TEST BANK FOR Medical-Surgical Nursing: Concepts for Clinical
Judgment and Collaborative Care 11th edition Author: Donna D.
Ignatavicius ISBN: 978-0323878265 COMPLETE GUIDE WITH
RATIONALES 100% VERIFIED A+ GRADE LATEST UPDATED
VERSION
FULL TEST BANK!!!
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Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical
Nursing
MULTIPLE CHOICE
1. A new nurse is working with a preceptor on a medical-surgical unit. The
preceptor advises the new nurse that which is the priority when working as a
professional nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
- ANSWER- B
All actions are appropriate for the professional nurse. However, ensuring client safety is
the priority. Health care errors have been widely reported for 25 years, many of which
result in client injury, death, and increased health care costs. There are several national
and international organizations that have either recommended or mandated safety
initiatives.
Every nurse has the responsibility to guard the client9s safety. The other actions are
important for quality nursing, but they are not as vital as providing safety. Not making
medication errors does provide safety, but is too narrow in scope to be the best answer.
DIF: Understanding TOP: Integrated Process: Nursing Process: Intervention KEY:
Client safety
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and
Infection Control
2. A nurse is orienting a new client and family to the medical-surgical unit.
What information does the nurse provide to best help the client promote his or her
own safety?
a. Encourage the client and family to be active partners.
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b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the client.
d. Tell the client to always wear his or her armband.
- ANSWER- A
Each action could be important for the client or family to perform. However, encouraging
the client to be active in his or her health care as a safety partner is the most critical. The
other actions are very limited in scope and do not provide the broad protection that being
active and involved does.
DIF: Understanding TOP: Integrated Process: Teaching/Learning KEY: Client safety
MSC: Client Needs Category: Safe and Effective Care Environment: Safety and
Infection Control
3. A nurse is caring for a postoperative client on the surgical unit. The client9s blood
pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would
the nurse take first?
a. Call the Rapid Response Team.
b. Document and continue to monitor.
c. Notify the primary health care provider.
d. Repeat the blood pressure in 15 minutes.
- ANSWER- A
The purpose of the Rapid Response Team (RRT) is to intervene when clients are
deteriorating before they suffer either respiratory or cardiac arrest. Since the client has
manifested a significant change, the nurse would call the RRT. Changes in blood pressure,
mental status, heart rate, temperature, oxygen saturation, and last 2 hours9 urine output
are particularly significant and are part of the Modified Early Warning System guide.
Documentation is vital, but the nurse must do more than document. The primary health
care provider would be notified, but this is not more important than calling the RRT. The
client9s blood pressure would be reassessed frequently, but the priority is getting the rapid
care to the client.
DIF: Applying TOP: Integrated Process: Communication and Documentation
KEY: Rapid Response Team (RRT), Clinical judgment
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MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation