Brunner & Suddarth's Textbook of Medical-
Surgical Nursing
15th Edition
Author(s)Janice Hinkle, Kerry H. Cheever,
Kristen Overbaugh
TEST BANK
1
Reference: Ch. 1 — Professional Nursing Practice — The
Practice of Nursing
Question Stem: A 68-year-old man with chronic heart failure
refuses discharge teaching and asks to leave AMA. Which initial
nursing action best aligns with professional nursing practice and
legal responsibilities?
A. Document the refusal and discharge him immediately.
B. Explain risks of leaving AMA, notify the provider, and
document the discussion.
C. Honor his request without further discussion to preserve
autonomy.
,D. Ask family members to sign a consent form allowing him to
leave.
Correct Answer: B
Rationales:
• Correct (B): Nurses must inform patients of risks, notify the
provider, and document informed refusal, balancing
autonomy with duty to ensure safe, informed decisions.
• A: Simply documenting and discharging without informing
the provider neglects the responsibility to attempt
resolution and fails to ensure informed refusal.
• C: Preserving autonomy is important but does not
eliminate the nurse's duty to communicate risks and
involve the provider.
• D: Family cannot override a competent patient's decision;
obtaining family signatures instead of proper
documentation is inappropriate.
Teaching Point: Document informed refusals and notify
providers when patients request AMA discharge.
Citation: Hinkle, J., Cheever, K., & Overbaugh, K. (2022).
Brunner & Suddarth’s Textbook of Medical-Surgical Nursing
(15th Ed.). Ch. 1.
2
,Reference: Ch. 1 — The Patient: Consumer of Nursing and
Health Care
Question Stem: A nurse is designing discharge instructions for a
patient with low health literacy. Which modification best
increases comprehension and supports patient-centered care?
A. Provide full medical terminology to ensure accuracy.
B. Use short sentences, plain language, and teach-back to
confirm understanding.
C. Give a printed 12-page pamphlet detailing pathophysiology.
D. Ask the patient to read the instructions later at home.
Correct Answer: B
Rationales:
• Correct (B): Using plain language, short sentences, and
teach-back aligns with patient-centered care and improves
comprehension for patients with low health literacy.
• A: Medical jargon reduces understanding and may increase
confusion.
• C: Long, dense materials overwhelm patients and are
ineffective for low literacy.
• D: Delaying education risks misunderstandings and unsafe
self-care after discharge.
Teaching Point: Use plain language and teach-back to ensure
patient understanding.
, Citation: Hinkle, J., Cheever, K., & Overbaugh, K. (2022).
Brunner & Suddarth’s Textbook of Medical-Surgical Nursing
(15th Ed.). Ch. 1.
3
Reference: Ch. 1 — The Patient’s Basic Needs: Maslow
Hierarchy of Needs
Question Stem: A postoperative patient with intact airway but
unstable hemorrhagic shock reports severe anxiety and
requests pain medication. Which priority nursing action reflects
correct application of Maslow’s hierarchy?
A. Administer PRN pain medication immediately to address
anxiety.
B. Assist the patient into a more comfortable position and
reassess vitals later.
C. Stabilize hemodynamics (airway, breathing, circulation)
before addressing pain/anxiety.
D. Provide emotional support only, since physiological needs are
stable.
Correct Answer: C
Rationales:
• Correct (C): Maslow’s principles and acute care priorities
require addressing physiological stability (circulation for
hemorrhagic shock) before secondary needs like pain and
anxiety.
Surgical Nursing
15th Edition
Author(s)Janice Hinkle, Kerry H. Cheever,
Kristen Overbaugh
TEST BANK
1
Reference: Ch. 1 — Professional Nursing Practice — The
Practice of Nursing
Question Stem: A 68-year-old man with chronic heart failure
refuses discharge teaching and asks to leave AMA. Which initial
nursing action best aligns with professional nursing practice and
legal responsibilities?
A. Document the refusal and discharge him immediately.
B. Explain risks of leaving AMA, notify the provider, and
document the discussion.
C. Honor his request without further discussion to preserve
autonomy.
,D. Ask family members to sign a consent form allowing him to
leave.
Correct Answer: B
Rationales:
• Correct (B): Nurses must inform patients of risks, notify the
provider, and document informed refusal, balancing
autonomy with duty to ensure safe, informed decisions.
• A: Simply documenting and discharging without informing
the provider neglects the responsibility to attempt
resolution and fails to ensure informed refusal.
• C: Preserving autonomy is important but does not
eliminate the nurse's duty to communicate risks and
involve the provider.
• D: Family cannot override a competent patient's decision;
obtaining family signatures instead of proper
documentation is inappropriate.
Teaching Point: Document informed refusals and notify
providers when patients request AMA discharge.
Citation: Hinkle, J., Cheever, K., & Overbaugh, K. (2022).
Brunner & Suddarth’s Textbook of Medical-Surgical Nursing
(15th Ed.). Ch. 1.
2
,Reference: Ch. 1 — The Patient: Consumer of Nursing and
Health Care
Question Stem: A nurse is designing discharge instructions for a
patient with low health literacy. Which modification best
increases comprehension and supports patient-centered care?
A. Provide full medical terminology to ensure accuracy.
B. Use short sentences, plain language, and teach-back to
confirm understanding.
C. Give a printed 12-page pamphlet detailing pathophysiology.
D. Ask the patient to read the instructions later at home.
Correct Answer: B
Rationales:
• Correct (B): Using plain language, short sentences, and
teach-back aligns with patient-centered care and improves
comprehension for patients with low health literacy.
• A: Medical jargon reduces understanding and may increase
confusion.
• C: Long, dense materials overwhelm patients and are
ineffective for low literacy.
• D: Delaying education risks misunderstandings and unsafe
self-care after discharge.
Teaching Point: Use plain language and teach-back to ensure
patient understanding.
, Citation: Hinkle, J., Cheever, K., & Overbaugh, K. (2022).
Brunner & Suddarth’s Textbook of Medical-Surgical Nursing
(15th Ed.). Ch. 1.
3
Reference: Ch. 1 — The Patient’s Basic Needs: Maslow
Hierarchy of Needs
Question Stem: A postoperative patient with intact airway but
unstable hemorrhagic shock reports severe anxiety and
requests pain medication. Which priority nursing action reflects
correct application of Maslow’s hierarchy?
A. Administer PRN pain medication immediately to address
anxiety.
B. Assist the patient into a more comfortable position and
reassess vitals later.
C. Stabilize hemodynamics (airway, breathing, circulation)
before addressing pain/anxiety.
D. Provide emotional support only, since physiological needs are
stable.
Correct Answer: C
Rationales:
• Correct (C): Maslow’s principles and acute care priorities
require addressing physiological stability (circulation for
hemorrhagic shock) before secondary needs like pain and
anxiety.
