LEWIS'S MEDICAL-SURGICAL NURSING
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference
Ch. 1 — Professional Nursing — Professional Nursing Practice
Stem
A newly graduated RN is assigned a patient with acute dyspnea
who has an order for nebulized bronchodilator PRN. The RN is
managing three other stable patients. Which action best
demonstrates professional nursing practice when the patient
,becomes more tachypneic and restless during the nebulizer
treatment?
A. Continue the nebulizer and chart the event as expected.
B. Stop the nebulizer, perform focused respiratory assessment,
and notify the provider.
C. Call the respiratory therapist to perform the assessment later
during rounding.
D. Increase the oxygen flow and leave the patient while you
finish other tasks.
Correct answer: B
Rationales
Correct (B): Recognize increased work of breathing and analyze
that tachypnea + restlessness may indicate worsening airflow or
hypoxia. Immediate focused respiratory assessment and timely
provider notification align with Lewis’s priority on safety and
early intervention; this follows NCSBN-CJM (Recognize →
Analyze → Intervene → Evaluate).
A: Unsafe—continuing without reassessment ignores changing
status and delays needed intervention.
C: Lower priority—RT involvement is helpful but waiting delays
immediate bedside assessment by the nurse.
D: Unsafe—adjusting oxygen without assessment and leaving
the bedside risks deterioration.
Teaching point: Early bedside reassessment and provider
notification for respiratory change is priority.
,Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference
Ch. 1 — Professional Nursing — Nursing Core Competencies
Stem
An RN preceptor evaluates a new graduate’s ability to use
clinical judgment during post-op handoff. Which demonstration
best shows mastery of nursing core competencies?
A. Recites all lab values without interpretation.
B. Describes patient-specific risks, identifies priority problems,
and outlines immediate nursing actions.
C. Provides a checklist of routine tasks to be completed in 24
hours.
D. States that the surgeon will handle post-op complications if
they occur.
Correct answer: B
Rationales
Correct (B): This answer shows application and analysis—
recognizing risks, prioritizing problems, and planning
interventions reflect core competencies and NCSBN-CJM steps
(Recognize → Analyze → Plan). Lewis emphasizes patient-
centered, competency-based care.
A: Recall-only—does not show interpretation or clinical
, judgment.
C: Task list alone lacks prioritization or clinical reasoning.
D: Defers accountability and violates scope of professional
nursing practice.
Teaching point: Nursing competencies require interpretation,
prioritization, and planning—not mere recall.
Citation: Harding et al. (2023). Ch. 1.
3
Reference
Ch. 1 — Professional Nursing — Continuum of Patient Care
Stem
A hospitalized patient nearing discharge expresses concern
about managing insulin at home. Which action best supports
continuity across the care continuum?
A. Tell the patient to watch online videos at home.
B. Arrange a diabetes education session with a nurse educator
before discharge and document teaching.
C. Suggest they call their primary care clinic after discharge.
D. Provide written instructions only and discharge as planned.
Correct answer: B
Rationales
Correct (B): Arranging bedside education and documenting it
promotes safe transition of care, addresses patient-centered
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference
Ch. 1 — Professional Nursing — Professional Nursing Practice
Stem
A newly graduated RN is assigned a patient with acute dyspnea
who has an order for nebulized bronchodilator PRN. The RN is
managing three other stable patients. Which action best
demonstrates professional nursing practice when the patient
,becomes more tachypneic and restless during the nebulizer
treatment?
A. Continue the nebulizer and chart the event as expected.
B. Stop the nebulizer, perform focused respiratory assessment,
and notify the provider.
C. Call the respiratory therapist to perform the assessment later
during rounding.
D. Increase the oxygen flow and leave the patient while you
finish other tasks.
Correct answer: B
Rationales
Correct (B): Recognize increased work of breathing and analyze
that tachypnea + restlessness may indicate worsening airflow or
hypoxia. Immediate focused respiratory assessment and timely
provider notification align with Lewis’s priority on safety and
early intervention; this follows NCSBN-CJM (Recognize →
Analyze → Intervene → Evaluate).
A: Unsafe—continuing without reassessment ignores changing
status and delays needed intervention.
C: Lower priority—RT involvement is helpful but waiting delays
immediate bedside assessment by the nurse.
D: Unsafe—adjusting oxygen without assessment and leaving
the bedside risks deterioration.
Teaching point: Early bedside reassessment and provider
notification for respiratory change is priority.
,Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference
Ch. 1 — Professional Nursing — Nursing Core Competencies
Stem
An RN preceptor evaluates a new graduate’s ability to use
clinical judgment during post-op handoff. Which demonstration
best shows mastery of nursing core competencies?
A. Recites all lab values without interpretation.
B. Describes patient-specific risks, identifies priority problems,
and outlines immediate nursing actions.
C. Provides a checklist of routine tasks to be completed in 24
hours.
D. States that the surgeon will handle post-op complications if
they occur.
Correct answer: B
Rationales
Correct (B): This answer shows application and analysis—
recognizing risks, prioritizing problems, and planning
interventions reflect core competencies and NCSBN-CJM steps
(Recognize → Analyze → Plan). Lewis emphasizes patient-
centered, competency-based care.
A: Recall-only—does not show interpretation or clinical
, judgment.
C: Task list alone lacks prioritization or clinical reasoning.
D: Defers accountability and violates scope of professional
nursing practice.
Teaching point: Nursing competencies require interpretation,
prioritization, and planning—not mere recall.
Citation: Harding et al. (2023). Ch. 1.
3
Reference
Ch. 1 — Professional Nursing — Continuum of Patient Care
Stem
A hospitalized patient nearing discharge expresses concern
about managing insulin at home. Which action best supports
continuity across the care continuum?
A. Tell the patient to watch online videos at home.
B. Arrange a diabetes education session with a nurse educator
before discharge and document teaching.
C. Suggest they call their primary care clinic after discharge.
D. Provide written instructions only and discharge as planned.
Correct answer: B
Rationales
Correct (B): Arranging bedside education and documenting it
promotes safe transition of care, addresses patient-centered
