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:
At the start of shift, the nurse receives report on four adult
med-surg patients.
Question Stem:
Which patient should the nurse assess first?
Answer Options:
A. A stable patient requesting PRN pain medication that is due
in 30 minutes
B. A newly admitted older adult who is confused, restless, and
has an oxygen saturation of 88% on room air
C. A patient scheduled for discharge later today
D. A patient with chronic back pain rated 6/10 who is
ambulatory
Correct Answer:
B
Detailed Rationale:
The confused, restless patient with SpO2 88% has an
immediate airway/breathing concern and may be deteriorating.
In med-surg nursing, the first priority is the patient with the
most unstable cues, especially those affecting oxygenation and
safety. Acute confusion can also indicate hypoxemia.
Incorrect Option Analysis:
, • A. Incorrect. Pain is important, but this patient is stable
and can wait. Misconception: all pain requests are urgent.
Risk: delayed care for a deteriorating patient.
• C. Incorrect. Discharge planning is important but not
immediate. Misconception: discharge tasks can outrank
unstable cues. Risk: missed early intervention.
• D. Incorrect. Chronic pain in an ambulatory patient is not
the priority. Misconception: pain rating alone determines
urgency. Risk: delayed response to respiratory
compromise.
Nursing Process Linkage:
Assessment
Clinical Judgment Competencies (NCJMM):
Recognize Cues, Prioritize Hypotheses
Difficulty Level:
Moderate
Bloom’s Cognitive Level:
Analyze
NCLEX Client Needs Category:
Physiological Adaptation
Key Learning Objective:
Prioritize the most unstable patient using ABCs and recognition
of deterioration.
, 2) MCQ
Clinical Scenario:
A nurse is caring for an adult patient from a culturally diverse
background who prefers to speak in their home language.
Question Stem:
Which nursing action best demonstrates patient-centered care?
Answer Options:
A. Ask the patient’s adult child to interpret complex teaching
B. Use a trained medical interpreter and ask the patient to
explain the plan in their own words
C. Speak slowly and loudly in English while using gestures
D. Provide written discharge instructions only
Correct Answer:
B
Detailed Rationale:
Patient-centered care respects language preference,
comprehension, autonomy, and safety. A trained interpreter
reduces errors, protects privacy, and supports informed
decision-making. Teach-back confirms understanding.
Incorrect Option Analysis:
• A. Incorrect. Family interpreters may omit or alter
information. Misconception: family translation is always
acceptable. Risk: inaccurate teaching, consent issues, and
privacy concerns.
Surgical Nursing
Making Connections to Practice
3rd Edition
• Author(s)Janice Hoffman; Nancy
Sullivan
• Print ISBN: 9781719647366
TEST BANK
,1) MCQ
Clinical Scenario:
At the start of shift, the nurse receives report on four adult
med-surg patients.
Question Stem:
Which patient should the nurse assess first?
Answer Options:
A. A stable patient requesting PRN pain medication that is due
in 30 minutes
B. A newly admitted older adult who is confused, restless, and
has an oxygen saturation of 88% on room air
C. A patient scheduled for discharge later today
D. A patient with chronic back pain rated 6/10 who is
ambulatory
Correct Answer:
B
Detailed Rationale:
The confused, restless patient with SpO2 88% has an
immediate airway/breathing concern and may be deteriorating.
In med-surg nursing, the first priority is the patient with the
most unstable cues, especially those affecting oxygenation and
safety. Acute confusion can also indicate hypoxemia.
Incorrect Option Analysis:
, • A. Incorrect. Pain is important, but this patient is stable
and can wait. Misconception: all pain requests are urgent.
Risk: delayed care for a deteriorating patient.
• C. Incorrect. Discharge planning is important but not
immediate. Misconception: discharge tasks can outrank
unstable cues. Risk: missed early intervention.
• D. Incorrect. Chronic pain in an ambulatory patient is not
the priority. Misconception: pain rating alone determines
urgency. Risk: delayed response to respiratory
compromise.
Nursing Process Linkage:
Assessment
Clinical Judgment Competencies (NCJMM):
Recognize Cues, Prioritize Hypotheses
Difficulty Level:
Moderate
Bloom’s Cognitive Level:
Analyze
NCLEX Client Needs Category:
Physiological Adaptation
Key Learning Objective:
Prioritize the most unstable patient using ABCs and recognition
of deterioration.
, 2) MCQ
Clinical Scenario:
A nurse is caring for an adult patient from a culturally diverse
background who prefers to speak in their home language.
Question Stem:
Which nursing action best demonstrates patient-centered care?
Answer Options:
A. Ask the patient’s adult child to interpret complex teaching
B. Use a trained medical interpreter and ask the patient to
explain the plan in their own words
C. Speak slowly and loudly in English while using gestures
D. Provide written discharge instructions only
Correct Answer:
B
Detailed Rationale:
Patient-centered care respects language preference,
comprehension, autonomy, and safety. A trained interpreter
reduces errors, protects privacy, and supports informed
decision-making. Teach-back confirms understanding.
Incorrect Option Analysis:
• A. Incorrect. Family interpreters may omit or alter
information. Misconception: family translation is always
acceptable. Risk: inaccurate teaching, consent issues, and
privacy concerns.
