LEWIS'S MEDICAL-SURGICAL NURSING
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference: Ch. 1 — Professional Nursing — Standards of
Professional Nursing Practice
Stem: A newly licensed RN is caring for a postop patient who
becomes hypotensive and confused. The nurse calls the
surgeon, documents findings, and begins IV bolus per standing
order, but the charge nurse questions whether the nurse
exceeded scope. Which action best demonstrates adherence to
professional nursing standards?
,A. Assist with additional history only after surgeon's orders.
B. Continue the IV bolus and notify the surgeon immediately.
C. Stop the IV bolus until the surgeon arrives.
D. Delegate assessment to the UAP and wait for orders.
Correct answer: B
Rationale — Correct: Continuing the IV bolus while notifying the
surgeon demonstrates application of nursing standards: timely
assessment, initiation of appropriate interventions within
scope, and communication. This action prioritizes physiologic
stabilization (perfusion) and aligns with standards for clinical
judgment and safety.
Rationale — A: Waiting to assist with history delays urgent
intervention and risks patient harm.
Rationale — C: Stopping an intervention that supports
perfusion is unsafe unless indicated.
Rationale — D: Delegating the assessment of an unstable
patient to UAP is inappropriate and unsafe.
Teaching point: Nurses must initiate urgent, scope-appropriate
interventions while communicating with providers.
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference: Ch. 1 — Professional Nursing — Domain of Nursing
Practice / Scope of Nursing Practice
Stem: An RN working on a med-surg unit is asked to perform a
,procedure normally done by the advanced practice clinician
because that clinician is delayed. The RN has received in-service
training but no formal competency check. Which action best
protects patient safety and professional scope?
A. Perform the procedure because of prior in-service
experience.
B. Refuse and tell the team that the clinician must wait.
C. Notify the supervisor and request supervision or competency
confirmation before performing.
D. Ask a peer RN to perform the procedure without informing
supervisor.
Correct answer: C
Rationale — Correct: Requesting supervision or confirmation of
competency adheres to scope-of-practice and professional
accountability; it ensures safe, competent care and respects
institutional standards. This aligns with Lewis’s emphasis on
appropriate delegation, legal/ethical considerations, and patient
safety.
Rationale — A: Acting without verified competency risks unsafe
care and legal exposure.
Rationale — B: Refusal might be appropriate if unsafe, but
abrupt refusal without escalating may delay needed care —
better to request supervision.
Rationale — D: Asking a peer without supervisor involvement
bypasses accountability and institutional processes.
, Teaching point: Verify competency or request supervision
before performing tasks outside accepted scope.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Definitions of
Nursing / Nursing’s View of Humanity
Stem: A nurse is planning care for a culturally diverse patient
with chronic heart failure who prefers traditional remedies that
may conflict with prescribed diet. Using a patient-centered view
of humanity, which approach best balances respect with safety?
A. Tell the patient traditional remedies must stop immediately.
B. Collaborate with the patient to integrate safe traditional
practices and adjust the care plan accordingly.
C. Ignore the patient’s preferences and enforce the diet strictly.
D. Document the preferences but make no changes to the plan.
Correct answer: B
Rationale — Correct: Collaborating respects patient-centered
care and cultural values while assessing safety risks; modifying
the plan when safe increases adherence and outcomes. This
aligns with Lewis’s emphasis on individualized care and
interprofessional coordination.
Rationale — A: Abrupt prohibition disrespects autonomy and
may reduce trust.
Rationale — C: Enforcing without collaboration can harm
therapeutic relationship and adherence.
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference: Ch. 1 — Professional Nursing — Standards of
Professional Nursing Practice
Stem: A newly licensed RN is caring for a postop patient who
becomes hypotensive and confused. The nurse calls the
surgeon, documents findings, and begins IV bolus per standing
order, but the charge nurse questions whether the nurse
exceeded scope. Which action best demonstrates adherence to
professional nursing standards?
,A. Assist with additional history only after surgeon's orders.
B. Continue the IV bolus and notify the surgeon immediately.
C. Stop the IV bolus until the surgeon arrives.
D. Delegate assessment to the UAP and wait for orders.
Correct answer: B
Rationale — Correct: Continuing the IV bolus while notifying the
surgeon demonstrates application of nursing standards: timely
assessment, initiation of appropriate interventions within
scope, and communication. This action prioritizes physiologic
stabilization (perfusion) and aligns with standards for clinical
judgment and safety.
Rationale — A: Waiting to assist with history delays urgent
intervention and risks patient harm.
Rationale — C: Stopping an intervention that supports
perfusion is unsafe unless indicated.
Rationale — D: Delegating the assessment of an unstable
patient to UAP is inappropriate and unsafe.
Teaching point: Nurses must initiate urgent, scope-appropriate
interventions while communicating with providers.
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference: Ch. 1 — Professional Nursing — Domain of Nursing
Practice / Scope of Nursing Practice
Stem: An RN working on a med-surg unit is asked to perform a
,procedure normally done by the advanced practice clinician
because that clinician is delayed. The RN has received in-service
training but no formal competency check. Which action best
protects patient safety and professional scope?
A. Perform the procedure because of prior in-service
experience.
B. Refuse and tell the team that the clinician must wait.
C. Notify the supervisor and request supervision or competency
confirmation before performing.
D. Ask a peer RN to perform the procedure without informing
supervisor.
Correct answer: C
Rationale — Correct: Requesting supervision or confirmation of
competency adheres to scope-of-practice and professional
accountability; it ensures safe, competent care and respects
institutional standards. This aligns with Lewis’s emphasis on
appropriate delegation, legal/ethical considerations, and patient
safety.
Rationale — A: Acting without verified competency risks unsafe
care and legal exposure.
Rationale — B: Refusal might be appropriate if unsafe, but
abrupt refusal without escalating may delay needed care —
better to request supervision.
Rationale — D: Asking a peer without supervisor involvement
bypasses accountability and institutional processes.
, Teaching point: Verify competency or request supervision
before performing tasks outside accepted scope.
Citation: Harding et al. (2023). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Definitions of
Nursing / Nursing’s View of Humanity
Stem: A nurse is planning care for a culturally diverse patient
with chronic heart failure who prefers traditional remedies that
may conflict with prescribed diet. Using a patient-centered view
of humanity, which approach best balances respect with safety?
A. Tell the patient traditional remedies must stop immediately.
B. Collaborate with the patient to integrate safe traditional
practices and adjust the care plan accordingly.
C. Ignore the patient’s preferences and enforce the diet strictly.
D. Document the preferences but make no changes to the plan.
Correct answer: B
Rationale — Correct: Collaborating respects patient-centered
care and cultural values while assessing safety risks; modifying
the plan when safe increases adherence and outcomes. This
aligns with Lewis’s emphasis on individualized care and
interprofessional coordination.
Rationale — A: Abrupt prohibition disrespects autonomy and
may reduce trust.
Rationale — C: Enforcing without collaboration can harm
therapeutic relationship and adherence.
