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Medical Surgical Nursing 10th Edition
i i i i i
Ignatavicius Workman Test Bank i i i
Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
i i i i i i i i i i
Ignatavicius: Medical-Surgical Nursing, 10th Edition
i i i i
MULTIPLEi CHOICE
1. Ai newi nursei isi workingi withi ai preceptori oni ai medical-surgicali unit.i Thei preceptori advisesi
thei newi nursei thati whichi isi thei priorityi wheni workingi asi ai professionali nurse?
a. Attendingi toi holistici clienti needs
b. Ensuringi clienti safety
c. Noti makingi medicationi errors
d. Providingi client-focusedi care
ANS:i B
Alli actionsi arei appropriatei fori thei professionali nurse.i However,i ensuringi clienti safetyi isi
thei priority.i Healthi carei errorsi havei beeni widelyi reportedi fori 25i years,i manyi ofi whichi
resulti ini clienti injury,i death,i andi increasedi healthi carei costs.i Therei arei severali nationali
andi internationali organizationsi thati havei eitheri recommendedi ori mandatedi safetyi
initiatives.
Everyi nursei hasi thei responsibilityi toi guardi thei client9si safety.i Thei otheri actionsi arei
importanti fori qualityi nursing,i buti theyi arei noti asi vitali asi providingi safety.i Noti makingi
medicationi errorsi doesi providei safety,i buti isi tooi narrowi ini scopei toi bei thei besti answer.
DIF: Understanding TOP:i Integratedi Process:i Nursingi Process:i
Interventioni KEY:i Clienti safety
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
2. Ai nursei isi orientingi ai newi clienti andi familyi toi thei medical-surgicali unit.i Whati
informationi doesi thei nursei providei toi besti helpi thei clienti promotei hisi ori heri owni
safety?
a. Encouragei thei clienti andi familyi toi bei activei partners.
b. Havei thei clienti monitori handi hygienei ini caregivers.
c. Offeri thei familyi thei opportunityi toi stayi withi thei client.
d. Tellithei clienti toi alwaysi weari hisi ori heri armband.
ANS:i A
Eachi actioni couldi bei importanti fori thei clienti ori familyi toi perform.i However,i encouragingi
thei clienti toi bei activei ini hisi ori heri healthi carei asi ai safetyi partneri isi thei mosti critical.i Thei
otheri actionsi arei veryi limitedi ini scopei andi doi noti providei thei broadi protectioni thati beingi
activei andi involvedi does.
DIF: Understanding TOP:i Integratedi Process:i Teaching/Learningi
KEY:i Clienti safety
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
3. Ai nursei isi caringi fori ai postoperativei clienti oni thei surgicali unit.i Thei client9si bloodi
pressurei wasi 142/76i mmi Hgi 30i minutesi ago,i andi nowi isi 88/50i mmi Hg.i Whati actioni
wouldi thei nursei takei first?
a. Calli thei Rapidi Responsei Team.
b. Documenti andi continuei toi monitor.
c. Notifyi thei primaryi healthi carei provider.
d. Repeati thei bloodi pressurei ini 15i minutes.
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ANS:i A
Thei purposei ofi thei Rapidi Responsei Teami (RRT)i isi toi intervenei wheni clientsi arei
deterioratingi beforei theyi sufferi eitheri respiratoryi ori cardiaci arrest.i Sincei thei clienti hasi
manifestedi ai significanti change,i thei nursei wouldi calli thei RRT.i Changesi ini bloodi pressure,i
mentali status,i hearti rate,i temperature,i oxygeni saturation,i andi lasti 2i hours9i urinei outputi arei
particularlyi significanti andi arei parti ofi thei Modifiedi Earlyi Warningi Systemi guide.i
Documentationi isi vital,i buti thei nursei musti doi morei thani document.i Thei primaryi healthi
carei provideri wouldi bei notified,i buti thisi isi noti morei importanti thani callingi thei RRT.i Thei
client9si bloodi pressurei wouldi bei reassessedi frequently,i buti thei priorityi isi gettingi thei rapidi
carei toi thei client.
DIF: Applying TOP:i Integratedi Process:i Communicationi andi
Documentationi KEY:i Rapidi Responsei Teami (RRT),i Clinicali judgment
MSC:i Clienti Needsi Category:i Physiologicali Integrity:i Physiologicali Adaptation
4. Ai nursei wishesi toi providei client-centeredi carei ini alli interactions.i Whichi actioni byithei nurse
besti demonstratesi thisi concept?
a. Assessesi fori culturali influencesi affectingi healthi care.
b. Ensuresi thati alli thei client9si basici needsi arei met.
c. Tellsi thei clienti andi familyi abouti alli upcomingi tests.
d. Thoroughlyi orientsi thei clienti andi familyi toi thei room.
ANS:i A
Showingi respecti fori thei clienti andi family9si preferencesi andi needsi isi essentiali toi ensurei ai
holistici ori <whole-person=i approachi toi care.i Byiassessingi thei effecti ofithei client9si culturei oni
healthi care,i thisi nursei isi practicingi client-focusedi care.i Providingi fori basici needsi doesi noti
demonstratei thisi competence.i Simplyi tellingi thei clienti abouti alli upcomingi testsi isi noti
providingi empoweringi education.i Orientingi thei clienti andi familyi toi thei roomi isi ani importanti
safetyi measure,i buti noti directlyi relatedi toi demonstratingi client-centeredi care.
DIF: Understanding TOP:i Integratedi Process:i Culturei andi Spiritualityi
KEY:i Client-centeredi care,i Culture MSC:i Clienti Needsi Category:i Psychosociali
Integrity
5. Ai clienti isi goingi toi bei admittedi fori ai scheduledi surgicali procedure.i Whichi actioni doesi
thei nursei explaini isi thei mosti importanti thingi thei clienti cani doi toi protecti againsti
errors?
a. Bringi ai listi ofi alli medicationsi andi whati theyi arei for.
b. Keepi thei provider9si phonei numberi byithei telephone.
c. Makei surei thati alli providersi washi handsi beforei enteringi thei room.
d. Writei downi thei namei ofi eachi caregiveri whoi comesi ini thei room.
ANS:i A
Medicationi reconciliationi isi ai formali processi ini whichi thei client9si actualicurrenti medicationsi
arei comparedi toi thei prescribedi medicationsi ati thei timei ofi admission,i transfer,i ori discharge.i
Thisi Nationali clienti Safetyi Goali isi importanti toi reducei medicationi errors.i Thei clienti wouldi
noti havei toi bei responsiblei fori providersi washingi theiri hands,i andi eveni ifi thei clienti doesi
so,i thisi isi tooi narrowi toi bei thei mosti importanti actioni toi preventi errors.i Keepingi thei
provider9si phonei numberi nearbyi andi documentingi everyonei whoi entersi thei roomi alsoi doi
noti guaranteei safety.
DIF: Applying TOP:i Integratedi Process:i
Teaching/Learningi KEY:i Clienti safety,i Informatics
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
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6. Whichi actioni byithei nursei workingi withi ai clienti besti demonstratesi respecti fori autonomy?
a. Asksi ifi thei clienti hasi questionsi beforei signingi ai consent.
b. Givesi thei clienti accuratei informationi wheni questioned.
c. Keepsi thei promisesi madei toi thei clienti andi family.
d. Treatsi thei clienti fairlyi comparedi toi otheri clients.
ANS:i A
Autonomyi isi self-determination.i Thei clienti wouldi makei decisionsi regardingi care.i Wheni thei
nursei obtainsi ai signaturei oni thei consenti form,i assessingi ifi thei clienti stilli hasi questionsi isi
vital,i becausei withouti fulli informationi thei clienti cannoti practicei autonomy.i Givingi accuratei
informationi isi practicingi withi veracity.i Keepingi promisesi isi upholdingi fidelity.i Treatingi thei
clienti fairlyi isi providingi sociali justice.
DIF: Applying TOP:i Integratedi Process:i Caring KEY:i Ethics,i Autonomyi
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi
Care
7. Ai nursei asksi ai morei seasonedi colleaguei toi explaini besti practicesi wheni communicatingi withi
ai personi fromi thei lesbian,i gay,i bisexual,i transgender,i andi questioning/queeri (LGBTQ)i
community.i Whati answeri byi thei facultyi isi mosti accurate?
a. Avoidi embarrassingi thei clienti byiaskingi questions.
b. Don9ti makei assumptionsi abouti hisi ori heri healthi needs.
c. Mosti LGBTQi peoplei doi noti wanti toi sharei information.
d. Noi differencesi existi ini communicatingi withi thisi population.
ANS:i B
Manyi membersi ofi thei LGBTQi communityi havei facedi discriminationi fromi healthi carei
providersi andi mayi bei reluctanti toi seeki healthi care.i Thei nursei wouldi neveri makei
assumptionsi abouti thei needsi ofi membersi ofi thisi population.i Rather,i respectfuli questionsi arei
appropriate.i Ifi approachedi withi sensitivity,i thei clienti withi anyi healthi carei needi isi morei
likelyi toi answeri honestly.
DIF: Understanding TOP:i Integratedi Process:i Teaching/Learning
KEY:i Healthi carei disparities,i LGBTQ MSC:i Clienti Needsi Category:i Psychosociali Integrity
8. Ai nursei isi callingi thei on-calli healthi carei provideri abouti ai clienti whoi hadi ai hysterectomyi
2i daysi agoi andi hasi paini thati isi unrelievedi byi thei prescribedi opioidi paini medication.i
Whichi statementi comprisesi thei backgroundi portioni ofi thei SBARi formati fori
communication?
a. <Ii wouldi likei youi toi orderi ai differenti paini medication.=
b. <Thisi clienti hasiallergiesi toi morphinei andi codeine.=
c. <Dr.i Smithi doesn9ti likei nonsteroidali anti-inflammatoryi meds.=
d. <Thisi clienti hadi ai vaginali hysterectomyi2i daysi ago.=
ANS:i B
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SBARi isi ai recommendedi formi ofi communication,i andi thei acronymi standsi fori Situation,i
Background,i Assessment,i andi Recommendation.i Appropriatei backgroundi informationi
includesi allergiesi toi medicationsi thei on-calli healthi carei provideri mighti order.i Situationi
describesi whati isi happeningi righti nowi thati musti bei communicated;i thei client9si surgeryi2i daysi
agoi wouldi bei consideredi background.i Assessmenti wouldi includei ani analysisi ofi thei client9si
problem;i nonei ofi thei optionsi hasi assessmenti information.i Askingi fori ai differenti paini
medicationi isi ai recommendation.i Recommendationi isi ai statementi ofi whati isi neededi ori
whati outcomei isi desired.
DIF: Applying TOP:i Integratedi Process:i Communicationi andi
Documentationi KEY:i Teamworki andi collaboration,i SBAR
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi Care
9. Ai nursei workingi oni ai cardiaci uniti delegatedi takingi vitali signsi toi ani experiencedi assistivei
personneli (AP).i Fouri hoursi later,i thei nursei notesi thati thei client9si bloodi pressurei takeni byi
thei APi wasi muchi higheri thani previousi readings,i andi thei client9si mentalistatusi hasi changed.i
Whati actioni byi thei nursei wouldi mosti likelyi havei preventedi thisi negativei outcome?
a. Determiningi ifi thei APi knewi howi toi takei bloodi pressure
b. Double-checkingi thei APi byi takingi anotheri bloodi pressure
c. Providingi morei appropriatei supervisioni ofi thei AP
d. Takingi thei bloodi pressurei insteadi ofi delegatingi thei task
ANS:i C
Supervisioni isi onei ofi thei fivei rightsi ofi delegationi andi includesi directing,i evaluating,i andi
followingi upi oni delegatedi tasks.i Thei nursei wouldi eitheri havei askedi thei APi abouti thei vitali
signsi ori instructedi thei APi toi reporti themi righti away.i Ani experiencedi APi wouldi knowi howi
toi takei vitali signsi andi thei nursei wouldi noti havei toi assessi thisi ati thisi point.i Double-
checkingi thei worki defeatsi thei purposei ofi delegation.i Vitali signsi arei withini thei scopei ofi
practicei fori ai APi andi arei permissiblei toi delegate.i Thei onlyi appropriatei answeri isi thati thei
nursei didi noti providei adequatei instructioni toi thei AP.
DIF: Analyzing TOP:i Integratedi Process:i Communicationi andi
Documentationi KEY:i Teamworki andi collaboration,i Delegation
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi Care
10. Ai newlyi graduatedi nursei ini thei hospitali statesi thati becausei ofi beingi soi new,i participationi
ini qualityi improvementi (QI)i projectsi isi noti wise.i Whati responsei byithei preceptingi nursei isi
best?
a. <Allistaffi nursesi arei requiredi toi participatei ini qualityiimprovementi here.=
b. <Evenibeingi new,i youi cani implementi activitiesi designedi toi improvei care.=
c. <It9sieasyitoi identifyiwhati indicatorsi wouldi bei usedi toi measurei quality.=
d. <Youishouldi aski toi bei assignedi toi thei researchi andi qualityicommittee.=
ANS:i B
Thei preceptori wouldi tryi toi reassurei thei nursei thati implementingi QIi measuresi isi noti outi ofi
linei fori ai newlyi licensedi nurse.i Simplyi statingi thati alli nursesi arei requiredi toi participatei
doesi noti helpi thei nursei understandi howi thati isi possiblei andi isi dismissive.i Identifyingi
indicatorsi ofi qualityi isi noti ani easy,i quicki processi andi wouldi noti bei thei besti placei toi
suggesti ai newi nursei toi start.i Askingi toi bei assignedi toi thei QIi committeei doesi noti givei thei
nursei informationi abouti howi toi implementi QIi ini dailyi practice.
DIF: Applying TOP:i Integratedi Process:i Communicationi andi Documentation
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Medical Surgical Nursing 10th Edition
i i i i i
Ignatavicius Workman Test Bank i i i
Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
i i i i i i i i i i
Ignatavicius: Medical-Surgical Nursing, 10th Edition
i i i i
MULTIPLEi CHOICE
1. Ai newi nursei isi workingi withi ai preceptori oni ai medical-surgicali unit.i Thei preceptori advisesi
thei newi nursei thati whichi isi thei priorityi wheni workingi asi ai professionali nurse?
a. Attendingi toi holistici clienti needs
b. Ensuringi clienti safety
c. Noti makingi medicationi errors
d. Providingi client-focusedi care
ANS:i B
Alli actionsi arei appropriatei fori thei professionali nurse.i However,i ensuringi clienti safetyi isi
thei priority.i Healthi carei errorsi havei beeni widelyi reportedi fori 25i years,i manyi ofi whichi
resulti ini clienti injury,i death,i andi increasedi healthi carei costs.i Therei arei severali nationali
andi internationali organizationsi thati havei eitheri recommendedi ori mandatedi safetyi
initiatives.
Everyi nursei hasi thei responsibilityi toi guardi thei client9si safety.i Thei otheri actionsi arei
importanti fori qualityi nursing,i buti theyi arei noti asi vitali asi providingi safety.i Noti makingi
medicationi errorsi doesi providei safety,i buti isi tooi narrowi ini scopei toi bei thei besti answer.
DIF: Understanding TOP:i Integratedi Process:i Nursingi Process:i
Interventioni KEY:i Clienti safety
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
2. Ai nursei isi orientingi ai newi clienti andi familyi toi thei medical-surgicali unit.i Whati
informationi doesi thei nursei providei toi besti helpi thei clienti promotei hisi ori heri owni
safety?
a. Encouragei thei clienti andi familyi toi bei activei partners.
b. Havei thei clienti monitori handi hygienei ini caregivers.
c. Offeri thei familyi thei opportunityi toi stayi withi thei client.
d. Tellithei clienti toi alwaysi weari hisi ori heri armband.
ANS:i A
Eachi actioni couldi bei importanti fori thei clienti ori familyi toi perform.i However,i encouragingi
thei clienti toi bei activei ini hisi ori heri healthi carei asi ai safetyi partneri isi thei mosti critical.i Thei
otheri actionsi arei veryi limitedi ini scopei andi doi noti providei thei broadi protectioni thati beingi
activei andi involvedi does.
DIF: Understanding TOP:i Integratedi Process:i Teaching/Learningi
KEY:i Clienti safety
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
3. Ai nursei isi caringi fori ai postoperativei clienti oni thei surgicali unit.i Thei client9si bloodi
pressurei wasi 142/76i mmi Hgi 30i minutesi ago,i andi nowi isi 88/50i mmi Hg.i Whati actioni
wouldi thei nursei takei first?
a. Calli thei Rapidi Responsei Team.
b. Documenti andi continuei toi monitor.
c. Notifyi thei primaryi healthi carei provider.
d. Repeati thei bloodi pressurei ini 15i minutes.
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ANS:i A
Thei purposei ofi thei Rapidi Responsei Teami (RRT)i isi toi intervenei wheni clientsi arei
deterioratingi beforei theyi sufferi eitheri respiratoryi ori cardiaci arrest.i Sincei thei clienti hasi
manifestedi ai significanti change,i thei nursei wouldi calli thei RRT.i Changesi ini bloodi pressure,i
mentali status,i hearti rate,i temperature,i oxygeni saturation,i andi lasti 2i hours9i urinei outputi arei
particularlyi significanti andi arei parti ofi thei Modifiedi Earlyi Warningi Systemi guide.i
Documentationi isi vital,i buti thei nursei musti doi morei thani document.i Thei primaryi healthi
carei provideri wouldi bei notified,i buti thisi isi noti morei importanti thani callingi thei RRT.i Thei
client9si bloodi pressurei wouldi bei reassessedi frequently,i buti thei priorityi isi gettingi thei rapidi
carei toi thei client.
DIF: Applying TOP:i Integratedi Process:i Communicationi andi
Documentationi KEY:i Rapidi Responsei Teami (RRT),i Clinicali judgment
MSC:i Clienti Needsi Category:i Physiologicali Integrity:i Physiologicali Adaptation
4. Ai nursei wishesi toi providei client-centeredi carei ini alli interactions.i Whichi actioni byithei nurse
besti demonstratesi thisi concept?
a. Assessesi fori culturali influencesi affectingi healthi care.
b. Ensuresi thati alli thei client9si basici needsi arei met.
c. Tellsi thei clienti andi familyi abouti alli upcomingi tests.
d. Thoroughlyi orientsi thei clienti andi familyi toi thei room.
ANS:i A
Showingi respecti fori thei clienti andi family9si preferencesi andi needsi isi essentiali toi ensurei ai
holistici ori <whole-person=i approachi toi care.i Byiassessingi thei effecti ofithei client9si culturei oni
healthi care,i thisi nursei isi practicingi client-focusedi care.i Providingi fori basici needsi doesi noti
demonstratei thisi competence.i Simplyi tellingi thei clienti abouti alli upcomingi testsi isi noti
providingi empoweringi education.i Orientingi thei clienti andi familyi toi thei roomi isi ani importanti
safetyi measure,i buti noti directlyi relatedi toi demonstratingi client-centeredi care.
DIF: Understanding TOP:i Integratedi Process:i Culturei andi Spiritualityi
KEY:i Client-centeredi care,i Culture MSC:i Clienti Needsi Category:i Psychosociali
Integrity
5. Ai clienti isi goingi toi bei admittedi fori ai scheduledi surgicali procedure.i Whichi actioni doesi
thei nursei explaini isi thei mosti importanti thingi thei clienti cani doi toi protecti againsti
errors?
a. Bringi ai listi ofi alli medicationsi andi whati theyi arei for.
b. Keepi thei provider9si phonei numberi byithei telephone.
c. Makei surei thati alli providersi washi handsi beforei enteringi thei room.
d. Writei downi thei namei ofi eachi caregiveri whoi comesi ini thei room.
ANS:i A
Medicationi reconciliationi isi ai formali processi ini whichi thei client9si actualicurrenti medicationsi
arei comparedi toi thei prescribedi medicationsi ati thei timei ofi admission,i transfer,i ori discharge.i
Thisi Nationali clienti Safetyi Goali isi importanti toi reducei medicationi errors.i Thei clienti wouldi
noti havei toi bei responsiblei fori providersi washingi theiri hands,i andi eveni ifi thei clienti doesi
so,i thisi isi tooi narrowi toi bei thei mosti importanti actioni toi preventi errors.i Keepingi thei
provider9si phonei numberi nearbyi andi documentingi everyonei whoi entersi thei roomi alsoi doi
noti guaranteei safety.
DIF: Applying TOP:i Integratedi Process:i
Teaching/Learningi KEY:i Clienti safety,i Informatics
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Safetyi andi Infectioni Control
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6. Whichi actioni byithei nursei workingi withi ai clienti besti demonstratesi respecti fori autonomy?
a. Asksi ifi thei clienti hasi questionsi beforei signingi ai consent.
b. Givesi thei clienti accuratei informationi wheni questioned.
c. Keepsi thei promisesi madei toi thei clienti andi family.
d. Treatsi thei clienti fairlyi comparedi toi otheri clients.
ANS:i A
Autonomyi isi self-determination.i Thei clienti wouldi makei decisionsi regardingi care.i Wheni thei
nursei obtainsi ai signaturei oni thei consenti form,i assessingi ifi thei clienti stilli hasi questionsi isi
vital,i becausei withouti fulli informationi thei clienti cannoti practicei autonomy.i Givingi accuratei
informationi isi practicingi withi veracity.i Keepingi promisesi isi upholdingi fidelity.i Treatingi thei
clienti fairlyi isi providingi sociali justice.
DIF: Applying TOP:i Integratedi Process:i Caring KEY:i Ethics,i Autonomyi
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi
Care
7. Ai nursei asksi ai morei seasonedi colleaguei toi explaini besti practicesi wheni communicatingi withi
ai personi fromi thei lesbian,i gay,i bisexual,i transgender,i andi questioning/queeri (LGBTQ)i
community.i Whati answeri byi thei facultyi isi mosti accurate?
a. Avoidi embarrassingi thei clienti byiaskingi questions.
b. Don9ti makei assumptionsi abouti hisi ori heri healthi needs.
c. Mosti LGBTQi peoplei doi noti wanti toi sharei information.
d. Noi differencesi existi ini communicatingi withi thisi population.
ANS:i B
Manyi membersi ofi thei LGBTQi communityi havei facedi discriminationi fromi healthi carei
providersi andi mayi bei reluctanti toi seeki healthi care.i Thei nursei wouldi neveri makei
assumptionsi abouti thei needsi ofi membersi ofi thisi population.i Rather,i respectfuli questionsi arei
appropriate.i Ifi approachedi withi sensitivity,i thei clienti withi anyi healthi carei needi isi morei
likelyi toi answeri honestly.
DIF: Understanding TOP:i Integratedi Process:i Teaching/Learning
KEY:i Healthi carei disparities,i LGBTQ MSC:i Clienti Needsi Category:i Psychosociali Integrity
8. Ai nursei isi callingi thei on-calli healthi carei provideri abouti ai clienti whoi hadi ai hysterectomyi
2i daysi agoi andi hasi paini thati isi unrelievedi byi thei prescribedi opioidi paini medication.i
Whichi statementi comprisesi thei backgroundi portioni ofi thei SBARi formati fori
communication?
a. <Ii wouldi likei youi toi orderi ai differenti paini medication.=
b. <Thisi clienti hasiallergiesi toi morphinei andi codeine.=
c. <Dr.i Smithi doesn9ti likei nonsteroidali anti-inflammatoryi meds.=
d. <Thisi clienti hadi ai vaginali hysterectomyi2i daysi ago.=
ANS:i B
, i
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SBARi isi ai recommendedi formi ofi communication,i andi thei acronymi standsi fori Situation,i
Background,i Assessment,i andi Recommendation.i Appropriatei backgroundi informationi
includesi allergiesi toi medicationsi thei on-calli healthi carei provideri mighti order.i Situationi
describesi whati isi happeningi righti nowi thati musti bei communicated;i thei client9si surgeryi2i daysi
agoi wouldi bei consideredi background.i Assessmenti wouldi includei ani analysisi ofi thei client9si
problem;i nonei ofi thei optionsi hasi assessmenti information.i Askingi fori ai differenti paini
medicationi isi ai recommendation.i Recommendationi isi ai statementi ofi whati isi neededi ori
whati outcomei isi desired.
DIF: Applying TOP:i Integratedi Process:i Communicationi andi
Documentationi KEY:i Teamworki andi collaboration,i SBAR
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi Care
9. Ai nursei workingi oni ai cardiaci uniti delegatedi takingi vitali signsi toi ani experiencedi assistivei
personneli (AP).i Fouri hoursi later,i thei nursei notesi thati thei client9si bloodi pressurei takeni byi
thei APi wasi muchi higheri thani previousi readings,i andi thei client9si mentalistatusi hasi changed.i
Whati actioni byi thei nursei wouldi mosti likelyi havei preventedi thisi negativei outcome?
a. Determiningi ifi thei APi knewi howi toi takei bloodi pressure
b. Double-checkingi thei APi byi takingi anotheri bloodi pressure
c. Providingi morei appropriatei supervisioni ofi thei AP
d. Takingi thei bloodi pressurei insteadi ofi delegatingi thei task
ANS:i C
Supervisioni isi onei ofi thei fivei rightsi ofi delegationi andi includesi directing,i evaluating,i andi
followingi upi oni delegatedi tasks.i Thei nursei wouldi eitheri havei askedi thei APi abouti thei vitali
signsi ori instructedi thei APi toi reporti themi righti away.i Ani experiencedi APi wouldi knowi howi
toi takei vitali signsi andi thei nursei wouldi noti havei toi assessi thisi ati thisi point.i Double-
checkingi thei worki defeatsi thei purposei ofi delegation.i Vitali signsi arei withini thei scopei ofi
practicei fori ai APi andi arei permissiblei toi delegate.i Thei onlyi appropriatei answeri isi thati thei
nursei didi noti providei adequatei instructioni toi thei AP.
DIF: Analyzing TOP:i Integratedi Process:i Communicationi andi
Documentationi KEY:i Teamworki andi collaboration,i Delegation
MSC:i Clienti Needsi Category:i Safei andi Effectivei Carei Environment:i Managementi ofi Care
10. Ai newlyi graduatedi nursei ini thei hospitali statesi thati becausei ofi beingi soi new,i participationi
ini qualityi improvementi (QI)i projectsi isi noti wise.i Whati responsei byithei preceptingi nursei isi
best?
a. <Allistaffi nursesi arei requiredi toi participatei ini qualityiimprovementi here.=
b. <Evenibeingi new,i youi cani implementi activitiesi designedi toi improvei care.=
c. <It9sieasyitoi identifyiwhati indicatorsi wouldi bei usedi toi measurei quality.=
d. <Youishouldi aski toi bei assignedi toi thei researchi andi qualityicommittee.=
ANS:i B
Thei preceptori wouldi tryi toi reassurei thei nursei thati implementingi QIi measuresi isi noti outi ofi
linei fori ai newlyi licensedi nurse.i Simplyi statingi thati alli nursesi arei requiredi toi participatei
doesi noti helpi thei nursei understandi howi thati isi possiblei andi isi dismissive.i Identifyingi
indicatorsi ofi qualityi isi noti ani easy,i quicki processi andi wouldi noti bei thei besti placei toi
suggesti ai newi nursei toi start.i Askingi toi bei assignedi toi thei QIi committeei doesi noti givei thei
nursei informationi abouti howi toi implementi QIi ini dailyi practice.
DIF: Applying TOP:i Integratedi Process:i Communicationi andi Documentation
