Medical-
Surgical Nursing: Concepts for Clinical Judgment and Collaborativ
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e Care 11th Edition
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by Donna D. Ignatavicius
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,Chapter 01: Overview of Professional Nursing Concepts for Medical-
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Surgical Nursing Ignatavicius: Medical-Surgical Nursing, 11th Edition
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MULTIPLEgCHOICE
1. Agnewgnursegisgworkinggwithgagpreceptorgongagmedical-
surgicalgunit.gThegpreceptorgadvisesgthegnewgnursegthatgwhichgisgthegprioritygwhengworkinggasg
agprofessionalgnurse?
a. Attendingg togholisticg clientg needs
b. Ensuringgclientgsafety
c. Notg makingg medicationg errors
d. Providingg client-focusedg care
ANS:g B
Allgactionsgaregappropriategforgthegprofessionalgnurse.gHowever,gensuringgclientgsafetygisgthegp
riority.gHealthgcaregerrorsghavegbeengwidelygreportedgforg25gyears,gmanygofgwhichgresultgingcli
entginjury,gdeath,gandgincreasedghealthgcaregcosts.gTheregaregseveralgnationalgandginternationa
lgorganizationsgthatghavegeithergrecommendedgorgmandatedgsafetyginitiatives.
Everygnurseghasgthegresponsibilitygtogguardgthegclient‘sgsafety.gThegothergactionsgaregimportantgf
orgqualitygnursing,gbutgtheygaregnotgasgvitalgasgprovidinggsafety.gNotgmakinggmedicationgerrorsgd
oesgprovidegsafety,gbutgisgtoognarrowgingscopegtogbegthegbestganswer.
DIF: Understanding
TOP:gIntegratedgProcess:gNursinggProcess:gInterventiongKEY:gClientgsafety
MSC:g Clientg NeedsgCategory:gSafegandgEffectivegCaregEnvironment:g SafetygandgInfectiongControl
2. Agnursegisgorientinggagnewgclientgandgfamilygtogthegmedical-
surgicalgunit.gWhatginformationgdoesgthegnursegprovidegtogbestghelpgthegclientgpromoteghisgo
rghergowngsafety?
a. Encouragegtheg clientg andg familygtog begactiveg partners.
b. Havegthegclientgmonitorghandghygienegingcaregivers.
c. Offergtheg familyg theg opportunitygtog staygwithg theg client.
d. Tellgthegclientgtogalwaysgwearghisgorghergarmband.
ANS:g A
Eachgactiongcouldgbegimportantgforgthegclientgorgfamilygtogperform.gHowever,gencouraginggthegcl
ientgtogbegactiveginghisgorgherghealthgcaregasgagsafetygpartnergisgthegmostgcritical.gThegothergaction
sgaregveryglimitedgingscopegandgdognotgprovidegthegbroadgprotectiongthatgbeinggactivegandginvolve
dgdoes.
DIF: Understanding
TOP:gIntegratedgProcess:gTeaching/LearninggKEY:gClientgsafety
MSC:g Clientg NeedsgCategory:gSafegandgEffectivegCaregEnvironment:g SafetygandgInfectiongControl
3. Agnursegisgcaringgforgagpostoperativegclientgongthegsurgicalgunit.gThegclient‘sgbloodgpressureg
wasg142/76gmmgHgg30gminutesgago,gandgnowgisg88/50gmmgHg.gWhatgactiongwouldgthegnursegt
akegfirst?
a. Callg thegRapidg ResponsegTeam.
b. Documentg andg continuegtog monitor.
,c. Notifygtheg primaryg healthg careg provider.
, d. Repeatgthegbloodgpressureging15gminutes.
ANS:g A
ThegpurposegofgthegRapidgResponsegTeamg(RRT)gisgtogintervenegwhengclientsgaregdeterioratinggb
eforegtheygsuffergeithergrespiratorygorgcardiacgarrest.gSincegthegclientghasgmanifestedgagsignifica
ntgchange,gthegnursegwouldgcallgthegRRT.gChangesgingbloodgpressure,gmentalgstatus,gheartgrate,gt
emperature,goxygengsaturation,gandglastg2ghoursg‘urinegoutputgaregparticularlygsignificantgandgar
egpartgofgthegModifiedgEarlygWarninggSystemgguide.gDocumentationgisgvital,gbutgthegnursegmust
gdog moregthangdocument. g Theg primaryghealth g careg providerg would gbegnotified,gbutgthisgisgnotg m
oregimportantgthangcallinggthegRRT.gThegclientg‘sgbloodgpressuregwouldgbegreassessedgfrequentl
y,gbutgthegprioritygisggettinggthegrapidgcaregtogthe
client.
DIF: Applying
TOP:gIntegratedgProcess:gCommunicationgandgDocumentationgKEY:gRapidgR
esponsegTeamg(RRT),gClinicalgjudgment
MSC:g ClientgNeedsgCategory:gPhysiologicalgIntegrity:gPhysiologicalgAdaptation
4. Agnursegwishesgtogprovidegclient-centeredgcaregingallginteractions.g Whichgactiongbygthegnurse
bestgdemonstratesg thisg concept?
a. Assessesg forg culturalg influencesg affectingg healthg care.
b. Ensuresgthatg allg theg client‘sg basicg needsg areg met.
c. Tellsgthegclientg andg familyg aboutg allg upcomingg tests.
d. Thoroughlygorientsgthegclientgandgfamilygtogthegroom.
ANS:g A
Showinggrespectgforgthegclientgandgfamily‘sgpreferencesgandgneedsgisgessentialgtogensuregagholist
icgorg―whole-
person‖gapproachgtogcare.gBygassessinggthegeffectgofgthegclient‘sgculturegonghealthgcare,gthisgnurseg
isgpracticinggclient-
focusedgcare.gProvidinggforgbasicgneedsgdoesgnotgdemonstrategthisgcompetence.gSimplygtellinggt
hegclientgaboutgallgupcominggtestsgisgnotgprovidinggempoweringgeducation.gOrientinggthegclientg
andgfamilygtogthegroomgisgangimportantgsafetygmeasure,gbutgnotgdirectlygrelatedgtogdemonstratingg
client-centeredgcare.
DIF: Understanding
TOP:gIntegratedgProcess:gCulturegandgSpiritualitygKEY:g Client-centeredgcare,gCulture
MSC:g ClientgNeedsgCategory:gPsychosocialgIntegrity
5. Agclientgisggoinggtogbegadmittedgforgagscheduledgsurgicalgprocedure.gWhichgactiongdoesgtheg
nursegexplaingisgthegmostgimportantgthinggthegclientgcangdogtogprotectgagainstgerrors?
a. Bringgaglistgofgallgmedicationsgandgwhatgtheygaregfor.
b. Keepg theg provider‘sg phoneg numberg bygtheg telephone.
c. Makegsuregthatg allg providersg washg handsg beforeg enteringg theg room.
d. Writegdowngthegnamegofgeachgcaregivergwhogcomesgingthegroom.
ANS:g A
Medicationgreconciliationgisgagformalgprocessgingwhichgthegclient‘sgactualgcurrentgmedicationsgar
egcomparedgtogthegprescribedgmedicationsgatgthegtimegofgadmission,gtransfer,gorgdischarge.gThisg
NationalgclientgSafetygGoalgisgimportantgtogreducegmedicationgerrors.gThegclientgwouldgnotghav
egtogbegresponsiblegforgprovidersgwashinggtheirghands,gandgevengifgthegclientgdoesgso,gthisgisgtoog
narrowgtogbegthegmostgimportantgactiongtogpreventgerrors.gKeepinggthegprovider‘sgphonegnumbe