Concepts For Interprofessional Collaborative Care 10th Edition Ignatavicius Workman Rebar Heimargartner Medical Surgical Nursing Test Bank

,Chapter 1: Introduction to Medical-Surgical Nursing Practice
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Ignatavicius: Medical-Surgical Nursing,10th Edition
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MULTIPLE CHOICE j




1. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The
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preceptor advises the student that which is the priority when working as a professional
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nurse?
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a. Attending to holistic client needs j j j j


b. Ensuring client safety j j


c. Not making medication errors j j j


d. Providing client-focused care j j




ANS: B j


All actions are appropriate for the professional nurse. However, ensuring client safety is the
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priority. Up to 98,000 deaths result each year from errors in hospital care, according to the 2000
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Institute of Medicine report. Many more clients have suffered injuries and less serious outcomes.
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Every nurse has the responsibility to guard the client’s safety.
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DIF: Understanding/Comprehension REF: 2 KEY: Patient safety j j


MSC: Integrated Process: Nursing Process: Intervention
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NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
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Control
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2. A nurse is orienting a new client and family to the inpatient unit. What information does the
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nurse provide to help the client promote his or her own safety?
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a. Encourage the client and family to be active partners. j j j j j j j j


b. Have the client monitor hand hygiene in caregivers.
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c. Offer the family the opportunity to stay with the client.
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d. Tell the client to always wear his or her armband.
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ANS: A j


Each action could be important for the client or family to perform. However, encouraging the
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client to be active in his or her health care as a partner is the most critical. The other actions
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are very limited in scope and do not provide the broad protection that being active and involved
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does.
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DIF: Understanding/Comprehension REF: 3 KEY: Patient safety j j


MSC: Integrated Process: Teaching/Learning
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NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
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Control
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3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure
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was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is
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best?
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a. Call the Rapid Response Team. j j j j


b. Document and continue to monitor. j j j j


c. Notify the primary care provider. j j j j


d. Repeat blood pressure measurement in 15 minutes. j j j j j j

, ANS: A j


The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
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before they suffer either respiratory or cardiac arrest. Since the client has manifested a
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significant change, the nurse should call the RRT. Changes in blood pressure, mental status,
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heart rate, and pain are particularly significant. Documentation is vital, but the nurse must do
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more than document. The primary care provider should be notified, but this is not the priority
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over calling the RRT. The client’s blood pressure should be reassessed frequently, but the
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priority is getting the rapid care to the client.
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DIF: Applying/Application REF: 3
KEY:
j j Rapid Response Team (RRT)| medical emergencies j j j j j


MSC: Integrated Process: Communication and Documentation
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NOT: jClient Needs Category: Physiological Integrity: Physiological Adaptation
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4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
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best demonstrates this concept?
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a. Assesses for cultural influences affecting health care j j j j j j


b. Ensures that all the clients’ basic needs are met j j j j j j j j


c. Tells the client and family about all upcoming tests j j j j j j j j


d. Thoroughly orients the client and family to the room j j j j j j j j




ANS: A j


Competency in client-focused care is demonstrated when the nurse focuses on j j j j j j j j j j


communication, culture, respect, compassion, client education, and empowerment. By assessing
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the effect of the client’s culture on health care, this nurse is practicing
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client-focused care. Providing for basic needs does not demonstrate this competence. Simply j j j j j j j j j j j


telling the client about all upcoming tests is not providing empowering education. Orienting
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the client and family to the room is an important safety measure, but not directly related to
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demonstrating client-centered care.
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DIF: Understanding/Comprehension REF: 3
KEY: Patient-centered care| culture MSC: Integrated Process: Caring
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NOT: Client Needs Category: Psychosocial Integrity
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5. A client is going to be admitted for a scheduled surgical procedure. Which action does the
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nurse explain is the most important thing the client can do to protect against errors?
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a. Bring a list of all medications and what they are for. j j j j j j j j j j


b. Keep the doctor’s phone number by the telephone. j j j j j j j


c. Make sure all providers wash hands before entering the room. j j j j j j j j j


d. Write down the name of each caregiver who comes in the room. j j j j j j j j j j j




ANS: A j


Medication errors are the most common type of health care mistake. The Joint Commission’s
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Speak Up campaign encourages clients to help ensure their safety. One recommendation is
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for clients to know all their medications and why they take them. This will help prevent
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medication errors.
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DIF: Applying/Application REF: 4
KEY: Speak Up campaign| patient safety j j j j j MSC: Integrated Process: Teaching/Learning j j j

, NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
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Control
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6. Which action by the nurse working with a client best demonstrates respect for autonomy?
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a. Asks if the client has questions before signing a consent
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b. Gives the client accurate information when questioned
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c. Keeps the promises made to the client and family j j j j j j j j


d. Treats the client fairly compared to other clients j j j j j j j




ANS: A j


Autonomy is self-determination. The client should make decisions regarding care. When the
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nurse obtains a signature on the consent form, assessing if the client still has questions is vital,
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because without full information the client cannot practice autonomy. Giving accurate
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information is practicing with veracity. Keeping promises is upholding fidelity. Treating the
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client fairly is providing social justice.
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DIF: Applying/Application REF: 4
KEY: Autonomy| ethical principles
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NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
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7. A student nurse asks the faculty to explain best practices when communicating with a
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person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)
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community. What answer by the faculty is most accurate?
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a. Avoid embarrassing the client by asking questions. j j j j j j


b. Don’t make assumptions about their health needs. j j j j j j


c. Most LGBTQ people do not want to share information.
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d. No differences exist in communicating with this population.
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ANS: B j


Many members of the LGBTQ community have faced discrimination from health care
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providers and may be reluctant to seek health care. The nurse should never make
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assumptions about the needs of members of this population. Rather, respectful questions are
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appropriate. If approached with sensitivity, the client with any health care need is more likely
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to answer honestly.
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DIF: Understanding/Comprehension REF: 4 KEY: LGBTQ| diversity j j


MSC: Integrated Process: Teaching/Learning
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NOT: Client Needs Category: Psychosocial Integrity
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8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago and
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has pain that is unrelieved by the prescribed narcotic pain medication. Which statement is part
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of the SBAR format for communication?
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a. A: “I would like you to order a different pain medication.”
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b. B: “This client has allergies to morphine and codeine.”
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c. R: “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.”
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d. S: “This client had a vaginal hysterectomy 2 days ago.”
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j ANS: B j