Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical scenario: A medical-surgical nurse receives handoff on
four patients. One patient is postoperative day 1 after
abdominal surgery and now has a blood pressure of 88/54 mm
Hg, heart rate of 118/min, and urine output of 20 mL/hr for the
last 2 hours.
Question stem: What is the nurse’s priority action?
Answer options:
A. Inspect the incision and dressing for bleeding
B. Administer the prescribed opioid for pain
C. Document the findings and recheck in 1 hour
D. Encourage the patient to use the incentive spirometer
Correct answer: A
Detailed rationale: The patient shows cues of possible
hypovolemia or hemorrhage: hypotension, tachycardia, and
decreased urine output. The nurse should immediately assess
for a likely cause, and visible bleeding at the incision is a fast,
relevant check. This reflects clinical judgment by recognizing
deterioration and taking focused action before delay. Pain
treatment, documentation, and incentive spirometry are not
priority actions when perfusion may be compromised.
Incorrect option analysis:
, • B: Incorrect because analgesia does not address possible
shock. Misconception: treating pain first when perfusion is
unstable. Risk: delayed recognition of hemorrhage.
• C: Incorrect because waiting may worsen outcomes.
Misconception: abnormal vital signs can be observed
without intervention. Risk: progression to circulatory
collapse.
• D: Incorrect because pulmonary hygiene is important, but
not before stabilizing circulation. Misconception: all
postoperative care has equal priority. Risk: missed early
shock signs.
Nursing process linkage: Assessment
NCJMM competencies: Recognize Cues; Take Action
Difficulty level: Difficult
Bloom’s level: Analyze
NCLEX client needs category: Physiological Adaptation
Key learning objective: Prioritize assessment and intervention
for signs of postoperative instability.
2) MCQ
Clinical scenario: A nurse is caring for an adult with chronic
heart failure who says, “I know the provider wants me to walk
more, but I only want to sit in the chair because I get tired.”
Question stem: Which nursing action best reflects patient-
centered care?
, Answer options:
A. Explain that walking is required for all heart failure patients
B. Ask the patient about personal goals and barriers, then plan
activity together
C. Document noncompliance with the exercise plan
D. Tell the patient to follow the care plan exactly as written
Correct answer: B
Detailed rationale: Patient-centered care means incorporating
the patient’s values, symptoms, preferences, and realistic goals
into the plan. Asking about barriers and collaborating on a plan
supports engagement and self-management. This approach
improves adherence and outcomes because the care plan
becomes meaningful and feasible.
Incorrect option analysis:
• A: Incorrect because it is directive, not collaborative.
Misconception: standard teaching fits every person
equally. Risk: reduced trust and poor adherence.
• C: Incorrect because it is judgmental and does not solve
the problem. Misconception: refusal equals
noncompliance rather than a clue to barriers. Risk:
damaged therapeutic relationship.
• D: Incorrect because it ignores the patient’s lived
experience. Misconception: patient-centered care means
passive compliance. Risk: poor follow-through and unmet
needs.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical scenario: A medical-surgical nurse receives handoff on
four patients. One patient is postoperative day 1 after
abdominal surgery and now has a blood pressure of 88/54 mm
Hg, heart rate of 118/min, and urine output of 20 mL/hr for the
last 2 hours.
Question stem: What is the nurse’s priority action?
Answer options:
A. Inspect the incision and dressing for bleeding
B. Administer the prescribed opioid for pain
C. Document the findings and recheck in 1 hour
D. Encourage the patient to use the incentive spirometer
Correct answer: A
Detailed rationale: The patient shows cues of possible
hypovolemia or hemorrhage: hypotension, tachycardia, and
decreased urine output. The nurse should immediately assess
for a likely cause, and visible bleeding at the incision is a fast,
relevant check. This reflects clinical judgment by recognizing
deterioration and taking focused action before delay. Pain
treatment, documentation, and incentive spirometry are not
priority actions when perfusion may be compromised.
Incorrect option analysis:
, • B: Incorrect because analgesia does not address possible
shock. Misconception: treating pain first when perfusion is
unstable. Risk: delayed recognition of hemorrhage.
• C: Incorrect because waiting may worsen outcomes.
Misconception: abnormal vital signs can be observed
without intervention. Risk: progression to circulatory
collapse.
• D: Incorrect because pulmonary hygiene is important, but
not before stabilizing circulation. Misconception: all
postoperative care has equal priority. Risk: missed early
shock signs.
Nursing process linkage: Assessment
NCJMM competencies: Recognize Cues; Take Action
Difficulty level: Difficult
Bloom’s level: Analyze
NCLEX client needs category: Physiological Adaptation
Key learning objective: Prioritize assessment and intervention
for signs of postoperative instability.
2) MCQ
Clinical scenario: A nurse is caring for an adult with chronic
heart failure who says, “I know the provider wants me to walk
more, but I only want to sit in the chair because I get tired.”
Question stem: Which nursing action best reflects patient-
centered care?
, Answer options:
A. Explain that walking is required for all heart failure patients
B. Ask the patient about personal goals and barriers, then plan
activity together
C. Document noncompliance with the exercise plan
D. Tell the patient to follow the care plan exactly as written
Correct answer: B
Detailed rationale: Patient-centered care means incorporating
the patient’s values, symptoms, preferences, and realistic goals
into the plan. Asking about barriers and collaborating on a plan
supports engagement and self-management. This approach
improves adherence and outcomes because the care plan
becomes meaningful and feasible.
Incorrect option analysis:
• A: Incorrect because it is directive, not collaborative.
Misconception: standard teaching fits every person
equally. Risk: reduced trust and poor adherence.
• C: Incorrect because it is judgmental and does not solve
the problem. Misconception: refusal equals
noncompliance rather than a clue to barriers. Risk:
damaged therapeutic relationship.
• D: Incorrect because it ignores the patient’s lived
experience. Misconception: patient-centered care means
passive compliance. Risk: poor follow-through and unmet
needs.
