Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
HaglerChapter 1-69!!!
Test Bank For Lewis's Medical- Surgical
Nursing, 12th Edition by Mariann M.
Harding, Jeffrey Kwong, Debra Hagler
Chapter 1-69
Chapter 01: Professional Nursing
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
MULTIPLE CHOICE
1. The nurse completes an admission database and explains that the plan of care and dischargegoals will be developed with
the patient‘s input. The patient asks, “How is this different fromwhat the physician does?” Which response would the nurse
provide?
a. “The role of the nurse is to administer medications and other treatments prescribedby your physician.”
b. “In addition to caring for you while you are sick, the nurses will help you plan tomaintain your health.”
c. “The nurse‘s job is to collect information and communicate any problems thatoccur to the physician.”
d. “Nurses perform many of the same procedures as the physician, but nurses are with the patients for a longer time than the
physician.”
ANS: B
The American Nurses Association (ANA) definition of nursing describes the role of nurses inpromoting health. The other
responses describe dependent and collaborative functions of the nursing role but do not accurately describe the nurse‘s
unique role in the health care system.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
2. Which statement by the nurse accurately describes the use of evidence-based practice (EBP)?
a. “Patient care is based on clinical judgment, experience, and traditions.”
b. “Data are analyzed later to show that the patient outcomes are consistently met.”
c. “Research from all published articles are used as a guide for planning patient care.”
d. “Recommendations are based on research, clinical expertise, and patient preferences.”
ANS: D
Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician expertise and consideration of
patient preferences. Clinical judgment based on the nurse‘s clinical experience is part of EBP, but clinical decision making should also
incorporate current research and research-based guidelines. Evaluation of patient outcomes is important, but data analysis is not required
to use EBP. All published articles do not provide research evidence; interventions should be based on credible research, preferably
randomized controlled studies with a large number of subjects.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care
Environment
pg. 1 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
,Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
HaglerChapter 1-69!!!
3. Which statement by the nurse provides a clear explanation of the nursing process?
a. “The nursing process is a research method of diagnosing the patient‘s health care problems.”
b. “The nursing process is used primarily to explain nursing interventions to other health care professionals.”
c. “The nursing process is a problem-solving tool used to identify and manage the
patients‘ health care needs.”
d. “The nursing process is based on nursing theory that incorporates the biopsychosocial nature of humans.”
ANS: C
The nursing process is a problem-solving approach to the identification and treatment of patients‘ problems. Nursing process does not
require research methods for diagnosis. The primary use of the nursing process is in patient care, not to establish nursing theory or explain
nursing interventions to other health care professionals.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care
Environment
4. A patient admitted to the hospital for surgery tells the nurse, “I do not feel comfortable leaving my children with my parents.”
Which action would the nurse take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing well.
c. Gather information on the patient‘s concerns about the child care arrangements.
d. Call the patient‘s parents to determine whether adequate child care is being provided.
ANS: C
Because 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.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
5. A patient with a bacterial infection is hypovolemic due to a fever and excessive diaphoresis. Which expected outcome would the
nurse select for this patient?
a. Patient has a balanced intake and output.
b. Patient‘s bedding is kept clean and free of moisture.
c. Patient understands the need for increased fluid intake.
d. Patient‘s skin remains cool and dry throughout hospitalization.
ANS: A
Balanced intake and output gives measurable data showing resolution of the problem of deficient fluid volume. The other statements would
not indicate that the problem of hypovolemia was resolved.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
pg. 2 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
,Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
HaglerChapter 1-69!!!
6. Which statement describes the purpose of the evaluation phase of the nursing process?
a. To document the nursing care plan in the progress notes of the health record
b. To determine if interventions have been effective in meeting patient outcomes
c. To decide whether the patient‘s health problems have been completely resolved
d. To establish if the patient agrees that the nursing care provided was satisfactory
ANS: B
Evaluation consists of determining whether the desired patient outcomes have been met and whether the nursing interventions were
appropriate. The other responses do not describe the evaluation phase.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care
Environment
7. Which statement describes the purpose of the assessment phase of the nursing process?
a. To teach interventions that relieve health problems
b. To use patient data to evaluate patient care outcomes
c. To obtain data to diagnose patient strengths and problems
d. To help the patient identify realistic outcomes for health problems
ANS: C
During the assessment phase, the nurse gathers information about the patient to diagnose patient strengths and problems. The other
responses are examples of the planning, intervention, and evaluation phases of the nursing process.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment
8. When developing the plan of care, which components would the nurse include in the clinical problem statement?
a. The problem and the suggested patient goals or outcomes
b. The problem, its causes, and the signs and symptoms of the problem
c. The problem with the possible etiology and the planned interventions
d. The problem, its pathophysiology, and the expected outcome
ANS: B
When writing clinical problems or nursing diagnoses, the subjective as well as objective data to support the problem‘s existence should be
included. Goals, outcomes, and interventions are not included in the problem statement.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care
Environment
9. Which patient care task would the nurse delegate to experienced assistive personnel (AP)?
a. Instruct the patient about the need to alternate activity and rest.
pg. 3 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
, Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
HaglerChapter 1-69!!!
b. Monitor level of shortness of breath or fatigue after ambulation.
c. Obtain the patient‘s blood pressure and pulse rate after ambulation.
d. Determine whether the patient is ready to increase the activity level.
ANS: C
AP education includes accurate vital sign measurement. Assessment and patient teaching require registered nurse education and scope of
practice and cannot be delegated.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
10. A nurse is caring for a group of patients on the medical-surgical unit with the help of one float registered nurse (RN), one assistive
personnel (AP), and one licensed practical/vocational nurse (LPN/VN). Which assignment, if delegated by the nurse, would be outside
that individual‘s scope of practice?
a. Check for the presence of bowel sounds by AP
b. Administration of oral medications by LPN/VN
c. Insulin administration by float RN from the pediatric unit
d. Measurement of a patient‘s urinary catheter output by AP
ANS: A
Assessment requires RN education and scope of practice so it cannot be delegated to an LPN/VN or AP. The other assignments made by
the RN are appropriate for the role of the team member.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
11. Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/VN)?
a. Complete the initial admission assessment and plan of care.
b. Measure bedside blood glucose before administering insulin.
c. Document teaching completed before a diagnostic procedure.
d. Instruct a patient about low-fat, reduced sodium dietary restrictions.
ANS: B
The education and scope of practice of the LPN/LVN include activities such as obtaining glucose testing using a finger stick and
administering insulin. Patient teaching and the initial assessment and development of the plan of care are nursing actions that require
registered nurse education and scope of practice.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
12. A nurse is assigned as a case manager for a hospitalized patient who has a spinal cord injury. Which activity can the patient expect
the nurse in this role to perform?
a. Care for the patient during hospitalization for the injuries.
b. Assist the patient with home care activities during recovery.
c. Coordinate the services the patient receives in the hospital and at home.
d. Determine what medical care the patient needs for optimal rehabilitation.
pg. 4 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
HaglerChapter 1-69!!!
Test Bank For Lewis's Medical- Surgical
Nursing, 12th Edition by Mariann M.
Harding, Jeffrey Kwong, Debra Hagler
Chapter 1-69
Chapter 01: Professional Nursing
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
MULTIPLE CHOICE
1. The nurse completes an admission database and explains that the plan of care and dischargegoals will be developed with
the patient‘s input. The patient asks, “How is this different fromwhat the physician does?” Which response would the nurse
provide?
a. “The role of the nurse is to administer medications and other treatments prescribedby your physician.”
b. “In addition to caring for you while you are sick, the nurses will help you plan tomaintain your health.”
c. “The nurse‘s job is to collect information and communicate any problems thatoccur to the physician.”
d. “Nurses perform many of the same procedures as the physician, but nurses are with the patients for a longer time than the
physician.”
ANS: B
The American Nurses Association (ANA) definition of nursing describes the role of nurses inpromoting health. The other
responses describe dependent and collaborative functions of the nursing role but do not accurately describe the nurse‘s
unique role in the health care system.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
2. Which statement by the nurse accurately describes the use of evidence-based practice (EBP)?
a. “Patient care is based on clinical judgment, experience, and traditions.”
b. “Data are analyzed later to show that the patient outcomes are consistently met.”
c. “Research from all published articles are used as a guide for planning patient care.”
d. “Recommendations are based on research, clinical expertise, and patient preferences.”
ANS: D
Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician expertise and consideration of
patient preferences. Clinical judgment based on the nurse‘s clinical experience is part of EBP, but clinical decision making should also
incorporate current research and research-based guidelines. Evaluation of patient outcomes is important, but data analysis is not required
to use EBP. All published articles do not provide research evidence; interventions should be based on credible research, preferably
randomized controlled studies with a large number of subjects.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care
Environment
pg. 1 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
,Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
HaglerChapter 1-69!!!
3. Which statement by the nurse provides a clear explanation of the nursing process?
a. “The nursing process is a research method of diagnosing the patient‘s health care problems.”
b. “The nursing process is used primarily to explain nursing interventions to other health care professionals.”
c. “The nursing process is a problem-solving tool used to identify and manage the
patients‘ health care needs.”
d. “The nursing process is based on nursing theory that incorporates the biopsychosocial nature of humans.”
ANS: C
The nursing process is a problem-solving approach to the identification and treatment of patients‘ problems. Nursing process does not
require research methods for diagnosis. The primary use of the nursing process is in patient care, not to establish nursing theory or explain
nursing interventions to other health care professionals.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care
Environment
4. A patient admitted to the hospital for surgery tells the nurse, “I do not feel comfortable leaving my children with my parents.”
Which action would the nurse take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing well.
c. Gather information on the patient‘s concerns about the child care arrangements.
d. Call the patient‘s parents to determine whether adequate child care is being provided.
ANS: C
Because 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.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
5. A patient with a bacterial infection is hypovolemic due to a fever and excessive diaphoresis. Which expected outcome would the
nurse select for this patient?
a. Patient has a balanced intake and output.
b. Patient‘s bedding is kept clean and free of moisture.
c. Patient understands the need for increased fluid intake.
d. Patient‘s skin remains cool and dry throughout hospitalization.
ANS: A
Balanced intake and output gives measurable data showing resolution of the problem of deficient fluid volume. The other statements would
not indicate that the problem of hypovolemia was resolved.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
pg. 2 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
,Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
HaglerChapter 1-69!!!
6. Which statement describes the purpose of the evaluation phase of the nursing process?
a. To document the nursing care plan in the progress notes of the health record
b. To determine if interventions have been effective in meeting patient outcomes
c. To decide whether the patient‘s health problems have been completely resolved
d. To establish if the patient agrees that the nursing care provided was satisfactory
ANS: B
Evaluation consists of determining whether the desired patient outcomes have been met and whether the nursing interventions were
appropriate. The other responses do not describe the evaluation phase.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care
Environment
7. Which statement describes the purpose of the assessment phase of the nursing process?
a. To teach interventions that relieve health problems
b. To use patient data to evaluate patient care outcomes
c. To obtain data to diagnose patient strengths and problems
d. To help the patient identify realistic outcomes for health problems
ANS: C
During the assessment phase, the nurse gathers information about the patient to diagnose patient strengths and problems. The other
responses are examples of the planning, intervention, and evaluation phases of the nursing process.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment
8. When developing the plan of care, which components would the nurse include in the clinical problem statement?
a. The problem and the suggested patient goals or outcomes
b. The problem, its causes, and the signs and symptoms of the problem
c. The problem with the possible etiology and the planned interventions
d. The problem, its pathophysiology, and the expected outcome
ANS: B
When writing clinical problems or nursing diagnoses, the subjective as well as objective data to support the problem‘s existence should be
included. Goals, outcomes, and interventions are not included in the problem statement.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care
Environment
9. Which patient care task would the nurse delegate to experienced assistive personnel (AP)?
a. Instruct the patient about the need to alternate activity and rest.
pg. 3 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
, Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
HaglerChapter 1-69!!!
b. Monitor level of shortness of breath or fatigue after ambulation.
c. Obtain the patient‘s blood pressure and pulse rate after ambulation.
d. Determine whether the patient is ready to increase the activity level.
ANS: C
AP education includes accurate vital sign measurement. Assessment and patient teaching require registered nurse education and scope of
practice and cannot be delegated.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
10. A nurse is caring for a group of patients on the medical-surgical unit with the help of one float registered nurse (RN), one assistive
personnel (AP), and one licensed practical/vocational nurse (LPN/VN). Which assignment, if delegated by the nurse, would be outside
that individual‘s scope of practice?
a. Check for the presence of bowel sounds by AP
b. Administration of oral medications by LPN/VN
c. Insulin administration by float RN from the pediatric unit
d. Measurement of a patient‘s urinary catheter output by AP
ANS: A
Assessment requires RN education and scope of practice so it cannot be delegated to an LPN/VN or AP. The other assignments made by
the RN are appropriate for the role of the team member.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
11. Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/VN)?
a. Complete the initial admission assessment and plan of care.
b. Measure bedside blood glucose before administering insulin.
c. Document teaching completed before a diagnostic procedure.
d. Instruct a patient about low-fat, reduced sodium dietary restrictions.
ANS: B
The education and scope of practice of the LPN/LVN include activities such as obtaining glucose testing using a finger stick and
administering insulin. Patient teaching and the initial assessment and development of the plan of care are nursing actions that require
registered nurse education and scope of practice.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
12. A nurse is assigned as a case manager for a hospitalized patient who has a spinal cord injury. Which activity can the patient expect
the nurse in this role to perform?
a. Care for the patient during hospitalization for the injuries.
b. Assist the patient with home care activities during recovery.
c. Coordinate the services the patient receives in the hospital and at home.
d. Determine what medical care the patient needs for optimal rehabilitation.
pg. 4 Test Bank For Lewis's Medical- Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra
Hagler
Chapter 1-69&%&^#$%&%##%^%#&*#&^%^#&^
