TEST BANK FOR LEWIS MEDICAL-SURGICAL
NURSING IN CANADA 5TH EDITION
,CHAPTER 01: Introduction to Medical Surgical Nursing Practice in
Canada Lewis: Medical-Surgical Nursing in Canada, 5th Canadian
Edition
MULTIPLE CHOICE :
1. The medical attendant is caring for a hospital client with a new diagnosis
of pneumonia and explains to the hospital client that together they will
plan the hospital client’s care and set goals for discharge. The hospital
client asks, “How is that different from what the doctor does?” Which
response by the medical attendant is most appropriate?
a. “The role of the medical attendant is to administer medications and other
treatments prescribed
by your doctor.”
b. “The medical attendant’s job is to help the doctor by collecting data and
communicating when there are problems.”
c. “Medical attendants perform many of the procedures done by physicians, but
medical attendants are here in
the health center for a longer time than doctors.”
d. “In addition to caring for you while you are sick, the medical attendants will assist
you to
develop an individualized plan to maintain your health.”
PRECISE CHOICE:-D
Reasoning :->>>This response is consistent with the Canadian nurses Association (CNA) definition
of nursing. Registered medical attendants are self-regulated health care professionals who work
autonomously and in collaboration with others. RNs enable individuals, families, groups, communities
and populations to achieve their optimal level of health. RNs coordinate health care, deliver direct
services, and support hospital clients in their self-care decisions and actions in situations of health,
illness, injury, and disability in all stages of life. The other responses describe some of the dependent
and collaborative functions of the nursing role but do not accurately describe the medical attendant’s
role in the health care system.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment
2. When caring for hospital clients using evidence-informed practice, which of the following does the
medical attendant use?
a. Clinical judgement based on experience
b. Evidence from a clinical research study
c. The best available evidence to guide clinical expertise
d. Evaluation of data showing that the hospital client
outcomes are met
PRECISE CHOICE:-C
Reasoning :->>>Evidence-informed nursing practice is a continuous interactive process involving the
explicit, conscientious, and judicious consideration of the best available evidence to provide care. Four
primary elements are: (a) clinical state, setting, and circumstances; (b) hospital client preferences and
actions; (c) best research evidence, and (d) health care resources. Clinical judgement based on the
medical attendant’s clinical experience is part of EIP, but clinical decision making also should
incorporate current research and research-based guidelines. Evidence from one clinical research study
does not provide an adequate substantiation for interventions. Evaluation of hospital client outcomes is
important, but interventions should be based on research from randomized control studies with a
large number of
, subjects.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Planning MSC: NCLEX: Safe and Effective Care Environment
3. Which of the following best explains the medical attendants’ primary use of the nursing process
when providing care to hospital clients?
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat hospital clients’ health care needs
c. As a scientific-based process of diagnosing the hospital client’s health care problems
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
PRECISE CHOICE:-B
Reasoning :->>>The nursing process is an assertive problem-solving approach to the identification and
treatment of hospital clients’ problems. Diagnosis is only one phase of the nursing process. The primary
use of the nursing process is in hospital client care, not to establish nursing theory or explain nursing
interventions to other health care professionals.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment
4. The medical attendant is caring for a critically ill hospital 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
PRECISE CHOICE:-D
Reasoning :->>>When implementing collaborative nursing actions, the medical attendant 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 hospital 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 TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment
5. The medical attendant is caring for a hospital client who has been admitted to the health center for
surgery and tells the medical attendant, “I do not feel right about leaving my children with my
neighbour.” Which action should the medical attendant take next?
a. Reassure the hospital client that these feelings are common for parents.
b. Have the hospital 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 hospital client’s feelings about the childcare arrangements.
PRECISE CHOICE:-D
Reasoning :->>>Since a complete assessment is necessary in order to identify a problem and choose an
appropriate intervention, the medical attendant’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: Application TOPIC: Nursing Process:
Assessment MSC: NCLEX: Psychosocial Integrity
6. The medical attendant is caring for a hospital client who has left-sided paralysis as the result of a
stroke and assesses a pressure injury on the hospital client’s left hip. Which of the following is
the most appropriate nursing diagnosis for this hospital client?
a. Impaired physical mobility related to decrease in muscle control (left-sided
paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
protecting tissue integrity
c. Impaired skin integrity related to pressure over bony prominence (impaired
circulation)
d. Ineffective peripheral tissue perfusion related to sedentary lifestyle
PRECISE CHOICE:-C
Reasoning :->>>The hospital client’s major problem is the impaired skin integrity as demonstrated by
the presence of a pressure injury. The medical attendant is able to treat the cause of impaired
circulation and pressure over bony prominence by frequently repositioning the hospital client.
Although left-sided weakness is a problem for the hospital client, the medical attendant cannot treat
the weakness. The “risk for” diagnosis is not appropriate for this hospital client, who already has
impaired tissue integrity. The hospital client does have ineffective peripheral tissue perfusion, but the
impaired skin integrity diagnosis indicates more clearly what the health problem is.
DIF: Cognitive Level: Application TOPIC: Nursing Process:
Diagnosis MSC: NCLEX: Physiological Integrity
7. The medical attendant caring for a hospital client with an infection has a nursing diagnosis of deficient
fluid volume related to excessive fluid loss through normal route (diaphoresis). Which of the
following is an appropriate hospital client outcome?
a. Hospital client has a balanced intake and output.
b. Hospital client’s bedding is changed when it becomes damp.
c. Hospital client understands the need for increased fluid intake.
d. Hospital client’s skin remains cool and dry throughout hospitalization.
PRECISE CHOICE:-A
Reasoning :->>>This statement gives measurable data showing resolution of the problem of deficient
fluid volume that was identified in the nursing diagnosis statement. The other statements would not
indicate that the problem of deficient fluid volume was resolved.
DIF: Cognitive Level: Application TOPIC: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity
8. Which of the following represents a nursing activity that is carried out during the evaluation phase of
the nursing process?
a. Determining if interventions have been effective in meeting hospital client outcomes.
b. Documenting the nursing care plan in the progress notes in the medical record.
c. Deciding whether the hospital client’s health problems have been completely resolved.
d. Asking the hospital client to evaluate whether the nursing care
provided was satisfactory.
PRECISE CHOICE:-A
Reasoning :->>>Evaluation consists of determining whether the desired hospital client outcomes have been
NURSING IN CANADA 5TH EDITION
,CHAPTER 01: Introduction to Medical Surgical Nursing Practice in
Canada Lewis: Medical-Surgical Nursing in Canada, 5th Canadian
Edition
MULTIPLE CHOICE :
1. The medical attendant is caring for a hospital client with a new diagnosis
of pneumonia and explains to the hospital client that together they will
plan the hospital client’s care and set goals for discharge. The hospital
client asks, “How is that different from what the doctor does?” Which
response by the medical attendant is most appropriate?
a. “The role of the medical attendant is to administer medications and other
treatments prescribed
by your doctor.”
b. “The medical attendant’s job is to help the doctor by collecting data and
communicating when there are problems.”
c. “Medical attendants perform many of the procedures done by physicians, but
medical attendants are here in
the health center for a longer time than doctors.”
d. “In addition to caring for you while you are sick, the medical attendants will assist
you to
develop an individualized plan to maintain your health.”
PRECISE CHOICE:-D
Reasoning :->>>This response is consistent with the Canadian nurses Association (CNA) definition
of nursing. Registered medical attendants are self-regulated health care professionals who work
autonomously and in collaboration with others. RNs enable individuals, families, groups, communities
and populations to achieve their optimal level of health. RNs coordinate health care, deliver direct
services, and support hospital clients in their self-care decisions and actions in situations of health,
illness, injury, and disability in all stages of life. The other responses describe some of the dependent
and collaborative functions of the nursing role but do not accurately describe the medical attendant’s
role in the health care system.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment
2. When caring for hospital clients using evidence-informed practice, which of the following does the
medical attendant use?
a. Clinical judgement based on experience
b. Evidence from a clinical research study
c. The best available evidence to guide clinical expertise
d. Evaluation of data showing that the hospital client
outcomes are met
PRECISE CHOICE:-C
Reasoning :->>>Evidence-informed nursing practice is a continuous interactive process involving the
explicit, conscientious, and judicious consideration of the best available evidence to provide care. Four
primary elements are: (a) clinical state, setting, and circumstances; (b) hospital client preferences and
actions; (c) best research evidence, and (d) health care resources. Clinical judgement based on the
medical attendant’s clinical experience is part of EIP, but clinical decision making also should
incorporate current research and research-based guidelines. Evidence from one clinical research study
does not provide an adequate substantiation for interventions. Evaluation of hospital client outcomes is
important, but interventions should be based on research from randomized control studies with a
large number of
, subjects.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Planning MSC: NCLEX: Safe and Effective Care Environment
3. Which of the following best explains the medical attendants’ primary use of the nursing process
when providing care to hospital clients?
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat hospital clients’ health care needs
c. As a scientific-based process of diagnosing the hospital client’s health care problems
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
PRECISE CHOICE:-B
Reasoning :->>>The nursing process is an assertive problem-solving approach to the identification and
treatment of hospital clients’ problems. Diagnosis is only one phase of the nursing process. The primary
use of the nursing process is in hospital client care, not to establish nursing theory or explain nursing
interventions to other health care professionals.
DIF: Cognitive Level: Comprehension TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment
4. The medical attendant is caring for a critically ill hospital 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
PRECISE CHOICE:-D
Reasoning :->>>When implementing collaborative nursing actions, the medical attendant 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 hospital 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 TOPIC: Nursing Process:
Implementation MSC: NCLEX: Safe and Effective Care Environment
5. The medical attendant is caring for a hospital client who has been admitted to the health center for
surgery and tells the medical attendant, “I do not feel right about leaving my children with my
neighbour.” Which action should the medical attendant take next?
a. Reassure the hospital client that these feelings are common for parents.
b. Have the hospital 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 hospital client’s feelings about the childcare arrangements.
PRECISE CHOICE:-D
Reasoning :->>>Since a complete assessment is necessary in order to identify a problem and choose an
appropriate intervention, the medical attendant’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: Application TOPIC: Nursing Process:
Assessment MSC: NCLEX: Psychosocial Integrity
6. The medical attendant is caring for a hospital client who has left-sided paralysis as the result of a
stroke and assesses a pressure injury on the hospital client’s left hip. Which of the following is
the most appropriate nursing diagnosis for this hospital client?
a. Impaired physical mobility related to decrease in muscle control (left-sided
paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
protecting tissue integrity
c. Impaired skin integrity related to pressure over bony prominence (impaired
circulation)
d. Ineffective peripheral tissue perfusion related to sedentary lifestyle
PRECISE CHOICE:-C
Reasoning :->>>The hospital client’s major problem is the impaired skin integrity as demonstrated by
the presence of a pressure injury. The medical attendant is able to treat the cause of impaired
circulation and pressure over bony prominence by frequently repositioning the hospital client.
Although left-sided weakness is a problem for the hospital client, the medical attendant cannot treat
the weakness. The “risk for” diagnosis is not appropriate for this hospital client, who already has
impaired tissue integrity. The hospital client does have ineffective peripheral tissue perfusion, but the
impaired skin integrity diagnosis indicates more clearly what the health problem is.
DIF: Cognitive Level: Application TOPIC: Nursing Process:
Diagnosis MSC: NCLEX: Physiological Integrity
7. The medical attendant caring for a hospital client with an infection has a nursing diagnosis of deficient
fluid volume related to excessive fluid loss through normal route (diaphoresis). Which of the
following is an appropriate hospital client outcome?
a. Hospital client has a balanced intake and output.
b. Hospital client’s bedding is changed when it becomes damp.
c. Hospital client understands the need for increased fluid intake.
d. Hospital client’s skin remains cool and dry throughout hospitalization.
PRECISE CHOICE:-A
Reasoning :->>>This statement gives measurable data showing resolution of the problem of deficient
fluid volume that was identified in the nursing diagnosis statement. The other statements would not
indicate that the problem of deficient fluid volume was resolved.
DIF: Cognitive Level: Application TOPIC: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity
8. Which of the following represents a nursing activity that is carried out during the evaluation phase of
the nursing process?
a. Determining if interventions have been effective in meeting hospital client outcomes.
b. Documenting the nursing care plan in the progress notes in the medical record.
c. Deciding whether the hospital client’s health problems have been completely resolved.
d. Asking the hospital client to evaluate whether the nursing care
provided was satisfactory.
PRECISE CHOICE:-A
Reasoning :->>>Evaluation consists of determining whether the desired hospital client outcomes have been
