,Chapter 01: Introduction to Medical-Surgical Nursing Practice in CanadaLewis:
%rv %rv %rv %rv %rv %rv %rv %rv
Medical-Surgical Nursing in Canada, 4th Canadian Edition
%rv %rv%rv %rv %rv %rv %rv %rv
MULTIPLE %rvCHOICE %rv:
1. The %rvnurse %rvis %rvcaring %rvfor %rva %rvclient % r v with %rva %rvnew %rvdiagnosis %rvof
%rvpneumonia %rvand % r v explains %rvto %rvthe %rvclient %rvthat %rvtogether %rvthey
%rvwill %rvplan %rvthe %rvclient’s %rvcare %rvand %rvset % r v goals %rvfor %rvdischarge.
%rvThe %rvclient %rvasks, %rv“How %rvis %rvthat %rvdifferent %rvfrom %rvwhat %rvthe
% r v doctor % r v does?” % r v Which % r v response % r v by % r v the % r v nurse % r v is
% r v most % r v appropriate?
a. “The %rv role % r v of %rvthe % r v nurse % r v is % r v to % r v administer % r v medications %rv and % r v other
% r v treatments % r v prescribed
by %rv your % r v doctor.”
b. “The %rvnurse’s %rvjob %rvis %rvto %rvhelp %rvthe %rvdoctor %rvby %rvcollecting %rvdata %rvand
%rvcommunicating % r v when % r v there %rvare %rvproblems.”
c. “Nurses %rvperform %rvmany %rvof %rvthe %rvprocedures %rvdone %rvby %rvphysicians, % r v but
% r v nurses %rvare %rvhere %rvin % r v the %rvhospital %rvfor %rva %rvlonger %rvtime %rvthan %rvdoctors.”
d. “In %rvaddition %rvto %rvcaring %rvfor %rvyou % r v while %rvyou %rvare %rvsick, %rvthe %rvnurses %rvwill
%rvassist %rvyou %rvto % r v develop %rvan %rvindividualized %rvplan %rvto % r v maintain %rvyour
%rvhealth.”
ANS: % r v D
This % r v response % r v is % r v consistent % r v with % r v the % r v Canadian % r v Nurses % r v Association % r v (CNA)
% r v definition % r v of % r v nursing. %rvRegistered % r v nurses % r v are % r v self-regulated % r v health % r v care
% r v professionals % r v who % r v work % r v autonomously % r v and % r v in %rvcollaboration % r v with % r v others. % r v RNs
% r v enable % r v individuals, % r v families, % r v groups, % r v communities % r v and % r v populations % r v to %rvachieve
% r v their % r v optimal % r v level % r v of % r v health. % r v RNs % r v coordinate % r v health % r v care, % r v deliver % r v direct
% r v services, % r v and % r v support %rvclients % r v in % r v their % r v self-care % r v decisions %rvand %rvactions % r v in
% r v situations % r v of %rvhealth, %rvillness, % r v injury, % r v and % r v disability %rvin %rvall %rvstages %rvof %rvlife. %rvThe %rvother
%rvresponses %rvdescribe %rvsome %rvof %rvthe %rvdependent %rvand %rvcollaborative %rvfunctions %rvof %rvthe %rvnursing
% r v role % r v but % r v do % r v not % r v accurately % r v describe % r v the % r v nurse’s % r v role % r v in % r v the % r v health % r v care
% r v system.
DIF: Cognitive %rvLevel: %rvComprehension TOP: % r v Nursing %rvProcess:
%rvImplementation %rvMSC: % r v NCLEX: %rvSafe %rvand %rvEffective %rvCare
%rvEnvironment
2. When % r v caring % r v for % r v clients %r v using % r v evidence-informed % r v practice, % r v which % r v of %r v the % r v following
% r v does % r v the % r v nurse %rv use?
a. Clinical %rv judgement % r v based % r v on % r v experience
b. Evidence % r v from %rv a % r v clinical % r v research % r v study
c. The %rv best %rv available % r v evidence % r v to % r v guide % r v clinical
% r v expertise
d. Evaluation % r v of % rv data % r v showing %rv that % r v the % r v client
% r v outcomes % r v are % r v met
ANS: % r v C
Evidence-informed % r v nursing % r v practice % r v is % r v a % r v continuous % r v interactive % r v process % r v involving
% r v the % r v explicit, %rvconscientious, %rvand % r v judicious %rvconsideration %rvof %rvthe %rvbest %rvavailable
% r v evidence %rvto % r v provide %rvcare. % r v Four % r v primary %rvelements % r v are: % r v (a) % r v clinical % r v state,
% r v setting, % r v and % r v circumstances; % r v (b) % r v client % r v preferences % r v and % r v actions; % r v (c) % r v best
,%rvresearch % r v evidence, % r v and % r v (d) % r v health % r v care % r v resources. % r v Clinical % r v judgement % r v based
% rv on % r v the % r v nurse’s % r v clinical %rvexperience % r v is % r v part % r v of % r v EIP, % r v but % r v clinical % r v decision
% r v making % r v also % r v should % r v incorporate % r v current % r v research % r v and %rvresearch-based % r v guidelines.
% r v Evidence % r v from % r v one % r v clinical % r v research % r v study % r v does % r v not % r v provide % r v an % r v adequate
%rvsubstantiation % r v for % r v interventions. % r v Evaluation % r v of %rvclient % r v outcomes %rvis %rvimportant, % r v but
%rvinterventions %rvshould %rvbe %rvbased % r v on % r v research % r v from % r v randomized % r v control % r v studies
% r v with % r v a % r v large % r v number % r v of % r v subjects.
, DIF: Cognitive Level: Comprehension TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
3. Which of the following best explains the nurses’ primary use of the nursing process when providing
care to clients?
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat clients’ health care needs
c. As a scientific-based process of diagnosing the client’s health care problems
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
ANS: B
The nursing process is an assertive problem-solving approach to the identification and treatment of
clients’ problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing
process is in client care, not to establish nursing theory or explain nursing interventions to other health
care professionals.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
4. The nurse is caring for a critically ill client in the intensive care unit and plans an every-2-hour turning
schedule to prevent skin breakdown. Which type of nursing function is demonstrated with this turning
schedule?
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D
When implementing collaborative nursing actions, the nurse is responsible primarily for monitoring
for complications of acute illness or providing care to prevent or treat complications. Independent
nursing actions are focused on health promotion, illness prevention, and client advocacy. A dependent
action would require a physician order to implement. Cooperative nursing functions are not described
as one of the formal nursing functions.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
5. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the nurse, “I
do not feel right about leaving my children with my neighbour.” Which action should the nurse take
next?
a. Reassure the client that these feelings are common for parents.
b. Have the client call the children to ensure that they are doing well.
c. Call the neighbour to determine whether adequate childcare is being provided.
d. Gather more data about the client’s feelings about the childcare arrangements.
ANS: D
Since 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.
%rv %rv %rv %rv %rv %rv %rv %rv
Medical-Surgical Nursing in Canada, 4th Canadian Edition
%rv %rv%rv %rv %rv %rv %rv %rv
MULTIPLE %rvCHOICE %rv:
1. The %rvnurse %rvis %rvcaring %rvfor %rva %rvclient % r v with %rva %rvnew %rvdiagnosis %rvof
%rvpneumonia %rvand % r v explains %rvto %rvthe %rvclient %rvthat %rvtogether %rvthey
%rvwill %rvplan %rvthe %rvclient’s %rvcare %rvand %rvset % r v goals %rvfor %rvdischarge.
%rvThe %rvclient %rvasks, %rv“How %rvis %rvthat %rvdifferent %rvfrom %rvwhat %rvthe
% r v doctor % r v does?” % r v Which % r v response % r v by % r v the % r v nurse % r v is
% r v most % r v appropriate?
a. “The %rv role % r v of %rvthe % r v nurse % r v is % r v to % r v administer % r v medications %rv and % r v other
% r v treatments % r v prescribed
by %rv your % r v doctor.”
b. “The %rvnurse’s %rvjob %rvis %rvto %rvhelp %rvthe %rvdoctor %rvby %rvcollecting %rvdata %rvand
%rvcommunicating % r v when % r v there %rvare %rvproblems.”
c. “Nurses %rvperform %rvmany %rvof %rvthe %rvprocedures %rvdone %rvby %rvphysicians, % r v but
% r v nurses %rvare %rvhere %rvin % r v the %rvhospital %rvfor %rva %rvlonger %rvtime %rvthan %rvdoctors.”
d. “In %rvaddition %rvto %rvcaring %rvfor %rvyou % r v while %rvyou %rvare %rvsick, %rvthe %rvnurses %rvwill
%rvassist %rvyou %rvto % r v develop %rvan %rvindividualized %rvplan %rvto % r v maintain %rvyour
%rvhealth.”
ANS: % r v D
This % r v response % r v is % r v consistent % r v with % r v the % r v Canadian % r v Nurses % r v Association % r v (CNA)
% r v definition % r v of % r v nursing. %rvRegistered % r v nurses % r v are % r v self-regulated % r v health % r v care
% r v professionals % r v who % r v work % r v autonomously % r v and % r v in %rvcollaboration % r v with % r v others. % r v RNs
% r v enable % r v individuals, % r v families, % r v groups, % r v communities % r v and % r v populations % r v to %rvachieve
% r v their % r v optimal % r v level % r v of % r v health. % r v RNs % r v coordinate % r v health % r v care, % r v deliver % r v direct
% r v services, % r v and % r v support %rvclients % r v in % r v their % r v self-care % r v decisions %rvand %rvactions % r v in
% r v situations % r v of %rvhealth, %rvillness, % r v injury, % r v and % r v disability %rvin %rvall %rvstages %rvof %rvlife. %rvThe %rvother
%rvresponses %rvdescribe %rvsome %rvof %rvthe %rvdependent %rvand %rvcollaborative %rvfunctions %rvof %rvthe %rvnursing
% r v role % r v but % r v do % r v not % r v accurately % r v describe % r v the % r v nurse’s % r v role % r v in % r v the % r v health % r v care
% r v system.
DIF: Cognitive %rvLevel: %rvComprehension TOP: % r v Nursing %rvProcess:
%rvImplementation %rvMSC: % r v NCLEX: %rvSafe %rvand %rvEffective %rvCare
%rvEnvironment
2. When % r v caring % r v for % r v clients %r v using % r v evidence-informed % r v practice, % r v which % r v of %r v the % r v following
% r v does % r v the % r v nurse %rv use?
a. Clinical %rv judgement % r v based % r v on % r v experience
b. Evidence % r v from %rv a % r v clinical % r v research % r v study
c. The %rv best %rv available % r v evidence % r v to % r v guide % r v clinical
% r v expertise
d. Evaluation % r v of % rv data % r v showing %rv that % r v the % r v client
% r v outcomes % r v are % r v met
ANS: % r v C
Evidence-informed % r v nursing % r v practice % r v is % r v a % r v continuous % r v interactive % r v process % r v involving
% r v the % r v explicit, %rvconscientious, %rvand % r v judicious %rvconsideration %rvof %rvthe %rvbest %rvavailable
% r v evidence %rvto % r v provide %rvcare. % r v Four % r v primary %rvelements % r v are: % r v (a) % r v clinical % r v state,
% r v setting, % r v and % r v circumstances; % r v (b) % r v client % r v preferences % r v and % r v actions; % r v (c) % r v best
,%rvresearch % r v evidence, % r v and % r v (d) % r v health % r v care % r v resources. % r v Clinical % r v judgement % r v based
% rv on % r v the % r v nurse’s % r v clinical %rvexperience % r v is % r v part % r v of % r v EIP, % r v but % r v clinical % r v decision
% r v making % r v also % r v should % r v incorporate % r v current % r v research % r v and %rvresearch-based % r v guidelines.
% r v Evidence % r v from % r v one % r v clinical % r v research % r v study % r v does % r v not % r v provide % r v an % r v adequate
%rvsubstantiation % r v for % r v interventions. % r v Evaluation % r v of %rvclient % r v outcomes %rvis %rvimportant, % r v but
%rvinterventions %rvshould %rvbe %rvbased % r v on % r v research % r v from % r v randomized % r v control % r v studies
% r v with % r v a % r v large % r v number % r v of % r v subjects.
, DIF: Cognitive Level: Comprehension TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
3. Which of the following best explains the nurses’ primary use of the nursing process when providing
care to clients?
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat clients’ health care needs
c. As a scientific-based process of diagnosing the client’s health care problems
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
ANS: B
The nursing process is an assertive problem-solving approach to the identification and treatment of
clients’ problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing
process is in client care, not to establish nursing theory or explain nursing interventions to other health
care professionals.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
4. The nurse is caring for a critically ill client in the intensive care unit and plans an every-2-hour turning
schedule to prevent skin breakdown. Which type of nursing function is demonstrated with this turning
schedule?
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D
When implementing collaborative nursing actions, the nurse is responsible primarily for monitoring
for complications of acute illness or providing care to prevent or treat complications. Independent
nursing actions are focused on health promotion, illness prevention, and client advocacy. A dependent
action would require a physician order to implement. Cooperative nursing functions are not described
as one of the formal nursing functions.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
5. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the nurse, “I
do not feel right about leaving my children with my neighbour.” Which action should the nurse take
next?
a. Reassure the client that these feelings are common for parents.
b. Have the client call the children to ensure that they are doing well.
c. Call the neighbour to determine whether adequate childcare is being provided.
d. Gather more data about the client’s feelings about the childcare arrangements.
ANS: D
Since 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.
