10th Edition Concepts for Interprofessional
Collaborative Care, by Donna D. Ignatavicius,
All chapters 1 – 69
,Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises
the new nurse that which is the priority when working as a professional nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
CORRECT ANSWER: B
All actions are appropriate for the professional nurse. However, ensuring client safety is the
priority. Health care errors have been widely reported for 25 years, many of which result in
client injury, death, and increased health care costs. There are several national and
international organizations that have either recommended or mandated safety initiatives.
Every nurse has the responsibility to guard the client’s safety. The other actions are
important for quality nursing, but they are not as vital as providing safety. Not making
medication errors does provide safety, but is too narrow in scope to be the best answer.
DIF: Understanding TOP: Integrated Process: Nursing Process: Intervention
KEY: Client safety
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
2. A nurse is orienting a new client and family to the medical-surgical unit. What information
does the nurse provide to best help the client promote his or her own safety?
a. Encourage the client and family to be active partners.
b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the client.
d. Tell the client to always wear his or her armband.
CORRECT ANSWER: A
Each action could be important for the client or family to perform. However, encouraging the
, client to be active in his or her health care as a safety partner is the most critical. The other
actions are very limited in scope and do not provide the broad protection that being active
and involved does.
DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Client safety
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the
nurse take first?
a. Call the Rapid Response Team.
b. Document and continue to monitor.
c. Notify the primary health care provider.
d. Repeat the blood pressure in 15 minutes.
CORRECT ANSWER: A
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
before they suffer either respiratory or cardiac arrest. Since the client has manifested a
significant change, the nurse would call the RRT. Changes in blood pressure, mental status,
heart rate, temperature, oxygen saturation, and last 2 hours’ urine output are particularly
significant and are part of the Modified Early Warning System guide. Documentation is vital,
but the nurse must do more than document. The primary health care provider would be
notified, but this is not more important than calling the RRT. The client’s blood pressure
would be reassessed frequently, but the priority is getting the rapid care to the client.
DIF: Applying TOP: Integrated Process: Communication and Documentation
KEY: Rapid Response Team (RRT), Clinical judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
best demonstrates this concept?
a. Assesses for cultural influences affecting health care.
b. Ensures that all the client’s basic needs are met.
c. Tells the client and family about all upcoming tests.
d. Thoroughly orients the client and family to the room.
CORRECT ANSWER: A
Showing respect for the client and family’s preferences and needs is essential to ensure a
, holistic tor t“whole-person” tapproach tto tcare. tBy tassessing tthe teffect tof tthe tclient’s
tculture ton thealth tcare, tthis tnurse tis tpracticing tclient-focused tcare. tProviding tfor tbasic
tneeds tdoes tnot tdemonstrate tthis tcompetence. tSimply ttelling tthe tclient tabout tall
tupcoming ttests tis tnot tproviding tempowering teducation. tOrienting tthe tclient tand tfamily
tto tthe troom tis tan timportant tsafety tmeasure, tbut tnot tdirectly trelated tto tdemonstrating
tclient-centered tcare.
DIF: Understanding TOP: tIntegrated tProcess: tCulture tand tSpirituality
tKEY: t Client-centered tcare, tCulture MSC: t Client tNeeds tCategory: tPsychosocial
tIntegrity
5. A tclient tis tgoing tto tbe tadmitted tfor ta tscheduled tsurgical tprocedure. tWhich taction
tdoes tthe tnurse texplain tis tthe tmost timportant tthing tthe tclient tcan tdo tto tprotect
tagainst terrors?
a. Bring ta tlist tof tall tmedications tand twhat tthey tare tfor.
b. Keep tthe tprovider’s tphone tnumber tby tthe ttelephone.
c. Make tsure tthat tall tproviders twash thands tbefore tentering tthe troom.
d. Write tdown tthe tname tof teach tcaregiver twho tcomes tin tthe troom.
CORRECT tANSWER: t A
Medication treconciliation tis ta tformal tprocess tin twhich tthe tclient’s tactual tcurrent
tmedications tare tcompared tto tthe tprescribed tmedications tat tthe ttime tof tadmission,
ttransfer, tor tdischarge. tThis tNational tclient tSafety tGoal tis timportant tto treduce
tmedication terrors. tThe tclient twould tnot thave tto tbe tresponsible tfor tproviders twashing
ttheir thands, tand teven tif tthe tclient tdoes tso, tthis tis ttoo tnarrow tto tbe tthe tmost
timportant taction tto tprevent terrors. tKeeping tthe tprovider’s tphone tnumber tnearby tand
tdocumenting teveryone twho tenters tthe troom talso tdo tnot tguarantee tsafety.
DIF: Applying TOP: t Integrated tProcess:
tTeaching/Learning tKEY: tClient tsafety, tInformatics
MSC: t Client tNeeds tCategory: tSafe tand tEffective tCare tEnvironment: tSafety tand tInfection tControl