mv mv Test bank - medical surgical nursing 10th edition ignatavicius workman-
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Medical Surgical Nursing 10th Edition m v m v m v m v
Ignatavicius Workman Test Bank
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Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
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Ignatavicius: Medical-Surgical Nursing, 10th Edition
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MULTIPLE CHOICE mv
1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises
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the
mv m new nurse that which is the priority when working as a professional nurse?
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a. Attending to holistic client needs mv mv mv mv
b. Ensuring client safety mv mv
c. Not making medication errors
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d. Providing client-focused care mv mv
ANS: B mv
All actions are appropriate for the professional nurse. However, ensuring client safety is the
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m priority. Health care errors have been widely reported for 25 years, many of which result
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in client injury, death, and increased health care costs. There are several national and
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m international organizations that have either recommended or mandated safety initiatives.
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Every nurse has the responsibility to guard the client’s safety. The other actions are
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important
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for quality nursing, but they are not as vital as providing safety. Not making medication
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errors does provide safety, but is too narrow in scope to be the best answer.
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DIF: Understanding m TOP: Integrated Process: Nursing Process:
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Intervention KEY: Client safety
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
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Control
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2. A nurse is orienting a new client and family to the medical-surgical unit. What
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information does the nurse provide to best help the client promote his or her own
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safety?
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a. Encourage the client and family to be active partners. mv mv mv mv mv mv mv mv
b. Have the client monitor hand hygiene in caregivers.
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c. Offer the family the opportunity to stay with the client.
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d. Tell the client to always wear his or her armband.
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ANS: A mv
Each action could be important for the client or family to perform. However, encouraging
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the client to be active in his or her health care as a safety partner is the most critical.
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The other actions are very limited in scope and do not provide the broad protection that
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being active and involved does.
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DIF: Understanding m TOP: Integrated Process:
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Teaching/Learning KEY: Client safety
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
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Control
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3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood
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pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action
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would the nurse take first?
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a. Call the Rapid Response Team. mv mv mv mv
b. Document and continue to monitor. mv mv mv mv
c. Notify the primary health care provider. mv mv mv mv mv
d. Repeat the blood pressure in 15 minutes. mv mv mv mv mv mv
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mv mv mv mv mv mv mv mv mv
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ANS: A mv
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
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m before they suffer either respiratory or cardiac arrest. Since the client has manifested a
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m significant change, the nurse would call the RRT. Changes in blood pressure, mental
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status, heart rate, temperature, oxygen saturation, and last 2 hours’ urine output are
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particularly significant and are part of the Modified Early Warning System guide.
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Documentation is vital, but the nurse must do more than document. The primary health
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care provider would be notified, but this is not more important than calling the RRT.
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The client’s blood pressure would be reassessed frequently, but the priority is getting
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the rapid care to the client.
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DIF: Applying TOP: Integrated Process: Communication and
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Documentation KEY: Rapid Response Team (RRT), Clinical judgment
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MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
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4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
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best demonstrates this concept?
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a. Assesses for cultural influences affecting health care. mv mv mv mv mv mv
b. Ensures that all the client’s basic needs are met. mv mv mv mv mv mv mv mv
c. Tells the client and family about all upcoming tests.
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d. Thoroughly orients the client and family to the room. mv mv mv mv mv mv mv mv
ANS: A mv
Showing respect for the client and family’s preferences and needs is essential to ensure a
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holistic or “whole-person” approach to care. By assessing the effect of the client’s culture
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on health care, this nurse is practicing client-focused care. Providing for basic needs
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does not demonstrate this competence. Simply telling the client about all upcoming
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tests is not providing empowering education. Orienting the client and family to the room
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is an important safety measure, but not directly related to demonstrating client-centered
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care.
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DIF: Understanding m v TOP: Integrated Process: Culture and Spirituality
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m KEY: Client-centered care, Culture
v m v mv mv MSC: Client Needs Category: Psychosocial
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Integrity
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5. A client is going to be admitted for a scheduled surgical procedure. Which action does
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the nurse explain is the most important thing the client can do to protect against
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errors?
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a. Bring a list of all medications and what they are for. mv mv mv mv mv mv mv mv mv mv
b. Keep the provider’s phone number by the telephone. mv mv mv mv mv mv mv
c. Make sure that all providers wash hands before entering the room.
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d. Write down the name of each caregiver who comes in the room.
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ANS: A mv
Medication reconciliation is a formal process in which the client’s actual current medications
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m are compared to the prescribed medications at the time of admission, transfer, or
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discharge. This National client Safety Goal is important to reduce medication errors.
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The client would not have to be responsible for providers washing their hands, and
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even if the client does so,
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this is too narrow to be the most important action to prevent errors. Keeping the
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provider’s phone number nearby and documenting everyone who enters the room also do
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not guarantee safety.
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DIF: Applying TOP: Integrated Process:
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Teaching/Learning KEY: Client safety, Informatics
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MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
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Control
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6. Which action by the nurse working with a client best demonstrates respect for autonomy?
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a. Asks if the client has questions before signing a consent.
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b. Gives the client accurate information when questioned.
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c. Keeps the promises made to the client and family. mv mv mv mv mv mv mv mv
d. Treats the client fairly compared to other clients. mv mv mv mv mv mv mv
ANS: A mv
Autonomy is self-determination. The client would make decisions regarding care. When
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the nurse obtains a signature on the consent form, assessing if the client still has questions
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is vital, because without full information the client cannot practice autonomy. Giving
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accurate information is practicing with veracity. Keeping promises is upholding fidelity.
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Treating the client fairly is providing social justice.
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DIF: Applying TOP: Integrated Process: Caring
m v KEY: Ethics, Autonomy m v mv mv mv mv
m MSC: Client Needs Category: Safe and Effective Care Environment: Management
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of Care
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7. A nurse asks a more seasoned colleague to explain best practices when communicating with
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a
mv person from the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ)
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m community. What answer by the faculty is most accurate?
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a. Avoid embarrassing the client by asking questions. mv mv mv mv mv mv
b. Don’t make assumptions about his or her health needs.mv mv mv mv mv mv mv mv
c. Most LGBTQ people do not want to share information.
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d. No differences exist in communicating with this population.
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ANS: B mv
Many members of the LGBTQ community have faced discrimination from health care
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m providers and may be reluctant to seek health care. The nurse would never make
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assumptions about the needs of members of this population. Rather, respectful questions
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are appropriate. If approached with sensitivity, the client with any health care need is
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more likely to answer honestly.
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DIF: Understanding m v TOP: Integrated Process: Teaching/Learning
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KEY: Health care disparities, LGBTQ
m v mv mv mv MSC: Client Needs Category: Psychosocial Integrity
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8. A nurse is calling the on-call health care provider about a client who had a hysterectomy
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2 days ago and has pain that is unrelieved by the prescribed opioid pain
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medication. Which statement comprises the background portion of the SBAR
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format for communication?
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a. “I would like you to order a different pain medication.”
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b. “This client has allergies to morphine and codeine.”
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c. “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
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d. “This client had a vaginal hysterectomy 2 days ago.”
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ANS: B mv
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