TEST BANK FOR Lewis's Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems, 5th Edition by Jane Tyerman, Shelley Cobbett, Mariann M. Harding, Jeffrey Kwong ISBN: 9780323791571 COMPLETE GUIDE All CHAPTERS COVERED 100%

Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank




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, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
Chapter 01: Introduction to Medical-
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Surgical Nursing Practice in Canada Lewis: Medical-
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Surgical Nursing in Canada, 5th Canadian Edition
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MULTIPLE CHOICE bn




1. When caring for clients using evidence-
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informed practice, which of the following does the nurse use?
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a. Clinical judgement based on experience bn bn bn bn



b. Evidence from a clinical research study bn bn bn bn bn



c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the client outcomes are met bn bn bn bn bn bn bn bn bn




ANS: C b n



Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscienti
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ous, and judicious consideration of the best available evidence to provide care. Four primary el
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ements are: (a) clinical state, setting, and circumstances; (b) client preferences and actions; (c)
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best research evidence; and (d) health care resources. Clinical judgement based on the nurse‘s
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clinical experience is part of EIP, but clinical decision making also should incorporate current
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research and research-
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based guidelines. Evidence from one clinical research study does not provide an adequate sub
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stantiation for interventions. Evaluation of client outcomes is important, but interventions sho
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uld be based on research from randomized control studies with a large number of subjects.
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DIF: Cognitive Level: Comprehension bn bn TOP: Nursing Process: Planning b n bn bn




2. Which of the following best expl a ins the nu r s e s ‘ primary use of the nursing process when pr
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N R I G B.C M bn bn bn bn bn bn bn bn bn bn bn bn bn b n bn bn bn bn bn bn bn




oviding care to clients? bn bn bn
USNT bn bn bn O
a. To explain nursing interventions to other health care professionals
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b. As a problem-solving tool to identify and treat clients‘ health care needs
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c. As a scientific-based process of diagnosing the client‘s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
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ANS: B b n



The nursing process is an assertive problem-
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solving approach to the identification and treatment of clients‘ problems. Diagnosis is only on
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e phase of the nursing process. The primary use of the nursing process is in client care, not to e
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stablish nursing theory or explain nursing interventions to other health care professionals.
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DIF: Cognitive Level: Comprehension bn bn TOP: Nursing Process: Implementation
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3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-
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hour turning schedule to prevent skin breakdown. Which type of nursing function is demonstr
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ated with this turning schedule?
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a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D b n




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, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank

When implementing collaborative nursing actions, the nurse is responsible primarily for monit
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oring for complications of acute illness or providing care to prevent or treat complications. In
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dependent nursing actions are focused on health promotion, illness prevention, and client adv
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ocacy. A dependent action would require a physician order to implement. Cooperative nursing
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functions are not described as one of the formal nursing functions.
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DIF: Cognitive Level: Application bn bn TOP: Nursing Process: Implementation
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4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
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nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which action sho
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uld the nurse take next?
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a. Reassure the client that these feelings are common for parents. bn bn bn bn bn bn bn bn bn



b. Have the client call the children to ensure that they are doing well.
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c. Call the neighbour to determine whether adequate childcare is being provided.
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d. Gather more data about the client‘s feelings about the childcare arrangements.
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ANS: D b n



Since a complete assessment is necessary in order to identify a problem and choose an approp
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riate intervention, the nurse‘s first action should be to obtain more information. The other acti
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ons may be appropriate, but more assessment is needed before the best intervention can be chos
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en.

DIF: Cognitive Level: Application bn bn TOP: Nursing Process: Assessment b n bn bn




5. The nurse is caring for a client who has left-
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sided paralysis as the result of a stroke and assesses a pressure injury on the clie nt‘s left
N isRthe most
I G B . Cnursing
M diagnosis f Uo r t Sh is cNlienTt?
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h ip . Which of the following
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O
a. Impaired physical mobility related to decrease in muscle control (left-sided bn bn bn bn bn bn bn bn bn



paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
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protecting tissue integrity bn bn



c. Impaired skin integrity related to pressure over bony prominence (impaired bn bn bn bn bn bn bn bn bn bn



circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle bn bn bn bn bn bn




ANS: C b n



The client‘s major problem is the impaired skin integrity as demonstrated by the presence of a p
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ressure injury. The nurse is able to treat the cause of altered circulation and pressure by freque
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ntly repositioning the client. Although left-
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sided weakness is a problem for the client, the nurse cannot treat the weakness. The ―risk for‖
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diagnosis is not appropriate for this client, who already has impaired tissue integrity. The client
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does have ineffective tissue perfusion, but the impaired skin integrity diagnosis indicates mor
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e clearly what the health problem is.
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DIF: Cognitive Level: Application bn bn TOP: Nursing Process: Diagnosis b n bn bn




6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid
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volume related to excessive diaphoresis. Which of the following is an appropriate client
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outcome?
a. Client has a balanced intake and output. bn bn bn bn bn bn



b. Client‘s bedding is changed when it becomes damp. bn bn bn bn bn bn bn




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, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank

c. Client understands the need for increased fluid intake.
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d. Client‘s skin remains cool and dry throughout hospitalization.
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ANS: A b n



This statement gives measurable data showing resolution of the problem of deficient fluid vol
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ume that was identified in the nursing diagnosis statement. The other statements would not indi
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cate that the problem of deficient fluid volume was resolved.
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DIF: Cognitive Level: Application bn bn TOP: Nursing Process: Planning b n bn bn




7. Which of the following represents a nursing activity that is carried out during the evaluation
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phase of the nursing process?
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a. Determining if interventions have been effective in meeting client outcomes bn bn bn bn bn bn bn bn bn



b. Documenting the nursing care plan in the progress notes in the medical record bn bn bn bn bn bn bn bn bn bn bn bn



c. Deciding whether the client‘s health problems have been completely resolved
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d. Asking the client to evaluate whether the nursing care provided was satisfactory
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ANS: A b n



Evaluation consists of determining whether the desired client outcomes have been met and w
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hether the nursing interventions were appropriate. The other responses do not describe the eval
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uation phase. bn




DIF: Cognitive Level: Comprehension bn bn TOP: Nursing Process: Evaluationb n bn bn




8. Which of the following would the nurse perform during the assessment phase of the nursing
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process?
a. Obtains data with which to diagnose client problems bn bn bn bn bn bn bn



b. Uses client data to develoNp p R
ri o riIty nGursB
U S N Tin.
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d iagMnoses
c. Teaches interventions to relieve client health problems bn
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bn
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bn bn
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bn
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d. Assists the client to identify realistic outcomes to health problems
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ANS: A b n



During the assessment phase, the nurse gathers information about the client. The other respon
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ses are examples of the intervention, diagnosis, and planning phases of the nursing process.
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DIF: Cognitive Level: Knowledge bn bn TOP: Nursing Process: Assessmentb n bn bn




9. Which of the following is an example of a correctly written nursing diagnosis statement?
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a. Altered tissue perfusion related to heart failure bn bn bn bn bn bn



b. Risk for impaired tissue integrity related to sacral redness
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c. Ineffective coping related to insufficient sense of control. bn bn bn bn bn bn bn



d. Altered urinary elimination related to urinary tract infection
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ANS: C b n



This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
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a client‘s response to a health problem that can be treated by nursing. The use of a medical d
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iagnosis (as in the responses beginning ―Altered tissue perfusion‖ and ―Altered urinary elim
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ination‖) is not appropriate. The response beginning ―Risk for impaired tissue integrity‖ uses
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the defining characteristics as the etiology.
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DIF: Cognitive Level: Comprehension bn bn TOP: Nursing Process: Diagnosis b n bn bn




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