Practical Nursing in Canada, 1st Edition
Authors:
Katherine Poser,Adrianne Dill Linton,Mary
Ann Matteson
TEST BANK.
1. A 68-year-old postoperative patient is receiving opioid
analgesia and is drowsy but arousable. Which nursing
action is the highest priority?
A. Encourage the patient to void.
B. Assess respiratory rate and oxygen saturation.
C. Offer ice chips for dry mouth.
D. Help the patient ambulate in the hall.
,Correct answer: B. Assess respiratory rate and oxygen
saturation.
Rationale: Opioids risk respiratory depression; airway and
breathing assessment take precedence to ensure safety.
Citation: Linton & Matteson, 1st ed.; Chapter: Aspects of
Medical-Surgical Nursing.
2. Which statement best describes the practical nurse’s
primary role in evidence-based practice (EBP) in a medical-
surgical setting?
A. Independently design randomized clinical trials.
B. Apply current best evidence to inform daily nursing care
and report outcomes.
C. Replace clinical judgment with protocols only.
D. Delegate EBP responsibilities solely to RNs.
Correct answer: B. Apply current best evidence to inform daily
nursing care and report outcomes.
Rationale: Practical nurses implement evidence-based
interventions within scope and contribute observations that
inform practice.
Citation: Linton & Matteson, 1st ed.; Chapter: Aspects of
Medical-Surgical Nursing.
3. Select all that apply — Which actions are appropriate
when delegating a basic task to a nursing assistant?
, A. Provide clear, task-specific instructions.
B. Delegate monitoring of patients receiving IV potassium.
C. Confirm the assistant’s competency for the delegated
task.
D. Instruct the assistant to report changes in patient
condition immediately.
E. Delegate medication administration without
supervision.
Correct answers: A, C, D.
Rationale: Delegation requires clarity, verification of
competency, and instruction to report changes. Tasks requiring
clinical judgment or medication administration (B, E) are not
appropriate to delegate to unlicensed staff.
Citation: Linton & Matteson, 1st ed.; Chapter: Aspects of
Medical-Surgical Nursing.
4. A practical nurse documents "patient appears anxious" in
the chart. Which documentation revision would be most
appropriate?
A. Leave as written — it’s subjective.
B. Add a nursing note: "Patient anxious; started on
lorazepam."
C. Replace with objective data: "Patient reports
palpitations, respiratory rate 24/min, states ‘I feel
nervous’."
D. Delete the note — avoid recording feelings.
, Correct answer: C. Replace with objective data: "Patient reports
palpitations, respiratory rate 24/min, states ‘I feel nervous’."
Rationale: Documentation should be objective, specific, and
include direct patient statements and measurable signs.
Citation: Linton & Matteson, 1st ed.; Chapter: Aspects of
Medical-Surgical Nursing.
5. A patient with a latex allergy is scheduled for a dressing
change. Which intervention best demonstrates patient
safety and advocacy?
A. Proceed using facility standard supplies.
B. Ask the patient if they “think” they’re allergic and
proceed if unsure.
C. Confirm allergy in chart, ensure latex-free supplies, and
notify the care team.
D. Delegate the dressing change to a student without
mentioning the allergy.
Correct answer: C. Confirm allergy in chart, ensure latex-free
supplies, and notify the care team.
Rationale: Confirming allergy and ensuring latex-free
environment prevents anaphylaxis and is advocacy.
Citation: Linton & Matteson, 1st ed.; Chapter: Aspects of
Medical-Surgical Nursing.