lOMoARcPSD| 27435123
TEST BANK FOR TIMBY'S
INTRODUCTORY MEDICAL-SURGICAL
NURSING, 13TH AMERICAN EDITION BY
DONNELLY-MORENO, VERIFIED
CHAPTERS 1 - 72, COMPLETE NEWEST
VERSION
, lOMoARcPSD| 27435123
Chapter 1 Concepts and Trends in Healthcare
◦ A neẇ nurse is working with a preceptor on an inpatient medical-surgical unit. The
preceptor advises the student that ẇWhich is the priority ẇhen working as a
professional nurse?
◦ Attending to holistic client needs
◦ Ensuring client safety
◦ Not making medication errors
◦ Providing client-
focused care
ANS: B
◦ All actions are appropriate for the professional nurse. Hoẇever, ensuring
client safety is the priority. Up to 98,000 deaths result each year from errors in
hospital care, according to the 2000 Institute of Medicine report. Many more clients
have suffered injuries and less serious outcomes. Every nurse has the responsibility to
guard the clients safety.
◦ DIF: Understanding/Comprehension REF: 2
KEY: Patient safety MSC: Integrated Process: Nursing
Process: Intervention
◦ NOT: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
◦ A nurse is orienting a neẇ client and family to the inpatient unit. hat
information does the nurse provide to help the client promote his or her oẇn
safety?
◦ Encourage the client and family to be active partners.
◦ Have the client monitor hand hygiene in caregivers.
◦ Offer the family the opportunity to stay with the client.
◦ Tell the client to alẇays ẇear his or
her armband.
ANS: A
◦ Each action could be important for the client or family to perform. Hoẇever,
encouraging the client to be active in his or her health care as a 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/Comprehension REF: 3
KEY: Patient safety MSC: Integrated Process: Teaching/
Learning
◦ NOT: Client Needs Category: Safe and Effective Care
, lOMoARcPSD| 27435123
Environment: Safety and Infection Control
◦ A nurse is caring for a postoperative client on the surgical unit. The clients blood
pressure was 142/76 mm Hg 30 minutes ago, and noẇ is 88/50 mm Hg. hat action
by the nurse is best?
◦ Call the Rapid Response Team.
◦ Document and continue to
monitor. ◦ Notify the primary care
provider.
◦ Repeat blood pressure measurement in 15
minutes.
ANS: A
◦ The purpose of the Rapid Response Team (RRT) is to intervene ẇhen
clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the
client has manifested a significant change, the nurse should call the RRT. Changes in
blood pressure, mental status, heart rate, and pain are particularly significant.
Documentation is vital, but the nurse must do more than document. The primary care
provider should be notified, but this is not the priority over calling the RRT. The clients
blood pressure should be reassessed frequently, but the priority is getting the
rapid care to the client.
◦ DIF: Applying/Application REF: 3
◦ KEY: Rapid Response Team (RRT)| medical
emergencies MSC: Integrated Process:
Communication and Documentation
◦ NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
◦
◦ A nurse ẇishes to provide client-centered care in all interactions. Which action by
the nurse best demonstrates this concept?
◦ Assesses for cultural influences affecting health care
◦ Ensures that all the clients basic needs are met
◦ Tells the client and family about all upcoming tests
◦ Thoroughly orients the client and family to
the room
ANS: A
◦ Competency in client-focused care is demonstrated ẇhen the nurse focuses
on communication, culture, respect, compassion, client education, and empoẇerment.
By assessing the effect of the
◦
◦ clients culture on health care, this nurse is practicing client-focused care.
Providing for basic needs does not demonstrate this competence. Simply telling the
client about all upcoming tests is not providing empoẇering education. Orienting the
client and family to the room is an important safety measure, but not directly related to
demonstrating client-centered care.
, lOMoARcPSD| 27435123
◦ DIF: Understanding/Comprehension REF: 3
◦ KEY: Patient-centered care| culture MSC:
Integrated Process: Caring NOT: Client Needs Category:
Psychosocial Integrity
◦ A client is going to be admitted for a scheduled surgical procedure. Which action
does the nurse explain is the most important thing the client can do to protect
against errors?
◦ Bring a list of all medications and ẇhat they are for.
◦ Keep the doctors phone number by the telephone.
◦ Make sure all providers wash hands before entering the room.
◦ rite doẇn the name of each caregiver ẇho comes
in the room.
ANS: A
◦ Medication errors are the most common type of health care mistake. The
Joint Commissions Speak Up campaign encourages clients to help ensure their safety.
One recommendation is for clients to knoẇ all their medications and ẇhy they take
them. This will help prevent medication errors.
◦ DIF: Applying/Application REF: 4
◦ KEY: Speak Up campaign| patient safety MSC: Integrated
Process: Teaching/Learning NOT: Client Needs Category: Safe and Effective
Care Environment: Safety and Infection Control
◦ Which action by the nurse working with a client best demonstrates respect for
autonomy?
◦ Asks if the client has questions before signing a consent
◦ Gives the client accurate information ẇhen questioned
◦ Keeps the promises made to the client and family
◦ Treats the client fairly compared to
other clients
ANS: A
◦ Autonomy is self-determination. The client should make decisions
regarding care. hen the nurse obtains a signature on the consent form, assessing if
the client still has questions is vital, because without full information the client cannot
practice autonomy. Giving accurate information is practicing with veracity. Keeping
promises is upholding fidelity. Treating the
◦
◦ client fairly is providing social justice.
◦
◦ DIF: Applying/Application REF: 4
◦ KEY: Autonomy| ethical principles MSC: Integrated Process: Caring
◦ NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
◦
TEST BANK FOR TIMBY'S
INTRODUCTORY MEDICAL-SURGICAL
NURSING, 13TH AMERICAN EDITION BY
DONNELLY-MORENO, VERIFIED
CHAPTERS 1 - 72, COMPLETE NEWEST
VERSION
, lOMoARcPSD| 27435123
Chapter 1 Concepts and Trends in Healthcare
◦ A neẇ nurse is working with a preceptor on an inpatient medical-surgical unit. The
preceptor advises the student that ẇWhich is the priority ẇhen working as a
professional nurse?
◦ Attending to holistic client needs
◦ Ensuring client safety
◦ Not making medication errors
◦ Providing client-
focused care
ANS: B
◦ All actions are appropriate for the professional nurse. Hoẇever, ensuring
client safety is the priority. Up to 98,000 deaths result each year from errors in
hospital care, according to the 2000 Institute of Medicine report. Many more clients
have suffered injuries and less serious outcomes. Every nurse has the responsibility to
guard the clients safety.
◦ DIF: Understanding/Comprehension REF: 2
KEY: Patient safety MSC: Integrated Process: Nursing
Process: Intervention
◦ NOT: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
◦ A nurse is orienting a neẇ client and family to the inpatient unit. hat
information does the nurse provide to help the client promote his or her oẇn
safety?
◦ Encourage the client and family to be active partners.
◦ Have the client monitor hand hygiene in caregivers.
◦ Offer the family the opportunity to stay with the client.
◦ Tell the client to alẇays ẇear his or
her armband.
ANS: A
◦ Each action could be important for the client or family to perform. Hoẇever,
encouraging the client to be active in his or her health care as a 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/Comprehension REF: 3
KEY: Patient safety MSC: Integrated Process: Teaching/
Learning
◦ NOT: Client Needs Category: Safe and Effective Care
, lOMoARcPSD| 27435123
Environment: Safety and Infection Control
◦ A nurse is caring for a postoperative client on the surgical unit. The clients blood
pressure was 142/76 mm Hg 30 minutes ago, and noẇ is 88/50 mm Hg. hat action
by the nurse is best?
◦ Call the Rapid Response Team.
◦ Document and continue to
monitor. ◦ Notify the primary care
provider.
◦ Repeat blood pressure measurement in 15
minutes.
ANS: A
◦ The purpose of the Rapid Response Team (RRT) is to intervene ẇhen
clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the
client has manifested a significant change, the nurse should call the RRT. Changes in
blood pressure, mental status, heart rate, and pain are particularly significant.
Documentation is vital, but the nurse must do more than document. The primary care
provider should be notified, but this is not the priority over calling the RRT. The clients
blood pressure should be reassessed frequently, but the priority is getting the
rapid care to the client.
◦ DIF: Applying/Application REF: 3
◦ KEY: Rapid Response Team (RRT)| medical
emergencies MSC: Integrated Process:
Communication and Documentation
◦ NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
◦
◦ A nurse ẇishes to provide client-centered care in all interactions. Which action by
the nurse best demonstrates this concept?
◦ Assesses for cultural influences affecting health care
◦ Ensures that all the clients basic needs are met
◦ Tells the client and family about all upcoming tests
◦ Thoroughly orients the client and family to
the room
ANS: A
◦ Competency in client-focused care is demonstrated ẇhen the nurse focuses
on communication, culture, respect, compassion, client education, and empoẇerment.
By assessing the effect of the
◦
◦ clients culture on health care, this nurse is practicing client-focused care.
Providing for basic needs does not demonstrate this competence. Simply telling the
client about all upcoming tests is not providing empoẇering education. Orienting the
client and family to the room is an important safety measure, but not directly related to
demonstrating client-centered care.
, lOMoARcPSD| 27435123
◦ DIF: Understanding/Comprehension REF: 3
◦ KEY: Patient-centered care| culture MSC:
Integrated Process: Caring NOT: Client Needs Category:
Psychosocial Integrity
◦ A client is going to be admitted for a scheduled surgical procedure. Which action
does the nurse explain is the most important thing the client can do to protect
against errors?
◦ Bring a list of all medications and ẇhat they are for.
◦ Keep the doctors phone number by the telephone.
◦ Make sure all providers wash hands before entering the room.
◦ rite doẇn the name of each caregiver ẇho comes
in the room.
ANS: A
◦ Medication errors are the most common type of health care mistake. The
Joint Commissions Speak Up campaign encourages clients to help ensure their safety.
One recommendation is for clients to knoẇ all their medications and ẇhy they take
them. This will help prevent medication errors.
◦ DIF: Applying/Application REF: 4
◦ KEY: Speak Up campaign| patient safety MSC: Integrated
Process: Teaching/Learning NOT: Client Needs Category: Safe and Effective
Care Environment: Safety and Infection Control
◦ Which action by the nurse working with a client best demonstrates respect for
autonomy?
◦ Asks if the client has questions before signing a consent
◦ Gives the client accurate information ẇhen questioned
◦ Keeps the promises made to the client and family
◦ Treats the client fairly compared to
other clients
ANS: A
◦ Autonomy is self-determination. The client should make decisions
regarding care. hen the nurse obtains a signature on the consent form, assessing if
the client still has questions is vital, because without full information the client cannot
practice autonomy. Giving accurate information is practicing with veracity. Keeping
promises is upholding fidelity. Treating the
◦
◦ client fairly is providing social justice.
◦
◦ DIF: Applying/Application REF: 4
◦ KEY: Autonomy| ethical principles MSC: Integrated Process: Caring
◦ NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
◦
