,Chapter 01: Professional Nursing
$@1 $@1 $@1
Harding: Lewis’s Medical-Surgical Nursing, 13th Edition
$@1 $@1 $@1 $@1 $@1
MULTIPLE CHOICE $@1
1. The nurse completes an admission database and explains that the plan of care a
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
nd discharge goals will be developed with the patient‗s input. The patient asks,
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@
―How is this different from what the physician does?‖ Which response would t
1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
he nurse provide?
$@1 $@1
a. ―The role of the nurse is to administer medications and other tre
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
atments prescribed by your physician.‖$@1 $@1 $@1 $@1
b. ―In addition to caring for you while you are sick, the nurses will hel
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
p you plan to maintain your health.‖
$@1 $@1 $@1 $@1 $@1 $@1
c. ―The nurse‗s job is to collect information and communicate any p
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
roblems that occur to the physician.‖ $@1 $@1 $@1 $@1 $@1
d. ―Nurses perform many of the same procedures as the physician, but
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $
nurses are with the patients for a longer time than the physicia
@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
n.‖
ANS: B $@1
The American Nurses Association (ANA) definition of nursing describes the role
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
of nurses in promoting health. The other responses describe dependent and colla
$@1 $ @ 1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
borative functions of the nursing role but do not accurately describe the nurse‗s
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
unique role in the health care system.
$@1 $@1 $@1 $@1 $@1 $@1
DIF: $ @ 1 Cognitive Level: Analyze (Analysis)
$@1 $@1 $@1
TOP: $ @ 1 Nursing Process: Implementation
$@1 $@1 $ @ 1 $ @ 1 MSC: $@1 NCLEX: Safe and Effective Care Enviro
$@1 $@1 $@1 $@1 $@1
nment
2. Which statement by the nurse accurately describes the use of evidence-
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
based practice (EBP)?
$@1 $@1
a. ―Patient care is based on clinical judgment, experience, and traditions.‖
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
b. ―Data are analyzed later to show that the patient outcomes are consistently met.‖
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. ―Research from all published articles are used as a guide for planning patient care.‖
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d. ―Recommendations are based on research, clinical expertise $@1 $@1 $@1 $@1 $@1 $@1
, and patient preferences.‖
$@1 $@1 $@1
ANS: D $@1
Evidence-based practice (EBP) is the use of the best research-
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
based evidence combined with clinician expertise and consideration of patient pref
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
erences. Clinical judgment based on the nurse‗s clinical experience is part of EB
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
P, but clinical decision making should also incorporate current research and resea
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
rch-
based guidelines. Evaluation of patient outcomes is important, but data analysis is
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
not required to use EBP. All published articles do not provide research evidenc
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
e; interventions should be based on credible research, preferably randomized contr
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
olled studies with a large number of subjects.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
DIF: Cognitive Level: Understand (Comprehension) $@1 $@1 $@1
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Car
$@1 $@1 $@1 $@1 $ @ 1 $@1 $@1 $@1 $@1
e Environment
$@1
,3. Which statement by the nurse provides a clear explanation of the nursing process?
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
a. ―The nursing process is a research method of diagnosing the patient
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
‗s health care problems.‖
$@1 $@1 $@1
b. ―The nursing process is used primarily to explain nursing interventi
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ons to other health care professionals.‖
$@1 $@1 $@1 $@1 $@1
c. ―The nursing process is a problem-solving tool used to identify and manage the
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
, patients‗ health care needs.‖ $@1 $@1 $@1
d. ―The nursing process is based on nursing theory that incor
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
porates the biopsychosocial nature of humans.‖
$@1 $@1 $@1 $@1 $@1
ANS: C $@1
The nursing process is a problem-
$@1 $@1 $@1 $@1 $@1
solving approach to the identification and treatment of patients‗ problems. Nursin
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
g process does not require research methods for diagnosis. The primary use of th
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
e nursing process is in patient care, not to establish nursing theory or explain n
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ursing interventions to other health care professionals.
$@1 $@1 $@1 $@1 $@1 $@1
DIF: Cognitive Level: Understand (Comprehension)
$@1 $@1 $@1
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Enviro
$@1 $@1 $@1 $@1 $ @ 1 $@1 $@1 $@1 $@1 $@1
nment
4. A patient admitted to the hospital for surgery tells the nurse, ―I do not feel c
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
omfortable leaving my children with my parents.‖ Which action would the
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $
nurse take next?
@1 $@1 $@1
a. Reassure the patient that these feelings are common for parents.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
b. Have the patient call the children to ensure that they are doing well.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. Gather information on the patient‗s concerns about the child care arrangements.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d. Call the patient‗s parents to determine whether adequate child
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
care is being provided.
$@1 $@1 $@1 $@1
ANS: C $@1
Because a complete assessment is necessary in order to identify a problem and
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
choose an appropriate intervention, the nurse‗s first action should be to obtain m
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ore information. The other actions may be appropriate, but more assessment is ne
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
eded before the best intervention can be chosen.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
DIF: Cognitive Level: Analyze (Analysis) $@1 $@1 $@1
TOP: Nursing Process: Assessment
$ @ 1 MSC: NCLEX: Psychosocial Integrity
$@1 $@1 $ @1 $@1 $@1
5. A patient with a bacterial infection is hypovolemic due to a fever an
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d excessive diaphoresis. Which expected outcome would the nurse sel
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ect for this patient?
$@1 $@1 $@1
a. Patient has a balanced intake and output.
$@1 $@1 $@1 $@1 $@1 $@1
b. Patient‗s bedding is kept clean and free of moisture.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. Patient understands the need for increased fluid intake.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
d. Patient‗s skin remains cool and dry throughout hospitalization.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
ANS: A $@1
Balanced intake and output gives measurable data showing resolution of the proble
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
m of deficient fluid volume. The other statements would not indicate that the pr
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
oblem of hypovolemia was resolved.
$@1 $@1 $@1 $@1
DIF: Cognitive Level: Apply (Application)
$@1 $@1 $@1
TOP: Nursing Process: Planning MSC:
$@1 $@1 $@1 $@1 $ @ 1 NCLEX: Physiological Integrity
$@1 $@1
6. Which $@1 statement describes the purpose of the evaluation phase of the nursing process?
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
a. To $@1 document the nursing care plan in the progress notes of the health record
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
b. To $@1 determine if interventions have been effective in meeting patient outcomes
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. To $@1 decide whether the patient‗s health problems have been completely resolved
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d. To $@1 establish if the patient agrees that the nursing care provided was satisfactory
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ANS: B $@1
$@1 $@1 $@1
Harding: Lewis’s Medical-Surgical Nursing, 13th Edition
$@1 $@1 $@1 $@1 $@1
MULTIPLE CHOICE $@1
1. The nurse completes an admission database and explains that the plan of care a
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
nd discharge goals will be developed with the patient‗s input. The patient asks,
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@
―How is this different from what the physician does?‖ Which response would t
1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
he nurse provide?
$@1 $@1
a. ―The role of the nurse is to administer medications and other tre
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
atments prescribed by your physician.‖$@1 $@1 $@1 $@1
b. ―In addition to caring for you while you are sick, the nurses will hel
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
p you plan to maintain your health.‖
$@1 $@1 $@1 $@1 $@1 $@1
c. ―The nurse‗s job is to collect information and communicate any p
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
roblems that occur to the physician.‖ $@1 $@1 $@1 $@1 $@1
d. ―Nurses perform many of the same procedures as the physician, but
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $
nurses are with the patients for a longer time than the physicia
@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
n.‖
ANS: B $@1
The American Nurses Association (ANA) definition of nursing describes the role
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
of nurses in promoting health. The other responses describe dependent and colla
$@1 $ @ 1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
borative functions of the nursing role but do not accurately describe the nurse‗s
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
unique role in the health care system.
$@1 $@1 $@1 $@1 $@1 $@1
DIF: $ @ 1 Cognitive Level: Analyze (Analysis)
$@1 $@1 $@1
TOP: $ @ 1 Nursing Process: Implementation
$@1 $@1 $ @ 1 $ @ 1 MSC: $@1 NCLEX: Safe and Effective Care Enviro
$@1 $@1 $@1 $@1 $@1
nment
2. Which statement by the nurse accurately describes the use of evidence-
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
based practice (EBP)?
$@1 $@1
a. ―Patient care is based on clinical judgment, experience, and traditions.‖
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
b. ―Data are analyzed later to show that the patient outcomes are consistently met.‖
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. ―Research from all published articles are used as a guide for planning patient care.‖
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d. ―Recommendations are based on research, clinical expertise $@1 $@1 $@1 $@1 $@1 $@1
, and patient preferences.‖
$@1 $@1 $@1
ANS: D $@1
Evidence-based practice (EBP) is the use of the best research-
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
based evidence combined with clinician expertise and consideration of patient pref
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
erences. Clinical judgment based on the nurse‗s clinical experience is part of EB
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
P, but clinical decision making should also incorporate current research and resea
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
rch-
based guidelines. Evaluation of patient outcomes is important, but data analysis is
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
not required to use EBP. All published articles do not provide research evidenc
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
e; interventions should be based on credible research, preferably randomized contr
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
olled studies with a large number of subjects.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
DIF: Cognitive Level: Understand (Comprehension) $@1 $@1 $@1
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Car
$@1 $@1 $@1 $@1 $ @ 1 $@1 $@1 $@1 $@1
e Environment
$@1
,3. Which statement by the nurse provides a clear explanation of the nursing process?
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
a. ―The nursing process is a research method of diagnosing the patient
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
‗s health care problems.‖
$@1 $@1 $@1
b. ―The nursing process is used primarily to explain nursing interventi
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ons to other health care professionals.‖
$@1 $@1 $@1 $@1 $@1
c. ―The nursing process is a problem-solving tool used to identify and manage the
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
, patients‗ health care needs.‖ $@1 $@1 $@1
d. ―The nursing process is based on nursing theory that incor
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
porates the biopsychosocial nature of humans.‖
$@1 $@1 $@1 $@1 $@1
ANS: C $@1
The nursing process is a problem-
$@1 $@1 $@1 $@1 $@1
solving approach to the identification and treatment of patients‗ problems. Nursin
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
g process does not require research methods for diagnosis. The primary use of th
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
e nursing process is in patient care, not to establish nursing theory or explain n
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ursing interventions to other health care professionals.
$@1 $@1 $@1 $@1 $@1 $@1
DIF: Cognitive Level: Understand (Comprehension)
$@1 $@1 $@1
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Enviro
$@1 $@1 $@1 $@1 $ @ 1 $@1 $@1 $@1 $@1 $@1
nment
4. A patient admitted to the hospital for surgery tells the nurse, ―I do not feel c
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
omfortable leaving my children with my parents.‖ Which action would the
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $
nurse take next?
@1 $@1 $@1
a. Reassure the patient that these feelings are common for parents.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
b. Have the patient call the children to ensure that they are doing well.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. Gather information on the patient‗s concerns about the child care arrangements.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d. Call the patient‗s parents to determine whether adequate child
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
care is being provided.
$@1 $@1 $@1 $@1
ANS: C $@1
Because a complete assessment is necessary in order to identify a problem and
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
choose an appropriate intervention, the nurse‗s first action should be to obtain m
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ore information. The other actions may be appropriate, but more assessment is ne
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
eded before the best intervention can be chosen.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
DIF: Cognitive Level: Analyze (Analysis) $@1 $@1 $@1
TOP: Nursing Process: Assessment
$ @ 1 MSC: NCLEX: Psychosocial Integrity
$@1 $@1 $ @1 $@1 $@1
5. A patient with a bacterial infection is hypovolemic due to a fever an
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d excessive diaphoresis. Which expected outcome would the nurse sel
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ect for this patient?
$@1 $@1 $@1
a. Patient has a balanced intake and output.
$@1 $@1 $@1 $@1 $@1 $@1
b. Patient‗s bedding is kept clean and free of moisture.
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. Patient understands the need for increased fluid intake.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
d. Patient‗s skin remains cool and dry throughout hospitalization.
$@1 $@1 $@1 $@1 $@1 $@1 $@1
ANS: A $@1
Balanced intake and output gives measurable data showing resolution of the proble
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
m of deficient fluid volume. The other statements would not indicate that the pr
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
oblem of hypovolemia was resolved.
$@1 $@1 $@1 $@1
DIF: Cognitive Level: Apply (Application)
$@1 $@1 $@1
TOP: Nursing Process: Planning MSC:
$@1 $@1 $@1 $@1 $ @ 1 NCLEX: Physiological Integrity
$@1 $@1
6. Which $@1 statement describes the purpose of the evaluation phase of the nursing process?
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
a. To $@1 document the nursing care plan in the progress notes of the health record
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
b. To $@1 determine if interventions have been effective in meeting patient outcomes
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
c. To $@1 decide whether the patient‗s health problems have been completely resolved
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
d. To $@1 establish if the patient agrees that the nursing care provided was satisfactory
$@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1 $@1
ANS: B $@1
