Test Bank For Timbys Introductory Medical Surgical Nursing 13th Edition By Loretta A. Donnelly-Moreno; Brigitte Moseley

◦
Timby's Introductory Medical-Surgical Nursing 13th Edition Moreno Test Bank
b b b b b b b b




Chapter 1
b Concepts and Trends in Healthcare
b b b b

, ◦
A new nurse is working with a preceptor on an inpatient medical-surgical unit.
b b b b b b b b b b b b


The preceptor advises the student that which is the priority when working as a
b b b b b b b b b b b b b b


professional nurse? b b


◦ Attending to holistic client needs b b b b



◦ Ensuring client safety b b



◦ Not making medication errors
b b b



◦ Providing client- b


focused care b b


ANS: B b b


◦ All actions are appropriate for the professional nurse. However,
b b b b b b b b


bensuring client safety is the priority. Up to 98,000 deaths result each year from
b b b b b b b b b b b b b


errors in hospital care, according to the 2000 Institute of Medicine report. Many more
b b b b b b b b b b b b b b


clients have suffered injuries and less serious outcomes. Every nurse has the
b b b b b b b b b b b b


responsibility to guard the clients safety.
b b b b b b




◦ DIF: Understanding/Comprehension REF: 2 b b b


KEY: Patient safety MSC: Integrated Process: Nursing
b b b b b b b


Process: Intervention
b b


◦ NOT: Client Needs Category: Safe and Effective Care b b b b b b b


Environment: Safety and Infection Control
b b b b b




◦ A nurse is orienting a new client and family to the inpatient unit. What
b b b b b b b b b b b b b


information does the nurse provide to help the client promote his or her own
b b b b b b b b b b b b b b


safety?
b


◦ Encourage the client and family to be active partners.
b b b b b b b b



◦ Have the client monitor hand hygiene in caregivers.
b b b b b b b



◦ Offer the family the opportunity to stay with the client.
b b b b b b b b b



◦ Tell the client to always wear his or
b b b b b b b


her armband. ANS: A
b b b b


◦ Each action could be important for the client or family to perform. b b b b b b b b b b b


However, encouraging the client to be active in his or her health care as a partner is
b b b b b b b b b b b b b b b b b


the most critical. The other actions are
b b b b b b b


◦
◦ very limited in scope and do not provide the broad protection that
b b b b b b b b b b b


being active and involved does.
b b b b b




◦ DIF: Understanding/Comprehension REF: 3 b b b


KEY: Patient safety MSC: Integrated Process: Teaching/
b b b b b b b


Learning
b


◦ NOT: Client Needs Category: Safe and Effective Care b b b b b b b

,Environment: Safety and Infection Control b b b b




◦ A nurse is caring for a postoperative client on the surgical unit. The clients blood
b b b b b b b b b b b b b b


pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What
b b b b b b b b b b b b b b b


action by the nurse is best?
b b b b b b


◦ Call the Rapid Response Team.
b b b b



◦ Document and continue to monitor. b b b b



◦ Notify the primary care provider. b b b b



◦ Repeat blood pressure measurement b b b


in 15 minutes. ANS: A
b b b b b


◦ The purpose of the Rapid Response Team (RRT) is to intervene when b b b b b b b b b b b


clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the
b b b b b b b b b b b b b


client has manifested a significant change, the nurse should call the RRT. Changes in
b b b b b b b b b b b b b b


blood pressure, mental status, heart rate, and pain are particularly significant.
b b b b b b b b b b b


Documentation is vital, but the nurse must do more than document. The primary care
b b b b b b b b b b b b b b


provider should be notified, but this is not the priority over calling the RRT. The
b b b b b b b b b b b b b b b


bclients blood pressure should be reassessed frequently, but the priority is getting the
b b b b b b b b b b b


rapid care to the client.
b b b b b




◦ DIF: Applying/Application REF: 3b b b



◦ KEY: Rapid Response Team (RRT)| b b b b


medical emergencies MSC: Integrated Process:
b b b b b


Communication and Documentation b b


◦ NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation b b b b b b b


◦
◦ A nurse wishes to provide client-centered care in all interactions. Which
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action by the nurse best demonstrates this concept?
b b b b b b b b


◦ Assesses for cultural influences affecting health care b b b b b b



◦ Ensures that all the clients basic needs are metb b b b b b b b



◦ Tells the client and family about all upcoming tests
b b b b b b b b



◦ Thoroughly orients the client and b b b b


family to the room ANS: A
b b b b b b


◦ Competency in client-focused care is demonstrated when the nurse b b b b b b b b


focuses on communication, culture, respect, compassion, client education, and
b b b b b b b b b


empowerment. By assessing the effect of the
b b b b b b b


◦
◦ clients culture on health care, this nurse is practicing client-focused b b b b b b b b b


care. Providing for basic needs does not demonstrate this competence. Simply telling
b b b b b b b b b b b b


the client about all upcoming tests is not providing empowering education. Orienting
b b b b b b b b b b b b


the client and family to the room is an important safety measure, but not directly
b b b b b b b b b b b b b b b


brelated to demonstrating client-centered care.
b b b b




◦ DIF: Understanding/Comprehension REF: 3
b b b

, ◦ KEY: Patient-centered care| culture MSC: b b b b


Integrated Process: Caring NOT: Client Needs Category:
b b b b b b b


Psychosocial Integrity b




◦ A client is going to be admitted for a scheduled surgical procedure. Which
b b b b b b b b b b b b


action does the nurse explain is the most important thing the client can do
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to protect against errors?
b b b b


◦ Bring a list of all medications and what they are for.
b b b b b b b b b b



◦ Keep the doctors phone number by the telephone.
b b b b b b b



◦ Make sure all providers wash hands before entering the room.
b b b b b b b b b



◦ Write down the name of each caregiver who
b b b b b b b


comes in the room. ANS: A
b b b b b b


◦ Medication errors are the most common type of health care mistake. b b b b b b b b b b


b The Joint Commissions Speak Up campaign encourages clients to help ensure their
b b b b b b b b b b b


b safety. One recommendation is for clients to know all their medications and why they
b b b b b b b b b b b b b


b take them. This will help prevent medication errors.
b b b b b b b




◦ DIF: Applying/Application REF: 4
b b b



◦ KEY: Speak Up campaign| patient safety MSC: Integrated b b b b b b b


b Process: Teaching/Learning NOT: Client Needs Category: Safe and Effective
b b b b b b b b


b Care Environment: Safety and Infection Control
b b b b b




◦ Which action by the nurse working with a client best demonstrates respect for
b b b b b b b b b b b b


autonomy?
b



◦ Asks if the client has questions before signing a consent
b b b b b b b b b



◦ Gives the client accurate information when questioned
b b b b b b



◦ Keeps the promises made to the client and family
b b b b b b b b



◦
Treats the client fairly b b b


compared to other clients b b b b


ANS: A b b


◦ Autonomy is self-determination. The client should make decisions b b b b b b b


regarding care. When the nurse obtains a signature on the consent form, assessing if
b b b b b b b b b b b b b b


bthe client still has questions is vital, because without full information the client cannot
b b b b b b b b b b b b b


practice autonomy. Giving accurate information is practicing with veracity. Keeping
b b b b b b b b b b


promises is upholding fidelity. Treating the
b b b b b b


◦
◦ client fairly is providing social justice.
b b b b b


◦
◦ DIF: Applying/Application REF: 4
b b b



◦ KEY: Autonomy| ethical principles MSC: Integrated Process: Caring
b b b b b b b



◦ NOT: Client Needs Category: Safe and Effective Care Environment: Management
b b b b b b b b b


of Care
b