TESTBANK
FOR
L
J
JL
MEDICAL SURGICAL
JL
JL NURSING9TH EDITION
JL
J L
JL IGNAVATICIUS
,Chapter 1: Introduction to Medical-Surgical Nursing Practice
JL JL JL JL JL JL
Ignatavicius: Medical-Surgical Nursing, 8th Edition
JL JL JL JL JL
MULTIPLE CHOICE JL
1. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The
JL JL JL JL JL JL JL JL JL JL JL JL JL
preceptor advises the student that which is the priority when working as a professional
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
nurse?
JL
a. Attending to holistic client needs JL JL JL JL
b. Ensuring client safety JL JL
c. Not making medication errors JL JL JL
d. Providing client-focused care JL JL
ANS: B J L J L
All actions are appropriate for the professional nurse. However, ensuring client safety is the
JL JL JL JL JL JL JL JL JL JL JL JL JL
priority. Up to 98,000 deaths result each year from errors in hospital care, according to the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
2000 Institute of Medicine report. Many more clients have suffered injuries and less serious
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
outcomes. Every nurse has the responsibility to guard the client’s safety.
JL JL JL JL JL JL JL JL JL JL JL
DIF: Understanding/Comprehension REF: 2 KEY: Patient J L
safety MSC: Integrated Process: Nursing Process: Intervention
JL JL J L JL JL JL JL
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
J L JL JL JL JL JL JL JL JL JL JL
Control
JL
2. A nurse is orienting a new client and family to the inpatient unit. What information does the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
nurse provide to help the client promote his or her own safety?
JL JL JL JL JL JL JL JL JL JL JL JL
a. Encourage the client and family to be active partners. JL JL JL JL JL JL JL JL
b. Have the client monitor hand hygiene in caregivers. JL JL JL JL JL JL JL
c. Offer the family the opportunity to stay with the client. JL JL JL JL JL JL JL JL JL
d. Tell the client to always wear his or her armband.
JL JL JL JL JL JL JL JL JL
ANS: A J L J L
Each action could be important for the client or family to perform. However, encouraging the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
client to be active in his or her health care as a partner is the most critical. The other actions
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
are very limited in scope and do not provide the broad protection that being active and
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
involved does.
JL JL
DIF: Understanding/Comprehension REF: 3 KEY: Patient J L
safety MSC: Integrated Process: Teaching/Learning
JL JL J L JL JL
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
J L JL JL JL JL JL JL JL JL JL JL
Control
JL
3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
best?
JL
a. Call the Rapid Response Team. JL JL JL JL
b. Document and continue to monitor. JL JL JL JL
c. Notify the primary care provider. JL JL JL JL
d. Repeat blood pressure measurement in 15 minutes. JL JL JL JL JL JL
, ANS: A J L J L
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
before they suffer either respiratory or cardiac arrest. Since the client has manifested a
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
significant change, the nurse should call the RRT. Changes in blood pressure, mental status,
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
heart rate, and pain are particularly significant. Documentation is vital, but the nurse must do
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
more than document. The primary care provider should be notified, but this is not the priority
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
over calling the RRT. The client’s blood pressure should be reassessed frequently, but the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
priority is getting the rapid care to the client.
JL JL JL JL JL JL JL JL JL
DIF: Applying/Application REF: 3
KEY: Rapid Response Team (RRT)| medical
J L J L JL JL JL JL
emergencies
JL
MSC: Integrated Process: Communication and Documentation
J L JL JL JL JL
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
J L JL JL JL JL JL JL
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
best demonstrates this concept?
JL JL JL JL
a. Assesses for cultural influences affecting health care JL JL JL JL JL JL
b. Ensures that all the clients’ basic needs are met JL JL JL JL JL JL JL JL
c. Tells the client and family about all upcoming tests JL JL JL JL JL JL JL JL
d. Thoroughly orients the client and family to the room JL JL JL JL JL JL JL JL
ANS: A J L J L
Competency in client-focused care is demonstrated when the nurse focuses on JL JL JL JL JL JL JL JL JL JL
communication, culture, respect, compassion, client education, and empowerment. By
JL JL JL JL JL JL JL JL JL
assessing the effect of the client’s culture on health care, this nurse is practicing
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
client-focused care. Providing for basic needs does not demonstrate this competence. Simply JL JL JL JL JL JL JL JL JL JL JL
telling the client about all upcoming tests is not providing empowering education. Orienting
JL JL JL JL JL JL JL JL JL JL JL JL JL
the client and family to the room is an important safety measure, but not directly related to
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
demonstrating client-centered care.
JL JL JL
DIF: Understanding/Comprehension REF: 3
KEY: Patient-centered care| culture MSC: Integrated Process:
J L JL JL J L JL
Caring NOT: Client Needs Category: Psychosocial Integrity
JL JL J L JL JL JL JL
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
nurse explain is the most important thing the client can do to protect against errors?
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
a. Bring a list of all medications and what they are for. JL JL JL JL JL JL JL JL JL JL
b. Keep the doctor’s phone number by the telephone. JL JL JL JL JL JL JL
c. Make sure all providers wash hands before entering the room. JL JL JL JL JL JL JL JL JL
d. Write down the name of each caregiver who comes in the room. JL JL JL JL JL JL JL JL JL JL JL
ANS: A J L J L
Medication errors are the most common type of health care mistake. The Joint Commission’sJL JL JL JL JL JL JL JL JL JL JL JL JL
Speak Up campaign encourages clients to help ensure their safety. One recommendation is
JL JL JL JL JL JL JL JL JL JL JL JL JL
for clients to know all their medications and why they take them. This will help prevent
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
medication errors.
JL JL
DIF: Applying/Application REF: 4
KEY: Speak Up campaign| patient safety MSC: Integrated Process: Teaching/Learning
J L JL JL JL JL J L JL JL
, NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
J L JL JL JL JL JL JL JL JL JL JL
Control
JL
6. Which action by the nurse working with a client best demonstrates respect for autonomy?
JL JL JL JL JL JL JL JL JL JL JL JL JL
a. Asks if the client has questions before signing a consent
JL JL JL JL JL JL JL JL JL
b. Gives the client accurate information when questioned JL JL JL JL JL JL
c. Keeps the promises made to the client and family JL JL JL JL JL JL JL JL
d. Treats the client fairly compared to other clients JL JL JL JL JL JL JL
ANS: A J L J L
Autonomy is self-determination. The client should make decisions regarding care. When the
JL JL JL JL JL JL JL JL JL JL JL
nurse obtains a signature on the consent form, assessing if the client still has questions is
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
vital, because without full information the client cannot practice autonomy. Giving accurate
JL JL JL JL JL JL JL JL JL JL JL JL
information is practicing with veracity. Keeping promises is upholding fidelity. Treating the
JL JL JL JL JL JL JL JL JL JL JL JL
client fairly is providing social justice.
JL JL JL JL JL JL
DIF: Applying/Application REF: 4
KEY: Autonomy| ethical principlesJ MSC: Integrated Process: Caring
L JL JL J L JL JL
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
J L JL JL JL JL JL JL JL JL JL JL
7. A student nurse asks the faculty to explain best practices when communicating with a
JL JL JL JL JL JL JL JL JL JL JL JL JL
person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)
JL JL JL JL JL JL JL JL JL JL
community. What answer by the faculty is most accurate?
JL JL JL JL JL JL JL JL JL
a. Avoid embarrassing the client by asking questions. JL JL JL JL JL JL
b. Don’t make assumptions about their health needs. JL JL JL JL JL JL
c. Most LGBTQ people do not want to share information. JL JL JL JL JL JL JL JL
d. No differences exist in communicating with this population.
JL JL JL JL JL JL JL
ANS: B J L J L
Many members of the LGBTQ community have faced discrimination from health care
JL JL JL JL JL JL JL JL JL JL JL
providers and may be reluctant to seek health care. The nurse should never make
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
assumptions about the needs of members of this population. Rather, respectful questions are
JL JL JL JL JL JL JL JL JL JL JL JL JL
appropriate. If approached with sensitivity, the client with any health care need is more likely
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
to answer honestly.
JL JL JL
DIF: Understanding/Comprehension REF: 4 KEY: J L LGBTQ|
diversity MSC: Integrated Process: Teaching/Learning
JL JL J L JL JL
NOT: Client Needs Category: Psychosocial Integrity
J L JL JL JL JL
8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
and has pain that is unrelieved by the prescribed narcotic pain medication. Which statement is
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
part of the SBAR format for communication?
JL JL JL JL JL JL JL
a. A: “I would like you to order a different pain medication.”
JL JL JL JL JL JL JL JL JL JL
b. B: “This client has allergies to morphine and codeine.”
JL JL JL JL JL JL JL JL
c. R: “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
JL JL JL JL JL JL JL
d. S: “This client had a vaginal hysterectomy 2 days ago.”
JL JL JL JL JL JL JL JL JL
JL ANS: J L B
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Distribution of this document is illegal
FOR
L
J
JL
MEDICAL SURGICAL
JL
JL NURSING9TH EDITION
JL
J L
JL IGNAVATICIUS
,Chapter 1: Introduction to Medical-Surgical Nursing Practice
JL JL JL JL JL JL
Ignatavicius: Medical-Surgical Nursing, 8th Edition
JL JL JL JL JL
MULTIPLE CHOICE JL
1. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The
JL JL JL JL JL JL JL JL JL JL JL JL JL
preceptor advises the student that which is the priority when working as a professional
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
nurse?
JL
a. Attending to holistic client needs JL JL JL JL
b. Ensuring client safety JL JL
c. Not making medication errors JL JL JL
d. Providing client-focused care JL JL
ANS: B J L J L
All actions are appropriate for the professional nurse. However, ensuring client safety is the
JL JL JL JL JL JL JL JL JL JL JL JL JL
priority. Up to 98,000 deaths result each year from errors in hospital care, according to the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
2000 Institute of Medicine report. Many more clients have suffered injuries and less serious
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
outcomes. Every nurse has the responsibility to guard the client’s safety.
JL JL JL JL JL JL JL JL JL JL JL
DIF: Understanding/Comprehension REF: 2 KEY: Patient J L
safety MSC: Integrated Process: Nursing Process: Intervention
JL JL J L JL JL JL JL
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
J L JL JL JL JL JL JL JL JL JL JL
Control
JL
2. A nurse is orienting a new client and family to the inpatient unit. What information does the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
nurse provide to help the client promote his or her own safety?
JL JL JL JL JL JL JL JL JL JL JL JL
a. Encourage the client and family to be active partners. JL JL JL JL JL JL JL JL
b. Have the client monitor hand hygiene in caregivers. JL JL JL JL JL JL JL
c. Offer the family the opportunity to stay with the client. JL JL JL JL JL JL JL JL JL
d. Tell the client to always wear his or her armband.
JL JL JL JL JL JL JL JL JL
ANS: A J L J L
Each action could be important for the client or family to perform. However, encouraging the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
client to be active in his or her health care as a partner is the most critical. The other actions
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
are very limited in scope and do not provide the broad protection that being active and
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
involved does.
JL JL
DIF: Understanding/Comprehension REF: 3 KEY: Patient J L
safety MSC: Integrated Process: Teaching/Learning
JL JL J L JL JL
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
J L JL JL JL JL JL JL JL JL JL JL
Control
JL
3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
best?
JL
a. Call the Rapid Response Team. JL JL JL JL
b. Document and continue to monitor. JL JL JL JL
c. Notify the primary care provider. JL JL JL JL
d. Repeat blood pressure measurement in 15 minutes. JL JL JL JL JL JL
, ANS: A J L J L
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
before they suffer either respiratory or cardiac arrest. Since the client has manifested a
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
significant change, the nurse should call the RRT. Changes in blood pressure, mental status,
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
heart rate, and pain are particularly significant. Documentation is vital, but the nurse must do
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
more than document. The primary care provider should be notified, but this is not the priority
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
over calling the RRT. The client’s blood pressure should be reassessed frequently, but the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
priority is getting the rapid care to the client.
JL JL JL JL JL JL JL JL JL
DIF: Applying/Application REF: 3
KEY: Rapid Response Team (RRT)| medical
J L J L JL JL JL JL
emergencies
JL
MSC: Integrated Process: Communication and Documentation
J L JL JL JL JL
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
J L JL JL JL JL JL JL
4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
best demonstrates this concept?
JL JL JL JL
a. Assesses for cultural influences affecting health care JL JL JL JL JL JL
b. Ensures that all the clients’ basic needs are met JL JL JL JL JL JL JL JL
c. Tells the client and family about all upcoming tests JL JL JL JL JL JL JL JL
d. Thoroughly orients the client and family to the room JL JL JL JL JL JL JL JL
ANS: A J L J L
Competency in client-focused care is demonstrated when the nurse focuses on JL JL JL JL JL JL JL JL JL JL
communication, culture, respect, compassion, client education, and empowerment. By
JL JL JL JL JL JL JL JL JL
assessing the effect of the client’s culture on health care, this nurse is practicing
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
client-focused care. Providing for basic needs does not demonstrate this competence. Simply JL JL JL JL JL JL JL JL JL JL JL
telling the client about all upcoming tests is not providing empowering education. Orienting
JL JL JL JL JL JL JL JL JL JL JL JL JL
the client and family to the room is an important safety measure, but not directly related to
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
demonstrating client-centered care.
JL JL JL
DIF: Understanding/Comprehension REF: 3
KEY: Patient-centered care| culture MSC: Integrated Process:
J L JL JL J L JL
Caring NOT: Client Needs Category: Psychosocial Integrity
JL JL J L JL JL JL JL
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
nurse explain is the most important thing the client can do to protect against errors?
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
a. Bring a list of all medications and what they are for. JL JL JL JL JL JL JL JL JL JL
b. Keep the doctor’s phone number by the telephone. JL JL JL JL JL JL JL
c. Make sure all providers wash hands before entering the room. JL JL JL JL JL JL JL JL JL
d. Write down the name of each caregiver who comes in the room. JL JL JL JL JL JL JL JL JL JL JL
ANS: A J L J L
Medication errors are the most common type of health care mistake. The Joint Commission’sJL JL JL JL JL JL JL JL JL JL JL JL JL
Speak Up campaign encourages clients to help ensure their safety. One recommendation is
JL JL JL JL JL JL JL JL JL JL JL JL JL
for clients to know all their medications and why they take them. This will help prevent
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
medication errors.
JL JL
DIF: Applying/Application REF: 4
KEY: Speak Up campaign| patient safety MSC: Integrated Process: Teaching/Learning
J L JL JL JL JL J L JL JL
, NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
J L JL JL JL JL JL JL JL JL JL JL
Control
JL
6. Which action by the nurse working with a client best demonstrates respect for autonomy?
JL JL JL JL JL JL JL JL JL JL JL JL JL
a. Asks if the client has questions before signing a consent
JL JL JL JL JL JL JL JL JL
b. Gives the client accurate information when questioned JL JL JL JL JL JL
c. Keeps the promises made to the client and family JL JL JL JL JL JL JL JL
d. Treats the client fairly compared to other clients JL JL JL JL JL JL JL
ANS: A J L J L
Autonomy is self-determination. The client should make decisions regarding care. When the
JL JL JL JL JL JL JL JL JL JL JL
nurse obtains a signature on the consent form, assessing if the client still has questions is
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
vital, because without full information the client cannot practice autonomy. Giving accurate
JL JL JL JL JL JL JL JL JL JL JL JL
information is practicing with veracity. Keeping promises is upholding fidelity. Treating the
JL JL JL JL JL JL JL JL JL JL JL JL
client fairly is providing social justice.
JL JL JL JL JL JL
DIF: Applying/Application REF: 4
KEY: Autonomy| ethical principlesJ MSC: Integrated Process: Caring
L JL JL J L JL JL
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
J L JL JL JL JL JL JL JL JL JL JL
7. A student nurse asks the faculty to explain best practices when communicating with a
JL JL JL JL JL JL JL JL JL JL JL JL JL
person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)
JL JL JL JL JL JL JL JL JL JL
community. What answer by the faculty is most accurate?
JL JL JL JL JL JL JL JL JL
a. Avoid embarrassing the client by asking questions. JL JL JL JL JL JL
b. Don’t make assumptions about their health needs. JL JL JL JL JL JL
c. Most LGBTQ people do not want to share information. JL JL JL JL JL JL JL JL
d. No differences exist in communicating with this population.
JL JL JL JL JL JL JL
ANS: B J L J L
Many members of the LGBTQ community have faced discrimination from health care
JL JL JL JL JL JL JL JL JL JL JL
providers and may be reluctant to seek health care. The nurse should never make
JL JL JL JL JL JL JL JL JL JL JL JL JL JL
assumptions about the needs of members of this population. Rather, respectful questions are
JL JL JL JL JL JL JL JL JL JL JL JL JL
appropriate. If approached with sensitivity, the client with any health care need is more likely
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
to answer honestly.
JL JL JL
DIF: Understanding/Comprehension REF: 4 KEY: J L LGBTQ|
diversity MSC: Integrated Process: Teaching/Learning
JL JL J L JL JL
NOT: Client Needs Category: Psychosocial Integrity
J L JL JL JL JL
8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
and has pain that is unrelieved by the prescribed narcotic pain medication. Which statement is
JL JL JL JL JL JL JL JL JL JL JL JL JL JL JL
part of the SBAR format for communication?
JL JL JL JL JL JL JL
a. A: “I would like you to order a different pain medication.”
JL JL JL JL JL JL JL JL JL JL
b. B: “This client has allergies to morphine and codeine.”
JL JL JL JL JL JL JL JL
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