TEST BANK FOR LEWIS MEDICAL-
SURGICAL NURSING IN CANADA 5TH
EDITION
,CHAPTER 01: Introduction to Medical Surgical Nursing
S S S S S S
Practice in Canada Lewis: Medical-Surgical Nursing in Canada, 5th Canadian Edition
S S S S S S S S S S S
MULTIPLE CHOICE : S S
1. The medical attendant is caring for a hospital client with a new diagnosis of
S S S S S S S S S S S S S S
pneumonia and explains to the hospital client that together they will plan the
S S S S S S S S S S S S S
hospital client‘s care and set goals for discharge. The hospital client asks, ―H
S S S S S S S S S S S S
ow is that different from what the doctor does?‖ Which response by the m
S S S S S S S S S S S S S
edical attendant is most appropriate?S S S S
a. ―The role of the medical attendant is to administer medications and other treat
S S S S S S S S S S S S
ments prescribed S
by your doctor.‖ S S
b. ―The medical attendant‘s job is to help the doctor by collecting data and com
S S S S S S S S S S S S S
municating when there are problems.‖ S S S S
c. ―Medical attendants perform many of the procedures done by physicians, but medi S S S S S S S S S S S
cal attendants are here in S S S S
the health center for a longer time than doctors.‖
S S S S S S S S
d. ―In addition to caring for you while you are sick, the medical attendants will assist you to
S S S S S S S S S S S S S S S S
develop an individualized plan to maintain your health.‖ S S S S S S S
PRECISE CHOICE:-D S
Reasoning :- S
>>>This response is consistent with the Canadian nurses Association (CNA) definition of nursing. Regis
S S S S S S S S S S S S S
tered medical attendants are self-
S S S S
regulated health care professionals who work autonomously and in collaboration with others. RNs enable i
S S S S S S S S S S S S S S
ndividuals, families, groups, communities and populations to achieve their optimal level of health. RNs co
S S S S S S S S S S S S S S
ordinate health care, deliver direct services, and support hospital clients in their self-
S S S S S S S S S S S S
care decisions and actions in situations of health, illness, injury, and disability in all stages of life. The other
S S S S S S S S S S S S S S S S S S S
responses describe some of the dependent and collaborative functions of the nursing role but do not accura
S S S S S S S S S S S S S S S S
tely describe the medical attendant‘s role in the health care system.
S S S S S S S S S S
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S
Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S
2. When caring for hospital clients using evidence-
S S S S S S
informed practice, which of the following does the medical attendant use?
S S S S S S S S S S
a. Clinical judgement based on experience S S S S
b. Evidence from a clinical research study S S S S S
c. The best available evidence to guide clinical expertise
S S S S S S S
d. Evaluation of data showing that the hospital client outcomes S S S S S S S S S
are met S
PRECISE CHOICE:-C S
Reasoning :->>>Evidence- S
informed nursing practice is a continuous interactive process involving the explicit, conscientious, and ju
S S S S S S S S S S S S S
dicious consideration of the best available evidence to provide care. Four primary elements are: (a) clinical
S S S S S S S S S S S S S S S
Sstate, setting, and circumstances; (b) hospital client preferences and actions; (c) best research evidence, a
S S S S S S S S S S S S S S
nd (d) health care resources. Clinical judgement based on the medical attendant‘s clinical experience is pa
S S S S S S S S S S S S S S S
rt of EIP, but clinical decision making also should incorporate current research and research-
S S S S S S S S S S S S S
based guidelines. Evidence from one clinical research study does not provide an adequate substantiation f
S S S S S S S S S S S S S S
or interventions. Evaluation of hospital client outcomes is important, but interventions should be based on
S S S S S S S S S S S S S S
Sresearch from randomized control studies with a large number of
S S S S S S S S S
, subjects.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S
Planning MSC: NCLEX: Safe and Effective Care Environment
S S S S S S S
3. Which of the following best explains the medical attendants‘ primary use of the nursing process when
S S S S S S S S S S S S S S S S
providing care to hospital clients? S S S S
a. To explain nursing interventions to other health care professionals
S S S S S S S S
b. As a problem-solving tool to identify and treat hospital clients‘ health care needs
S S S S S S S S S S S S
c. As a scientific-based process of diagnosing the hospital client‘s health care problems
S S S S S S S S S S S
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
S S S S S S S S S S
PRECISE CHOICE:-B S
Reasoning :->>>The nursing process is an assertive problem-
S S S S S S S
solving approach to the identification and treatment of hospital clients‘ problems. Diagnosis is only one ph
S S S S S S S S S S S S S S S
ase of the nursing process. The primary use of the nursing process is in hospital client care, not to establish n
S S S S S S S S S S S S S S S S S S S S
ursing theory or explain nursing interventions to other health care professionals.
S S S S S S S S S S
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S
Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S
4. The medical attendant is caring for a critically ill hospital client in the intensive care unit and plans an every
S S S S S S S S S S S S S S S S S S S
- 2-
S
hour turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated with t
S S S S S S S S S S S S S S S
his turning schedule?
S S
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
PRECISE CHOICE:-D S
Reasoning :- S
>>>When implementing collaborative nursing actions, the medical attendant is responsible primarily for mo
S S S S S S S S S S S S
nitoring for complications of acute illness or providing care to prevent or treat complications.
S S S S S S S S S S S S S
Independent nursing actions are focused on health promotion, illness prevention, and hospital client advo
S S S S S S S S S S S S S
cacy. A dependent action would require a physician order to implement. Cooperative nursing functions
S S S S S S S S S S S S S S
are not described as one of the formal nursing functions.
S S S S S S S S S
DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S
5. The medical attendant is caring for a hospital client who has been admitted to the health center for surgery a
S S S S S S S S S S S S S S S S S S S
nd tells the medical attendant, ―I do not feel right about leaving my children with my neighbour.‖ Which act
S S S S S S S S S S S S S S S S S S
ion should the medical attendant take next?
S S S S S S
a. Reassure the hospital client that these feelings are common for parents.
S S S S S S S S S S
b. Have the hospital client call the children to ensure that they are doing well.
S S S S S S S S S S S S S
c. Call the neighbour to determine whether adequate childcare is being provided.
S S S S S S S S S S
d. Gather more data about the hospital client‘s feelings about the childcare arrangements.
S S S S S S S S S S S
PRECISE CHOICE:-D S
Reasoning :- S
>>>Since a complete assessment is necessary in order to identify a problem and choose an appropriate inter
S S S S S S S S S S S S S S S S
vention, the medical attendant‘s first action should be to obtain more information. The other actions may be ap
S S S S S S S S S S S S S S S S S
propriate, but more assessment is needed before the best intervention can be chosen.
S S S S S S S S S S S S
, DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Assessment MSC: NCLEX: Psychosocial Integrity
S S S S
6. The medical attendant is caring for a hospital client who has left-
S S S S S S S S S S S
sided paralysis as the result of a stroke and assesses a pressure injury on the hospital client‘s left hip.
S S S S S S S S S S S S S S S S S S S
Which of the following is the most appropriate nursing diagnosis for this hospital client?
S S S S S S S S S S S S S
a. Impaired physical mobility related to decrease in muscle control (left-
S S S S S S S S S
sided paralysis) S
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about prot
S S S S S S S S S S S
ecting tissue integrity S S
c. Impaired skin integrity related to pressure over bony prominence (impaired circ
S S S S S S S S S S
ulation)
d. Ineffective peripheral tissue perfusion related to sedentary lifestyle
S S S S S S S
PRECISE CHOICE:-C S
Reasoning :- S
>>>The hospital client‘s major problem is the impaired skin integrity as demonstrated by the presence of a
S S S S S S S S S S S S S S S S
Spressure injury. The medical attendant is able to treat the cause of impaired circulation and pressure over
S S S S S S S S S S S S S S S S S
bony prominence by frequently repositioning the hospital client. Although left-
S S S S S S S S S
sided weakness is a problem for the hospital client, the medical attendant cannot treat the weakness. The ―
S S S S S S S S S S S S S S S S S
risk for‖ diagnosis is not appropriate for this hospital client, who already has impaired tissue integrity. The
S S S S S S S S S S S S S S S S
Shospital client does have ineffective peripheral tissue perfusion, but the impaired skin integrity diagnosis
S S S S S S S S S S S S S S
indicates more clearly what the health problem is.
S S S S S S S
DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Diagnosis MSC: NCLEX: Physiological Integrity
S S S S
7. The medical attendant caring for a hospital client with an infection has a nursing diagnosis of deficient fluid v
S S S S S S S S S S S S S S S S S S
olume related to excessive fluid loss through normal route (diaphoresis). Which of the following is an ap
S S S S S S S S S S S S S S S S
propriate hospital client outcome?
S S S
a. Hospital client has a balanced intake and output. S S S S S S S
b. Hospital client‘s bedding is changed when it becomes damp.
S S S S S S S S
c. Hospital client understands the need for increased fluid intake.
S S S S S S S S
d. Hospital client‘s skin remains cool and dry throughout hospitalization.
S S S S S S S S
PRECISE CHOICE:-A S
Reasoning :- S
>>>This statement gives measurable data showing resolution of the problem of deficient fluid volume that w
S S S S S S S S S S S S S S S
as identified in the nursing diagnosis statement. The other statements would not indicate that the problem
S S S S S S S S S S S S S S S S
of deficient fluid volume was resolved.
S S S S S
DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Planning MSC: NCLEX: Physiological Integrity
S S S S
8. Which of the following represents a nursing activity that is carried out during the evaluation phase of the n
S S S S S S S S S S S S S S S S S S
ursing process? S
a. Determining if interventions have been effective in meeting hospital client outcomes.
S S S S S S S S S S
b. Documenting the nursing care plan in the progress notes in the medical record. S S S S S S S S S S S S
c. Deciding whether the hospital client‘s health problems have been completely resolved.
S S S S S S S S S S
d. Asking the hospital client to evaluate whether the nursing care provided w
S S S S S S S S S S S
as satisfactory.
S
SURGICAL NURSING IN CANADA 5TH
EDITION
,CHAPTER 01: Introduction to Medical Surgical Nursing
S S S S S S
Practice in Canada Lewis: Medical-Surgical Nursing in Canada, 5th Canadian Edition
S S S S S S S S S S S
MULTIPLE CHOICE : S S
1. The medical attendant is caring for a hospital client with a new diagnosis of
S S S S S S S S S S S S S S
pneumonia and explains to the hospital client that together they will plan the
S S S S S S S S S S S S S
hospital client‘s care and set goals for discharge. The hospital client asks, ―H
S S S S S S S S S S S S
ow is that different from what the doctor does?‖ Which response by the m
S S S S S S S S S S S S S
edical attendant is most appropriate?S S S S
a. ―The role of the medical attendant is to administer medications and other treat
S S S S S S S S S S S S
ments prescribed S
by your doctor.‖ S S
b. ―The medical attendant‘s job is to help the doctor by collecting data and com
S S S S S S S S S S S S S
municating when there are problems.‖ S S S S
c. ―Medical attendants perform many of the procedures done by physicians, but medi S S S S S S S S S S S
cal attendants are here in S S S S
the health center for a longer time than doctors.‖
S S S S S S S S
d. ―In addition to caring for you while you are sick, the medical attendants will assist you to
S S S S S S S S S S S S S S S S
develop an individualized plan to maintain your health.‖ S S S S S S S
PRECISE CHOICE:-D S
Reasoning :- S
>>>This response is consistent with the Canadian nurses Association (CNA) definition of nursing. Regis
S S S S S S S S S S S S S
tered medical attendants are self-
S S S S
regulated health care professionals who work autonomously and in collaboration with others. RNs enable i
S S S S S S S S S S S S S S
ndividuals, families, groups, communities and populations to achieve their optimal level of health. RNs co
S S S S S S S S S S S S S S
ordinate health care, deliver direct services, and support hospital clients in their self-
S S S S S S S S S S S S
care decisions and actions in situations of health, illness, injury, and disability in all stages of life. The other
S S S S S S S S S S S S S S S S S S S
responses describe some of the dependent and collaborative functions of the nursing role but do not accura
S S S S S S S S S S S S S S S S
tely describe the medical attendant‘s role in the health care system.
S S S S S S S S S S
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S
Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S
2. When caring for hospital clients using evidence-
S S S S S S
informed practice, which of the following does the medical attendant use?
S S S S S S S S S S
a. Clinical judgement based on experience S S S S
b. Evidence from a clinical research study S S S S S
c. The best available evidence to guide clinical expertise
S S S S S S S
d. Evaluation of data showing that the hospital client outcomes S S S S S S S S S
are met S
PRECISE CHOICE:-C S
Reasoning :->>>Evidence- S
informed nursing practice is a continuous interactive process involving the explicit, conscientious, and ju
S S S S S S S S S S S S S
dicious consideration of the best available evidence to provide care. Four primary elements are: (a) clinical
S S S S S S S S S S S S S S S
Sstate, setting, and circumstances; (b) hospital client preferences and actions; (c) best research evidence, a
S S S S S S S S S S S S S S
nd (d) health care resources. Clinical judgement based on the medical attendant‘s clinical experience is pa
S S S S S S S S S S S S S S S
rt of EIP, but clinical decision making also should incorporate current research and research-
S S S S S S S S S S S S S
based guidelines. Evidence from one clinical research study does not provide an adequate substantiation f
S S S S S S S S S S S S S S
or interventions. Evaluation of hospital client outcomes is important, but interventions should be based on
S S S S S S S S S S S S S S
Sresearch from randomized control studies with a large number of
S S S S S S S S S
, subjects.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S
Planning MSC: NCLEX: Safe and Effective Care Environment
S S S S S S S
3. Which of the following best explains the medical attendants‘ primary use of the nursing process when
S S S S S S S S S S S S S S S S
providing care to hospital clients? S S S S
a. To explain nursing interventions to other health care professionals
S S S S S S S S
b. As a problem-solving tool to identify and treat hospital clients‘ health care needs
S S S S S S S S S S S S
c. As a scientific-based process of diagnosing the hospital client‘s health care problems
S S S S S S S S S S S
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
S S S S S S S S S S
PRECISE CHOICE:-B S
Reasoning :->>>The nursing process is an assertive problem-
S S S S S S S
solving approach to the identification and treatment of hospital clients‘ problems. Diagnosis is only one ph
S S S S S S S S S S S S S S S
ase of the nursing process. The primary use of the nursing process is in hospital client care, not to establish n
S S S S S S S S S S S S S S S S S S S S
ursing theory or explain nursing interventions to other health care professionals.
S S S S S S S S S S
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process: S S S S
Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S
4. The medical attendant is caring for a critically ill hospital client in the intensive care unit and plans an every
S S S S S S S S S S S S S S S S S S S
- 2-
S
hour turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated with t
S S S S S S S S S S S S S S S
his turning schedule?
S S
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
PRECISE CHOICE:-D S
Reasoning :- S
>>>When implementing collaborative nursing actions, the medical attendant is responsible primarily for mo
S S S S S S S S S S S S
nitoring for complications of acute illness or providing care to prevent or treat complications.
S S S S S S S S S S S S S
Independent nursing actions are focused on health promotion, illness prevention, and hospital client advo
S S S S S S S S S S S S S
cacy. A dependent action would require a physician order to implement. Cooperative nursing functions
S S S S S S S S S S S S S S
are not described as one of the formal nursing functions.
S S S S S S S S S
DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Implementation MSC: NCLEX: Safe and Effective Care Environment S S S S S S S
5. The medical attendant is caring for a hospital client who has been admitted to the health center for surgery a
S S S S S S S S S S S S S S S S S S S
nd tells the medical attendant, ―I do not feel right about leaving my children with my neighbour.‖ Which act
S S S S S S S S S S S S S S S S S S
ion should the medical attendant take next?
S S S S S S
a. Reassure the hospital client that these feelings are common for parents.
S S S S S S S S S S
b. Have the hospital client call the children to ensure that they are doing well.
S S S S S S S S S S S S S
c. Call the neighbour to determine whether adequate childcare is being provided.
S S S S S S S S S S
d. Gather more data about the hospital client‘s feelings about the childcare arrangements.
S S S S S S S S S S S
PRECISE CHOICE:-D S
Reasoning :- S
>>>Since a complete assessment is necessary in order to identify a problem and choose an appropriate inter
S S S S S S S S S S S S S S S S
vention, the medical attendant‘s first action should be to obtain more information. The other actions may be ap
S S S S S S S S S S S S S S S S S
propriate, but more assessment is needed before the best intervention can be chosen.
S S S S S S S S S S S S
, DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Assessment MSC: NCLEX: Psychosocial Integrity
S S S S
6. The medical attendant is caring for a hospital client who has left-
S S S S S S S S S S S
sided paralysis as the result of a stroke and assesses a pressure injury on the hospital client‘s left hip.
S S S S S S S S S S S S S S S S S S S
Which of the following is the most appropriate nursing diagnosis for this hospital client?
S S S S S S S S S S S S S
a. Impaired physical mobility related to decrease in muscle control (left-
S S S S S S S S S
sided paralysis) S
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about prot
S S S S S S S S S S S
ecting tissue integrity S S
c. Impaired skin integrity related to pressure over bony prominence (impaired circ
S S S S S S S S S S
ulation)
d. Ineffective peripheral tissue perfusion related to sedentary lifestyle
S S S S S S S
PRECISE CHOICE:-C S
Reasoning :- S
>>>The hospital client‘s major problem is the impaired skin integrity as demonstrated by the presence of a
S S S S S S S S S S S S S S S S
Spressure injury. The medical attendant is able to treat the cause of impaired circulation and pressure over
S S S S S S S S S S S S S S S S S
bony prominence by frequently repositioning the hospital client. Although left-
S S S S S S S S S
sided weakness is a problem for the hospital client, the medical attendant cannot treat the weakness. The ―
S S S S S S S S S S S S S S S S S
risk for‖ diagnosis is not appropriate for this hospital client, who already has impaired tissue integrity. The
S S S S S S S S S S S S S S S S
Shospital client does have ineffective peripheral tissue perfusion, but the impaired skin integrity diagnosis
S S S S S S S S S S S S S S
indicates more clearly what the health problem is.
S S S S S S S
DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Diagnosis MSC: NCLEX: Physiological Integrity
S S S S
7. The medical attendant caring for a hospital client with an infection has a nursing diagnosis of deficient fluid v
S S S S S S S S S S S S S S S S S S
olume related to excessive fluid loss through normal route (diaphoresis). Which of the following is an ap
S S S S S S S S S S S S S S S S
propriate hospital client outcome?
S S S
a. Hospital client has a balanced intake and output. S S S S S S S
b. Hospital client‘s bedding is changed when it becomes damp.
S S S S S S S S
c. Hospital client understands the need for increased fluid intake.
S S S S S S S S
d. Hospital client‘s skin remains cool and dry throughout hospitalization.
S S S S S S S S
PRECISE CHOICE:-A S
Reasoning :- S
>>>This statement gives measurable data showing resolution of the problem of deficient fluid volume that w
S S S S S S S S S S S S S S S
as identified in the nursing diagnosis statement. The other statements would not indicate that the problem
S S S S S S S S S S S S S S S S
of deficient fluid volume was resolved.
S S S S S
DIF: Cognitive Level: Application TOPIC: Nursing Process: S S S S
Planning MSC: NCLEX: Physiological Integrity
S S S S
8. Which of the following represents a nursing activity that is carried out during the evaluation phase of the n
S S S S S S S S S S S S S S S S S S
ursing process? S
a. Determining if interventions have been effective in meeting hospital client outcomes.
S S S S S S S S S S
b. Documenting the nursing care plan in the progress notes in the medical record. S S S S S S S S S S S S
c. Deciding whether the hospital client‘s health problems have been completely resolved.
S S S S S S S S S S
d. Asking the hospital client to evaluate whether the nursing care provided w
S S S S S S S S S S S
as satisfactory.
S
