Surgical Nursing Making Connections to Practice
3rd Edition Janice J. Hoffman
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Chapter 1: Foundations for Medical-Surgical Nursing
MULTIPLE CHOICE
1. Which type of nursing is the root of all other nursing practice areas?
A. Pediatric nursing
B. Maternal-child nursing
C. Medical-surgical nursing
D. Mental health–psychiatric nursing
ANS: C
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 1. Describing the role and competencies of medical-surgical
nursing
Chapter page reference: p. 2
Heading: Introduction
Integrated Processes: N/A
Client Need: N/A
Cognitive Level: Knowledge [Remembering]
Concept: Professionalism
Difficulty: Easy
Feedback
A Pediatric nursing is only focused on the care of younger persons.
B Maternal-child nursing focuses on the care of pregnant women and families in
the childbearing years.
C Medical-surgical nursing is the root of all nursing practice as care provided here
can be implemented in all other areas of nursing practice.
D Mental health–psychiatric nursing focuses on emotional and behavioral
concerns and disorders.
PTS: 1 CON: Professionalism
2. Which competency did the Nursing Executive Center of the Advisory Board identify as the
greatest academic practice gap for new graduate nurses?
A. Knowledge of pharmacology
B. Interpretation of assessment data
C. Knowledge of pathophysiology
D. Decision making
ANS: C
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Copyright © 2024 F. A. Davis Company
, 2
Chapter learning objective: 1. Describing the role and competencies of medical-surgical
nursing
Chapter page reference: p. 3
Heading: Competencies in Medical-Surgical Nursing
Integrated Processes: N/A
Client Need: N/A
Cognitive Level: Knowledge [Remembering]
Concept: Professionalism
Difficulty: Easy
Feedback
A 28% of nursing executives identified knowledge of pharmacological
implications of medications as the largest academic practice gap.
B 18% of nursing executives identified interpretation of assessment data as the
largest academic practice gap.
C 34% of nursing executives identified knowledge of pathophysiology of patient
conditions as the largest academic practice gap.
D 20% of nursing executives identified decision making based on the nursing
process as the largest academic practice gap.
PTS: 1 CON: Professionalism
3. In the Nursing Executive Center of the Advisory Board report, what recommendations are
made to address the academic practice gap for new graduate nurses?
A. Mandatory number of clinical hours
B. Increased credits in all entry level courses
C. Residency programs
D. Additional science prerequisite courses
ANS: C
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 1. Describing the role and competencies of medical-surgical
nursing
Chapter page reference: p. 3
Heading: Competencies in Medical-Surgical Nursing
Integrated Processes: N/A
Client Need: N/A
Cognitive Level: Comprehension [Understanding]
Concept: Healthcare Systems
Difficulty: Moderate
Feedback
Copyright © 2024 F. A. Davis Company
, 3
A Clinical hours in nursing programs are not a specific recommendation related to
the academic practice gap, and clinical hours are more related to state
regulations, academic institutional policies, and accreditation standards.
B Total credits of nursing programs are not a recommendation to address the
academic practice gap. Credits are primarily based on state, university, or higher
education regulatory bodies recommendations or requirements.
C Suggested strategies to better prepare the nurse graduate for the realities of
practice include the increased use of simulation in nursing education programs,
extended transition-to-practice and residency programs, as well as the
establishment of academic service partnerships.
D Prerequisite courses for nursing programs were not specifically addressed in
relation to the academic practice gap. Decisions related to prerequisite courses
are typically determined by school and/or university curriculum committees.
PTS: 1 CON: Healthcare Systems
4. The medical-surgical nurse wants to determine if a policy change is needed for an identified
clinical problem. Which is the nurse’s first action?
A. Developing a question
B. Disseminating the findings
C. Conducting a review of the literature
D. Evaluating outcomes of practice change
ANS: A
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 3. Discussing the incorporation of evidence-based practices into
medical-surgical nursing
Chapter page reference: p. 4
Heading: Evidence-Based Nursing Care/Box 1.3 Steps of Evidence-Based Practice
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive Level: Comprehension
Concept: Evidence-Based Practice
Difficulty: Moderate
Feedback
A The first step of evidence-based practice is to develop a question based on the
clinical issue.
B The last step of evidence-based practice is to disseminate findings.
C The second step of evidence-based practice is to conduct a review of the
literature, or current evidence, available.
D The fifth step of evidence-based practice is to evaluate the outcomes associated
with the practice change.
Copyright © 2024 F. A. Davis Company
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PTS: 1 CON: Evidence-Based Practice
5. Which statement regarding the use of the nursing process in clinical practice is accurate?
A. “The nursing process is closely related to clinical decision making.”
B. “The nursing process is used by all members of the interprofessional team to plan
care.”
C. “The nursing process has four basic steps: assessment, planning, implementation,
and evaluation.”
D. “The nursing process is being replaced by the implementation of evidence-based
practice.”
ANS: A
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 1. Describing the role and competencies of medical-surgical
nursing
Chapter page reference: pp. 3-4
Heading: Competencies Related to the Nursing Process
Integrated Processes: Nursing Process: Diagnosis
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Caring
Difficulty: Moderate
Feedback
A The nursing process is closely related to the nurse’s decision making in the
clinical environment because it requires understanding the relationships among
physiology, pathophysiology, clinical manifestations, and management of
patients. This statement is accurate.
B The nursing process is not used by all members of the interprofessional team to
plan care.
C The nursing process has five, not four, basic steps: assessment, diagnosis,
planning, implementation, and evaluation.
D The nursing process is not being replaced by the implementation of evidence-
based practice.
PTS: 1 CON: Caring
6. The nurse develops a research question based on observations noted while providing care to
patients on the medical-surgical unit. Which step does the nurse implement next during the
process of evidence-based practice?
A. Search for the best evidence.
B. Evaluate the quality of the evidence.
Copyright © 2024 F. A. Davis Company
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C. Integrate the evidence into unit practice.
D. Disseminate the evidence to the staff on the unit.
ANS: A
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 3. Discussing the incorporation of evidence-based practices into
medical-surgical nursing
Chapter page reference: p. 4
Heading: Evidence-Based Nursing Care
Integrated Processes: N/A
Client Need: N/A
Cognitive Level: Comprehension [Remembering]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
A The first step of evidence-based practice is to develop a research question.
Because the nurse has completed this, the next step is to search and collate the
best evidence.
B The third step of evidence-based practice is to evaluate the quality of the
evidence.
C The fourth step of evidence-based practice is to integrate the evidence into
practice.
D The final step of evidence-based practice is to disseminate the evidence. This
step is completed only after the fifth step, which is evaluating the outcomes of
the practice change.
PTS: 1 CON: Evidence-Based Practice
7. The medical-surgical nurse identifies a clinical practice issue and wants to determine if there
is sufficient evidence to support a change in practice. Which type of study provides the
strongest evidence to support a practice change?
A. Randomized controlled study
B. Quasi-experimental study
C. Case-control study
D. Cohort study
ANS: A
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 3. Discussing the incorporation of evidence-based practices into
medical-surgical nursing
Chapter page reference: p. 5
Heading: Evidence-Based Nursing Care
Integrated Processes: N/A
Copyright © 2024 F. A. Davis Company
, 6
Client Need: N/A
Cognitive Level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Moderate
Feedback
A Systematic reviews of randomized controlled studies (Level I) are the highest
level of evidence because they include data from selected studies that randomly
assigned participants to control and experimental groups. The lower numeric
rating of the level of evidence indicates the highest level of evidence; therefore,
this approach provides the strongest evidence to support a practice change.
B Quasi-experimental studies also use control and experimental groups but do not
include random assignment. They are considered Level III, so this study
approach does not provide the strongest evidence to support a practice change.
C Case-control studies include two groups and are considered Level IV. For this
reason, this approach does not provide the strongest evidence to support a
practice change.
D Cohort studies use a cohort of people and follow them over the course of time in
for development of disease/disorders. They are considered Level IV, so this
approach does not provide the strongest evidence to support a practice change.
PTS: 1 CON: Evidence-Based Practice
8. The nurse is evaluating the level of evidence found during a recent review of the literature.
Which evidence carries the lowest level of support for a practice change?
A. Level IV
B. Level V
C. Level VI
D. Level VII
ANS: D
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 3. Discussing the incorporation of evidence-based practices into
medical-surgical nursing
Chapter page reference: p. 5
Heading: Evidence-Based Nursing Care/ Box 1.4 Evaluating Levels of Evidence
Integrated Processes: N/A
Client Need: N/A
Cognitive Level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Moderate
Feedback
Copyright © 2024 F. A. Davis Company
, 7
A The lower the numerical value of the evidence, the greater the support for a
change in practice. Level IV is evidence from case-control and cohort studies
and does not carry the lowest level of support for a practice change.
B The lower the numerical value of the evidence, the greater the support for a
change in practice. Level V is evidence from systematic reviews of descriptive
and qualitative studies and does not carry the lowest level of support for a
practice change.
C The lower the numerical value of the evidence, the greater the support for a
change in practice. Level VI is evidence from a single descriptive or qualitative
study and does not carry the lowest level of support for a practice change.
D The lower the numerical value of the evidence, the greater the support for a
change in practice. Level VII is the lowest level of evidence to support a
practice change and is based on expert individual authorities or committees.
PTS: 1 CON: Evidence-Based Practice
9. The nurse is reviewing evidence from a quasi-experimental research study. Which level of
evidence should the nurse identify for this research study?
A. Level I
B. Level II
C. Level III
D. Level IV
ANS: C
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 3. Discussing the incorporation of evidence-based practices into
medical-surgical nursing
Chapter page reference: p. 5
Heading: Evidence-Based Nursing Care/Box 1.4 Evaluating Levels of Evidence
Integrated Processes: N/A
Client Need: N/A
Cognitive Level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
A A systemic review of randomized controlled studies, not a quasi-experimental
research study, is identified as Level I.
B Evidence from at least one randomized control study, not a quasi-experimental
research study, is identified as Level II.
C A quasi-experimental research study is identified as Level III.
D Evidence from case-control or cohort studies, not a quasi-experimental research
study, is identified as a Level IV.
Copyright © 2024 F. A. Davis Company
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PTS: 1 CON: Evidence-Based Practice
10. Which level of evidence should the nurse identify when reviewing evidence from a single
descriptive research study?
A. Level IV
B. Level V
C. Level VI
D. Level VII
ANS: C
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Chapter learning objective: 3. Discussing the incorporation of evidence-based practices into
medical-surgical nursing
Chapter page reference: p.5
Heading: Evidence-Based Nursing Practice/Box 1.4 Evaluating Levels of Evidence
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
A Evidence from case-control or cohort studies, not a single descriptive research
study, is identified as a Level IV.
B Evidence from systemic reviews of descriptive or qualitative studies, not a
single descriptive research study, is identified as Level V.
C Evidence from a single descriptive research study is identified as Level VI.
D Evidence from expert individual authorities or committees, not a single
descriptive research study, is identified as Level VII.
PTS: 1 CON: Evidence-Based Practice
11. To deliver patient-centered care, the nurse needs to understand the implications of findings
from which organization that provides a standardized approach to the collection of data from
patients regarding their experiences within the healthcare system?
A. The Joint Commission (TJC)
B. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
C. The Nursing Executive Center of the Advisory Board
D. American Nurse Credentialing Center Magnet® Recognition program
ANS: B
Chapter number and title: 1, Foundations for Medical-Surgical Nursing
Copyright © 2024 F. A. Davis Company