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 competency best demonstrates effective medical-surgical nursing practice?
A. Completing assigned tasks according to the unit routine
B. Integrating assessment findings, clinical judgment, evidence, and patient preferences
into nursing care
C. Following provider prescriptions without questioning unexpected findings
D. Prioritizing completion of documentation over changes in patient condition
Correct Answer: B
Rationale:
Medical-surgical nursing requires the nurse to integrate clinical knowledge, assessment
findings, evidence-based practice, patient preferences, safety principles, and clinical
judgment when providing care. This approach supports individualized and safe nursing
practice.
Why the other options are incorrect:
• A: Completing tasks is important, but competency involves more than following a
routine.
1
, • B: Correct. Effective practice integrates clinical judgment, evidence, patient
preferences, and assessment findings.
• C: Nurses have a responsibility to recognize and communicate concerns about
potentially unsafe or inappropriate prescriptions.
• D: Documentation is important, but a change in patient condition takes priority over
routine documentation.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 2
A nurse is caring for four patients. Which action best demonstrates clinical judgment?
A. Administering medications at the scheduled time without reassessing the patients
B. Using the same assessment sequence for every patient regardless of diagnosis
C. Comparing current findings with baseline data and determining which change requires
immediate intervention
D. Asking another nurse to make decisions whenever the patient's condition changes
Correct Answer: C
Rationale:
Clinical judgment involves recognizing meaningful cues, analyzing their significance,
determining priorities, taking appropriate action, and evaluating outcomes. Comparing
current findings with baseline data helps the nurse identify clinically significant
deterioration.
Why the other options are incorrect:
• A: Medication administration requires appropriate assessment and clinical
reasoning rather than simply following the schedule.
• B: Assessment should be individualized according to the patient's condition and
risks.
• C: Correct. Identifying meaningful changes from baseline and determining their
urgency is a core component of clinical judgment.
• D: Collaboration is appropriate, but the nurse remains responsible for exercising
professional judgment within the scope of practice.
2
,Cognitive Level: Analysis
NCLEX Client-Needs Category: Reduction of Risk Potential
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 3
Which statement most accurately describes evidence-based nursing care?
A. Care based exclusively on the nurse's previous clinical experience
B. Care based primarily on patient preference regardless of clinical evidence
C. Care that combines the best available evidence, clinical expertise, and patient
preferences
D. Care based on unit routines that have been used successfully for many years
Correct Answer: C
Rationale:
Evidence-based nursing integrates the best available research evidence with professional
clinical expertise and the patient's values, preferences, and circumstances. This approach
supports safe, individualized, and scientifically informed care.
Why the other options are incorrect:
• A: Experience is valuable but should not be the sole basis for clinical decisions.
• B: Patient preferences are important but must be considered alongside clinical
evidence and professional judgment.
• C: Correct. Evidence-based care incorporates evidence, clinical expertise, and
patient preferences.
• D: Long-standing practices may not reflect current evidence.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 4
3
, A patient newly diagnosed with heart failure tells the nurse, "I don't want to follow the
diet the provider recommended because I don't think I need it." Which response best
demonstrates patient-centered care?
A. "You need to follow the prescribed diet if you want to avoid complications."
B. "The diet is standard for patients with your diagnosis, so you should follow it."
C. "Tell me what concerns you have about the recommended diet so we can discuss
options that fit your preferences."
D. "Your family should help you make sure that you follow the diet after discharge."
Correct Answer: C
Rationale:
Patient-centered care respects the patient's values, preferences, concerns, and ability to
participate in decisions. Exploring the patient's concerns allows the nurse to identify
barriers and collaborate on realistic strategies rather than simply issuing instructions.
Why the other options are incorrect:
• A: This approach is directive and does not explore the patient's concerns.
• B: A standardized recommendation does not eliminate the need for individualized
education.
• C: Correct. The nurse acknowledges the patient's autonomy and invites
collaborative problem-solving.
• D: Family involvement should occur with the patient's permission and should not
replace patient participation.
Cognitive Level: Application
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Assessment
Question 5
The nurse is teaching a newly licensed nurse about the nursing process. Which
statement indicates correct understanding?
A. "Assessment continues only until the nursing diagnosis is established."
B. "Evaluation determines whether the patient's outcomes have been achieved and
whether the plan needs modification."
C. "Implementation occurs before the nurse identifies patient problems."
D. "Planning consists primarily of carrying out prescribed medical treatments."
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 competency best demonstrates effective medical-surgical nursing practice?
A. Completing assigned tasks according to the unit routine
B. Integrating assessment findings, clinical judgment, evidence, and patient preferences
into nursing care
C. Following provider prescriptions without questioning unexpected findings
D. Prioritizing completion of documentation over changes in patient condition
Correct Answer: B
Rationale:
Medical-surgical nursing requires the nurse to integrate clinical knowledge, assessment
findings, evidence-based practice, patient preferences, safety principles, and clinical
judgment when providing care. This approach supports individualized and safe nursing
practice.
Why the other options are incorrect:
• A: Completing tasks is important, but competency involves more than following a
routine.
1
, • B: Correct. Effective practice integrates clinical judgment, evidence, patient
preferences, and assessment findings.
• C: Nurses have a responsibility to recognize and communicate concerns about
potentially unsafe or inappropriate prescriptions.
• D: Documentation is important, but a change in patient condition takes priority over
routine documentation.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 2
A nurse is caring for four patients. Which action best demonstrates clinical judgment?
A. Administering medications at the scheduled time without reassessing the patients
B. Using the same assessment sequence for every patient regardless of diagnosis
C. Comparing current findings with baseline data and determining which change requires
immediate intervention
D. Asking another nurse to make decisions whenever the patient's condition changes
Correct Answer: C
Rationale:
Clinical judgment involves recognizing meaningful cues, analyzing their significance,
determining priorities, taking appropriate action, and evaluating outcomes. Comparing
current findings with baseline data helps the nurse identify clinically significant
deterioration.
Why the other options are incorrect:
• A: Medication administration requires appropriate assessment and clinical
reasoning rather than simply following the schedule.
• B: Assessment should be individualized according to the patient's condition and
risks.
• C: Correct. Identifying meaningful changes from baseline and determining their
urgency is a core component of clinical judgment.
• D: Collaboration is appropriate, but the nurse remains responsible for exercising
professional judgment within the scope of practice.
2
,Cognitive Level: Analysis
NCLEX Client-Needs Category: Reduction of Risk Potential
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 3
Which statement most accurately describes evidence-based nursing care?
A. Care based exclusively on the nurse's previous clinical experience
B. Care based primarily on patient preference regardless of clinical evidence
C. Care that combines the best available evidence, clinical expertise, and patient
preferences
D. Care based on unit routines that have been used successfully for many years
Correct Answer: C
Rationale:
Evidence-based nursing integrates the best available research evidence with professional
clinical expertise and the patient's values, preferences, and circumstances. This approach
supports safe, individualized, and scientifically informed care.
Why the other options are incorrect:
• A: Experience is valuable but should not be the sole basis for clinical decisions.
• B: Patient preferences are important but must be considered alongside clinical
evidence and professional judgment.
• C: Correct. Evidence-based care incorporates evidence, clinical expertise, and
patient preferences.
• D: Long-standing practices may not reflect current evidence.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 4
3
, A patient newly diagnosed with heart failure tells the nurse, "I don't want to follow the
diet the provider recommended because I don't think I need it." Which response best
demonstrates patient-centered care?
A. "You need to follow the prescribed diet if you want to avoid complications."
B. "The diet is standard for patients with your diagnosis, so you should follow it."
C. "Tell me what concerns you have about the recommended diet so we can discuss
options that fit your preferences."
D. "Your family should help you make sure that you follow the diet after discharge."
Correct Answer: C
Rationale:
Patient-centered care respects the patient's values, preferences, concerns, and ability to
participate in decisions. Exploring the patient's concerns allows the nurse to identify
barriers and collaborate on realistic strategies rather than simply issuing instructions.
Why the other options are incorrect:
• A: This approach is directive and does not explore the patient's concerns.
• B: A standardized recommendation does not eliminate the need for individualized
education.
• C: Correct. The nurse acknowledges the patient's autonomy and invites
collaborative problem-solving.
• D: Family involvement should occur with the patient's permission and should not
replace patient participation.
Cognitive Level: Application
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Assessment
Question 5
The nurse is teaching a newly licensed nurse about the nursing process. Which
statement indicates correct understanding?
A. "Assessment continues only until the nursing diagnosis is established."
B. "Evaluation determines whether the patient's outcomes have been achieved and
whether the plan needs modification."
C. "Implementation occurs before the nurse identifies patient problems."
D. "Planning consists primarily of carrying out prescribed medical treatments."
4
