iswe providingw e socialwe justice.
◦
◦ DIF:weApplying/Applicationw e REF:w e 4
◦ KEY:weAutonomy|w e ethicalwe principleswe MSC:we Integratedwe Process:we Caring
◦ NOT:we Clientwe Needsw e Category:we Safewe andwe Effectivewe Carew e Environment:we Manage
ment
ofweCare
