TEST BANK
MEDICAL- SURGICAL NURSING
CONCEPTS AND PRACTICE 3RD EDITION
BY DEWIT STROMBERG DALLRED
ALL 1-48 CHAPTERS INCLUSIVE
,Test Bank For Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
Chapter 01: Caring for Medical-Surgical Patients
MULTIPLE CHOICE
1. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to improve the health
of Americans in the second decade of the century?
a. Research funding
b. Health information distribution
c. Healthy lifestyle encouragement
d. Health improvement program designs
ANS: C
Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce infant mortality,
cancer, cardiovascular disease, and HIV/AIDS, and to increase effective immunizations, healthy eating habits, and healthy
weight.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6
OBJ: 7 TOP: Healthy People 2020
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. Which term explains the type of care that addresses interventions for all dimensions of a patient’s life?
a. Focused care
b. General care
c. Directed care
d. Holistic care
ANS: D
Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of the patient.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6
OBJ: 8 TOP: Holistic Care
KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. A patient furiously says, “My doctor was so busy giving me instructions that he didn’t hear what I was trying to ask
him!” Which response is most empathetic?
a. “When people ignore me, I really get mad.”
b. “I’m sure that the doctor was rushed and unaware of your needs.”
c. “I’ll bet that made you feel very frustrated.”
d. “Take a deep breath and plan what you will say to him tomorrow.”
ANS: C
Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the emotion. Belittling the patient’s
feelings, showing sympathy, or defending the doctor makes the patient feel devalued.
PTS: 1 DIF: Cognitive Level: Analysis REF: 10
OBJ: 10 TOP: Nurse–Patient Relationship
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
4. The nurse is explaining differences in a therapeutic relationship and a social relationship to a patient. Which
information about therapeutic relationships is most important for the nurse to include in the explanation?
a. Therapeutic relationships lack formal boundaries.
b. Therapeutic relationships are goal directed.
c. Therapeutic relationships meet the needs of each person in the relationship.
d. Therapeutic relationships extend past the hospitalization period.
ANS: B
The therapeutic relationship is focused on the patient and is goal directed and designed to meet only the needs of the patient and
does not extend past the period of hospitalization.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 9
OBJ: 10 TOP: Therapeutic Relationship
,KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
5. The long-term care facility nurse is caring for a newly admitted 80-year-old patient who is depressed. Which approach
is best for the nurse to employ?
a. Encourage the resident to engage in an activity.
b. Remind the resident of reasons to be positive.
c. Point out episodes of negative behavior.
d. Present a bright and cheerful behavior.
ANS: A
Activity and social interaction are helpful to depressed patients. Presenting a cheery approach and pointing out negative behavior
and reasons to be positive are not therapeutic at this stage of the relationship.
PTS: 1 DIF: Cognitive Level: Analysis REF: 10
OBJ: 10 TOP: Depressed Behavior
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
6. The nurse is caring for a patient who has been on antidepressants for 3 days. The patient tearfully says, “I still feel
terrible. I don’t think anything can help how I feel.” Which response is best?
a. “I will tell the charge nurse how you are feeling.”
b. “You just need to be patient and give your medicine some time to work.”
c. “Look how much you have improved since you were admitted to the facility.”
d. “It must be frustrating to be going through this difficult time.”
ANS: D
This response is an empathetic response that allows for further exploration of the patient’s feelings. The other responses will
block communication with this patient.
PTS: 1 DIF: Cognitive Level: Application REF: 9
OBJ: 10 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
7. An overweight male patient rips off his hospital gown, throws it out the door, and shouts, “I’m not wearing this stupid
gown! It is too small, too short, and exposes my backside to the world!” Which response is most appropriate?
a. Remind patient of the need to wear the gown for convenience in care.
b. Confer with the patient for methods to acquire a larger gown.
c. Replace the torn gown with another.
d. Inform the charge nurse of the hostile behavior.
ANS: B
Allowing hostile patients to make reasonable requests defuses the anger and allows patients to vent their feelings.
PTS: 1 DIF: Cognitive Level: Application 9
REF:
OBJ: 10 TOP: Hostile Behavior
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
8. The nurse is caring for a patient who states, “You are the only nurse who understands about my pain.
Can’t you give me an extra dose of pain medication?” How should the nurse respond to the patient’s request?
a. Explain that dosage schedules are by physician’s
orders.
b. Ignore the request.
c. Tell the patient that his behavior is manipulative.
d. Agree to give an extra dose of pain medication.
ANS: A
A matter-of-fact response to a manipulative request limits the effect of the manipulation, thereby helping the nurse
to avoid becoming defensive or being swayed by flattery.
PTS: 1 DIF: Cognitive Level: Application 9
REF:
OBJ: 10 TOP: Manipulative Behavior
KEY: Nursing Process Step:
Implementation MSC: NCLEX:
Psychosocial Integrity
, 9. A female patient who has recently been diagnosed with an inoperable brain tumor asks the nurse, “Do
you think God punishes us?” Which response demonstrates therapeutic communication?
a. “What do you think?”
b. “God loves you.”
c. “Would like to speak with the chaplain?”
d. “God will not give you more than you can
bear.”
ANS: A
Sitting with the patient and offering oneself to listen to the patient’s concerns and encouraging reflection is the
best approach rather than responding with a cliché or suggesting speaking with the chaplain.
PTS: 1 DIF: Cognitive Level: Application 10
REF:
OBJ: 10 TOP: Spiritual Care
KEY: Nursing Process Step:
Implementation MSC: NCLEX:
Psychosocial Integrity
10. The nurse is communicating with a patient who voices concern about an upcoming high-risk
procedure. Which statement best demonstrates empathy?
a. “Would you like to talk about your feelings regarding the
procedure?”
b. “My mother had the same procedure and did very well.”
c. “I can’t imagine how you feel.”
d. “It must be difficult preparing for the procedure; how are you
feeling?”
ANS: D
This statement by the nurse displays empathy by trying to place oneself in the patient’s circumstance and
validating the patient’s feelings. Simply asking patients if they would like to talk about their feelings does not
show empathy and may elicit a “yes” or “no” response. Telling the patient one’s mother had the procedure or
stating “I can’t imagine how you feel” does not show empathy toward the patient.
PTS: 1 DIF: Cognitive Level: Application 10
REF:
OBJ: 10 TOP: Nurse–Patient Relationship
KEY: Nursing Process Step:
Implementation MSC: NCLEX:
11. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)?
a. To test and license LPN/LVNs.
b. To define the scope of LPN/LVN practice.
c. To improve the quality of care provided by the LPN/LVN.
d. To limit the LPN/LVN employment placement.
ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each
state defines the scope of nursing practice in that state.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
OBJ: 3 TOP: NPA KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
12. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational nurse has not
been taught during her educational program. How should the vocational nurse respond?
a. Ask a more experienced nurse to demonstrate the procedure.
b. Look up the procedure in the procedure manual.
c. Attempt to perform the procedure with supervision.
d. Inform the charge nurse of her lack of training in this procedure.
ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational nurse should seek
further training to gain proficiency. Although the other options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application REF: 3
OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
MEDICAL- SURGICAL NURSING
CONCEPTS AND PRACTICE 3RD EDITION
BY DEWIT STROMBERG DALLRED
ALL 1-48 CHAPTERS INCLUSIVE
,Test Bank For Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
Chapter 01: Caring for Medical-Surgical Patients
MULTIPLE CHOICE
1. Which area is the major focus of Healthy People 2020 and the primary mechanism through which to improve the health
of Americans in the second decade of the century?
a. Research funding
b. Health information distribution
c. Healthy lifestyle encouragement
d. Health improvement program designs
ANS: C
Healthy People 2020 focuses on expanding ongoing programs to include support and information to reduce infant mortality,
cancer, cardiovascular disease, and HIV/AIDS, and to increase effective immunizations, healthy eating habits, and healthy
weight.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6
OBJ: 7 TOP: Healthy People 2020
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. Which term explains the type of care that addresses interventions for all dimensions of a patient’s life?
a. Focused care
b. General care
c. Directed care
d. Holistic care
ANS: D
Holistic care addresses the physiologic, psychological, social, cultural, and spiritual needs of the patient.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6
OBJ: 8 TOP: Holistic Care
KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. A patient furiously says, “My doctor was so busy giving me instructions that he didn’t hear what I was trying to ask
him!” Which response is most empathetic?
a. “When people ignore me, I really get mad.”
b. “I’m sure that the doctor was rushed and unaware of your needs.”
c. “I’ll bet that made you feel very frustrated.”
d. “Take a deep breath and plan what you will say to him tomorrow.”
ANS: C
Empathy demonstrates that the nurse perceives the patient’s feelings but does not share the emotion. Belittling the patient’s
feelings, showing sympathy, or defending the doctor makes the patient feel devalued.
PTS: 1 DIF: Cognitive Level: Analysis REF: 10
OBJ: 10 TOP: Nurse–Patient Relationship
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
4. The nurse is explaining differences in a therapeutic relationship and a social relationship to a patient. Which
information about therapeutic relationships is most important for the nurse to include in the explanation?
a. Therapeutic relationships lack formal boundaries.
b. Therapeutic relationships are goal directed.
c. Therapeutic relationships meet the needs of each person in the relationship.
d. Therapeutic relationships extend past the hospitalization period.
ANS: B
The therapeutic relationship is focused on the patient and is goal directed and designed to meet only the needs of the patient and
does not extend past the period of hospitalization.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 9
OBJ: 10 TOP: Therapeutic Relationship
,KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
5. The long-term care facility nurse is caring for a newly admitted 80-year-old patient who is depressed. Which approach
is best for the nurse to employ?
a. Encourage the resident to engage in an activity.
b. Remind the resident of reasons to be positive.
c. Point out episodes of negative behavior.
d. Present a bright and cheerful behavior.
ANS: A
Activity and social interaction are helpful to depressed patients. Presenting a cheery approach and pointing out negative behavior
and reasons to be positive are not therapeutic at this stage of the relationship.
PTS: 1 DIF: Cognitive Level: Analysis REF: 10
OBJ: 10 TOP: Depressed Behavior
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
6. The nurse is caring for a patient who has been on antidepressants for 3 days. The patient tearfully says, “I still feel
terrible. I don’t think anything can help how I feel.” Which response is best?
a. “I will tell the charge nurse how you are feeling.”
b. “You just need to be patient and give your medicine some time to work.”
c. “Look how much you have improved since you were admitted to the facility.”
d. “It must be frustrating to be going through this difficult time.”
ANS: D
This response is an empathetic response that allows for further exploration of the patient’s feelings. The other responses will
block communication with this patient.
PTS: 1 DIF: Cognitive Level: Application REF: 9
OBJ: 10 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
7. An overweight male patient rips off his hospital gown, throws it out the door, and shouts, “I’m not wearing this stupid
gown! It is too small, too short, and exposes my backside to the world!” Which response is most appropriate?
a. Remind patient of the need to wear the gown for convenience in care.
b. Confer with the patient for methods to acquire a larger gown.
c. Replace the torn gown with another.
d. Inform the charge nurse of the hostile behavior.
ANS: B
Allowing hostile patients to make reasonable requests defuses the anger and allows patients to vent their feelings.
PTS: 1 DIF: Cognitive Level: Application 9
REF:
OBJ: 10 TOP: Hostile Behavior
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
8. The nurse is caring for a patient who states, “You are the only nurse who understands about my pain.
Can’t you give me an extra dose of pain medication?” How should the nurse respond to the patient’s request?
a. Explain that dosage schedules are by physician’s
orders.
b. Ignore the request.
c. Tell the patient that his behavior is manipulative.
d. Agree to give an extra dose of pain medication.
ANS: A
A matter-of-fact response to a manipulative request limits the effect of the manipulation, thereby helping the nurse
to avoid becoming defensive or being swayed by flattery.
PTS: 1 DIF: Cognitive Level: Application 9
REF:
OBJ: 10 TOP: Manipulative Behavior
KEY: Nursing Process Step:
Implementation MSC: NCLEX:
Psychosocial Integrity
, 9. A female patient who has recently been diagnosed with an inoperable brain tumor asks the nurse, “Do
you think God punishes us?” Which response demonstrates therapeutic communication?
a. “What do you think?”
b. “God loves you.”
c. “Would like to speak with the chaplain?”
d. “God will not give you more than you can
bear.”
ANS: A
Sitting with the patient and offering oneself to listen to the patient’s concerns and encouraging reflection is the
best approach rather than responding with a cliché or suggesting speaking with the chaplain.
PTS: 1 DIF: Cognitive Level: Application 10
REF:
OBJ: 10 TOP: Spiritual Care
KEY: Nursing Process Step:
Implementation MSC: NCLEX:
Psychosocial Integrity
10. The nurse is communicating with a patient who voices concern about an upcoming high-risk
procedure. Which statement best demonstrates empathy?
a. “Would you like to talk about your feelings regarding the
procedure?”
b. “My mother had the same procedure and did very well.”
c. “I can’t imagine how you feel.”
d. “It must be difficult preparing for the procedure; how are you
feeling?”
ANS: D
This statement by the nurse displays empathy by trying to place oneself in the patient’s circumstance and
validating the patient’s feelings. Simply asking patients if they would like to talk about their feelings does not
show empathy and may elicit a “yes” or “no” response. Telling the patient one’s mother had the procedure or
stating “I can’t imagine how you feel” does not show empathy toward the patient.
PTS: 1 DIF: Cognitive Level: Application 10
REF:
OBJ: 10 TOP: Nurse–Patient Relationship
KEY: Nursing Process Step:
Implementation MSC: NCLEX:
11. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)?
a. To test and license LPN/LVNs.
b. To define the scope of LPN/LVN practice.
c. To improve the quality of care provided by the LPN/LVN.
d. To limit the LPN/LVN employment placement.
ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each
state defines the scope of nursing practice in that state.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
OBJ: 3 TOP: NPA KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
12. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the vocational nurse has not
been taught during her educational program. How should the vocational nurse respond?
a. Ask a more experienced nurse to demonstrate the procedure.
b. Look up the procedure in the procedure manual.
c. Attempt to perform the procedure with supervision.
d. Inform the charge nurse of her lack of training in this procedure.
ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational nurse should seek
further training to gain proficiency. Although the other options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application REF: 3
OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
