FINAL EXAM; Medical-Surgical
Nursing (Evolve) NCLEX and Mastery
Questions and Answers TESTBANK
(1.1) Which nursing activities may be safely delegated to competent assistive personnel (AP)?
Select all that apply.
A.) Discharge teaching
B.) Blood pressure monitoring
C.) Gastrostomy feeding
D.) Oxygen administration
E.) Ambulation assistance - <CORRECT ANSWER >>B, E
(1.2) A nurse assures a client experiencing abdominal surgical pain that comfort measures,
including drug therapy, will be provided as the client needs them. Which ethical principles apply
in the situation? Select all that apply.
A.) Beneficence
B.) Social justice
C.) Autonomy
D.) Fidelity
E.) Veracity - <CORRECT ANSWER >>A, D, E
(1.1 M) The nurse provides an SBAR hand-off communication regarding a client whose blood
pressure and respiratory rate have decreased. Where will the nurse include these data as part
of the SBAR format?
A.) Situation
,B.) Background
C.) Assessment
D.) Recommendation - <CORRECT ANSWER >>A
(1.2 M) The nurse collaborates with the registered dietitian nutritionist to improve the
nutritional status of clients on a hospital unit. Which priority professional nursing concepts
apply in this situation? Select all that apply.
A.) Quality Improvement
B.) Ethics
C.) Health Care Disparities
D.) Systems Thinking
E.) Teamwork and Collaboration - <CORRECT ANSWER >>A, D, E
(2.1) Which environments of care will the nurse recognize as components of the health care
system? Select all that apply.
A.) Long-term care
B.) Primary care
C.) Free-standing emergency department
D.) National League of Nursing
E.) Patient-centered medical home
F.) World Health Organization - <CORRECT ANSWER >>A, B, C, E
(2.2) What is the generalist registered nurse's role related to patient care within a system?
Select all that apply.
A.) Caring
,B.) Teaching
C.) Collaborating
D.) Advocating
E.) Researching
F.) Prescribing - <CORRECT ANSWER >>A, B, C, D, E
(2.1 M) The nurse is participating in a unit meeting to discuss daily nursing care expectations.
Which nursing statement reflects systems level thinking?
A.) "It is important to provide care consistent with the client's expectation."
B.) "I will always consider my client's cultural preferences when delivering care."
C.) "I have been comparing our rates of infection with other units in the hospital."
D.) "I will look for the policy about family visitation to show my client." - <CORRECT ANSWER
>>C
(2.2 M) Which nursing action reflects implementation of systems level thinking?
A.) Conducting a skin assessment on a newly admitted client
B.) Documenting a pressure injury in the electronic health record
C.) Notifying the health care provider of a 2" x 1" pressure injury on the coccyx
D.) Participating in a quality improvement project about eliminating pressure injury occurrences
- <CORRECT ANSWER >>D
(2.3 M) How will the experienced nurse explain systems thinking to a new nurse?
A.) Reading a journal article to enhance one's understanding of a specific disorder
B.) Providing patient-centered care to each individual, recognizing his or her uniqueness
C.) Engaging in a professional development activity to earn continuing education credit
, D.) Using information from individual client care to improve outcomes at a macro level -
<CORRECT ANSWER >>D
(3.1) Which assessment findings indicate to the nurse that a client taking warfarin may have
decreased CLOTTING? (Select all that apply.)
A.) Frequent nosebleeds
B.) Lower leg swelling
C.) Upper extremity bruising
D.) Difficulty breathing
E.) Intermittent chest pain
F.) Dark stools - <CORRECT ANSWER >>A, C, F
(3.2) The nurse is conducting assessments for clients at potential risk for infection. Which client
is MOST at risk for acquiring an INFECTION?
A.) A client who had an opened incision for abdominal surgery
B.) A client who has not been immunized for pneumonia or influenza
C.) A client who works in a high-stress job for an accounting practice
D.) A client who is 85 years old and in good health - <CORRECT ANSWER >>A
(3.3) A client reports increasing diffuse pain in the entire right leg. What is the nurse's PRIORITY
ACTION at this time?
A.) Elevate the right leg on a pillow
B.) Perform a peripheral vascular assessment
C.) Check for swelling in the right leg
D.) Notify the Rapid Response Team immediately - <CORRECT ANSWER >>B
Nursing (Evolve) NCLEX and Mastery
Questions and Answers TESTBANK
(1.1) Which nursing activities may be safely delegated to competent assistive personnel (AP)?
Select all that apply.
A.) Discharge teaching
B.) Blood pressure monitoring
C.) Gastrostomy feeding
D.) Oxygen administration
E.) Ambulation assistance - <CORRECT ANSWER >>B, E
(1.2) A nurse assures a client experiencing abdominal surgical pain that comfort measures,
including drug therapy, will be provided as the client needs them. Which ethical principles apply
in the situation? Select all that apply.
A.) Beneficence
B.) Social justice
C.) Autonomy
D.) Fidelity
E.) Veracity - <CORRECT ANSWER >>A, D, E
(1.1 M) The nurse provides an SBAR hand-off communication regarding a client whose blood
pressure and respiratory rate have decreased. Where will the nurse include these data as part
of the SBAR format?
A.) Situation
,B.) Background
C.) Assessment
D.) Recommendation - <CORRECT ANSWER >>A
(1.2 M) The nurse collaborates with the registered dietitian nutritionist to improve the
nutritional status of clients on a hospital unit. Which priority professional nursing concepts
apply in this situation? Select all that apply.
A.) Quality Improvement
B.) Ethics
C.) Health Care Disparities
D.) Systems Thinking
E.) Teamwork and Collaboration - <CORRECT ANSWER >>A, D, E
(2.1) Which environments of care will the nurse recognize as components of the health care
system? Select all that apply.
A.) Long-term care
B.) Primary care
C.) Free-standing emergency department
D.) National League of Nursing
E.) Patient-centered medical home
F.) World Health Organization - <CORRECT ANSWER >>A, B, C, E
(2.2) What is the generalist registered nurse's role related to patient care within a system?
Select all that apply.
A.) Caring
,B.) Teaching
C.) Collaborating
D.) Advocating
E.) Researching
F.) Prescribing - <CORRECT ANSWER >>A, B, C, D, E
(2.1 M) The nurse is participating in a unit meeting to discuss daily nursing care expectations.
Which nursing statement reflects systems level thinking?
A.) "It is important to provide care consistent with the client's expectation."
B.) "I will always consider my client's cultural preferences when delivering care."
C.) "I have been comparing our rates of infection with other units in the hospital."
D.) "I will look for the policy about family visitation to show my client." - <CORRECT ANSWER
>>C
(2.2 M) Which nursing action reflects implementation of systems level thinking?
A.) Conducting a skin assessment on a newly admitted client
B.) Documenting a pressure injury in the electronic health record
C.) Notifying the health care provider of a 2" x 1" pressure injury on the coccyx
D.) Participating in a quality improvement project about eliminating pressure injury occurrences
- <CORRECT ANSWER >>D
(2.3 M) How will the experienced nurse explain systems thinking to a new nurse?
A.) Reading a journal article to enhance one's understanding of a specific disorder
B.) Providing patient-centered care to each individual, recognizing his or her uniqueness
C.) Engaging in a professional development activity to earn continuing education credit
, D.) Using information from individual client care to improve outcomes at a macro level -
<CORRECT ANSWER >>D
(3.1) Which assessment findings indicate to the nurse that a client taking warfarin may have
decreased CLOTTING? (Select all that apply.)
A.) Frequent nosebleeds
B.) Lower leg swelling
C.) Upper extremity bruising
D.) Difficulty breathing
E.) Intermittent chest pain
F.) Dark stools - <CORRECT ANSWER >>A, C, F
(3.2) The nurse is conducting assessments for clients at potential risk for infection. Which client
is MOST at risk for acquiring an INFECTION?
A.) A client who had an opened incision for abdominal surgery
B.) A client who has not been immunized for pneumonia or influenza
C.) A client who works in a high-stress job for an accounting practice
D.) A client who is 85 years old and in good health - <CORRECT ANSWER >>A
(3.3) A client reports increasing diffuse pain in the entire right leg. What is the nurse's PRIORITY
ACTION at this time?
A.) Elevate the right leg on a pillow
B.) Perform a peripheral vascular assessment
C.) Check for swelling in the right leg
D.) Notify the Rapid Response Team immediately - <CORRECT ANSWER >>B
