TEST BANK FOR MEDICAL SURGICAL NURSING:C
3 3 3 3 3
ONCEPTS FOR CLINICAL JUDGEMENT AND COLLA
3 3 3 3 3
BORATIVE CARE 11TH EDITION IGNATAVICIUS
3 3 3 3
TEST BANK 3
,Test3Bank3-3Medical-Surgical3 Nursing:3Concepts3for3Interprofessional3Collaborative3Care311e 2
Chapter301:3Overview3of3Professional3Nursing3Concepts3for3Medical-Surgical3Nursing
MULTIPLE3CHOICE
A3nurse3wishes3to3provide3client-
centered3care3in3all3interactions.3Which3action3by3the3nurse3bestdemonst
rates3this3concept?
Assesses3for3cultural3influences3affecting3health3care
Ensures3that3all3the3clients3basic3needs3are3met
Tells3the3client3and3family3about3all3upcoming3tests
Thoroughly3orients3the3client3and3family3to3the3room
ANS:3A
Competency3in3client-
focused3care3is3demonstrated3when3the3nurse3focuses3on3communication, 3culture,3re
spect3compassion,3client3education, 3and3empowerment. 3By3assessing3the3effect3of3the
3 clients3culture3on3health3care,3this3nurse3is3practicing3client-
focused3care.3Providing3for3basic3needs3does3not3demonstrate3this3competence. 3Simp
ly3telling3the3client3about3all3upcoming3tests3is3not3providing3empowering3education.
3 Orienting3the3client3and3family3to3the3room3is3an3important3safety3measure,3but3not
3 directly3related3to3demonstrating3client-centered3care.
DIF:3Understanding/Comprehension3REF:33
KEY:3Patient-centered3care|3culture3MSC:3Integrated
Process:3CaringNOT:3Client3Needs3Category:
Psychosocial3Integrity
A3nurse3is3caring3for3a3postoperative3client3on3the3surgical3unit.3The3clients3blood3p
ressure3was3142/763mm3Hg3303minutes3ago,3and3now3is388/503mm3Hg.3What3action3
by3the3nurse3is3best?
Call3the3Rapid3Response3Team.
Document3and3continue3to3monitor.
Notify3the3primary3care3provider.
Repeat3blood3pressure3measurement3in3153minutes.
ANS:3A
The3purpose3of3the3Rapid3Response3Team3(RRT)3is3to3intervene3when3clients3are3dete
riorating3before3they3suffer3either3respiratory3or3cardiac3arrest.3Since3the3client3has3m
,anifested3a3significant3change,3the3nurse3should3call3the3RRT.3Changes3in3blood3pressu
re,3mental3status,3heart3rate,3and3pain3are3particularly3significant.
, Test3Bank3-3Medical-Surgical3 Nursing:3Concepts3for3Interprofessional3Collaborative3Care311e 3
Documentation3is3vital,3but3the3nurse3must3do3more3than3document. 3The3primary3c
are3provider3should3be3notified,3but3this3is3not3the3priority3over3calling3the3RRT.3Th
e3clients3blood3pressure3should3be3reassessed3frequently, 3but3the3priority3is3getting3
the3rapid3care3to3the3client.
DIF:3Applying/Application3REF:33
KEY:3Rapid3Response3Team3(RRT)|3medical
emergencies3MSC:3Integrated3Process:
Communication3and3Documentation
NOT:3Client3Needs3Category:3Physiological3Integrity:3Physiological3Adaptation
A3nurse3is3orienting3a3new3client3and3family3to3the3inpatient3unit.3What3informati
on3does3the3nurse3provide3to3help3the3client3promote3his3or3her3own3safety?
Encourage3the3client3and3family3to3be3active3partners.
Have3the3client3monitor3hand3hygiene3in3caregivers.
Offer3the3family3the3opportunity3to3stay3with3the3client.
Tell3the3client3to3always3wear3his3or3her3armband.
ANS:3A
Each3action3could3be3important3for3the3client3or3family3to3perform. 3However,3enco
uraging3the3client3to3be3active3in3his3or3her3health3care3as3a3partner3is3the3most3cr
itical.3The3other3actions3are3very3limited3in3scope3and3do3not3provide3the3broad3pr
otection3that3being3active3and3involved3does.
DIF:
Understanding/Comprehension
REF:33KEY:3Patient3safety
3 3 3 3 3
ONCEPTS FOR CLINICAL JUDGEMENT AND COLLA
3 3 3 3 3
BORATIVE CARE 11TH EDITION IGNATAVICIUS
3 3 3 3
TEST BANK 3
,Test3Bank3-3Medical-Surgical3 Nursing:3Concepts3for3Interprofessional3Collaborative3Care311e 2
Chapter301:3Overview3of3Professional3Nursing3Concepts3for3Medical-Surgical3Nursing
MULTIPLE3CHOICE
A3nurse3wishes3to3provide3client-
centered3care3in3all3interactions.3Which3action3by3the3nurse3bestdemonst
rates3this3concept?
Assesses3for3cultural3influences3affecting3health3care
Ensures3that3all3the3clients3basic3needs3are3met
Tells3the3client3and3family3about3all3upcoming3tests
Thoroughly3orients3the3client3and3family3to3the3room
ANS:3A
Competency3in3client-
focused3care3is3demonstrated3when3the3nurse3focuses3on3communication, 3culture,3re
spect3compassion,3client3education, 3and3empowerment. 3By3assessing3the3effect3of3the
3 clients3culture3on3health3care,3this3nurse3is3practicing3client-
focused3care.3Providing3for3basic3needs3does3not3demonstrate3this3competence. 3Simp
ly3telling3the3client3about3all3upcoming3tests3is3not3providing3empowering3education.
3 Orienting3the3client3and3family3to3the3room3is3an3important3safety3measure,3but3not
3 directly3related3to3demonstrating3client-centered3care.
DIF:3Understanding/Comprehension3REF:33
KEY:3Patient-centered3care|3culture3MSC:3Integrated
Process:3CaringNOT:3Client3Needs3Category:
Psychosocial3Integrity
A3nurse3is3caring3for3a3postoperative3client3on3the3surgical3unit.3The3clients3blood3p
ressure3was3142/763mm3Hg3303minutes3ago,3and3now3is388/503mm3Hg.3What3action3
by3the3nurse3is3best?
Call3the3Rapid3Response3Team.
Document3and3continue3to3monitor.
Notify3the3primary3care3provider.
Repeat3blood3pressure3measurement3in3153minutes.
ANS:3A
The3purpose3of3the3Rapid3Response3Team3(RRT)3is3to3intervene3when3clients3are3dete
riorating3before3they3suffer3either3respiratory3or3cardiac3arrest.3Since3the3client3has3m
,anifested3a3significant3change,3the3nurse3should3call3the3RRT.3Changes3in3blood3pressu
re,3mental3status,3heart3rate,3and3pain3are3particularly3significant.
, Test3Bank3-3Medical-Surgical3 Nursing:3Concepts3for3Interprofessional3Collaborative3Care311e 3
Documentation3is3vital,3but3the3nurse3must3do3more3than3document. 3The3primary3c
are3provider3should3be3notified,3but3this3is3not3the3priority3over3calling3the3RRT.3Th
e3clients3blood3pressure3should3be3reassessed3frequently, 3but3the3priority3is3getting3
the3rapid3care3to3the3client.
DIF:3Applying/Application3REF:33
KEY:3Rapid3Response3Team3(RRT)|3medical
emergencies3MSC:3Integrated3Process:
Communication3and3Documentation
NOT:3Client3Needs3Category:3Physiological3Integrity:3Physiological3Adaptation
A3nurse3is3orienting3a3new3client3and3family3to3the3inpatient3unit.3What3informati
on3does3the3nurse3provide3to3help3the3client3promote3his3or3her3own3safety?
Encourage3the3client3and3family3to3be3active3partners.
Have3the3client3monitor3hand3hygiene3in3caregivers.
Offer3the3family3the3opportunity3to3stay3with3the3client.
Tell3the3client3to3always3wear3his3or3her3armband.
ANS:3A
Each3action3could3be3important3for3the3client3or3family3to3perform. 3However,3enco
uraging3the3client3to3be3active3in3his3or3her3health3care3as3a3partner3is3the3most3cr
itical.3The3other3actions3are3very3limited3in3scope3and3do3not3provide3the3broad3pr
otection3that3being3active3and3involved3does.
DIF:
Understanding/Comprehension
REF:33KEY:3Patient3safety
