,Chapterws01:wsIntroductionwstowsMedical-
SurgicalwsNursingwsPracticewsinwsCanada
Lewis
ws
:wsMedical-SurgicalwsNursingwsinwsCanada,ws4thwsCanadianwsEdition
MULTIPLEwsCHOICE
1. Whenwscaringwsforwsclientswsusingwsevidence-
informedwspractice,wswhichwsofwsthewsfollowingwsdoesw s thewsnursewsuse?
a. Clinicalwsjudgementwsbasedwsonwsexperience
b. Evidencewsfromwsawsclinicalwsresearchwsstudy
c. Thewsbestwsavailablewsevidencewstowsguidewsclinicalwsexpertise
d. Evaluationwsofwsdatawsshowingwsthatwsthewsclientwsoutcomeswsarewsmet
ANS:wsC
Evidence-
informedwsnursingwspracticewsiswsawscontinuouswsinteractivewsprocesswsinvolvingwsthewsexplicit,wsc
onscientious,wsandwsjudiciouswsconsiderationwsofwsthewsbestwsavailablewsevidencewstowsprovidewscar
e.wsFourwsprimarywselementswsare:ws(a)wsclinicalwsstate,wssetting,wsandwscircumstances;ws(b)wsclientw
spreferenceswsandwsactions;ws(c)wsbestwsresearchwsevidence;wsandws(d)wshealthwscarewsresources.wsCli
nicalwsjudgementwsbasedwson
thewsnurse’swsclinicalwsexperiencealdecisionmakingalsowsshouldiswspartwsofwsincorporatewscurrentwsresear
chwsandwsresearch-basedwsguidelines.wsEvidencewsfromwsonewsclinical
researchwsstudywsdoeswsnotwsprovidewsanwsadequatewssubstantiationwsforwsinterventions.wsEvalua
tionwsofwsclientwsoutcomeswsiswsimportant,wsbutwsinterventionswsshouldwsbewsbasedwsonwsresearc
hwsfromwsrandomizedwscontrolwsstudieswswithwsawslargewsnumberwsofwssubjects.
DIF:w s w s CognitivewsLevel:wsComprehension TOP:wsNursingwsProcess:wsPlanning
2.w s Whichwsofwsthewsfollowingwsbestwsexplainswsthewsnurses’primarywsusewsofwsthewsnursingwspro
cesswswhen
providingwscarewstowsclients NURSINGwsTB.COM
?
a. Towsexplainwsnursingwsinterventionswstowsotherwshealthwscarewsprofessionals
b. Aswsawsproblem-solvingwstoolwstowsidentifywsandwstreatwsclients’healthcareneeds
c. Aswsawsscientific-basedwsprocesswsofwsdiagnosingwsthewsclient’shealthcareproblems
d. Towsestablishwsnursingwstheorywsthatwsincorporateswsthewsbiopsychosocialwsnaturewsofwshumans
ANS:wsB
Thewsnursingwsprocesswsiswsanwsassertivewsproblem-
solvingwsapproachwstowsthewsidentificationwsandwstreatmentwsofwsclients’wsproblems.wsDiagnosiswsprimaryw
susewsofwsthewsnursingwsprocesswsiswsinwsclientwscare,wsnotwstowsestablishwsnursingwstheorywsorwsexplain
nursingwsinterventionswstowsotherwshealthwscarewsprofessionals.
DIF:w s w s CognitivewsLevel:wsComprehension TOP:wsNursingwsProcess:wsImplementation
3. Thewsnursewsiswscaringwsforwsawscriticallywsillwsclientwsinwsthewsintensivewscarewsunitwsandwsplansw
anwseveryws2-
s
hourwsturningwsschedulewstowspreventwsskinwsbreakdown.wsWhichwstypewsofwsnursingwsfuncti
ws
onwsiswsdemonstratedwswithwsthiswsturningwsschedule?
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
,ANS:wsD
, Whenwsimplementingwscollaborativewsnursingwsactions,wsthewsnursewsiswsresponsiblewsprimar
ilywsforwsmonitoringwsforwscomplicationswsofwsacutewsillnesswsorwsprovidingwscarewstowspreve
ntwsorwstreatwscomplications.wsIndependentwsnursingwsactionswsarewsfocusedwsonwshealthwspr
omotion,wsillnesswsprevention,wsandwsclientwsadvocacy.wsAwsdependentwsactionwswouldwsreq
uirewsawsphysicianwsorderwstowsimplement.wsCooperativewsnursingwsfunctionswsarewsnotwsdes
cribedwsaswsonewsofwsthewsformalwsnursingwsfunctions.
DIF:w s w s CognitivewsLevel:wsApplication TOP:wsNursingwsProcess:wsImplementation
4. Thewsnursewsiswscaringwsforwsawsclientwswhowshaswsbeenwsadmittedwstowsthewshospitalwsforwssurgerywsandwste
llswsthewsnurse,ws―Iwsdowsnotwsfeelwsrightwsaboutwsleavingwsshouldwsthewsnursewstakewsnext?
a. Reassurewsthewsclientwsthatwsthesewsfeelingswsarewscommonwsforwsparents.
b. Havewsthewsclientwscallwsthewschildrenwstowsensurewsthatwstheywsarewsdoingwswell.
c. Callwsthewsneighbourwstowsdeterminewswhetherwsadequatewschildcarewsiswsbeingwsprovided.
d. Gatherwsmorewsdatawsaboutwsthewsclient’sfeelingsaboutwsthewschildcarewsarrangements.
ANS:wsD
Sincewsawscompletewsassessmentwsiswsnecessarywsinwsorderwstowsidentifywsawsproblemwsandwschoosewsanwsappr
riatewsintervention,wsthewsnurse’swsfirswsotherwsactionswsmaywsbewsappropriate,wsbutwsmorewsassessmentwsiswsn
dedwsbeforewsthewsbestwsintervention
canwsbewschosen.
DIF:w s w s CognitivewsLevel:wsApplication TOP:wsNursingwsProcess:wsAssessment
5. Thewsnursewsiswscaringwsforwsawsclientwswhowshaswsleft-sidedwsparalysiswsaswsthewsresultwsofwsawsstrokewsand
assesseswsawspressurewsinjurywsonwsthewsclient’sleftwship.wsWhichwsofwsthewsfollowingwsiswsthewsmost
NURSINGTB.COM
appropriatewsnursingwsdiagnosiswsforwsthiswsclient?
a. Impairedw s physicalw s mobilityw s relatedw s tow s decreasew s inw s musclew s cont
rolw s (left-wssidedwsparalysis)
b. Riskw s forw s impairedw s tissuew s integrityw s asw s evidencedw s byw s insufficientw s k
nowledgewsaboutwsprotectingwstissuewsintegrity
c. Impairedw s skinw s integrityw s relatedw s tow s pressurew s overw s bonyw s pr
ominencew s (impairedwscirculation)
d. Ineffectivewstissuewsperfusionwsrelatedwstowssedentarywslifestyle
ANS:wsC
Thewsclient’smajorproblemwsiswsthewsimpairedwsskinwsintegritywsaswsdemonstratedwsbywsthewsprese
ncewsofwsawspressurewsinjury.wsThewsnursewsiswsablewstowstreatwsthewscausewsofwsalteredwscirculation
wsandwspressurewsbywsfrequentlywsrepositioningwsthewsclient.wsAlthoughwsleft-
sidedwsweaknesswsiswsawsproblemwsforwsthewsclient,
thewsnursewscannotwstreatfor‖wsthediagnosisweaknessis.wsnotThewsap―wswhowsalreadywshaswsimpairedwstissue
ntegrity.wsThewsclientwsdoeswshavewsineffectivewstissuewsperfusion,
butwsthewsimpairedwsskinwsintegritywsdiagnosiswsindicateswsmorewsclearlywswhatwsthewshealthwsproblemwsis.
DIF:w s w s CognitivewsLevel:wsApplication TOP:wsNursingwsProcess:wsDiagnosis
6. Thewsnursewscaringwsforwsawsclientwswithwsanwsinfectionwshaswsawsnursingwsdiagnosiswsofwsdefi
cientwsfluidwsvolumewsrelatedwstowsexcessivewsdiaphoresis.wsWhichwsofwsthewsfollowingwsisws
anwsappropriatewsclientwsoutcome?
a. Clientwshaswsawsbalancedwsintakewsandwsoutput.
b. Client’sbeddingischangedwswhenwsitwsbecomeswsdamp.