Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
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Chapter 01: Introduction to Medical-
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Surgical Nursing Practice in Canada Lewis: Medical-
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Surgical Nursing in Canada, 5th Canadian Edition
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NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank #t #t #t #t #t #t #t #t
MULTIPLE CHOICE #t
1. When caring for clients using evidence-
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informed practice, which of the following does the nurse use?
#t #t #t #t #t #t #t #t #t
a. Clinical judgement based on experience #t #t #t #t
b. Evidence from a clinical research study #t #t #t #t #t
c. The best available evidence to guide clinical expertise
#t #t #t #t #t #t #t
d. Evaluation of data showing that the client outcomes are met #t #t #t #t #t #t #t #t #t
ANS: C # t
Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscienti
#t #t #t #t #t #t #t #t #t #t #t
ous, and judicious consideration of the best available evidence to provide care. Four primary el
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
ements are: (a) clinical state, setting, and circumstances; (b) client preferences and actions; (c)
#t #t #t #t #t #t #t #t #t #t #t #t #t
best research evidence; and (d) health care resources. Clinical judgement based on the nurse‘s
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
clinical experience is part of EIP, but clinical decision making also should incorporate current
#t #t #t #t #t #t #t #t #t #t #t #t #t #
research and research-
t #t #t
based guidelines. Evidence from one clinical research study does not provide an adequate sub
#t #t #t #t #t #t #t #t #t #t #t #t #t
stantiation for interventions. Evaluation of client outcomes is important, but interventions sho
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uld be based on research from randomized control studies with a large number of subjects.
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DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Planning #t #t
2. Which of the following best N
#t e x p lRa i n sIt h eGn u B
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e sC
#t imary use of the nursing process when #t #t #t #t #t #t #t #t #t
providing care to clients? USNT O
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a. To explain nursing interventions to other health care professionals
#t #t #t #t #t #t #t #t
b. As a problem-solving tool to identify and treat clients‘ health care needs
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c. As a scientific-based process of diagnosing the client‘s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
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ANS: B # t
The nursing process is an assertive problem-
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solving approach to the identification and treatment of clients‘ problems. Diagnosis is only on
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e phase of the nursing process. The
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primary use of the nursing process is in client care, not to establish nursing theory or explain n
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
ursing interventions to other health care professionals.
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DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Implementation #t #t
3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-
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hour turning schedule to prevent skin breakdown. Which type of nursing function is demonstr
#t #t #t #t #t #t #t #t #t #t #t #t #t
ated with this turning schedule?
#t #t #t #t
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D # t
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank #t #t #t #t #t #t #t #t
When implementing collaborative nursing actions, the nurse is responsible primarily for moni
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toring for complications of acute illness or providing care to prevent or treat complications. I
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
ndependent nursing actions are focused on health promotion, illness prevention, and client ad
#t #t #t #t #t #t #t #t #t #t #t #t
vocacy. A dependent action would require a physician order to implement. Cooperative nursi
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ng functions are not described as one of the formal nursing functions.
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DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Implementation #t #t
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which action shou
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
ld the nurse take next?
#t #t #t #t
a. Reassure the client that these feelings are common for parents. #t #t #t #t #t #t #t #t #t
b. Have the client call the children to ensure that they are doing well.
#t #t #t #t #t #t #t #t #t #t #t #t
c. Call the neighbour to determine whether adequate childcare is being provided.
#t #t #t #t #t #t #t #t #t #t
d. Gather more data about the client‘s feelings about the childcare arrangements.
#t #t #t #t #t #t #t #t #t #t
ANS: D # t
Since a complete assessment is necessary in order to identify a problem and choose an approp
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
riate intervention, the nurse‘s first action should be to obtain more information. The other acti
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ons may be appropriate, but more assessment is needed before the best intervention can be cho
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sen.
DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Assessment #t #t
5. The nurse is caring for a client who has left-
#t #t #t #t #t #t #t #t #t
sided paralysis as the result of a stroke and assesses a pressure injury o n t h e cl i e nt ‘s l
N R I G
#t #t #t #t #t #t #t #t #t #t #t #t #t
eft h i p . W hich of the following is the most
B. C M
#t #t #t #t #t #t #t
appropriate nursing diagnosis fUo r t S
h i s cNl i e nTt ? O
#t #t #t #t #t
a. Impaired physical mobility related to decrease in muscle control (left-
#t #t #t #t #t #t #t #t #t
sided paralysis) #t
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
#t #t #t #t #t #t #t #t #t #t #
protecting tissue integrity
t #t #t
c. Impaired skin integrity related to pressure over bony prominence (impaired
#t #t #t #t #t #t #t #t #t #t
circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle #t #t #t #t #t #t
ANS: C # t
The client‘s major problem is the impaired skin integrity as demonstrated by the presence of a
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
pressure injury. The nurse is able to treat the cause of altered circulation and pressure by freq
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
uently repositioning the client. Although left-sided weakness is a problem for the client,
#t #t #t #t #t #t #t #t #t #t #t #t
the nurse cannot treat the weakness. The ―risk for‖ diagnosis is not appropriate for this client,
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
who already has impaired tissue integrity. The client does have ineffective tissue perfusion, b
#t #t #t #t #t #t #t #t #t #t #t #t #t
ut the impaired skin integrity diagnosis indicates more clearly what the health problem is.
#t #t #t #t #t #t #t #t #t #t #t #t #t
DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Diagnosis #t #t
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
volume related to excessive diaphoresis. Which of the following is an appropriate client
#t #t #t #t #t #t #t #t #t #t #t #t #t
outcome?
#t
a. Client has a balanced intake and output. #t #t #t #t #t #t
b. Client‘s bedding is changed when it becomes damp. #t #t #t #t #t #t #t
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank #t #t #t #t #t #t #t #t
c. Client understands the need for increased fluid intake.
#t #t #t #t #t #t #t
d. Client‘s skin remains cool and dry throughout hospitalization.
#t #t #t #t #t #t #t
ANS: A # t
This statement gives measurable data showing resolution of the problem of deficient fluid vol
#t #t #t #t #t #t #t #t #t #t #t #t #t
ume that was identified in the nursing diagnosis statement. The other statements would not ind
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
icate that the problem of deficient fluid volume was resolved.
#t #t #t #t #t #t #t #t #t
DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Planning #t #t
7. Which of the following represents a nursing activity that is carried out during the evaluation
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #
phase of the nursing process?
t #t #t #t #t
a. Determining if interventions have been effective in meeting client outcomes #t #t #t #t #t #t #t #t #t
b. Documenting the nursing care plan in the progress notes in the medical record #t #t #t #t #t #t #t #t #t #t #t #t
c. Deciding whether the client‘s health problems have been completely resolved
#t #t #t #t #t #t #t #t #t
d. Asking the client to evaluate whether the nursing care provided was satisfactory
#t #t #t #t #t #t #t #t #t #t #t
ANS: A # t
Evaluation consists of determining whether the desired client outcomes have been met and w
#t #t #t #t #t #t #t #t #t #t #t #t #t
hether the nursing interventions were appropriate. The other responses do not describe the eva
#t #t #t #t #t #t #t #t #t #t #t #t #t
luation phase. #t
DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Evaluation #t #t
8. Which of the following would the nurse perform during the assessment phase of the nursing
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
process?
a. Obtains data with which to diagnose client problems #t #t #t #t #t #t #t
b. Uses client data to develoNp pR I
i t yTnGursB
in.
gC iagMnoses
Urior
SN
#t dO
c. Teaches interventions to relieve client health problems#t
#t #t #t
#t #t
#t
#t #t
#t
#t
#t
#t
#t
#t
d. Assists the client to identify realistic outcomes to health problems
#t #t #t #t #t #t #t #t #t
ANS: A # t
During the assessment phase, the nurse gathers information about the client. The other respon
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ses are examples of the intervention, diagnosis, and planning phases of the nursing process.
#t #t #t #t #t #t #t #t #t #t #t #t #t
DIF: Cognitive Level: Knowledge #t #t TOP: # t Nursing Process: Assessment #t #t
9. Which of the following is an example of a correctly written nursing diagnosis statement?
#t #t #t #t #t #t #t #t #t #t #t #t #t
a. Altered tissue perfusion related to heart failure #t #t #t #t #t #t
b. Risk for impaired tissue integrity related to sacral redness
#t #t #t #t #t #t #t #t
c. Ineffective coping related to insufficient sense of control. #t #t #t #t #t #t #t
d. Altered urinary elimination related to urinary tract infection
#t #t #t #t #t #t #t
ANS: C # t
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
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a client‘s response to a health problem that can be treated by nursing. The use of a medical d
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
iagnosis (as in the responses beginning ―Altered tissue perfusion‖ and ―Altered urinary
#t #t #t #t #t #t #t #t #t #t #t
elimination‖) is not appropriate. The response beginning ―Risk for impaired tissue integrity‖ us
#t #t #t #t #t #t #t #t #t #t #t #t
es the defining characteristics as the etiology.
#t #t #t #t #t #t
DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Diagnosis #t #t
NURSINGTB.COM
#t #t #t #t #t #t #t #t
Chapter 01: Introduction to Medical-
#t #t #t #t
Surgical Nursing Practice in Canada Lewis: Medical-
#t #t #t #t #t #t
Surgical Nursing in Canada, 5th Canadian Edition
#t #t #t #t #t #t
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank #t #t #t #t #t #t #t #t
MULTIPLE CHOICE #t
1. When caring for clients using evidence-
#t #t #t #t #t
informed practice, which of the following does the nurse use?
#t #t #t #t #t #t #t #t #t
a. Clinical judgement based on experience #t #t #t #t
b. Evidence from a clinical research study #t #t #t #t #t
c. The best available evidence to guide clinical expertise
#t #t #t #t #t #t #t
d. Evaluation of data showing that the client outcomes are met #t #t #t #t #t #t #t #t #t
ANS: C # t
Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscienti
#t #t #t #t #t #t #t #t #t #t #t
ous, and judicious consideration of the best available evidence to provide care. Four primary el
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
ements are: (a) clinical state, setting, and circumstances; (b) client preferences and actions; (c)
#t #t #t #t #t #t #t #t #t #t #t #t #t
best research evidence; and (d) health care resources. Clinical judgement based on the nurse‘s
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
clinical experience is part of EIP, but clinical decision making also should incorporate current
#t #t #t #t #t #t #t #t #t #t #t #t #t #
research and research-
t #t #t
based guidelines. Evidence from one clinical research study does not provide an adequate sub
#t #t #t #t #t #t #t #t #t #t #t #t #t
stantiation for interventions. Evaluation of client outcomes is important, but interventions sho
#t #t #t #t #t #t #t #t #t #t #t
uld be based on research from randomized control studies with a large number of subjects.
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Planning #t #t
2. Which of the following best N
#t e x p lRa i n sIt h eGn u B
#t r s. ‘ prM
e sC
#t imary use of the nursing process when #t #t #t #t #t #t #t #t #t
providing care to clients? USNT O
#t #t #t #t #t #t
a. To explain nursing interventions to other health care professionals
#t #t #t #t #t #t #t #t
b. As a problem-solving tool to identify and treat clients‘ health care needs
#t #t #t #t #t #t #t #t #t #t #t
c. As a scientific-based process of diagnosing the client‘s health care problems
#t #t #t #t #t #t #t #t #t #t
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
#t #t #t #t #t #t #t #t #t #t
ANS: B # t
The nursing process is an assertive problem-
#t #t #t #t #t #t
solving approach to the identification and treatment of clients‘ problems. Diagnosis is only on
#t #t #t #t #t #t #t #t #t #t #t #t #t
e phase of the nursing process. The
#t #t #t #t #t #t
primary use of the nursing process is in client care, not to establish nursing theory or explain n
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
ursing interventions to other health care professionals.
#t #t #t #t #t #t
DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Implementation #t #t
3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
hour turning schedule to prevent skin breakdown. Which type of nursing function is demonstr
#t #t #t #t #t #t #t #t #t #t #t #t #t
ated with this turning schedule?
#t #t #t #t
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D # t
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank #t #t #t #t #t #t #t #t
When implementing collaborative nursing actions, the nurse is responsible primarily for moni
#t #t #t #t #t #t #t #t #t #t #t
toring for complications of acute illness or providing care to prevent or treat complications. I
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
ndependent nursing actions are focused on health promotion, illness prevention, and client ad
#t #t #t #t #t #t #t #t #t #t #t #t
vocacy. A dependent action would require a physician order to implement. Cooperative nursi
#t #t #t #t #t #t #t #t #t #t #t #t
ng functions are not described as one of the formal nursing functions.
#t #t #t #t #t #t #t #t #t #t #t
DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Implementation #t #t
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which action shou
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
ld the nurse take next?
#t #t #t #t
a. Reassure the client that these feelings are common for parents. #t #t #t #t #t #t #t #t #t
b. Have the client call the children to ensure that they are doing well.
#t #t #t #t #t #t #t #t #t #t #t #t
c. Call the neighbour to determine whether adequate childcare is being provided.
#t #t #t #t #t #t #t #t #t #t
d. Gather more data about the client‘s feelings about the childcare arrangements.
#t #t #t #t #t #t #t #t #t #t
ANS: D # t
Since a complete assessment is necessary in order to identify a problem and choose an approp
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
riate intervention, the nurse‘s first action should be to obtain more information. The other acti
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
ons may be appropriate, but more assessment is needed before the best intervention can be cho
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
sen.
DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Assessment #t #t
5. The nurse is caring for a client who has left-
#t #t #t #t #t #t #t #t #t
sided paralysis as the result of a stroke and assesses a pressure injury o n t h e cl i e nt ‘s l
N R I G
#t #t #t #t #t #t #t #t #t #t #t #t #t
eft h i p . W hich of the following is the most
B. C M
#t #t #t #t #t #t #t
appropriate nursing diagnosis fUo r t S
h i s cNl i e nTt ? O
#t #t #t #t #t
a. Impaired physical mobility related to decrease in muscle control (left-
#t #t #t #t #t #t #t #t #t
sided paralysis) #t
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
#t #t #t #t #t #t #t #t #t #t #
protecting tissue integrity
t #t #t
c. Impaired skin integrity related to pressure over bony prominence (impaired
#t #t #t #t #t #t #t #t #t #t
circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle #t #t #t #t #t #t
ANS: C # t
The client‘s major problem is the impaired skin integrity as demonstrated by the presence of a
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
pressure injury. The nurse is able to treat the cause of altered circulation and pressure by freq
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
uently repositioning the client. Although left-sided weakness is a problem for the client,
#t #t #t #t #t #t #t #t #t #t #t #t
the nurse cannot treat the weakness. The ―risk for‖ diagnosis is not appropriate for this client,
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
who already has impaired tissue integrity. The client does have ineffective tissue perfusion, b
#t #t #t #t #t #t #t #t #t #t #t #t #t
ut the impaired skin integrity diagnosis indicates more clearly what the health problem is.
#t #t #t #t #t #t #t #t #t #t #t #t #t
DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Diagnosis #t #t
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
volume related to excessive diaphoresis. Which of the following is an appropriate client
#t #t #t #t #t #t #t #t #t #t #t #t #t
outcome?
#t
a. Client has a balanced intake and output. #t #t #t #t #t #t
b. Client‘s bedding is changed when it becomes damp. #t #t #t #t #t #t #t
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank #t #t #t #t #t #t #t #t
c. Client understands the need for increased fluid intake.
#t #t #t #t #t #t #t
d. Client‘s skin remains cool and dry throughout hospitalization.
#t #t #t #t #t #t #t
ANS: A # t
This statement gives measurable data showing resolution of the problem of deficient fluid vol
#t #t #t #t #t #t #t #t #t #t #t #t #t
ume that was identified in the nursing diagnosis statement. The other statements would not ind
#t #t #t #t #t #t #t #t #t #t #t #t #t #t
icate that the problem of deficient fluid volume was resolved.
#t #t #t #t #t #t #t #t #t
DIF: Cognitive Level: Application #t #t TOP: # t Nursing Process: Planning #t #t
7. Which of the following represents a nursing activity that is carried out during the evaluation
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #
phase of the nursing process?
t #t #t #t #t
a. Determining if interventions have been effective in meeting client outcomes #t #t #t #t #t #t #t #t #t
b. Documenting the nursing care plan in the progress notes in the medical record #t #t #t #t #t #t #t #t #t #t #t #t
c. Deciding whether the client‘s health problems have been completely resolved
#t #t #t #t #t #t #t #t #t
d. Asking the client to evaluate whether the nursing care provided was satisfactory
#t #t #t #t #t #t #t #t #t #t #t
ANS: A # t
Evaluation consists of determining whether the desired client outcomes have been met and w
#t #t #t #t #t #t #t #t #t #t #t #t #t
hether the nursing interventions were appropriate. The other responses do not describe the eva
#t #t #t #t #t #t #t #t #t #t #t #t #t
luation phase. #t
DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Evaluation #t #t
8. Which of the following would the nurse perform during the assessment phase of the nursing
#t #t #t #t #t #t #t #t #t #t #t #t #t #t #t
process?
a. Obtains data with which to diagnose client problems #t #t #t #t #t #t #t
b. Uses client data to develoNp pR I
i t yTnGursB
in.
gC iagMnoses
Urior
SN
#t dO
c. Teaches interventions to relieve client health problems#t
#t #t #t
#t #t
#t
#t #t
#t
#t
#t
#t
#t
#t
d. Assists the client to identify realistic outcomes to health problems
#t #t #t #t #t #t #t #t #t
ANS: A # t
During the assessment phase, the nurse gathers information about the client. The other respon
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ses are examples of the intervention, diagnosis, and planning phases of the nursing process.
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DIF: Cognitive Level: Knowledge #t #t TOP: # t Nursing Process: Assessment #t #t
9. Which of the following is an example of a correctly written nursing diagnosis statement?
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a. Altered tissue perfusion related to heart failure #t #t #t #t #t #t
b. Risk for impaired tissue integrity related to sacral redness
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c. Ineffective coping related to insufficient sense of control. #t #t #t #t #t #t #t
d. Altered urinary elimination related to urinary tract infection
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ANS: C # t
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
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a client‘s response to a health problem that can be treated by nursing. The use of a medical d
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iagnosis (as in the responses beginning ―Altered tissue perfusion‖ and ―Altered urinary
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elimination‖) is not appropriate. The response beginning ―Risk for impaired tissue integrity‖ us
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es the defining characteristics as the etiology.
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DIF: Cognitive Level: Comprehension #t #t TOP: # t Nursing Process: Diagnosis #t #t
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