Davis Advantage for Medical-
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario:
A medical-surgical nurse receives report on four adult patients.
Question Stem:
Which patient should the nurse assess first?
Answer Options:
A. A patient requesting pain medication for incisional pain rated
6/10
B. A patient with new confusion, respiratory rate 30/min, and
SpO2 89% on room air
C. A patient waiting for discharge instructions after an
uncomplicated appendectomy
D. A patient who has not yet eaten breakfast and reports mild
nausea
Correct Answer:
B
Detailed Rationale:
This patient shows signs of deterioration affecting oxygenation
and perfusion. New confusion, tachypnea, and hypoxemia are
priority cues that suggest the patient may be unstable. The
nurse should assess immediately and intervene using airway-
breathing-circulation priorities.
Incorrect Option Analysis:
, • A: Pain needs attention, but it is not more urgent than
compromised oxygenation.
Misconception: Assuming pain is always the highest
priority.
Safety risk: Delayed response to hypoxemia.
• C: Discharge teaching is important but can wait until the
unstable patient is addressed.
Misconception: Prioritizing planned care over acute
instability.
Safety risk: Missed early intervention.
• D: Mild nausea is uncomfortable but not immediately life-
threatening.
Misconception: Treating comfort concerns as
emergencies.
Safety risk: Failure to recognize respiratory compromise.
Nursing Process Linkage:
Assessment
NCJMM Competencies:
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty:
Moderate
Bloom’s Cognitive Level:
Analyze
NCLEX Client Needs Category:
Physiological Adaptation
, Key Learning Objective:
Identify priority cues indicating acute patient deterioration.
2) SATA
Clinical Scenario:
A nurse is reviewing evidence-based practice principles during
orientation.
Question Stem:
Which actions are consistent with evidence-based nursing care?
Select all that apply.
Answer Options:
A. Use current, credible research and clinical practice guidelines
B. Follow the same routine because it has always worked on
the unit
C. Combine research evidence, clinical expertise, and patient
preferences
D. Evaluate whether the intervention improved patient
outcomes
E. Rely mainly on the most experienced coworker’s opinion
Correct Answers:
A, C, D
Detailed Rationale:
Evidence-based nursing care integrates the best available
evidence, professional judgment, and the patient’s values and
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario:
A medical-surgical nurse receives report on four adult patients.
Question Stem:
Which patient should the nurse assess first?
Answer Options:
A. A patient requesting pain medication for incisional pain rated
6/10
B. A patient with new confusion, respiratory rate 30/min, and
SpO2 89% on room air
C. A patient waiting for discharge instructions after an
uncomplicated appendectomy
D. A patient who has not yet eaten breakfast and reports mild
nausea
Correct Answer:
B
Detailed Rationale:
This patient shows signs of deterioration affecting oxygenation
and perfusion. New confusion, tachypnea, and hypoxemia are
priority cues that suggest the patient may be unstable. The
nurse should assess immediately and intervene using airway-
breathing-circulation priorities.
Incorrect Option Analysis:
, • A: Pain needs attention, but it is not more urgent than
compromised oxygenation.
Misconception: Assuming pain is always the highest
priority.
Safety risk: Delayed response to hypoxemia.
• C: Discharge teaching is important but can wait until the
unstable patient is addressed.
Misconception: Prioritizing planned care over acute
instability.
Safety risk: Missed early intervention.
• D: Mild nausea is uncomfortable but not immediately life-
threatening.
Misconception: Treating comfort concerns as
emergencies.
Safety risk: Failure to recognize respiratory compromise.
Nursing Process Linkage:
Assessment
NCJMM Competencies:
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty:
Moderate
Bloom’s Cognitive Level:
Analyze
NCLEX Client Needs Category:
Physiological Adaptation
, Key Learning Objective:
Identify priority cues indicating acute patient deterioration.
2) SATA
Clinical Scenario:
A nurse is reviewing evidence-based practice principles during
orientation.
Question Stem:
Which actions are consistent with evidence-based nursing care?
Select all that apply.
Answer Options:
A. Use current, credible research and clinical practice guidelines
B. Follow the same routine because it has always worked on
the unit
C. Combine research evidence, clinical expertise, and patient
preferences
D. Evaluate whether the intervention improved patient
outcomes
E. Rely mainly on the most experienced coworker’s opinion
Correct Answers:
A, C, D
Detailed Rationale:
Evidence-based nursing care integrates the best available
evidence, professional judgment, and the patient’s values and
