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 74-year-old postoperative patient is more confused than
earlier in the shift. Vital signs are T 38.6°C (101.5°F), HR
112/min, RR 28/min, BP 94/58 mm Hg, and SpO₂ 90% on room
air.
Question Stem:
What is the nurse’s first action?
Answer Options:
A. Assess oxygen saturation and lung sounds
B. Document the findings and reassess at the end of the shift
C. Offer oral fluids and encourage rest
D. Administer acetaminophen and wait for the fever to resolve
Correct Answer:
A
Detailed Rationale:
The patient shows cues of possible clinical deterioration,
including tachypnea, hypotension, fever, and new confusion.
The nurse should immediately assess oxygenation and
respiratory status because impaired oxygen delivery may be
contributing to altered mental status and instability. This
reflects the assessment step of the nursing process and the
NCJMM skill of Recognize Cues.
Incorrect Option Analysis:
• B: Incorrect because delayed documentation without
action can worsen outcomes.
, • C: Incorrect because fluids may be appropriate later, but
airway/breathing assessment comes first.
• D: Incorrect because treating fever alone ignores the
unstable presentation and delays urgent evaluation.
Nursing Process Linkage: Assessment
Clinical Judgment Competency: Recognize Cues
Difficulty Level: Moderate
Bloom’s Cognitive Level: Apply
NCLEX Client Needs Category: Physiological Adaptation
Key Learning Objective: Identify early deterioration cues and
prioritize immediate nursing assessment.
2) MCQ
Clinical Scenario:
A newly licensed nurse asks what makes evidence-based
nursing care different from “just following routine.”
Question Stem:
Which statement by the preceptor best explains evidence-
based nursing care?
Answer Options:
A. “It means following the same nursing routine that worked
last year.”
B. “It combines best current evidence, clinical expertise, and
patient preferences.”
C. “It means following physician preference as the main guide.”
, D. “It means using only randomized controlled trials for every
decision.”
Correct Answer:
B
Detailed Rationale:
Evidence-based practice integrates best available evidence,
clinical expertise, and patient values/preferences. It supports
safe, individualized care and better outcomes.
Incorrect Option Analysis:
• A: Incorrect; routine alone may be outdated or ineffective.
• C: Incorrect; interprofessional input matters, but nursing
care is not based only on physician preference.
• D: Incorrect; randomized trials are valuable, but nursing
decisions also use guidelines, quality data, and clinical
judgment.
Nursing Process Linkage: Planning
Clinical Judgment Competency: Generate Solutions
Difficulty Level: Easy
Bloom’s Cognitive Level: Understand
NCLEX Client Needs Category: Management of Care
Key Learning Objective: Describe the meaning of evidence-
based nursing care.
3) SATA
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
1) MCQ
,Clinical Scenario:
A 74-year-old postoperative patient is more confused than
earlier in the shift. Vital signs are T 38.6°C (101.5°F), HR
112/min, RR 28/min, BP 94/58 mm Hg, and SpO₂ 90% on room
air.
Question Stem:
What is the nurse’s first action?
Answer Options:
A. Assess oxygen saturation and lung sounds
B. Document the findings and reassess at the end of the shift
C. Offer oral fluids and encourage rest
D. Administer acetaminophen and wait for the fever to resolve
Correct Answer:
A
Detailed Rationale:
The patient shows cues of possible clinical deterioration,
including tachypnea, hypotension, fever, and new confusion.
The nurse should immediately assess oxygenation and
respiratory status because impaired oxygen delivery may be
contributing to altered mental status and instability. This
reflects the assessment step of the nursing process and the
NCJMM skill of Recognize Cues.
Incorrect Option Analysis:
• B: Incorrect because delayed documentation without
action can worsen outcomes.
, • C: Incorrect because fluids may be appropriate later, but
airway/breathing assessment comes first.
• D: Incorrect because treating fever alone ignores the
unstable presentation and delays urgent evaluation.
Nursing Process Linkage: Assessment
Clinical Judgment Competency: Recognize Cues
Difficulty Level: Moderate
Bloom’s Cognitive Level: Apply
NCLEX Client Needs Category: Physiological Adaptation
Key Learning Objective: Identify early deterioration cues and
prioritize immediate nursing assessment.
2) MCQ
Clinical Scenario:
A newly licensed nurse asks what makes evidence-based
nursing care different from “just following routine.”
Question Stem:
Which statement by the preceptor best explains evidence-
based nursing care?
Answer Options:
A. “It means following the same nursing routine that worked
last year.”
B. “It combines best current evidence, clinical expertise, and
patient preferences.”
C. “It means following physician preference as the main guide.”
, D. “It means using only randomized controlled trials for every
decision.”
Correct Answer:
B
Detailed Rationale:
Evidence-based practice integrates best available evidence,
clinical expertise, and patient values/preferences. It supports
safe, individualized care and better outcomes.
Incorrect Option Analysis:
• A: Incorrect; routine alone may be outdated or ineffective.
• C: Incorrect; interprofessional input matters, but nursing
care is not based only on physician preference.
• D: Incorrect; randomized trials are valuable, but nursing
decisions also use guidelines, quality data, and clinical
judgment.
Nursing Process Linkage: Planning
Clinical Judgment Competency: Generate Solutions
Difficulty Level: Easy
Bloom’s Cognitive Level: Understand
NCLEX Client Needs Category: Management of Care
Key Learning Objective: Describe the meaning of evidence-
based nursing care.
3) SATA
