Davis Advantage for Medical-Surgical Nursing,
3rd Edition
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy Sullivan
Chapter 1: Foundations for Medical-Surgical Nursing
Question 1
Which statement best describes the primary purpose of clinical judgment in medical-
surgical nursing?
A. Completing all assigned nursing tasks within the scheduled shift
B. Using patient data and nursing knowledge to make safe, timely care decisions
C. Following provider prescriptions without independently interpreting patient findings
D. Documenting care after interventions have been completed
Correct Answer: B
Rationale:
Clinical judgment involves gathering and interpreting relevant patient information,
recognizing meaningful changes, determining priorities, selecting appropriate actions, and
evaluating outcomes. It is central to safe medical-surgical nursing because patients may
experience rapidly changing or complex conditions. Clinical judgment is more than task
completion or documentation; it requires the nurse to connect patient findings with
nursing knowledge and make reasoned decisions.
Why the other options are incorrect:
1
, • A: Completing tasks is part of nursing practice, but task completion alone does not
demonstrate clinical judgment.
• B: Correct. Clinical judgment requires the nurse to interpret patient information and
make safe decisions based on the patient's condition.
• C: Nurses must independently assess and interpret patient findings rather than
simply follow prescriptions without clinical evaluation.
• D: Documentation is important, but it records care rather than representing the full
clinical-judgment process.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
CJMM Focus: Analyze Cues
Question 2
Which activity is most directly associated with evidence-based nursing care?
A. Selecting interventions solely on the basis of personal experience
B. Using the newest intervention regardless of supporting evidence
C. Integrating research evidence, clinical expertise, and patient preferences
D. Following the same intervention for every patient with the same diagnosis
Correct Answer: C
Rationale:
Evidence-based nursing care integrates the best available evidence with clinical expertise
and the patient's values, preferences, and clinical circumstances. This approach supports
individualized, scientifically supported care. Personal experience can contribute to clinical
expertise, but it should not replace current evidence or patient preferences.
Why the other options are incorrect:
• A: Personal experience alone may be incomplete or outdated and does not
represent evidence-based practice.
• B: A newer intervention is not automatically better; the nurse should consider the
quality and applicability of evidence.
• C: Correct. Evidence-based care combines evidence, professional expertise, and
patient-specific considerations.
2
, • D: Standardization may be useful in some circumstances, but care must still be
individualized to the patient.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 3
Which action best demonstrates patient-centered care?
A. Giving every patient the same discharge instructions
B. Making decisions for the patient to avoid delays
C. Incorporating the patient's preferences and goals into the plan of care
D. Prioritizing institutional routines over individual patient concerns
Correct Answer: C
Rationale:
Patient-centered care respects the patient's values, preferences, needs, and goals while
maintaining safe and effective care. The nurse collaborates with the patient rather than
simply directing care. Individualization is particularly important when developing education
and discharge plans.
Why the other options are incorrect:
• A: Education should be tailored to the patient's needs, literacy, readiness, and
circumstances.
• B: Nurses should support participation in decisions rather than unnecessarily
making decisions for capable patients.
• C: Correct. Incorporating patient preferences and goals is a central feature of
patient-centered care.
• D: Institutional procedures are important for safety, but they should not
automatically override individualized patient needs.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
3
, Question 4
A nurse is caring for a hospitalized adult who states, “I understand what the provider
explained, but I am still unsure whether I want this treatment.” Which nursing response is
most appropriate?
A. “You should follow the provider's recommendation because it is medically appropriate.”
B. “I can explain the nursing aspects of your care and help you identify questions to discuss
with the provider.”
C. “You need to make the decision now so treatment is not delayed.”
D. “Your family should decide because they may understand your condition better.”
Correct Answer: B
Rationale:
Patient-centered care includes supporting informed participation in healthcare decisions.
The nurse can clarify nursing-related information, assess understanding, identify concerns,
reinforce previously provided information, and facilitate communication with the
appropriate healthcare professional. The nurse should not pressure the patient or transfer
decision-making authority unnecessarily to family members.
Why the other options are incorrect:
• A: The nurse should not pressure the patient to accept treatment simply because
the provider recommends it.
• B: Correct. The nurse supports patient understanding and facilitates
communication while respecting the patient's autonomy.
• C: Pressuring the patient undermines patient-centered decision-making.
• D: Family involvement should depend on the patient's preferences and appropriate
decision-making circumstances.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
Question 5
A nurse receives handoff for four patients. Which patient should the nurse assess first?
A. A patient awaiting discharge who needs clarification about dietary instructions
B. A patient with chronic arthritis reporting the usual level of joint pain
4
3rd Edition
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy Sullivan
Chapter 1: Foundations for Medical-Surgical Nursing
Question 1
Which statement best describes the primary purpose of clinical judgment in medical-
surgical nursing?
A. Completing all assigned nursing tasks within the scheduled shift
B. Using patient data and nursing knowledge to make safe, timely care decisions
C. Following provider prescriptions without independently interpreting patient findings
D. Documenting care after interventions have been completed
Correct Answer: B
Rationale:
Clinical judgment involves gathering and interpreting relevant patient information,
recognizing meaningful changes, determining priorities, selecting appropriate actions, and
evaluating outcomes. It is central to safe medical-surgical nursing because patients may
experience rapidly changing or complex conditions. Clinical judgment is more than task
completion or documentation; it requires the nurse to connect patient findings with
nursing knowledge and make reasoned decisions.
Why the other options are incorrect:
1
, • A: Completing tasks is part of nursing practice, but task completion alone does not
demonstrate clinical judgment.
• B: Correct. Clinical judgment requires the nurse to interpret patient information and
make safe decisions based on the patient's condition.
• C: Nurses must independently assess and interpret patient findings rather than
simply follow prescriptions without clinical evaluation.
• D: Documentation is important, but it records care rather than representing the full
clinical-judgment process.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
CJMM Focus: Analyze Cues
Question 2
Which activity is most directly associated with evidence-based nursing care?
A. Selecting interventions solely on the basis of personal experience
B. Using the newest intervention regardless of supporting evidence
C. Integrating research evidence, clinical expertise, and patient preferences
D. Following the same intervention for every patient with the same diagnosis
Correct Answer: C
Rationale:
Evidence-based nursing care integrates the best available evidence with clinical expertise
and the patient's values, preferences, and clinical circumstances. This approach supports
individualized, scientifically supported care. Personal experience can contribute to clinical
expertise, but it should not replace current evidence or patient preferences.
Why the other options are incorrect:
• A: Personal experience alone may be incomplete or outdated and does not
represent evidence-based practice.
• B: A newer intervention is not automatically better; the nurse should consider the
quality and applicability of evidence.
• C: Correct. Evidence-based care combines evidence, professional expertise, and
patient-specific considerations.
2
, • D: Standardization may be useful in some circumstances, but care must still be
individualized to the patient.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 3
Which action best demonstrates patient-centered care?
A. Giving every patient the same discharge instructions
B. Making decisions for the patient to avoid delays
C. Incorporating the patient's preferences and goals into the plan of care
D. Prioritizing institutional routines over individual patient concerns
Correct Answer: C
Rationale:
Patient-centered care respects the patient's values, preferences, needs, and goals while
maintaining safe and effective care. The nurse collaborates with the patient rather than
simply directing care. Individualization is particularly important when developing education
and discharge plans.
Why the other options are incorrect:
• A: Education should be tailored to the patient's needs, literacy, readiness, and
circumstances.
• B: Nurses should support participation in decisions rather than unnecessarily
making decisions for capable patients.
• C: Correct. Incorporating patient preferences and goals is a central feature of
patient-centered care.
• D: Institutional procedures are important for safety, but they should not
automatically override individualized patient needs.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
3
, Question 4
A nurse is caring for a hospitalized adult who states, “I understand what the provider
explained, but I am still unsure whether I want this treatment.” Which nursing response is
most appropriate?
A. “You should follow the provider's recommendation because it is medically appropriate.”
B. “I can explain the nursing aspects of your care and help you identify questions to discuss
with the provider.”
C. “You need to make the decision now so treatment is not delayed.”
D. “Your family should decide because they may understand your condition better.”
Correct Answer: B
Rationale:
Patient-centered care includes supporting informed participation in healthcare decisions.
The nurse can clarify nursing-related information, assess understanding, identify concerns,
reinforce previously provided information, and facilitate communication with the
appropriate healthcare professional. The nurse should not pressure the patient or transfer
decision-making authority unnecessarily to family members.
Why the other options are incorrect:
• A: The nurse should not pressure the patient to accept treatment simply because
the provider recommends it.
• B: Correct. The nurse supports patient understanding and facilitates
communication while respecting the patient's autonomy.
• C: Pressuring the patient undermines patient-centered decision-making.
• D: Family involvement should depend on the patient's preferences and appropriate
decision-making circumstances.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
Question 5
A nurse receives handoff for four patients. Which patient should the nurse assess first?
A. A patient awaiting discharge who needs clarification about dietary instructions
B. A patient with chronic arthritis reporting the usual level of joint pain
4
