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 reflects the role of the medical-surgical nurse when caring for a
hospitalized adult with multiple chronic conditions?
A. Focusing primarily on completing scheduled tasks efficiently
B. Integrating assessment findings, clinical judgment, evidence, and patient preferences
into care
C. Following standardized interventions without modifying the plan of care
D. Delegating most direct-care responsibilities to other members of the healthcare team
Correct Answer: B
Rationale:
Medical-surgical nursing requires the nurse to integrate patient assessment data, clinical
judgment, evidence-based practice, and patient preferences when planning and providing
care. This approach supports individualized, safe, patient-centered care rather than task
completion alone.
Why the other options are incorrect:
• A: Efficient task completion is important but does not represent the full competency
required of the medical-surgical nurse.
1
, • B: Correct. Integrating clinical data, evidence, judgment, and patient preferences
reflects comprehensive professional nursing practice.
• C: Standardized interventions may provide guidance, but the nurse must
individualize care based on the patient's changing condition.
• D: Delegation is an important competency, but the RN retains responsibility for
appropriate assessment, clinical judgment, and evaluation.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
CJMM Focus: Analyze Cues
Question 2
A nursing student asks why clinical judgment is emphasized in medical-surgical nursing.
Which response by the instructor is most appropriate?
A. “Clinical judgment allows nurses to replace the provider's diagnostic process.”
B. “Clinical judgment primarily involves memorizing common disease manifestations.”
C. “Clinical judgment helps nurses interpret patient information and determine appropriate
actions.”
D. “Clinical judgment is mainly used when a patient refuses treatment.”
Correct Answer: C
Rationale:
Clinical judgment involves interpreting relevant patient information, recognizing significant
findings, determining priorities, selecting appropriate actions, and evaluating outcomes. It
is a central component of safe nursing practice.
Why the other options are incorrect:
• A: Nurses use clinical judgment within the nursing scope of practice and do not
replace the provider's diagnostic role.
• B: Memorization alone does not constitute clinical judgment.
• C: Correct. Clinical judgment connects patient information with nursing decisions
and interventions.
• D: Clinical judgment is required across many patient-care situations, not only
treatment refusal.
Cognitive Level: Recall
2
,NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
CJMM Focus: Analyze Cues
Question 3
Which action best demonstrates evidence-based nursing care?
A. Using an intervention because it has always been performed on the unit
B. Selecting an intervention supported by current evidence while considering the patient's
needs and preferences
C. Choosing the intervention preferred by the most experienced nurse
D. Using the intervention that requires the least amount of documentation
Correct Answer: B
Rationale:
Evidence-based nursing care involves using the best available evidence while integrating
clinical expertise and patient needs and preferences. The nurse should avoid relying solely
on tradition, personal preference, or convenience.
Why the other options are incorrect:
• A: Long-standing practice does not establish that an intervention is supported by
current evidence.
• B: Correct. Evidence-based practice incorporates relevant evidence with
professional judgment and patient considerations.
• C: Experience is valuable but should not substitute for evidence.
• D: Documentation requirements do not determine whether an intervention is
clinically appropriate.
Cognitive Level: Recall
NCLEX Client-Needs Category: Reduction of Risk Potential
Nursing Process: Planning
Question 4
A 72-year-old patient is admitted with weakness and dizziness. The patient says, “I am
worried that I will not be able to manage everything when I go home.” Which nursing action
best demonstrates patient-centered care?
A. Providing standardized discharge instructions without asking additional questions
B. Asking about the patient's concerns, abilities, resources, and preferences before
3
, developing the discharge plan
C. Completing the discharge plan based only on the provider's recommendations
D. Asking the patient's family to make all discharge decisions
Correct Answer: B
Rationale:
Patient-centered care recognizes the patient as an active participant in decisions affecting
health and treatment. Assessing concerns, abilities, available resources, and preferences
allows the nurse to develop a plan that is individualized and realistic.
Why the other options are incorrect:
• A: Standardized information may be useful but does not address the patient's
individual circumstances.
• B: Correct. Exploring concerns and preferences supports individualized,
collaborative care.
• C: The nurse must incorporate the patient's perspective rather than relying
exclusively on provider recommendations.
• D: Family involvement may be appropriate with the patient's permission, but the
patient should not automatically be excluded from decisions.
Cognitive Level: Application
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 5
The RN receives report on four medical-surgical patients. Which patient should the nurse
assess first?
A. A patient with chronic arthritis reporting pain of 6/10 before the next scheduled
analgesic
B. A patient awaiting discharge who needs reinforcement of dietary instructions
C. A patient newly admitted with pneumonia who has increasing work of breathing and an
oxygen saturation of 88%
D. A patient with diabetes whose premeal blood glucose is 178 mg/dL
Correct Answer: C
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 reflects the role of the medical-surgical nurse when caring for a
hospitalized adult with multiple chronic conditions?
A. Focusing primarily on completing scheduled tasks efficiently
B. Integrating assessment findings, clinical judgment, evidence, and patient preferences
into care
C. Following standardized interventions without modifying the plan of care
D. Delegating most direct-care responsibilities to other members of the healthcare team
Correct Answer: B
Rationale:
Medical-surgical nursing requires the nurse to integrate patient assessment data, clinical
judgment, evidence-based practice, and patient preferences when planning and providing
care. This approach supports individualized, safe, patient-centered care rather than task
completion alone.
Why the other options are incorrect:
• A: Efficient task completion is important but does not represent the full competency
required of the medical-surgical nurse.
1
, • B: Correct. Integrating clinical data, evidence, judgment, and patient preferences
reflects comprehensive professional nursing practice.
• C: Standardized interventions may provide guidance, but the nurse must
individualize care based on the patient's changing condition.
• D: Delegation is an important competency, but the RN retains responsibility for
appropriate assessment, clinical judgment, and evaluation.
Cognitive Level: Application
NCLEX Client-Needs Category: Management of Care
Nursing Process: Planning
CJMM Focus: Analyze Cues
Question 2
A nursing student asks why clinical judgment is emphasized in medical-surgical nursing.
Which response by the instructor is most appropriate?
A. “Clinical judgment allows nurses to replace the provider's diagnostic process.”
B. “Clinical judgment primarily involves memorizing common disease manifestations.”
C. “Clinical judgment helps nurses interpret patient information and determine appropriate
actions.”
D. “Clinical judgment is mainly used when a patient refuses treatment.”
Correct Answer: C
Rationale:
Clinical judgment involves interpreting relevant patient information, recognizing significant
findings, determining priorities, selecting appropriate actions, and evaluating outcomes. It
is a central component of safe nursing practice.
Why the other options are incorrect:
• A: Nurses use clinical judgment within the nursing scope of practice and do not
replace the provider's diagnostic role.
• B: Memorization alone does not constitute clinical judgment.
• C: Correct. Clinical judgment connects patient information with nursing decisions
and interventions.
• D: Clinical judgment is required across many patient-care situations, not only
treatment refusal.
Cognitive Level: Recall
2
,NCLEX Client-Needs Category: Management of Care
Nursing Process: Assessment
CJMM Focus: Analyze Cues
Question 3
Which action best demonstrates evidence-based nursing care?
A. Using an intervention because it has always been performed on the unit
B. Selecting an intervention supported by current evidence while considering the patient's
needs and preferences
C. Choosing the intervention preferred by the most experienced nurse
D. Using the intervention that requires the least amount of documentation
Correct Answer: B
Rationale:
Evidence-based nursing care involves using the best available evidence while integrating
clinical expertise and patient needs and preferences. The nurse should avoid relying solely
on tradition, personal preference, or convenience.
Why the other options are incorrect:
• A: Long-standing practice does not establish that an intervention is supported by
current evidence.
• B: Correct. Evidence-based practice incorporates relevant evidence with
professional judgment and patient considerations.
• C: Experience is valuable but should not substitute for evidence.
• D: Documentation requirements do not determine whether an intervention is
clinically appropriate.
Cognitive Level: Recall
NCLEX Client-Needs Category: Reduction of Risk Potential
Nursing Process: Planning
Question 4
A 72-year-old patient is admitted with weakness and dizziness. The patient says, “I am
worried that I will not be able to manage everything when I go home.” Which nursing action
best demonstrates patient-centered care?
A. Providing standardized discharge instructions without asking additional questions
B. Asking about the patient's concerns, abilities, resources, and preferences before
3
, developing the discharge plan
C. Completing the discharge plan based only on the provider's recommendations
D. Asking the patient's family to make all discharge decisions
Correct Answer: B
Rationale:
Patient-centered care recognizes the patient as an active participant in decisions affecting
health and treatment. Assessing concerns, abilities, available resources, and preferences
allows the nurse to develop a plan that is individualized and realistic.
Why the other options are incorrect:
• A: Standardized information may be useful but does not address the patient's
individual circumstances.
• B: Correct. Exploring concerns and preferences supports individualized,
collaborative care.
• C: The nurse must incorporate the patient's perspective rather than relying
exclusively on provider recommendations.
• D: Family involvement may be appropriate with the patient's permission, but the
patient should not automatically be excluded from decisions.
Cognitive Level: Application
NCLEX Client-Needs Category: Health Promotion and Maintenance
Nursing Process: Assessment
CJMM Focus: Recognize Cues
Question 5
The RN receives report on four medical-surgical patients. Which patient should the nurse
assess first?
A. A patient with chronic arthritis reporting pain of 6/10 before the next scheduled
analgesic
B. A patient awaiting discharge who needs reinforcement of dietary instructions
C. A patient newly admitted with pneumonia who has increasing work of breathing and an
oxygen saturation of 88%
D. A patient with diabetes whose premeal blood glucose is 178 mg/dL
Correct Answer: C
4
