Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care 11th Edition by Ignatavicius Chapters 1-69

Medical-Surgical Nursing: bt bt




Concepts for Clinical Judgment and Collaborative Care 11th
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Edition by Ignatavicius
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Chapters 1-69
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, Concepts for Medical-Surgical NursingIgnatavicius: Medical-Surgical Nursing, 11th
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Edition
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MULTIPLE CHOICE bt




1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor
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advises thenew nurse that which is the priority when working as a professional nurse?
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a. Attending to holistic client needs bt bt bt bt




b. Ensuring client safety bt bt




c. Not making medication errors bt bt bt




d. Providing client-focused care bt bt




ACCURATE ANSWER: bt




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Rationale:All actions are appropriate for the professional nurse. However, ensuring bt bt bt bt bt bt bt bt bt




client safety is thepriority. Health care errors have been widely reported for 25 years,
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many of which result inclient injury, death, and increased health care costs. There are
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several national and international organizations that have either recommended or
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mandated safety initiatives.
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Every nurse has the responsibility to guard the client’s safety. The other actions are
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importantfor quality nursing, but they are not as vital as providing safety. Not making
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medication errorsdoes provide safety, but is too narrow in scope to be the best accurate
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answerwer.
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DIF: Understanding TOP: Integrated Process: Nursing Process: b t bt bt bt




InterventionKEY: Client safety
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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2. A nurse is orienting a new client and family to the medical-surgical unit. What
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informationdoes the nurse provide to best help the client promote his or her own
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safety?
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a. Encourage the client and family to be active partners. bt bt bt bt bt bt bt bt




b. Have the client monitor hand hygiene in caregivers.
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c. Offer the family the opportunity to stay with the client.
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d. Tell the client to always wear his or her armband.
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ACCURATE ANSWER: bt




A
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Rationale:Each action could be important for the client or family to perform. However, bt bt bt bt bt bt bt bt bt bt bt bt




bt encouraging theclient to be active in his or her health care as a safety partner is the mostbt tb bt bt bt bt bt bt bt bt bt bt bt bt bt bt bt bt




bt critical. The other actions are very limited in scope and do not provide the broad
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bt protection that being active andinvolved does. bt bt bt bt tb bt




DIF: Understanding TOP: Integrated Process: b t bt




Teaching/LearningKEY: Client safety
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood
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bt pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action
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bt would the nursetake first? bt bt tb bt

, a. Call the Rapid Response Team. bt bt bt bt




b. Document and continue to monitor. bt bt bt bt




c. Notify the primary health care provider. bt bt bt bt bt




d. Repeat the blood pressure in 15 minutes. bt bt bt bt bt bt




ACCURATE ANSWER: A bt b t




Rationale:The purpose of the Rapid Response Team (RRT) is to intervene when clients bt bt bt bt bt bt bt bt bt bt bt bt




bt are deterioratingbefore they suffer either respiratory or cardiac arrest. Since the client
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bt has manifested a significant change, the nurse would call the RRT. Changes in blood
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bt pressure, mental status, heart rate, temperature, oxygen saturation, and last 2 hours’
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bt urine output are particularly significant and are part of the Modified Early Warning
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bt System guide. Documentation is vital, but the nurse must do more than document. The
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bt primary health care provider would be notified, but this is not more important than
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bt calling the RRT. The client’s blood pressure would be reassessed frequently, but the
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bt priority is getting the rapid care to the client. bt bt bt bt bt bt bt bt




DIF: Applying TOP: Integrated Process: Communication and b t bt bt bt




DocumentationKEY: Rapid Response Team (RRT), Clinical judgment
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MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
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4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
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best demonstrates this concept?
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a. Assesses for cultural influences affecting health care. bt bt bt bt bt bt




b. Ensures that all the client’s basic needs are met. bt bt bt bt bt bt bt bt




c. Tells the client and family about all upcoming tests. bt bt bt bt bt bt bt bt




d. Thoroughly orients the client and family to the room. bt bt bt bt bt bt bt bt




ACCURATE ANSWER: A bt b t




Rationale:Showing respect for the client and family’s preferences and needs is essential bt bt bt bt bt bt bt bt bt bt bt




bt to ensure a holistic or “whole-person” approach to care. By assessing the effect of the
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bt client’s culture onhealth care, this nurse is practicing client-focused care. Providing for
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bt basic needs does not demonstrate this competence. Simply telling the client about all
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bt upcoming tests is not providing empowering education. Orienting the client and family
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bt to the room is an importantsafety measure, but not directly related to demonstrating
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bt client-centered care. bt




DIF: Understanding TOP: Integrated Process: Culture and Spirituality
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KEY: Client-centered care, Culture
bt b t bt bt MSC: Client Needs Category: Psychosocial b t bt bt bt




Integrity
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5. A client is going to be admitted for a scheduled surgical procedure. Which action does
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thenurse explain is the most important thing the client can do to protect against
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errors?
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a. Bring a list of all medications and what they are for. bt bt bt bt bt bt bt bt bt bt




b. Keep the provider’s phone number by the telephone. bt bt bt bt bt bt bt




c. Make sure that all providers wash hands before entering the room. bt bt bt bt bt bt bt bt bt bt




d. Write down the name of each caregiver who comes in the room. bt bt bt bt bt bt bt bt bt bt bt




ACCURATE ANSWER: A bt b t




Rationale:Medication reconciliation is a formal process in which the client’s actual current bt bt bt bt bt bt bt bt bt bt bt




bt medicationsare compared to the prescribed medications at the time of admission, tb bt bt bt bt bt bt bt bt bt bt




bt traccurate answerfer, or discharge. This National client Safety Goal is important to bt bt bt bt bt bt bt bt bt bt bt




bt reduce medication errors. The client would not have to be responsible for providers
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bt washing their hands, and even if the client does so, this is too narrow to be the most
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, bt important action to prevent errors. Keeping the provider’s phone number nearby and
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bt documenting everyone who enters the room also do not guarantee safety. bt bt bt bt bt bt bt bt bt bt




DIF: Applying TOP: Integrated Process: b t bt




Teaching/LearningKEY: Client safety, Informatics
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
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6. Which action by the nurse working with a client best demonstrates respect for autonomy?
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a. Asks if the client has questions before signing a consent.
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b. Gives the client accurate information when questioned. bt bt bt bt bt bt




c. Keeps the promises made to the client and family. bt bt bt bt bt bt bt bt




d. Treats the client fairly compared to other clients. bt bt bt bt bt bt bt




ACCURATE ANSWER: A bt b t




Rationale:Autonomy is self-determination. The client would make decisions regarding bt bt bt bt bt bt bt bt




bt care. When the nurse obtains a signature on the consent form, assessing if the client still
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bt has questions is vital,because without full information the client cannot practice
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bt autonomy. Giving accurate information is practicing with veracity. Keeping promises is
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bt upholding fidelity. Treating the client fairly is providing social justice.
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DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, Autonomy b t bt bt bt bt




MSC: Client Needs Category: Safe and Effective Care Environment: Management of
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Care
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7. A nurse asks a more seasoned colleague to explain best practices when communicating
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with aperson from the lesbian, gay, bisexual, traccurate answergender, and
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questioning/queer (LGBTQ) community. What accurate answerwer by the faculty is
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most accurate?
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a. Avoid embarrassing the client by asking questions. bt bt bt bt bt bt




b. Don’t make assumptions about his or her health needs. bt bt bt bt bt bt bt bt




c. Most LGBTQ people do not want to share information.
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d. No differences exist in communicating with this population.
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ACCURATE ANSWER: B bt b t




Rationale:Many members of the LGBTQ community have faced discrimination from bt bt bt bt bt bt bt bt bt




bt health care providers and may be reluctant to seek health care. The nurse would never
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bt make assumptions about the needs of members of this population. Rather, respectful
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bt questions are appropriate. Ifapproached with sensitivity, the client with any health care
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bt need is more likely to accurate answerwer honestly.
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DIF: Understanding TOP: Integrated Process: Teaching/Learning b t bt bt




KEY: Health care disparities, LGBTQ
b t bt bt bt MSC: Client Needs Category: Psychosocial Integrity b t bt bt bt bt




8. A nurse is calling the on-call health care provider about a client who had a
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hysterectomy 2days ago and has pain that is unrelieved by the prescribed opioid pain
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medication. Which statement comprises the background portion of the SBAR format
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for communication?
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a. “I would like you to order a different pain medication.”
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b. “This client has allergies to morphine and codeine.” bt bt bt bt bt bt bt




c. “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
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d. “This client had a vaginal hysterectomy 2 days ago.” bt bt bt bt bt bt bt bt




ACCURATE ANSWER: B bt b t