Medical-Surgical Nursing in Canada 4th Edition Lewi Test Bank
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Chapter 01: Introduction to Medical-Surgical Nursing Practice in Canada
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NURSINGTB.COM
, Medical-Surgical Nursing in Canada 4th Edition Lewi Test Bank q q q q q q q q
Lewis: Medical-Surgical Nursing in Canada, 5th Canadian Edition
q q q q q q q q
MULTIPLE CHOICE q
1. When caring for clients using evidence-informed practice, which of the following does the
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q nurse use? q
a. Clinical judgement based on experience
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b. Evidence from a clinical research study q q q q q
c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the client outcomes are met
q q q q q q q q q
ANS: C q
Evidence-informed nursing practice is a continuous interactive process involving the explicit,
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conscientious, and judicious consideration of the best available evidence to provide care. Four
q q q q q q q q q q q q q
primary elements are: (a) clinical state, setting, and circumstances; (b) client preferences and
q q q q q q q q q q q q q
actions; (c) best research evidence; and (d) health care resources. Clinical judgement based on
q q q q q q q q q q q q q q
the nurse’s clinical experience is part of EIP, but clinical decision making also should
q q q q q q q q q q q q q q
incorporate current research and research-based guidelines. Evidence from one clinical
q q q q q q q q q q
research study does not provide an adequate substantiation for interventions. Evaluation of
q q q q q q q q q q q q
client outcomes is important, but interventions should be based on research from randomized
q q q q q q q q q q q q q
control studies with a large number of subjects.
q q q q q q q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Planning q q
2. Which of the following best e x p l a i n s t h e n u r s e s ’ primary use of the nursing process when
q
N R I G B.C M
q q q q q q q q q q q
providing care to clients? USNT Oq q q
q q q
a. To explain nursing interventions to other health care professionals
q q q q q q q q
b. As a problem-solving tool to identify and treat clients’ health care needs
q q q q q q q q q q q
c. As a scientific-based process of diagnosing the client’s health care problems
q q q q q q q q q q
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
q q q q q q q q q q
ANS: B q
The nursing process is an assertive problem-solving approach to the identification and
q q q q q q q q q q q
treatment of clients’ problems. Diagnosis is only one phase of the nursing process. The
q q q q q q q q q q q q q
qprimary use of the nursing process is in client care, not to establish nursing theory or explain
q q q q q q q q q q q q q q q q
qnursing interventions to other health care professionals.
q q q q q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Implementation q q
3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-hour
q q q q q q q q q q q q q q q q q q
turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated
q q q q q q q q q q q q q
with this turning schedule?
q q q q
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D q
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 4th Edition Lewi Test Bank q q q q q q q q
When implementing collaborative nursing actions, the nurse is responsible primarily for
q q q q q q q q q q
monitoring for complications of acute illness or providing care to prevent or treat
q q q q q q q q q q q q q
complications. Independent nursing actions are focused on health promotion, illness
q q q q q q q q q q
prevention, and client advocacy. A dependent action would require a physician order to
q q q q q q q q q q q q q
implement. Cooperative nursing functions are not described as one of the formal nursing
q q q q q q q q q q q q q
functions.
q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Implementation q q
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
q q q q q q q q q q q q q q q q q q
nurse, “I do not feel right about leaving my children with my neighbour.” Which action
q q q q q q q q q q q q q q q
should the nurse take next?
q q q q q
a. Reassure the client that these feelings are common for parents.
q q q q q q q q q
b. Have the client call the children to ensure that they are doing well.
q q q q q q q q q q q q
c. Call the neighbour to determine whether adequate childcare is being provided.
q q q q q q q q q q
d. Gather more data about the client’s feelings about the childcare arrangements.
q q q q q q q q q q
ANS: D q
Since a complete assessment is necessary in order to identify a problem and choose an
q q q q q q q q q q q q q q
appropriate intervention, the nurse’s first action should be to obtain more information. The
q q q q q q q q q q q q q
other actions may be appropriate, but more assessment is needed before the best intervention
q q q q q q q q q q q q q q
can be chosen.
q q q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Assessment q q
5. The nurse is caring for a client who has left-sided paralysis as the result of a stroke and
q q q q q q q q q q q q q q q q q
assesses a pressure injury on the clie nt’s left h ip . W hich of the following is the most
N fUoRr tShIi s cNGl i e nT
Bt ?. C
O M
q q q q q q q q q q q
appropriate nursing diagnosis q q q q q
a. Impaired physical mobility related to decrease in muscle control (left-sided
q q q q q q q q q
paralysis)
q
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
q q q q q q q q q q
protecting tissue integrity
q q q
c. Impaired skin integrity related to pressure over bony prominence (impaired
q q q q q q q q q
circulation)
q
d. Ineffective tissue perfusion related to sedentary lifestyle q q q q q q
ANS: C q
The client’s major problem is the impaired skin integrity as demonstrated by the presence of a
q q q q q q q q q q q q q q q
qpressure injury. The nurse is able to treat the cause of altered circulation and pressure by
q q q q q q q q q q q q q q q
qfrequently repositioning the client. Although left-sided weakness is a problem for the client,
q q q q q q q q q q q q
the nurse cannot treat the weakness. The “risk for” diagnosis is not appropriate for this client,
q q q q q q q q q q q q q q q
qwho already has impaired tissue integrity. The client does have ineffective tissue perfusion,
q q q q q q q q q q q q
qbut the impaired skin integrity diagnosis indicates more clearly what the health problem is.
q q q q q q q q q q q q q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Diagnosis q q
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid
q q q q q q q q q q q q q q q
volume related to excessive diaphoresis. Which of the following is an appropriate client
q q q q q q q q q q q q q
outcome?
q
a. Client has a balanced intake and output. q q q q q q
b. Client’s bedding is changed when it becomes damp.q q q q q q q
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 4th Edition Lewi Test Bank q q q q q q q q
c. Client understands the need for increased fluid intake.
q q q q q q q
d. Client’s skin remains cool and dry throughout hospitalization.
q q q q q q q
ANS: A q
This statement gives measurable data showing resolution of the problem of deficient fluid
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volume that was identified in the nursing diagnosis statement. The other statements would not
q q q q q q q q q q q q q q
indicate that the problem of deficient fluid volume was resolved.
q q q q q q q q q q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Planning q q
7. Which of the following represents a nursing activity that is carried out during the evaluation
q q q q q q q q q q q q q q
q phase of the nursing process?
q q q q
a. Determining if interventions have been effective in meeting client outcomes
q q q q q q q q q
b. Documenting the nursing care plan in the progress notes in the medical record q q q q q q q q q q q q
c. Deciding whether the client’s health problems have been completely resolved
q q q q q q q q q
d. Asking the client to evaluate whether the nursing care provided was satisfactory
q q q q q q q q q q q
ANS: A q
Evaluation consists of determining whether the desired client outcomes have been met and
q q q q q q q q q q q q
whether the nursing interventions were appropriate. The other responses do not describe the
q q q q q q q q q q q q q
evaluation phase.
q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Evaluation q q
8. Which of the following would the nurse perform during the assessment phase of the nursing
q q q q q q q q q q q q q q
process?
q
a. Obtains data with which to diagnose client problems
q q q q q q q
b. Uses client data to develoNp pR ItyTnGursB
in.
gC
q
Uriori
SN O Mnoses
d iag
c. Teaches interventions to relieve client health problems
q
q q q
q q
q
q q
q
q
q
q
q
q
d. Assists the client to identify realistic outcomes to health problems
q q q q q q q q q
ANS: A q
During the assessment phase, the nurse gathers information about the client. The other
q q q q q q q q q q q q
responses are examples of the intervention, diagnosis, and planning phases of the nursing
q q q q q q q q q q q q q
process.
q
DIF: Cognitive Level: Knowledge q q TOP: q Nursing Process: Assessment q q
9. Which of the following is an example of a correctly written nursing diagnosis statement?
q q q q q q q q q q q q q
a. Altered tissue perfusion related to heart failure
q q q q q q
b. Risk for impaired tissue integrity related to sacral redness
q q q q q q q q
c. Ineffective coping related to insufficient sense of control. q q q q q q q
d. Altered urinary elimination related to urinary tract infection
q q q q q q q
ANS: C q
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
q q q q q q q q q q q q
a client’s response to a health problem that can be treated by nursing. The use of a medical
q q q q q q q q q q q q q q q q q q
diagnosis (as in the responses beginning “Altered tissue perfusion” and “Altered urinary
q q q q q q q q q q q q
elimination”) is not appropriate. The response beginning “Risk for impaired tissue integrity”
q q q q q q q q q q q
uses the defining characteristics as the etiology.
q q q q q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Diagnosis q q
NURSINGTB.COM
q q q q q q q q
Chapter 01: Introduction to Medical-Surgical Nursing Practice in Canada
q q q q q q q q
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 4th Edition Lewi Test Bank q q q q q q q q
Lewis: Medical-Surgical Nursing in Canada, 5th Canadian Edition
q q q q q q q q
MULTIPLE CHOICE q
1. When caring for clients using evidence-informed practice, which of the following does the
q q q q q q q q q q q q
q nurse use? q
a. Clinical judgement based on experience
q q q q
b. Evidence from a clinical research study q q q q q
c. The best available evidence to guide clinical expertise
q q q q q q q
d. Evaluation of data showing that the client outcomes are met
q q q q q q q q q
ANS: C q
Evidence-informed nursing practice is a continuous interactive process involving the explicit,
q q q q q q q q q q
conscientious, and judicious consideration of the best available evidence to provide care. Four
q q q q q q q q q q q q q
primary elements are: (a) clinical state, setting, and circumstances; (b) client preferences and
q q q q q q q q q q q q q
actions; (c) best research evidence; and (d) health care resources. Clinical judgement based on
q q q q q q q q q q q q q q
the nurse’s clinical experience is part of EIP, but clinical decision making also should
q q q q q q q q q q q q q q
incorporate current research and research-based guidelines. Evidence from one clinical
q q q q q q q q q q
research study does not provide an adequate substantiation for interventions. Evaluation of
q q q q q q q q q q q q
client outcomes is important, but interventions should be based on research from randomized
q q q q q q q q q q q q q
control studies with a large number of subjects.
q q q q q q q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Planning q q
2. Which of the following best e x p l a i n s t h e n u r s e s ’ primary use of the nursing process when
q
N R I G B.C M
q q q q q q q q q q q
providing care to clients? USNT Oq q q
q q q
a. To explain nursing interventions to other health care professionals
q q q q q q q q
b. As a problem-solving tool to identify and treat clients’ health care needs
q q q q q q q q q q q
c. As a scientific-based process of diagnosing the client’s health care problems
q q q q q q q q q q
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
q q q q q q q q q q
ANS: B q
The nursing process is an assertive problem-solving approach to the identification and
q q q q q q q q q q q
treatment of clients’ problems. Diagnosis is only one phase of the nursing process. The
q q q q q q q q q q q q q
qprimary use of the nursing process is in client care, not to establish nursing theory or explain
q q q q q q q q q q q q q q q q
qnursing interventions to other health care professionals.
q q q q q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Implementation q q
3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-hour
q q q q q q q q q q q q q q q q q q
turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated
q q q q q q q q q q q q q
with this turning schedule?
q q q q
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D q
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 4th Edition Lewi Test Bank q q q q q q q q
When implementing collaborative nursing actions, the nurse is responsible primarily for
q q q q q q q q q q
monitoring for complications of acute illness or providing care to prevent or treat
q q q q q q q q q q q q q
complications. Independent nursing actions are focused on health promotion, illness
q q q q q q q q q q
prevention, and client advocacy. A dependent action would require a physician order to
q q q q q q q q q q q q q
implement. Cooperative nursing functions are not described as one of the formal nursing
q q q q q q q q q q q q q
functions.
q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Implementation q q
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
q q q q q q q q q q q q q q q q q q
nurse, “I do not feel right about leaving my children with my neighbour.” Which action
q q q q q q q q q q q q q q q
should the nurse take next?
q q q q q
a. Reassure the client that these feelings are common for parents.
q q q q q q q q q
b. Have the client call the children to ensure that they are doing well.
q q q q q q q q q q q q
c. Call the neighbour to determine whether adequate childcare is being provided.
q q q q q q q q q q
d. Gather more data about the client’s feelings about the childcare arrangements.
q q q q q q q q q q
ANS: D q
Since a complete assessment is necessary in order to identify a problem and choose an
q q q q q q q q q q q q q q
appropriate intervention, the nurse’s first action should be to obtain more information. The
q q q q q q q q q q q q q
other actions may be appropriate, but more assessment is needed before the best intervention
q q q q q q q q q q q q q q
can be chosen.
q q q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Assessment q q
5. The nurse is caring for a client who has left-sided paralysis as the result of a stroke and
q q q q q q q q q q q q q q q q q
assesses a pressure injury on the clie nt’s left h ip . W hich of the following is the most
N fUoRr tShIi s cNGl i e nT
Bt ?. C
O M
q q q q q q q q q q q
appropriate nursing diagnosis q q q q q
a. Impaired physical mobility related to decrease in muscle control (left-sided
q q q q q q q q q
paralysis)
q
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
q q q q q q q q q q
protecting tissue integrity
q q q
c. Impaired skin integrity related to pressure over bony prominence (impaired
q q q q q q q q q
circulation)
q
d. Ineffective tissue perfusion related to sedentary lifestyle q q q q q q
ANS: C q
The client’s major problem is the impaired skin integrity as demonstrated by the presence of a
q q q q q q q q q q q q q q q
qpressure injury. The nurse is able to treat the cause of altered circulation and pressure by
q q q q q q q q q q q q q q q
qfrequently repositioning the client. Although left-sided weakness is a problem for the client,
q q q q q q q q q q q q
the nurse cannot treat the weakness. The “risk for” diagnosis is not appropriate for this client,
q q q q q q q q q q q q q q q
qwho already has impaired tissue integrity. The client does have ineffective tissue perfusion,
q q q q q q q q q q q q
qbut the impaired skin integrity diagnosis indicates more clearly what the health problem is.
q q q q q q q q q q q q q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Diagnosis q q
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid
q q q q q q q q q q q q q q q
volume related to excessive diaphoresis. Which of the following is an appropriate client
q q q q q q q q q q q q q
outcome?
q
a. Client has a balanced intake and output. q q q q q q
b. Client’s bedding is changed when it becomes damp.q q q q q q q
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 4th Edition Lewi Test Bank q q q q q q q q
c. Client understands the need for increased fluid intake.
q q q q q q q
d. Client’s skin remains cool and dry throughout hospitalization.
q q q q q q q
ANS: A q
This statement gives measurable data showing resolution of the problem of deficient fluid
q q q q q q q q q q q q
volume that was identified in the nursing diagnosis statement. The other statements would not
q q q q q q q q q q q q q q
indicate that the problem of deficient fluid volume was resolved.
q q q q q q q q q q
DIF: Cognitive Level: Application q q TOP: q Nursing Process: Planning q q
7. Which of the following represents a nursing activity that is carried out during the evaluation
q q q q q q q q q q q q q q
q phase of the nursing process?
q q q q
a. Determining if interventions have been effective in meeting client outcomes
q q q q q q q q q
b. Documenting the nursing care plan in the progress notes in the medical record q q q q q q q q q q q q
c. Deciding whether the client’s health problems have been completely resolved
q q q q q q q q q
d. Asking the client to evaluate whether the nursing care provided was satisfactory
q q q q q q q q q q q
ANS: A q
Evaluation consists of determining whether the desired client outcomes have been met and
q q q q q q q q q q q q
whether the nursing interventions were appropriate. The other responses do not describe the
q q q q q q q q q q q q q
evaluation phase.
q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Evaluation q q
8. Which of the following would the nurse perform during the assessment phase of the nursing
q q q q q q q q q q q q q q
process?
q
a. Obtains data with which to diagnose client problems
q q q q q q q
b. Uses client data to develoNp pR ItyTnGursB
in.
gC
q
Uriori
SN O Mnoses
d iag
c. Teaches interventions to relieve client health problems
q
q q q
q q
q
q q
q
q
q
q
q
q
d. Assists the client to identify realistic outcomes to health problems
q q q q q q q q q
ANS: A q
During the assessment phase, the nurse gathers information about the client. The other
q q q q q q q q q q q q
responses are examples of the intervention, diagnosis, and planning phases of the nursing
q q q q q q q q q q q q q
process.
q
DIF: Cognitive Level: Knowledge q q TOP: q Nursing Process: Assessment q q
9. Which of the following is an example of a correctly written nursing diagnosis statement?
q q q q q q q q q q q q q
a. Altered tissue perfusion related to heart failure
q q q q q q
b. Risk for impaired tissue integrity related to sacral redness
q q q q q q q q
c. Ineffective coping related to insufficient sense of control. q q q q q q q
d. Altered urinary elimination related to urinary tract infection
q q q q q q q
ANS: C q
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
q q q q q q q q q q q q
a client’s response to a health problem that can be treated by nursing. The use of a medical
q q q q q q q q q q q q q q q q q q
diagnosis (as in the responses beginning “Altered tissue perfusion” and “Altered urinary
q q q q q q q q q q q q
elimination”) is not appropriate. The response beginning “Risk for impaired tissue integrity”
q q q q q q q q q q q
uses the defining characteristics as the etiology.
q q q q q q
DIF: Cognitive Level: Comprehension q q TOP: q Nursing Process: Diagnosis q q
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