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 action best demonstrates the medical-surgical nurse's role in evidence-based
nursing care?
A. Using a familiar intervention because it worked for another patient
B. Combining current research evidence, clinical expertise, and patient preferences when
making care decisions
C. Following unit routines even when the patient's condition differs from the usual situation
D. Selecting the intervention that requires the fewest nursing resources
Correct Answer: B
Rationale:
Evidence-based nursing care integrates the best available evidence with the nurse's
clinical expertise and the patient's values, preferences, and clinical circumstances. This
approach supports individualized, scientifically supported care rather than relying solely
on tradition, convenience, or personal experience.
Why the other options are incorrect:
1
, • A: Personal experience can contribute to clinical expertise but should not be the
sole basis for a nursing decision.
• B: This is correct because evidence-based practice combines research evidence,
professional judgment, and patient preferences.
• C: Routine practices should not replace individualized assessment and evidence-
based decision-making.
• D: Resource use matters, but cost or convenience alone does not determine the
most appropriate intervention.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 2
Which statement best describes patient-centered care in the medical-surgical
setting?
A. The nurse makes decisions for the patient to promote efficiency
B. The interdisciplinary team determines goals before discussing them with the patient
C. The nurse adapts care to the patient's values, preferences, needs, and expressed goals
D. The nurse provides identical interventions to patients with the same diagnosis
Correct Answer: C
Rationale:
Patient-centered care recognizes the patient as an active participant in health-care
decisions. Although standardized evidence-based approaches are useful, the nurse must
individualize care according to the patient's preferences, values, cultural considerations,
needs, and goals.
Why the other options are incorrect:
• A: Medical-surgical nursing should support patient participation rather than remove
autonomy.
• B: Patients should be included in goal setting and care planning whenever possible.
• C: This is correct because patient-centered care emphasizes individualized,
respectful, collaborative decision-making.
2
, • D: Two patients with the same diagnosis may have different risks, preferences,
priorities, and responses to treatment.
Cognitive Level: Recall
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Planning
Question 3
Which nursing action is most consistent with effective interprofessional
communication?
A. Waiting until the end of the shift to report a significant change
B. Communicating relevant assessment findings clearly and promptly to the appropriate
team member
C. Sharing only information the nurse believes the provider already knows
D. Documenting the change without verbally communicating it
Correct Answer: D
Rationale:
This question requires recognizing that effective interprofessional communication depends
on timely sharing of clinically important information. Simply documenting a significant
change may not ensure that the appropriate team member receives and acts on the
information promptly. The nurse should communicate important findings through an
appropriate, timely channel and document the communication as required.
Why the other options are incorrect:
• A: Delaying clinically important information can place the patient at risk.
• B: Prompt communication is appropriate, but the option is less complete because
effective communication also requires accurate, relevant, and structured reporting.
• C: The nurse should not assume that another team member already knows an
important finding.
• D: This is correct because documentation alone does not substitute for timely
direct communication when action may be required.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Implementation
3
, Question 4
A 72-year-old patient is admitted with pneumonia. The patient's temperature is 38.7°C
(101.7°F), respiratory rate is 30/min, oxygen saturation is 88% on room air, and the patient
is increasingly confused. Which action should the nurse take first?
A. Reassess the patient's orientation in 30 minutes
B. Encourage oral fluids
C. Apply oxygen according to the patient's prescribed or emergency oxygen protocol and
rapidly reassess respiratory status
D. Complete the admission history before beginning interventions
Correct Answer: C
Rationale:
The patient has significant respiratory compromise, evidenced by tachypnea, hypoxemia,
and acute mental-status change. The immediate priority is to support oxygenation and
rapidly reassess the patient's response. The clinical picture suggests deterioration
requiring prompt action rather than completion of nonurgent admission activities.
Why the other options are incorrect:
• A: Delaying reassessment when the patient is already hypoxemic and confused is
unsafe.
• B: Hydration may be appropriate, but oxygenation takes priority when there is acute
respiratory compromise.
• C: This is correct because improving oxygenation and reassessing the patient's
response addresses the most immediate threat.
• D: Administrative and historical information should not take priority over acute
physiologic instability.
Cognitive Level: Analysis
NCLEX Client-Needs Category: Physiological Adaptation
Nursing Process: Implementation
CJMM Focus: Take Action
Question 5
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 action best demonstrates the medical-surgical nurse's role in evidence-based
nursing care?
A. Using a familiar intervention because it worked for another patient
B. Combining current research evidence, clinical expertise, and patient preferences when
making care decisions
C. Following unit routines even when the patient's condition differs from the usual situation
D. Selecting the intervention that requires the fewest nursing resources
Correct Answer: B
Rationale:
Evidence-based nursing care integrates the best available evidence with the nurse's
clinical expertise and the patient's values, preferences, and clinical circumstances. This
approach supports individualized, scientifically supported care rather than relying solely
on tradition, convenience, or personal experience.
Why the other options are incorrect:
1
, • A: Personal experience can contribute to clinical expertise but should not be the
sole basis for a nursing decision.
• B: This is correct because evidence-based practice combines research evidence,
professional judgment, and patient preferences.
• C: Routine practices should not replace individualized assessment and evidence-
based decision-making.
• D: Resource use matters, but cost or convenience alone does not determine the
most appropriate intervention.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
Question 2
Which statement best describes patient-centered care in the medical-surgical
setting?
A. The nurse makes decisions for the patient to promote efficiency
B. The interdisciplinary team determines goals before discussing them with the patient
C. The nurse adapts care to the patient's values, preferences, needs, and expressed goals
D. The nurse provides identical interventions to patients with the same diagnosis
Correct Answer: C
Rationale:
Patient-centered care recognizes the patient as an active participant in health-care
decisions. Although standardized evidence-based approaches are useful, the nurse must
individualize care according to the patient's preferences, values, cultural considerations,
needs, and goals.
Why the other options are incorrect:
• A: Medical-surgical nursing should support patient participation rather than remove
autonomy.
• B: Patients should be included in goal setting and care planning whenever possible.
• C: This is correct because patient-centered care emphasizes individualized,
respectful, collaborative decision-making.
2
, • D: Two patients with the same diagnosis may have different risks, preferences,
priorities, and responses to treatment.
Cognitive Level: Recall
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Planning
Question 3
Which nursing action is most consistent with effective interprofessional
communication?
A. Waiting until the end of the shift to report a significant change
B. Communicating relevant assessment findings clearly and promptly to the appropriate
team member
C. Sharing only information the nurse believes the provider already knows
D. Documenting the change without verbally communicating it
Correct Answer: D
Rationale:
This question requires recognizing that effective interprofessional communication depends
on timely sharing of clinically important information. Simply documenting a significant
change may not ensure that the appropriate team member receives and acts on the
information promptly. The nurse should communicate important findings through an
appropriate, timely channel and document the communication as required.
Why the other options are incorrect:
• A: Delaying clinically important information can place the patient at risk.
• B: Prompt communication is appropriate, but the option is less complete because
effective communication also requires accurate, relevant, and structured reporting.
• C: The nurse should not assume that another team member already knows an
important finding.
• D: This is correct because documentation alone does not substitute for timely
direct communication when action may be required.
Cognitive Level: Recall
NCLEX Client-Needs Category: Management of Care
Nursing Process: Implementation
3
, Question 4
A 72-year-old patient is admitted with pneumonia. The patient's temperature is 38.7°C
(101.7°F), respiratory rate is 30/min, oxygen saturation is 88% on room air, and the patient
is increasingly confused. Which action should the nurse take first?
A. Reassess the patient's orientation in 30 minutes
B. Encourage oral fluids
C. Apply oxygen according to the patient's prescribed or emergency oxygen protocol and
rapidly reassess respiratory status
D. Complete the admission history before beginning interventions
Correct Answer: C
Rationale:
The patient has significant respiratory compromise, evidenced by tachypnea, hypoxemia,
and acute mental-status change. The immediate priority is to support oxygenation and
rapidly reassess the patient's response. The clinical picture suggests deterioration
requiring prompt action rather than completion of nonurgent admission activities.
Why the other options are incorrect:
• A: Delaying reassessment when the patient is already hypoxemic and confused is
unsafe.
• B: Hydration may be appropriate, but oxygenation takes priority when there is acute
respiratory compromise.
• C: This is correct because improving oxygenation and reassessing the patient's
response addresses the most immediate threat.
• D: Administrative and historical information should not take priority over acute
physiologic instability.
Cognitive Level: Analysis
NCLEX Client-Needs Category: Physiological Adaptation
Nursing Process: Implementation
CJMM Focus: Take Action
Question 5
4
