14/01/2024g13:24 MedgSurggtestgquestion
Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
Chapterg01:gProfessionalgNursing
Harding:g Lewis’sg Medical-Surgicalg Nursing,g 11thg Edition
MULTIPLEgg CHOICE
1. Theg nurseg completesg ang admissiong databaseg andg explainsg thatg theg plang ofg careg andg dischar
geggoalsg willg beg developed g withg theg patient’sg input.g Theg patientg asks,g “How g isg thisg differe
ntg fromgwhatgthegdoctorgdoes?”gWhichgresponsegwouldgbegmostgappropriategforgthegnurse
gtogmake?
a. “Thegrolegof gthegnursegisgtogadminister gmedications gand gothergtreatmentsgprescri
bedgbygyourg doctor.”
b. “Ing additiong tog caringg forg youg whileg youg areg sick,g theg nursesg willg helpg youg pl
ang togmaintaing yourghealth.”
c. “Theg nurse’sgjobg isgtoghelpgthegdoctorgbygcollectingg informationgand
communicatingg anyg problemsg thatg occur.”
d. “Nursesgperformgmanygofgthegsamegproceduresgasgthegdoctor,gbutgnursesgareg
withgthegpatientsgforgaglongergtimegthangthegdoctor.”
ANS:g B
Theg Americang Nursesg Associationg (ANA)g definitiong ofg nursingg describesg theg roleg ofg nurse
sg ingpromotingg health.g Theg otherg responsesg describeg dependentg andg collaborativeg functionsg
ofg thegnursinggrolegbutgdognotgaccuratelygdescribe gthegnurse’sguniquegrolegingtheg healthgca
regsystem.
DIF:gggCognitivegLevel:gAnalyzeg(analysis)
TOP:g NursinggProcess:gImplementation MSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
2. Theg nurseg describesg tog ag studentg nurseg howg tog useg evidence-
basedg practiceg (EBP)g wheng caringgforgpatients.gWhichgstatementgbygtheg nursegaccuratelygde
scribesgtheg usegofgEBP?
a. “Inferencesg fromg allg publishedg articlesg areg usedg asg ag guide.”
b. “Patientg careg isg basedg ong clinicalg judgment,g experience,g andg traditions.”
c. “Datagareganalyzedglatergtogshowgthatgthegpatientgoutcomesgaregconsistentlygmet.”
d. “Recommendationsgaregbased gongresearch,gclinicalgexpertise,gand gpati
entgpreferences.”
ANS:g D
Evidence-basedg practiceg (EBP)g isg theg useg ofg theg bestg research-
basedg evidenceg combinedg withgcliniciang expertiseg andg considerationg ofg patientg preferences.g
Clinicalg judgmentg basedg ong thegnurse’sgclinicalgexperiencegisgpartgofgEBP,gbutgclinicalgde
cisiongmakinggshouldgalsogincorporateg currentg researchg andg research-
basedg guidelines.g Evaluationg ofg patientg outcomesg isgimportant,g butg datag analysisg isg notg requ
iredg tog useg EBP.g Allg publishedg articlesg dog notg providegresearchg evidence;g interventionsg sho
uldg beg basedg ong credibleg research,g preferablyg randomizedgcontrolledgstudiesgwithgaglargegnu
mbergofgsubjects.
DIF:ggggCognitivegLevel:gRememberg(knowledge)
TOP:gNursinggProcess:gPlanning
gMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
3. Theg nurseg teachesg ag studentg nurseg aboutg howg tog applyg theg nursingg processg wheng provi
dinggpatientg care.g Whichg statementg byg theg studentg nurseg indicatesg thatg teachingg wasg suc
cessful?
a. “Thegnursinggprocessg isgagresearchgmethodgofgdiagnosinggthegpatient’s ghealthgcare
problems.”
b. “Theg nursingg processgisgusedgprimarilygtogexplaing nursingg interventionsgtogother
TESTBANKWORLD.ORG
about:blank 1/694
,14/01/2024g13:24 MedgSurggtestgquestion
Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
healthg careg professionals.”
c. “Theg nursingg processg isg ag problem-solvingg toolg usedg tog identifyg andg treatg the
patients’ghealthg careg needs.”
d. “Thegnursinggprocessgisgbasedgongnursinggtheorygthatgincorporatesg
thegbiopsychosocialgnaturegofghumans.”
ANS:g C
Theg nursingg processg isg agproblem-
solvingg approachg togtheg identificationgandg treatmentg ofgpatients’gproblems.gNursinggprocess
gdoesgnotgrequiregresearchgmethodsgforgdiagnosis.gThe gprimaryg useg ofg theg nursingg processg
isg ing patientg care,g notg tog establishg nursingg theoryg org explaingnursingginterventionsgtogothergh
ealthgcaregprofessionals.
DIF:ggggCognitivegLevel:gUnderstandg(comprehension)
TOP:gNursinggProcess:gEvaluation
gMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
4. Agpatientgadmittedgtogtheghospitalgforgsurgerygtellsgthegnurse,g“Igdognotgfeelgcomfor
tablegleavinggmygchildrengwithgmygparents.”gWhichgactiongshouldgthegnursegtakeg
next?
a. Reassureg theg patientg thatg theseg feelingsg aregcommong forg parents.
b. Haveg theg patientg callg theg childreng tog ensureg thatg theyg aregdoingg well.
c. Gatherginformationgongthegpatient’s gconcernsgaboutgthegchild gcaregarrangements.
d. Callgthegpatient’sgparentsgtogdeterminegwhethergadequategchildgcaregisgbeing
provided.
ANS:g C
Becausegag completegassessmentg isg necessaryg ingorderg tog identifyg agproblemg andgchooseg an
gappropriategintervention,gthegnurse’sgfirstgaction gshouldgbe gtogobtain gmore ginformation.g
Thegotherg actionsg mayg beg appropriate,g butg moreg assessmentg isg neededg beforeg theg bestg inte
rventiongcangbegchosen.
DIF:gggCognitivegLevel:gAnalyzeg(analysis)
OBJ:ggg SpecialgQuestions:gPrioritization
TOP:gNursinggProcess:gAssessment
gMSC:g NCLEX:gPsychosocialgIntegrity
5. Ag patientg withg ag bacterialg infectiong isg hypovolemicg dueg tog ag feverg andg excessiveg diaphor
esis.gWhichgexpectedgoutcomegwouldgtheg nursegrecognizegasgappropriategforgthisg patient?
a. Patientg hasg ag balancedg intakeg andg output.
b. Patient’sgbeddingg isgkeptgcleangandg freegofg moisture.
c. Patientg understandsg theg needg forg increasedg fluidg intake.
d. Patient’sgskin gremainsg coolgandgdrygthroughout ghospitalization.
ANS:g A
Balancedg intakeg andg outputg givesg measurableg datag showingg resolutiong ofg theg problem
g ofgdeficientg fluidg volume.g Theg otherg statementsgwouldg notg indicategthatg thegproblemg
ofghypovolemiagwasgresolved.
DIF:ggggCognitivegLevel:gApplyg(application) TOP:
NursinggProcess:gPlanninggMSC:gNCLE
X:gPhysiologicalgIntegrity
6. Afterg administeringg medication,g theg nurseg asksg theg patientg ifg paing wasg relieved.g Whatg is
g thegpurposegofgthe gevaluationgphasegofgthegnursinggprocess?
a. Tog documentg theg nursingg careg plang ing theg progressg notesg ofg theg healthg record
b. Tog determineg ifg interventionsg haveg beeng effectiveg ing meetingg patientg outcomes
TESTBANKWORLD.ORG
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,14/01/2024g13:24 MedgSurggtestgquestion
Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
c. Togdecidegwhether gthegpatient’s ghealthgproblems ghavegbeengcompletelygresolved
d. Tog establishg ifg theg patientg agreesg thatg theg nursingg careg providedg wasg satisfactory
ANS:g B
Evaluationgconsistsgofgdetermininggwhethergthegdesiredgpatientgoutcomesghavegbeengmetga
ndgwhethergthegnursingginterventionsgweregappropriate.gThegothergresponsesgdognotgdescrib
egthegevaluationgphase.
DIF:ggggCognitivegLevel:gUnderstandg(comprehension)
TOP:gNursinggProcess:gEvaluation
gMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
7. Theg nurseg interviewsg ag patientg whileg completingg theg healthg historyg andg physicalg examinati
on.gWhatgisgthegpurposegofgthegassessmentgphasegofgthegnursinggprocess?
a. Tog teachg interventionsg thatg relieveg healthg problems
b. Tog useg patientg datag tog evaluateg patientg careg outcomes
c. Tog helpg theg patientg identifyg realisticg outcomesg forg healthg problems
d. Tog obtaing datag withg whichg tog diagnoseg patientg strengthsg andg problems
ANS:g D
Duringg theg assessmentg phase,g theg nurseg gathersg informationg aboutg theg patientg tog diagnoseg
patientgstrengthsgandgproblems.gTheg otherg responsesgaregexamplesgofgthegplanning,ginterve
ntion,gandgevaluationgphasesgofgthegnursinggprocess.
DIF:ggg CognitivegLevel:gUnderstandg(comprehension)
TOP:g NursinggProcess:gAssessment MSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
8. Theg nurseg admitsg ag patientg tog theg hospitalg andg developsg ag plang ofg care.g Whatg compon
entsgshouldgthegnursegincludegingthegpatientgproblemgstatement?
a. Theg problemg andg theg suggestedg patientg goalsg org outcomes
b. Theg problem,g itsg causes,g andg theg signsg andg symptomsg ofg theg problem
c. Theg problemg withg theg possibleg etiologyg andg theg plannedg interventions
d. Theg problem,g theg pathophysiologyg ofg theg problem,g andg theg expectedg outcome
ANS:g B
Wheng writingg patientg problemsg org nursingg diagnoses,g thisg formatg shouldg beg used:g probl
em,getiology,gandgsignsgandgsymptoms.gThegsubjectivegasgwellgasgobjectiveg datagshouldg
begincluded.g Goals,g outcomes,g andg interventionsg areg notg includedg ing theg problemg statem
ent.
DIF:ggggCognitivegLevel:gUnderstandg(comprehension)
TOP:gNursinggProcess:gDiagnosi
sgMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
9. Whichg patientg careg taskg isg appropriateg forg theg nurseg tog delegateg tog experiencedg unlicen
sedgassistivegpersonnelg(UAP)?
a. Instructg theg patientg aboutg theg needg tog alternateg activityg andg rest.
b. Monitorg levelg ofg shortnessg ofg breathg org fatigueg afterg ambulation.
c. Obtaingthegpatient’sgbloodgpressuregandgpulsegrategaftergambulation.
d. Determineg whetherg theg patientg isg readyg tog increaseg theg activityg level.
ANS:g C
UAPg educationg includesg accurateg vitalg signg measurement.g Assessmentg andg patientg teachi
nggrequiregregisteredg nursegeducationgandg scopegofgpracticegandgcannotgbegdelegated.
TESTBANKWORLD.ORG
about:blank 3/694
, 14/01/2024g13:24 MedgSurggtestgquestion
Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
DIF:gggCognitivegLevel:gApplyg(application)
OBJ:ggg SpecialgQuestions:gDelegation
TOP:gNursinggProcess:gPlanning
gMSC:g NCLEX:gSafegandgEffectivegCaregEnvironment
10. Ag nurseg isg caringg forg ag groupg ofg patientsg ong theg medical-
surgicalg unitg withg theg helpg ofg oneg floatgregisteredg nurseg(RN),goneg unlicensedgassistivegperso
nnelg(UAP),gandgoneglicensedgpractical/vocationalg nurseg (LPN/VN).g Whichg assignment,g ifg d
elegatedg byg theg nurse,g wouldg beginappropriate?
a. Checkg forg theg presenceg ofg bowelg soundsg byg UAP
b. Administrationg ofg oralg medicationsg byg LPN/VN
c. Insuling administrationg byg floatg RNg fromg theg pediatricg unit
d. Measurementgofg ag patient’sg urinaryg catheterg outputgbyg UAP
ANS:g A
AssessmentgrequiresgRNgeducationg andgscopegofg practicegsog itgcannotg begdelegatedg tog ang
LPN/VNg org UAP.g Theg otherg assignmentsg madeg byg theg RNg areg appropriateg forg theg roleg of
g thegteamgmember.
DIF:gggCognitivegLevel:gApplyg(application)
OBJ:ggg SpecialgQuestions:gDelegation
TOP:gNursinggProcess:gPlanning
gMSC:g NCLEX:gSafegandgEffectivegCaregEnvironment
11. Whichg taskg isg appropriateg forg theg nurseg tog delegateg tog ag licensedg practical/vocationalg n
urseg(LPN/VN)?
a. Completeg theg initialg admissiong assessmentg andg plang ofg care.
b. Measureg bedsideg bloodg glucoseg beforeg administeringg insulin.
c. Documentg teachingg completedg beforeg ag diagnosticg procedure.
d. Instructg ag patientg aboutg low-fat,g reducedg sodiumg dietaryg restrictions.
ANS:g B
Thegeducationg andg scopeg ofg practiceg ofg theg LPN/LVNg includeg activitiesgsuchg asg obtaining
gglucoseg testingg usingg ag fingerg stickg andg administeringg insulin.g Patientg teachingg andg theg i
nitialgassessmentg andg developmentg ofg theg plang ofg caregareg nursingg actionsg thatg requireg regi
steredgnursegeducationgandgscopegofgpractice.
DIF:gggCognitivegLevel:gApplyg(application)
OBJ:ggg SpecialgQuestions:gDelegation
TOP:gNursinggProcess:gPlanning
gMSC:g NCLEX:gSafegandgEffectivegCaregEnvironment
12. Ag nurseg isg assignedg asg ag caseg managerg forg ag hospitalizedg patientg withg ag spinalg cordg in
jury.gWhichgactivitygcangthegpatientgexpectgthegnursegingthisgrolegtogperform?
a. Careg forg theg patientg duringg hospitalizationg forg theg injuries.
b. Assistg theg patientg withg homeg careg activitiesg duringg recovery.
c. Coordinateg theg servicesg theg patientg receivesg ing theg hospitalg andg atg home.
d. Determineg whatg medicalg careg theg patientg needsg forg optimalg rehabilitation.
ANS:g C
Thegrolegofgthegcasegmanagergisgtogcoordinategthegpatient’sgcaregthroughgmultiplegsettingsg
andglevelsg ofg careg tog allowg theg maximalg patientg benefitg atg theg leastg cost.g Theg casegmanager
g doesg notgprovideg directg careg ing theg acuteg org homeg setting.g Theg casegmanagerg coordinatesg a
ndg advocatesgforgcaregthegHCPgdeterminesgwhatgmedicalgcaregisgneeded.
TESTBANKWORLD.ORG
about:blank 4/694
Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
Chapterg01:gProfessionalgNursing
Harding:g Lewis’sg Medical-Surgicalg Nursing,g 11thg Edition
MULTIPLEgg CHOICE
1. Theg nurseg completesg ang admissiong databaseg andg explainsg thatg theg plang ofg careg andg dischar
geggoalsg willg beg developed g withg theg patient’sg input.g Theg patientg asks,g “How g isg thisg differe
ntg fromgwhatgthegdoctorgdoes?”gWhichgresponsegwouldgbegmostgappropriategforgthegnurse
gtogmake?
a. “Thegrolegof gthegnursegisgtogadminister gmedications gand gothergtreatmentsgprescri
bedgbygyourg doctor.”
b. “Ing additiong tog caringg forg youg whileg youg areg sick,g theg nursesg willg helpg youg pl
ang togmaintaing yourghealth.”
c. “Theg nurse’sgjobg isgtoghelpgthegdoctorgbygcollectingg informationgand
communicatingg anyg problemsg thatg occur.”
d. “Nursesgperformgmanygofgthegsamegproceduresgasgthegdoctor,gbutgnursesgareg
withgthegpatientsgforgaglongergtimegthangthegdoctor.”
ANS:g B
Theg Americang Nursesg Associationg (ANA)g definitiong ofg nursingg describesg theg roleg ofg nurse
sg ingpromotingg health.g Theg otherg responsesg describeg dependentg andg collaborativeg functionsg
ofg thegnursinggrolegbutgdognotgaccuratelygdescribe gthegnurse’sguniquegrolegingtheg healthgca
regsystem.
DIF:gggCognitivegLevel:gAnalyzeg(analysis)
TOP:g NursinggProcess:gImplementation MSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
2. Theg nurseg describesg tog ag studentg nurseg howg tog useg evidence-
basedg practiceg (EBP)g wheng caringgforgpatients.gWhichgstatementgbygtheg nursegaccuratelygde
scribesgtheg usegofgEBP?
a. “Inferencesg fromg allg publishedg articlesg areg usedg asg ag guide.”
b. “Patientg careg isg basedg ong clinicalg judgment,g experience,g andg traditions.”
c. “Datagareganalyzedglatergtogshowgthatgthegpatientgoutcomesgaregconsistentlygmet.”
d. “Recommendationsgaregbased gongresearch,gclinicalgexpertise,gand gpati
entgpreferences.”
ANS:g D
Evidence-basedg practiceg (EBP)g isg theg useg ofg theg bestg research-
basedg evidenceg combinedg withgcliniciang expertiseg andg considerationg ofg patientg preferences.g
Clinicalg judgmentg basedg ong thegnurse’sgclinicalgexperiencegisgpartgofgEBP,gbutgclinicalgde
cisiongmakinggshouldgalsogincorporateg currentg researchg andg research-
basedg guidelines.g Evaluationg ofg patientg outcomesg isgimportant,g butg datag analysisg isg notg requ
iredg tog useg EBP.g Allg publishedg articlesg dog notg providegresearchg evidence;g interventionsg sho
uldg beg basedg ong credibleg research,g preferablyg randomizedgcontrolledgstudiesgwithgaglargegnu
mbergofgsubjects.
DIF:ggggCognitivegLevel:gRememberg(knowledge)
TOP:gNursinggProcess:gPlanning
gMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
3. Theg nurseg teachesg ag studentg nurseg aboutg howg tog applyg theg nursingg processg wheng provi
dinggpatientg care.g Whichg statementg byg theg studentg nurseg indicatesg thatg teachingg wasg suc
cessful?
a. “Thegnursinggprocessg isgagresearchgmethodgofgdiagnosinggthegpatient’s ghealthgcare
problems.”
b. “Theg nursingg processgisgusedgprimarilygtogexplaing nursingg interventionsgtogother
TESTBANKWORLD.ORG
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,14/01/2024g13:24 MedgSurggtestgquestion
Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
healthg careg professionals.”
c. “Theg nursingg processg isg ag problem-solvingg toolg usedg tog identifyg andg treatg the
patients’ghealthg careg needs.”
d. “Thegnursinggprocessgisgbasedgongnursinggtheorygthatgincorporatesg
thegbiopsychosocialgnaturegofghumans.”
ANS:g C
Theg nursingg processg isg agproblem-
solvingg approachg togtheg identificationgandg treatmentg ofgpatients’gproblems.gNursinggprocess
gdoesgnotgrequiregresearchgmethodsgforgdiagnosis.gThe gprimaryg useg ofg theg nursingg processg
isg ing patientg care,g notg tog establishg nursingg theoryg org explaingnursingginterventionsgtogothergh
ealthgcaregprofessionals.
DIF:ggggCognitivegLevel:gUnderstandg(comprehension)
TOP:gNursinggProcess:gEvaluation
gMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
4. Agpatientgadmittedgtogtheghospitalgforgsurgerygtellsgthegnurse,g“Igdognotgfeelgcomfor
tablegleavinggmygchildrengwithgmygparents.”gWhichgactiongshouldgthegnursegtakeg
next?
a. Reassureg theg patientg thatg theseg feelingsg aregcommong forg parents.
b. Haveg theg patientg callg theg childreng tog ensureg thatg theyg aregdoingg well.
c. Gatherginformationgongthegpatient’s gconcernsgaboutgthegchild gcaregarrangements.
d. Callgthegpatient’sgparentsgtogdeterminegwhethergadequategchildgcaregisgbeing
provided.
ANS:g C
Becausegag completegassessmentg isg necessaryg ingorderg tog identifyg agproblemg andgchooseg an
gappropriategintervention,gthegnurse’sgfirstgaction gshouldgbe gtogobtain gmore ginformation.g
Thegotherg actionsg mayg beg appropriate,g butg moreg assessmentg isg neededg beforeg theg bestg inte
rventiongcangbegchosen.
DIF:gggCognitivegLevel:gAnalyzeg(analysis)
OBJ:ggg SpecialgQuestions:gPrioritization
TOP:gNursinggProcess:gAssessment
gMSC:g NCLEX:gPsychosocialgIntegrity
5. Ag patientg withg ag bacterialg infectiong isg hypovolemicg dueg tog ag feverg andg excessiveg diaphor
esis.gWhichgexpectedgoutcomegwouldgtheg nursegrecognizegasgappropriategforgthisg patient?
a. Patientg hasg ag balancedg intakeg andg output.
b. Patient’sgbeddingg isgkeptgcleangandg freegofg moisture.
c. Patientg understandsg theg needg forg increasedg fluidg intake.
d. Patient’sgskin gremainsg coolgandgdrygthroughout ghospitalization.
ANS:g A
Balancedg intakeg andg outputg givesg measurableg datag showingg resolutiong ofg theg problem
g ofgdeficientg fluidg volume.g Theg otherg statementsgwouldg notg indicategthatg thegproblemg
ofghypovolemiagwasgresolved.
DIF:ggggCognitivegLevel:gApplyg(application) TOP:
NursinggProcess:gPlanninggMSC:gNCLE
X:gPhysiologicalgIntegrity
6. Afterg administeringg medication,g theg nurseg asksg theg patientg ifg paing wasg relieved.g Whatg is
g thegpurposegofgthe gevaluationgphasegofgthegnursinggprocess?
a. Tog documentg theg nursingg careg plang ing theg progressg notesg ofg theg healthg record
b. Tog determineg ifg interventionsg haveg beeng effectiveg ing meetingg patientg outcomes
TESTBANKWORLD.ORG
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Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
c. Togdecidegwhether gthegpatient’s ghealthgproblems ghavegbeengcompletelygresolved
d. Tog establishg ifg theg patientg agreesg thatg theg nursingg careg providedg wasg satisfactory
ANS:g B
Evaluationgconsistsgofgdetermininggwhethergthegdesiredgpatientgoutcomesghavegbeengmetga
ndgwhethergthegnursingginterventionsgweregappropriate.gThegothergresponsesgdognotgdescrib
egthegevaluationgphase.
DIF:ggggCognitivegLevel:gUnderstandg(comprehension)
TOP:gNursinggProcess:gEvaluation
gMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
7. Theg nurseg interviewsg ag patientg whileg completingg theg healthg historyg andg physicalg examinati
on.gWhatgisgthegpurposegofgthegassessmentgphasegofgthegnursinggprocess?
a. Tog teachg interventionsg thatg relieveg healthg problems
b. Tog useg patientg datag tog evaluateg patientg careg outcomes
c. Tog helpg theg patientg identifyg realisticg outcomesg forg healthg problems
d. Tog obtaing datag withg whichg tog diagnoseg patientg strengthsg andg problems
ANS:g D
Duringg theg assessmentg phase,g theg nurseg gathersg informationg aboutg theg patientg tog diagnoseg
patientgstrengthsgandgproblems.gTheg otherg responsesgaregexamplesgofgthegplanning,ginterve
ntion,gandgevaluationgphasesgofgthegnursinggprocess.
DIF:ggg CognitivegLevel:gUnderstandg(comprehension)
TOP:g NursinggProcess:gAssessment MSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
8. Theg nurseg admitsg ag patientg tog theg hospitalg andg developsg ag plang ofg care.g Whatg compon
entsgshouldgthegnursegincludegingthegpatientgproblemgstatement?
a. Theg problemg andg theg suggestedg patientg goalsg org outcomes
b. Theg problem,g itsg causes,g andg theg signsg andg symptomsg ofg theg problem
c. Theg problemg withg theg possibleg etiologyg andg theg plannedg interventions
d. Theg problem,g theg pathophysiologyg ofg theg problem,g andg theg expectedg outcome
ANS:g B
Wheng writingg patientg problemsg org nursingg diagnoses,g thisg formatg shouldg beg used:g probl
em,getiology,gandgsignsgandgsymptoms.gThegsubjectivegasgwellgasgobjectiveg datagshouldg
begincluded.g Goals,g outcomes,g andg interventionsg areg notg includedg ing theg problemg statem
ent.
DIF:ggggCognitivegLevel:gUnderstandg(comprehension)
TOP:gNursinggProcess:gDiagnosi
sgMSC:gNCLEX:gSafegandgEffectivegCaregEnvironment
9. Whichg patientg careg taskg isg appropriateg forg theg nurseg tog delegateg tog experiencedg unlicen
sedgassistivegpersonnelg(UAP)?
a. Instructg theg patientg aboutg theg needg tog alternateg activityg andg rest.
b. Monitorg levelg ofg shortnessg ofg breathg org fatigueg afterg ambulation.
c. Obtaingthegpatient’sgbloodgpressuregandgpulsegrategaftergambulation.
d. Determineg whetherg theg patientg isg readyg tog increaseg theg activityg level.
ANS:g C
UAPg educationg includesg accurateg vitalg signg measurement.g Assessmentg andg patientg teachi
nggrequiregregisteredg nursegeducationgandg scopegofgpracticegandgcannotgbegdelegated.
TESTBANKWORLD.ORG
about:blank 3/694
, 14/01/2024g13:24 MedgSurggtestgquestion
Lewis'sg Medicalg Surgicalg Nursinggs11thg Editiong Hardingg Testg Bank
DIF:gggCognitivegLevel:gApplyg(application)
OBJ:ggg SpecialgQuestions:gDelegation
TOP:gNursinggProcess:gPlanning
gMSC:g NCLEX:gSafegandgEffectivegCaregEnvironment
10. Ag nurseg isg caringg forg ag groupg ofg patientsg ong theg medical-
surgicalg unitg withg theg helpg ofg oneg floatgregisteredg nurseg(RN),goneg unlicensedgassistivegperso
nnelg(UAP),gandgoneglicensedgpractical/vocationalg nurseg (LPN/VN).g Whichg assignment,g ifg d
elegatedg byg theg nurse,g wouldg beginappropriate?
a. Checkg forg theg presenceg ofg bowelg soundsg byg UAP
b. Administrationg ofg oralg medicationsg byg LPN/VN
c. Insuling administrationg byg floatg RNg fromg theg pediatricg unit
d. Measurementgofg ag patient’sg urinaryg catheterg outputgbyg UAP
ANS:g A
AssessmentgrequiresgRNgeducationg andgscopegofg practicegsog itgcannotg begdelegatedg tog ang
LPN/VNg org UAP.g Theg otherg assignmentsg madeg byg theg RNg areg appropriateg forg theg roleg of
g thegteamgmember.
DIF:gggCognitivegLevel:gApplyg(application)
OBJ:ggg SpecialgQuestions:gDelegation
TOP:gNursinggProcess:gPlanning
gMSC:g NCLEX:gSafegandgEffectivegCaregEnvironment
11. Whichg taskg isg appropriateg forg theg nurseg tog delegateg tog ag licensedg practical/vocationalg n
urseg(LPN/VN)?
a. Completeg theg initialg admissiong assessmentg andg plang ofg care.
b. Measureg bedsideg bloodg glucoseg beforeg administeringg insulin.
c. Documentg teachingg completedg beforeg ag diagnosticg procedure.
d. Instructg ag patientg aboutg low-fat,g reducedg sodiumg dietaryg restrictions.
ANS:g B
Thegeducationg andg scopeg ofg practiceg ofg theg LPN/LVNg includeg activitiesgsuchg asg obtaining
gglucoseg testingg usingg ag fingerg stickg andg administeringg insulin.g Patientg teachingg andg theg i
nitialgassessmentg andg developmentg ofg theg plang ofg caregareg nursingg actionsg thatg requireg regi
steredgnursegeducationgandgscopegofgpractice.
DIF:gggCognitivegLevel:gApplyg(application)
OBJ:ggg SpecialgQuestions:gDelegation
TOP:gNursinggProcess:gPlanning
gMSC:g NCLEX:gSafegandgEffectivegCaregEnvironment
12. Ag nurseg isg assignedg asg ag caseg managerg forg ag hospitalizedg patientg withg ag spinalg cordg in
jury.gWhichgactivitygcangthegpatientgexpectgthegnursegingthisgrolegtogperform?
a. Careg forg theg patientg duringg hospitalizationg forg theg injuries.
b. Assistg theg patientg withg homeg careg activitiesg duringg recovery.
c. Coordinateg theg servicesg theg patientg receivesg ing theg hospitalg andg atg home.
d. Determineg whatg medicalg careg theg patientg needsg forg optimalg rehabilitation.
ANS:g C
Thegrolegofgthegcasegmanagergisgtogcoordinategthegpatient’sgcaregthroughgmultiplegsettingsg
andglevelsg ofg careg tog allowg theg maximalg patientg benefitg atg theg leastg cost.g Theg casegmanager
g doesg notgprovideg directg careg ing theg acuteg org homeg setting.g Theg casegmanagerg coordinatesg a
ndg advocatesgforgcaregthegHCPgdeterminesgwhatgmedicalgcaregisgneeded.
TESTBANKWORLD.ORG
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