FULL TEST BANK
TEST BANK FOR MEDICAL SURGICAL NURSING:
CONCEPTS FOR CLINICAL JUDGMENT AND
COLLABORATIVE CARE, 11TH EDITION
1
,TABLE OF CONTENTS
UNIT I: Essential Concepts of Medical-Surgical Nursing
1. Overview of Professional Nursing Concepts for Medical-Surgical Nursing
2. Clinical Judgment and Systems Thinking
3. Overview of Health Concepts for Medical-Surgical Nursing
4. Concepts of Care for Older Adults
5. Concepts of Care for Transgender and Non-Binary Patients
6. Assessment and Concepts of Care for Patients with Pain
7. Concepts of Rehabilitation for Chronic and Disabling Health Conditions
8. Concepts of Care for Patients at End-of-Life
9. Concepts of Care for Perioperative Patients
UNIT II: Concepts of Emergency Care and Disaster Preparedness
10. Concepts of Emergency and Trauma Nursing
11. Concepts of Care for Patients with Common Environmental Emergencies
12. Concepts of Disaster Preparedness
UNIT III: Concepts of Fluid, Electrolyte, and Acid-Base Balance and Imbalance
13. Concepts of Fluid and Electrolyte Balance and Imbalance
14. Concepts of Acid-Base Balance and Imbalance
15. Concepts of Infusion Therapy
UNIT IV: Interprofessional Collaboration for Patients with Immunity Conditions
16. Concepts of Inflammation and Immunity
17. Concepts of Care for Patients with Allergy and Immunity Conditions
18. Concepts of Care for Patients with Cancer
19. Concepts of Care for Patients with Infection
UNIT V: Interprofessional Collaboration for Patients with Integumentary System
Conditions
20. Assessment of the Skin, Hair, and Nails
21. Concepts of Care for Patients with Conditions of the Skin, Hair, and Nails
UNIT VI: Interprofessional Collaboration for Patients with Respiratory System
Conditions
22. Assessment of the Respiratory System
23. Concepts of Care for Patients with Noninfectious Upper Respiratory Conditions
24. Concepts of Care for Patients with Noninfectious Lower Respiratory Conditions
25. Concepts of Care for Patients with Infectious Respiratory Conditions
26. Critical Care of Patients with Respiratory Emergencies
UNIT VII: Interprofessional Collaboration for Patients with Cardiovascular System
Conditions
27. Assessment of the Cardiovascular System
28. Concepts of Care for Patients with Dysrhythmias
29. Concepts of Care for Patients with Cardiac Conditions
30. Concepts of Care for Patients with Vascular Conditions
31. Critical Care of Patients with Shock
32. Critical Care of Patients with Acute Coronary Syndromes
UNIT VIII: Interprofessional Collaboration for Patients with Hematologic System
Conditions
33. Assessment of the Hematologic System
34. Concepts of Care for Patients with Hematologic Conditions
UNIT IX: Interprofessional Collaboration for Patients with Nervous System
Conditions
35. Assessment of the Nervous System
2
,36. Concepts of Care for Patients with Conditions of the Central Nervous System: The
Brain
37. Concepts of Care for Patients with Conditions of the Central Nervous System: The
Spinal Cord
38. Critical Care of Patients with Neurologic Emergencies
UNIT X: Interprofessional Collaboration for Patients with Sensory System
Conditions
39. Assessment and Concepts of Care for Patients with Eye and Vision Conditions
40. Assessment and Concepts of Care for Patients with Ear and Hearing Conditions
UNIT XI: Interprofessional Collaboration for Patients with Musculoskeletal System
Conditions
41. Assessment of the Musculoskeletal System
42. Concepts of Care for Patients with Musculoskeletal Conditions
43. Concepts of Care for Patients with Arthritis and Total Joint Arthroplasty
44. Concepts of Care for Patients with Musculoskeletal Trauma
UNIT XII: Interprofessional Collaboration for Patients with Gastrointestinal System
Conditions
45. Assessment of the Gastrointestinal System
46. Concepts of Care for Patients with Oral Cavity and Esophageal Conditions
47. Concepts of Care for Patients with Stomach Conditions
48. Concepts of Care for Patients with Noninflammatory Intestinal Conditions
49. Concepts of Care for Patients with Inflammatory Intestinal Conditions
50. Concepts of Care for Patients with Liver Conditions
51. Concepts of Care for Patients with Conditions of the Biliary System and Pancreas
52. Concepts of Care for Patients with Malnutrition: Undernutrition and Obesity
UNIT XIII: Interprofessional Collaboration for Patients with Endocrine System
Conditions
53. Assessment of the Endocrine System
54. Concepts of Care for Patients with Pituitary and Adrenal Gland Conditions
55. Concepts of Care for Patients with Conditions of the Thyroid and Parathyroid Glands
56. Concepts of Care for Patients with Diabetes Mellitus
UNIT XIV: Interprofessional Collaboration for Patients with Renal/Urinary System
Conditions
57. Assessment of the Renal/Urinary System
58. Concepts of Care for Patients with Urinary Conditions
59. Concepts of Care for Patients with Kidney Conditions
60. Concepts of Care for Patients with Acute Kidney Injury and Chronic Kidney Disease
UNIT XV: Interprofessional Collaboration for Patients with Reproductive System
Conditions
61. Assessment of the Reproductive System
62. Concepts of Care for Patients with Breast Conditions
63. Concepts of Care for Patients with Gynecologic Conditions
64. Concepts of Care for Patients with Male Reproductive Conditions
65. Concepts of Care for Patients with Sexually Transmitted Infections
3
,Chapter 01: Overview Of Professional Nursing Concepts For Medical-Surgical
Nursing Ignatavicius: Medical-Surgical Nursing, 11th Edition
MULTIPLE CHOICE
1. A New Nurse Is Working With A Preceptor On A Medical-Surgical Unit. The Preceptor
Advises TheNew Nurse That Which Is The Priority When Working As A Professional
Nurse?
a. Attending To Holistic Client Needs
b. Ensuring Client Safety
c. Not Making Medication Errors
d. Providing Client-Focused Care
ANS: B
All Actions Are Appropriate For The Professional Nurse. However, Ensuring Client Safety Is
ThePriority. Health Care Errors Have Been Widely Reported For 25 Years, Many Of Which
Result InClient Injury, Death, And Increased Health Care Costs. There Are Several National
And International Organizations That Have Either Recommended Or Mandated Safety
Initiatives.
Every Nurse Has The Responsibility To Guard The Client‘s Safety. The Other Actions Are
Important For Quality Nursing, But They Are Not As Vital As Providing Safety. Not Making
Medication Errorsdoes Provide Safety, But Is Too Narrow In Scope To Be The Best Answer.
DIF: Understanding TOP: Integrated Process: NURSING Process:
Interventionkey: Client Safety
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
2. A Nurse Is Orienting A New Client And Family To The Medical-Surgical Unit. What
InformationDoes The Nurse Provide To Best Help The Client Promote His Or Her Own
Safety?
a. Encourage The Client And Family To Be Active Partners.
b. Have The Client Monitor Hand Hygiene In Caregivers.
c. Offer The Family The Opportunity To Stay With Theclient.
d. Tell The Client To Always Wear His Or Her Armband.
ANS: A
Each Action Could Be Important For The Client Or Family To Perform. However,
Encouraging The Client To Be Active In His Or Her Health Care As A Safety Partner Is The
Most Critical. The Other Actions Are Very Limited In Scope And Do Not Provide The Broad
Protection That Being Active AndInvolved Does.
DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Client Safety
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
3. A Nurse Is Caring For A Postoperative Client On The Surgical Unit. The Client‘s Blood
Pressure Was 142/76 Mm Hg 30 Minutes Ago, And Now Is 88/50 Mm Hg. What Action
Would The NurseTake First?
a. Call The Rapid Response Team.
b. Document And Continue To Monitor.
c. Notify The Primary Health Provider
d. Repeat The Blood Pressure In 15 Minutes.
ANS: A
4
, The Purpose Of The Rapid Response Team (RRT) Is To Intervene When Clients Are
DeterioratingBefore They Suffer Either Respiratory Or Cardiac Arrest. Since The Client Has
Manifested A Significant Change, The Nurse Would Call The RRT. Changes In Blood
Pressure, Mental Status, Heart Rate, Temperature, Oxygen Saturation, And Last 2 Hours‘
Urine Output Are Particularly Significant And Are Part Of The Modified Early Warning
System Guide. Documentation Is Vital, But The Nurse Must Do More Than Document. The
Primary Health Care Provider Would Be Notified, But This Is Not More Important Than
Calling The RRT. The Client‘s Blood Pressure Would Be Reassessed Frequently, But The
Priority Is Getting The Rapid Care To The Client.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Rapid Response Team (RRT), Clinical Judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
4. A Nurse Wishes To Provide Client-Centered Care In All Interactions. Which Action By The
Nurse
Best Demonstrates This Concept?
a. Assesses For Cultural Influences Affecting Health Care.
b. Ensures That All The Client‘s Basic Needs Are Met.
c. Tells The Client And Family About All Upcoming Tests.
d. Thoroughly Orients The Client And Family To Theroom.
ANS: A
Showing Respect For The Client And Family‘s Preferences And Needs Is Essential To
Ensure A Holistic Or ―Whole-Person‖ Approach To Care. By Assessing The Effect Of The
Client‘s Culture OnHealth Care, This Nurse Is Practicing Client-Focused Care. Providing
For Basic Needs Does Not Demonstrate This Competence. Simply Telling The Client About
All Upcoming Tests Is Not Providing Empowering Education. Orienting The Client And
Family To The Room Is An ImportantSafety Measure, But Not Directly Related To
Demonstrating Client-Centered Care.
DIF: Understanding TOP: Integrated Process: Culture And Spirituality
KEY: Client-Centered Care, Culture MSC: Client Needs Category: Psychosocial Integrity
5. A Client Is Going To Be Admitted For A Scheduled Surgical Procedure. Which Action
Does TheNurse Explain Is The Most Important Thing The Client Can Do To Protect
Against Errors?
a. Bring A List Of All Medications And What They Are For.
b. Keep The Provider‘s Phone Number By The Telephone.
c. Make Sure That All Providers Wash Hands Before Entering The Room.
d. Write Down The Name Of Each Caregiver Who Comes In The Room.
ANS: A
Medication Reconciliation Is A Formal Process In Which The Client‘s Actual Current
MedicationsAre Compared To The Prescribed Medications At The Time Of Admission,
Transfer, Or Discharge. This National Client Safety Goal Is Important To Reduce
Medication Errors. The Client Would Not Have To Be Responsible For Providers Washing
Their Hands, And Even If The Client Does So, This Is Too Narrow To Be The Most
Important Action To Prevent Errors. Keeping The Provider‘s Phone Number Nearby And
Documenting Everyone Who Enters The Room Also Do Not Guarantee Safety.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Client Safety, Informatics
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
5
, ANS: A
The Purpose Of The Rapid Response Team (RRT) Is To Intervene When Clients Are
DeterioratingBefore They Suffer Either Respiratory Or Cardiac Arrest. Since The Client Has
Manifested A Significant Change, The Nurse Would Call The RRT. Changes In Blood
Pressure, Mental Status, Heart Rate, Temperature, Oxygen Saturation, And Last 2 Hours‘
Urine Output Are Particularly Significant And Are Part Of The Modified Early Warning
System Guide. Documentation Is Vital, But The Nurse Must Do More Than Document. The
Primary Health Care Provider Would Be Notified, But This Is Not More Important Than
Calling The RRT. The Client‘s Blood Pressure Would Be Reassessed Frequently, But The
Priority Is Getting The Rapid Care To The Client.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Rapid Response Team (RRT), Clinical Judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
6. A Nurse Wishes To Provide Client-Centered Care In All Interactions. Which Action By The
Nurse
Best Demonstrates This Concept?
a. Assesses For Cultural Influences Affecting Health Care.
b. Ensures That All The Client‘s Basic Needs Are Met.
c. Tells The Client And Family About All Upcoming Tests.
d. Thoroughly Orients The Client And Family To Theroom.
ANS: A
Showing Respect For The Client And Family‘s Preferences And Needs Is Essential To
Ensure A Holistic Or ―Whole-Person‖ Approach To Care. By Assessing The Effect Of The
Client‘s Culture OnHealth Care, This Nurse Is Practicing Client-Focused Care. Providing
For Basic Needs Does Not Demonstrate This Competence. Simply Telling The Client About
All Upcoming Tests Is Not Providing Empowering Education. Orienting The Client And
Family To The Room Is An ImportantSafety Measure, But Not Directly Related To
Demonstrating Client-Centered Care.
DIF: Understanding TOP: Integrated Process: Culture And Spirituality
KEY: Client-Centered Care, Culture MSC: Client Needs Category: Psychosocial Integrity
7. A Client Is Going To Be Admitted For A Scheduled Surgical Procedure. Which Action
Does TheNurse Explain Is The Most Important Thing The Client Can Do To Protect
Against Errors?
a. Bring A List Of All Medications And What They Are For.
b. Keep The Provider‘s Phone Number By The Telephone.
c. Make Sure That All Providers Wash Hands Before Entering The Room.
d. Write Down The Name Of Each Caregiver Who Comes In The Room.
ANS: A
Medication Reconciliation Is A Formal Process In Which The Client‘s Actual Current
MedicationsAre Compared To The Prescribed Medications At The Time Of Admission,
Transfer, Or Discharge. This National Client Safety Goal Is Important To Reduce
Medication Errors. The Client Would Not Have To Be Responsible For Providers Washing
Their Hands, And Even If The Client Does So, This Is Too Narrow To Be The Most
Important Action To Prevent Errors. Keeping The Provider‘s Phone Number Nearby And
Documenting Everyone Who Enters The Room Also Do Not Guarantee Safety.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Client Safety, Informatics
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
6
,8. Which Action By The Nurse Working With A Client Best Demonstrates Respect For Autonomy?
a. Asks If The Client Has Questions Before Signing A Consent.
b. Gives The Client Accurate Information When Questioned.
c. Keeps The Promises Made To The Client And Family.
d. Treats The Client Fairly Compared To Otherclients.
ANS: A
Autonomy Is Self-Determination. The Client Would Make Decisions Regarding Care. When
The Nurse Obtains A Signature On The Consent Form, Assessing If The Client Still Has
Questions Is Vital,Because Without Full Information The Client Cannot Practice Autonomy.
Giving Accurate Information Is Practicing With Veracity. Keeping Promises Is Upholding
Fidelity. Treating The Client Fairly Is Providing Social Justice.
DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, Autonomy
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of
Care
9. A Nurse Asks A More Seasoned Colleague To Explain Best Practices When Communicating
With APerson From The Lesbian, Gay, Bisexual, Transgender, And Questioning/Queer
(LGBTQ) Community. What Answer By The Faculty Is Most Accurate?
a. Avoid Embarrassing The Client By Asking Questions.
b. Don‘t Make Assumptions About His Or Her Health Needs.
c. Most LGBTQ People Do Not Want To Share Information.
d. No Differences Exist In Communicating With This Population.
ANS: B
Many Members Of The LGBTQ Community Have Faced Discrimination From Health Care
Providers And May Be Reluctant To Seek Health Care. The Nurse Would Never Make
Assumptions About The Needs Of Members Of This Population. Rather, Respectful
Questions Are Appropriate. IfApproached With Sensitivity, The Client With Any Health
Care Need Is More Likely To Answer Honestly.
DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Health Care Disparities, LGBTQ MSC: Client Needs Category: Psychosocial Integrity
10. A Nurse Is Calling The On-Call Health Care Provider About A Client Who Had A
Hysterectomy 2Days Ago And Has Pain That Is Unrelieved By The Prescribed Opioid
Pain Medication. Which Statement Comprises The Background Portion Of The SBAR
Format Forcommunication?
a. ―I Would Like You To Order A Different Pain Medication.‖
b. ―This Client Has Allergies To Morphine And Codeine.‖
c. ―Dr. Smith Doesn‘t Like Nonsteroidal Anti-Inflammatorymeds.‖
d. ―This Client Had A Vaginal Hysterectomy 2 Days Ago.‖
ANS: B
7
, SBAR Is A Recommended Form Of Communication, And The Acronym Stands For
Situation, Background, Assessment, And Recommendation. Appropriate Background
Information Includes Allergies To Medications The On-Call Health Care Provider Might
Order. Situation Describes What Is Happening Right Now That Must Be Communicated; The
Client‘s Surgery 2 DaysAgo Would Be Considered Background. Assessment Would Include
An Analysis Of The Client‘s Problem; None Of The Options Has Assessment Information.
Asking For A Different Pain Medication Is A Recommendation. Recommendation Is A
Statement Of What Is Needed Or What Outcome Is Desired.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, SBAR
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
11. A Nurse Working On A Cardiac Unit Delegated Taking Vital Signs To An Experienced
Assistive Personnel (AP). Four Hours Later, The Nurse Notes That The Client‘s Blood
Pressure Taken By The AP Was Much Higher Than Previous Readings, And The Client‘s
Mental Status Has Changed. WhatAction By The Nurse Would Most Likely Have Prevented
This Negative Outcome?
a. Determining If The AP Knew How To Take Blood Pressure
b. Double-Checking The AP By Taking Another Blood Pressure
c. Providing More Appropriate Supervision Of The AP
d. Taking The Blood Pressure Instead Of Delegating The Task
ANS: C
Supervision Is One Of The Five Rights Of Delegation And Includes Directing, Evaluating,
And Following Up On Delegated Tasks. The Nurse Would Either Have Asked The AP
About The Vital Signs Or Instructed The AP To Report Them Right Away. An Experienced
AP Would Know How ToTake Vital Signs And The Nurse Would Not Have To Assess This
At This Point. Double-Checking TheWork Defeats The Purpose Of Delegation. Vital Signs
Are Within The Scope Of Practice For A AP And Are Permissible To Delegate. The Only
Appropriate Answer Is That The Nurse Did Not ProvideAdequate Instruction To The AP.
DIF: Analyzing TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, Delegation
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
12. A Newly Graduated Nurse In The Hospital States That Because Of Being So New,
Participation In Quality Improvement (QI) Projects Is Not Wise. What Response By The
Precepting Nurse Is Best?
a. ―All Staff Nurses Are Required To Participate In Quality Improvementhere.‖
b. ―Even Being New, You Can Implement Activities Designed To Improvecare.‖
c. ―It‘s Easy To Identify What Indicators Would Be Used To Measurequality.‖
d. ―You Should Ask To Be Assigned To The Research And Quality Committee.‖
ANS: B
The Preceptor Would Try To Reassure The Nurse That Implementing QI Measures Is Not Out
Of LineFor A Newly Licensed Nurse. Simply Stating That All Nurses Are Required To
Participate Does Not Help The Nurse Understand How That Is Possible And Is Dismissive.
Identifying Indicators Of Quality Is Not An Easy, Quick Process And Would Not Be The Best
Place To Suggest A New Nurse ToStart. Asking To Be Assigned To The QI Committee Does
Not Give The Nurse Information About How To Implement QI In Daily Practice.
DIF: Applying TOP: Integrated Process: Communication And Documentation
8
, KEY: Systems Thinking, Quality Improvement
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
13. A Nurse Is Talking With A Co-Worker Who Is Moving To A New State And Needs To
Find NewEmployment There. What Advice By The Nurse Is Best?
a. Ask The Hospitals There About Standard Nurse–Client Ratios.
b. Choose The Hospital That Has The Newest Technology.
c. Find A Hospital That Has Achieved Magnet Status.
d. Work In A Facility Affiliated With A Medical Or NURSING School.
ANS: C
Client Magnet Status Is Awarded By The Joint Commission (TJC) And Certifies That
Nurses CanDemonstrate How Best Current Evidence Guides Their Practice. New
Technology Doesn‘t Necessarily Mean That The Hospital Is Safe. Affiliation With A Health
Profession School Has Several Advantages, But Safety Is Most Important.
DIF: Understanding
TOP: Integrated Process: Communication And
DocumentationKEY: Evidence-Based Practice, Magnet
Status
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
MULTIPLE RESPONSE
1. A Nurse Manager Wishes To Ensure That The Nurses On The Unit Are Practicing At Their
Highest Levels Of Competency. Which Areas Would The Manager Assess To Determine If
The NURSINGStaffdemonstrate Competency According To The Institute Of Medicine
(IOM) Report Health Professions Education: A Bridge To Quality? (Select All That Apply.)
a. Collaborating With An Interprofessional Team
b. Implementing Evidence-Based Care
c. Providing Family-Focused Care
d. Routinely Using Informatics In Practice
e. Using Quality Improvement In Client Care
f. Formalizing Systems Thinking When Implementing Care
ANS: A, B, D, E
The IOM Report Lists Five Broad Core Competencies That All Health Care Providers
Should Practice. These Include Collaborating With The Interprofessional Team,
Implementing Evidence-Based Practice, Providing Patient-Focused Care, Using Informatics
In Client Care, AndUsing Quality Improvement In Client Care. Systems Thinking Is
Required For Quality Improvement But Is Not A Specified Part Of The IOM Report.
DIF: Remembering TOP: Integrated Process: NURSING Process:
Assessmentkey: Competencies, Institute Of Medicine (IOM)
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
2. A Nurse Is Interested In Making Interprofessional Work A High Priority. Which Actions
By TheNurse Best Demonstrate This Skill? (Select All That Apply.)
a. Consults With Other Disciplines On Client Care.
b. Coordinates Discharge Planning For Home Safety.
c. Participates In Comprehensive Client Rounding.
d. Routinely Asks Other Disciplines About Clientprogress.
9
, e. Shows The NURSING Care Plans To Other Disciplines.
f. Delegate Tasks To Unlicensed Personnel Appropriately.
ANS: A, B, C, D, F
Collaborating With The Interprofessional Team Involves Planning, Implementing, And
Evaluating Client Care As A Team With All Other Involved Disciplines Included. Simply
ShowingOther Caregivers The NURSING Care Plan Is Not Actively Involving Them Or
Collaborating With Them.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, Interprofessional Team
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
3. The Nurse Utilizing Evidence-Based Practice (EBP) Considers Which Factors When
PlanningCare? (Select All That Apply.)
a. Cost-Saving Measures
b. Nurse‘s Expertise
c. Client Preferences
d. Research Findings
e. Values Of The Client
f. Plan-Do-Study-Act Model
ANS: B, C, D, E
EBP Consists Of Utilizing Current Evidence, The Client‘s Values And Preferences, And The
Nurse‘s Expertise When Planning Care. It Does Not Include Cost-Saving Measures. The
PDSA Model Is A Systematic Model For Quality Improvement, But Is Not A Specific
Component Of EBP.
DIF: Remembering TOP: Integrated Process: NURSING Process:
Planningkey: Evidence-Based Practice (EBP)
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
4. A Nurse Manager Wants To Improve Hand-Off Communication Among The Staff. What
Actions ByThe Manager Would Best Help Achieve This Goal? (Select All That Apply.)
a. Attend Hand-Off Rounds To Coach And Mentor.
b. Create A Template Of Suggested Topics To Include In Report.
c. Encourage Staff To Ask Questions During Hand-Off.
d. Give Raises Based On Compliance With Reporting.
e. Provide Education On The SBAR Method Of Communication
ANS: A, B, C, E
The SBAR Method Of Communication Has Been Identified As An Excellent Method Of
Communication Between Health Care Professionals. It Is A Formalized Structure Consisting
Of Situation, Background, Assessment, And Recommendation/Request. Using A Formalized
Mechanism For Communication Helps Ensure Successful Hand-Off And Fewer Client Errors.
WhenEstablishing This New Format For Report, The Most Helpful Actions By The Manager
Would Be To Provide Initial Education On The Process, Develop A Template With Suggested
Topics Under Each Heading, Attend Rounds To Coach And Mentor, And Encourage Staff To
Ask Questions To Clarify Information. Basing Raises On Compliance Would Not Be The
Most Helpful Method Because Raises Are Often Determined Only Once A Year And Are
Based On Multiple Criteria.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, Communication
10
TEST BANK FOR MEDICAL SURGICAL NURSING:
CONCEPTS FOR CLINICAL JUDGMENT AND
COLLABORATIVE CARE, 11TH EDITION
1
,TABLE OF CONTENTS
UNIT I: Essential Concepts of Medical-Surgical Nursing
1. Overview of Professional Nursing Concepts for Medical-Surgical Nursing
2. Clinical Judgment and Systems Thinking
3. Overview of Health Concepts for Medical-Surgical Nursing
4. Concepts of Care for Older Adults
5. Concepts of Care for Transgender and Non-Binary Patients
6. Assessment and Concepts of Care for Patients with Pain
7. Concepts of Rehabilitation for Chronic and Disabling Health Conditions
8. Concepts of Care for Patients at End-of-Life
9. Concepts of Care for Perioperative Patients
UNIT II: Concepts of Emergency Care and Disaster Preparedness
10. Concepts of Emergency and Trauma Nursing
11. Concepts of Care for Patients with Common Environmental Emergencies
12. Concepts of Disaster Preparedness
UNIT III: Concepts of Fluid, Electrolyte, and Acid-Base Balance and Imbalance
13. Concepts of Fluid and Electrolyte Balance and Imbalance
14. Concepts of Acid-Base Balance and Imbalance
15. Concepts of Infusion Therapy
UNIT IV: Interprofessional Collaboration for Patients with Immunity Conditions
16. Concepts of Inflammation and Immunity
17. Concepts of Care for Patients with Allergy and Immunity Conditions
18. Concepts of Care for Patients with Cancer
19. Concepts of Care for Patients with Infection
UNIT V: Interprofessional Collaboration for Patients with Integumentary System
Conditions
20. Assessment of the Skin, Hair, and Nails
21. Concepts of Care for Patients with Conditions of the Skin, Hair, and Nails
UNIT VI: Interprofessional Collaboration for Patients with Respiratory System
Conditions
22. Assessment of the Respiratory System
23. Concepts of Care for Patients with Noninfectious Upper Respiratory Conditions
24. Concepts of Care for Patients with Noninfectious Lower Respiratory Conditions
25. Concepts of Care for Patients with Infectious Respiratory Conditions
26. Critical Care of Patients with Respiratory Emergencies
UNIT VII: Interprofessional Collaboration for Patients with Cardiovascular System
Conditions
27. Assessment of the Cardiovascular System
28. Concepts of Care for Patients with Dysrhythmias
29. Concepts of Care for Patients with Cardiac Conditions
30. Concepts of Care for Patients with Vascular Conditions
31. Critical Care of Patients with Shock
32. Critical Care of Patients with Acute Coronary Syndromes
UNIT VIII: Interprofessional Collaboration for Patients with Hematologic System
Conditions
33. Assessment of the Hematologic System
34. Concepts of Care for Patients with Hematologic Conditions
UNIT IX: Interprofessional Collaboration for Patients with Nervous System
Conditions
35. Assessment of the Nervous System
2
,36. Concepts of Care for Patients with Conditions of the Central Nervous System: The
Brain
37. Concepts of Care for Patients with Conditions of the Central Nervous System: The
Spinal Cord
38. Critical Care of Patients with Neurologic Emergencies
UNIT X: Interprofessional Collaboration for Patients with Sensory System
Conditions
39. Assessment and Concepts of Care for Patients with Eye and Vision Conditions
40. Assessment and Concepts of Care for Patients with Ear and Hearing Conditions
UNIT XI: Interprofessional Collaboration for Patients with Musculoskeletal System
Conditions
41. Assessment of the Musculoskeletal System
42. Concepts of Care for Patients with Musculoskeletal Conditions
43. Concepts of Care for Patients with Arthritis and Total Joint Arthroplasty
44. Concepts of Care for Patients with Musculoskeletal Trauma
UNIT XII: Interprofessional Collaboration for Patients with Gastrointestinal System
Conditions
45. Assessment of the Gastrointestinal System
46. Concepts of Care for Patients with Oral Cavity and Esophageal Conditions
47. Concepts of Care for Patients with Stomach Conditions
48. Concepts of Care for Patients with Noninflammatory Intestinal Conditions
49. Concepts of Care for Patients with Inflammatory Intestinal Conditions
50. Concepts of Care for Patients with Liver Conditions
51. Concepts of Care for Patients with Conditions of the Biliary System and Pancreas
52. Concepts of Care for Patients with Malnutrition: Undernutrition and Obesity
UNIT XIII: Interprofessional Collaboration for Patients with Endocrine System
Conditions
53. Assessment of the Endocrine System
54. Concepts of Care for Patients with Pituitary and Adrenal Gland Conditions
55. Concepts of Care for Patients with Conditions of the Thyroid and Parathyroid Glands
56. Concepts of Care for Patients with Diabetes Mellitus
UNIT XIV: Interprofessional Collaboration for Patients with Renal/Urinary System
Conditions
57. Assessment of the Renal/Urinary System
58. Concepts of Care for Patients with Urinary Conditions
59. Concepts of Care for Patients with Kidney Conditions
60. Concepts of Care for Patients with Acute Kidney Injury and Chronic Kidney Disease
UNIT XV: Interprofessional Collaboration for Patients with Reproductive System
Conditions
61. Assessment of the Reproductive System
62. Concepts of Care for Patients with Breast Conditions
63. Concepts of Care for Patients with Gynecologic Conditions
64. Concepts of Care for Patients with Male Reproductive Conditions
65. Concepts of Care for Patients with Sexually Transmitted Infections
3
,Chapter 01: Overview Of Professional Nursing Concepts For Medical-Surgical
Nursing Ignatavicius: Medical-Surgical Nursing, 11th Edition
MULTIPLE CHOICE
1. A New Nurse Is Working With A Preceptor On A Medical-Surgical Unit. The Preceptor
Advises TheNew Nurse That Which Is The Priority When Working As A Professional
Nurse?
a. Attending To Holistic Client Needs
b. Ensuring Client Safety
c. Not Making Medication Errors
d. Providing Client-Focused Care
ANS: B
All Actions Are Appropriate For The Professional Nurse. However, Ensuring Client Safety Is
ThePriority. Health Care Errors Have Been Widely Reported For 25 Years, Many Of Which
Result InClient Injury, Death, And Increased Health Care Costs. There Are Several National
And International Organizations That Have Either Recommended Or Mandated Safety
Initiatives.
Every Nurse Has The Responsibility To Guard The Client‘s Safety. The Other Actions Are
Important For Quality Nursing, But They Are Not As Vital As Providing Safety. Not Making
Medication Errorsdoes Provide Safety, But Is Too Narrow In Scope To Be The Best Answer.
DIF: Understanding TOP: Integrated Process: NURSING Process:
Interventionkey: Client Safety
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
2. A Nurse Is Orienting A New Client And Family To The Medical-Surgical Unit. What
InformationDoes The Nurse Provide To Best Help The Client Promote His Or Her Own
Safety?
a. Encourage The Client And Family To Be Active Partners.
b. Have The Client Monitor Hand Hygiene In Caregivers.
c. Offer The Family The Opportunity To Stay With Theclient.
d. Tell The Client To Always Wear His Or Her Armband.
ANS: A
Each Action Could Be Important For The Client Or Family To Perform. However,
Encouraging The Client To Be Active In His Or Her Health Care As A Safety Partner Is The
Most Critical. The Other Actions Are Very Limited In Scope And Do Not Provide The Broad
Protection That Being Active AndInvolved Does.
DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Client Safety
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
3. A Nurse Is Caring For A Postoperative Client On The Surgical Unit. The Client‘s Blood
Pressure Was 142/76 Mm Hg 30 Minutes Ago, And Now Is 88/50 Mm Hg. What Action
Would The NurseTake First?
a. Call The Rapid Response Team.
b. Document And Continue To Monitor.
c. Notify The Primary Health Provider
d. Repeat The Blood Pressure In 15 Minutes.
ANS: A
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, The Purpose Of The Rapid Response Team (RRT) Is To Intervene When Clients Are
DeterioratingBefore They Suffer Either Respiratory Or Cardiac Arrest. Since The Client Has
Manifested A Significant Change, The Nurse Would Call The RRT. Changes In Blood
Pressure, Mental Status, Heart Rate, Temperature, Oxygen Saturation, And Last 2 Hours‘
Urine Output Are Particularly Significant And Are Part Of The Modified Early Warning
System Guide. Documentation Is Vital, But The Nurse Must Do More Than Document. The
Primary Health Care Provider Would Be Notified, But This Is Not More Important Than
Calling The RRT. The Client‘s Blood Pressure Would Be Reassessed Frequently, But The
Priority Is Getting The Rapid Care To The Client.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Rapid Response Team (RRT), Clinical Judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
4. A Nurse Wishes To Provide Client-Centered Care In All Interactions. Which Action By The
Nurse
Best Demonstrates This Concept?
a. Assesses For Cultural Influences Affecting Health Care.
b. Ensures That All The Client‘s Basic Needs Are Met.
c. Tells The Client And Family About All Upcoming Tests.
d. Thoroughly Orients The Client And Family To Theroom.
ANS: A
Showing Respect For The Client And Family‘s Preferences And Needs Is Essential To
Ensure A Holistic Or ―Whole-Person‖ Approach To Care. By Assessing The Effect Of The
Client‘s Culture OnHealth Care, This Nurse Is Practicing Client-Focused Care. Providing
For Basic Needs Does Not Demonstrate This Competence. Simply Telling The Client About
All Upcoming Tests Is Not Providing Empowering Education. Orienting The Client And
Family To The Room Is An ImportantSafety Measure, But Not Directly Related To
Demonstrating Client-Centered Care.
DIF: Understanding TOP: Integrated Process: Culture And Spirituality
KEY: Client-Centered Care, Culture MSC: Client Needs Category: Psychosocial Integrity
5. A Client Is Going To Be Admitted For A Scheduled Surgical Procedure. Which Action
Does TheNurse Explain Is The Most Important Thing The Client Can Do To Protect
Against Errors?
a. Bring A List Of All Medications And What They Are For.
b. Keep The Provider‘s Phone Number By The Telephone.
c. Make Sure That All Providers Wash Hands Before Entering The Room.
d. Write Down The Name Of Each Caregiver Who Comes In The Room.
ANS: A
Medication Reconciliation Is A Formal Process In Which The Client‘s Actual Current
MedicationsAre Compared To The Prescribed Medications At The Time Of Admission,
Transfer, Or Discharge. This National Client Safety Goal Is Important To Reduce
Medication Errors. The Client Would Not Have To Be Responsible For Providers Washing
Their Hands, And Even If The Client Does So, This Is Too Narrow To Be The Most
Important Action To Prevent Errors. Keeping The Provider‘s Phone Number Nearby And
Documenting Everyone Who Enters The Room Also Do Not Guarantee Safety.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Client Safety, Informatics
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
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, ANS: A
The Purpose Of The Rapid Response Team (RRT) Is To Intervene When Clients Are
DeterioratingBefore They Suffer Either Respiratory Or Cardiac Arrest. Since The Client Has
Manifested A Significant Change, The Nurse Would Call The RRT. Changes In Blood
Pressure, Mental Status, Heart Rate, Temperature, Oxygen Saturation, And Last 2 Hours‘
Urine Output Are Particularly Significant And Are Part Of The Modified Early Warning
System Guide. Documentation Is Vital, But The Nurse Must Do More Than Document. The
Primary Health Care Provider Would Be Notified, But This Is Not More Important Than
Calling The RRT. The Client‘s Blood Pressure Would Be Reassessed Frequently, But The
Priority Is Getting The Rapid Care To The Client.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Rapid Response Team (RRT), Clinical Judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
6. A Nurse Wishes To Provide Client-Centered Care In All Interactions. Which Action By The
Nurse
Best Demonstrates This Concept?
a. Assesses For Cultural Influences Affecting Health Care.
b. Ensures That All The Client‘s Basic Needs Are Met.
c. Tells The Client And Family About All Upcoming Tests.
d. Thoroughly Orients The Client And Family To Theroom.
ANS: A
Showing Respect For The Client And Family‘s Preferences And Needs Is Essential To
Ensure A Holistic Or ―Whole-Person‖ Approach To Care. By Assessing The Effect Of The
Client‘s Culture OnHealth Care, This Nurse Is Practicing Client-Focused Care. Providing
For Basic Needs Does Not Demonstrate This Competence. Simply Telling The Client About
All Upcoming Tests Is Not Providing Empowering Education. Orienting The Client And
Family To The Room Is An ImportantSafety Measure, But Not Directly Related To
Demonstrating Client-Centered Care.
DIF: Understanding TOP: Integrated Process: Culture And Spirituality
KEY: Client-Centered Care, Culture MSC: Client Needs Category: Psychosocial Integrity
7. A Client Is Going To Be Admitted For A Scheduled Surgical Procedure. Which Action
Does TheNurse Explain Is The Most Important Thing The Client Can Do To Protect
Against Errors?
a. Bring A List Of All Medications And What They Are For.
b. Keep The Provider‘s Phone Number By The Telephone.
c. Make Sure That All Providers Wash Hands Before Entering The Room.
d. Write Down The Name Of Each Caregiver Who Comes In The Room.
ANS: A
Medication Reconciliation Is A Formal Process In Which The Client‘s Actual Current
MedicationsAre Compared To The Prescribed Medications At The Time Of Admission,
Transfer, Or Discharge. This National Client Safety Goal Is Important To Reduce
Medication Errors. The Client Would Not Have To Be Responsible For Providers Washing
Their Hands, And Even If The Client Does So, This Is Too Narrow To Be The Most
Important Action To Prevent Errors. Keeping The Provider‘s Phone Number Nearby And
Documenting Everyone Who Enters The Room Also Do Not Guarantee Safety.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Client Safety, Informatics
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
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,8. Which Action By The Nurse Working With A Client Best Demonstrates Respect For Autonomy?
a. Asks If The Client Has Questions Before Signing A Consent.
b. Gives The Client Accurate Information When Questioned.
c. Keeps The Promises Made To The Client And Family.
d. Treats The Client Fairly Compared To Otherclients.
ANS: A
Autonomy Is Self-Determination. The Client Would Make Decisions Regarding Care. When
The Nurse Obtains A Signature On The Consent Form, Assessing If The Client Still Has
Questions Is Vital,Because Without Full Information The Client Cannot Practice Autonomy.
Giving Accurate Information Is Practicing With Veracity. Keeping Promises Is Upholding
Fidelity. Treating The Client Fairly Is Providing Social Justice.
DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, Autonomy
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of
Care
9. A Nurse Asks A More Seasoned Colleague To Explain Best Practices When Communicating
With APerson From The Lesbian, Gay, Bisexual, Transgender, And Questioning/Queer
(LGBTQ) Community. What Answer By The Faculty Is Most Accurate?
a. Avoid Embarrassing The Client By Asking Questions.
b. Don‘t Make Assumptions About His Or Her Health Needs.
c. Most LGBTQ People Do Not Want To Share Information.
d. No Differences Exist In Communicating With This Population.
ANS: B
Many Members Of The LGBTQ Community Have Faced Discrimination From Health Care
Providers And May Be Reluctant To Seek Health Care. The Nurse Would Never Make
Assumptions About The Needs Of Members Of This Population. Rather, Respectful
Questions Are Appropriate. IfApproached With Sensitivity, The Client With Any Health
Care Need Is More Likely To Answer Honestly.
DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Health Care Disparities, LGBTQ MSC: Client Needs Category: Psychosocial Integrity
10. A Nurse Is Calling The On-Call Health Care Provider About A Client Who Had A
Hysterectomy 2Days Ago And Has Pain That Is Unrelieved By The Prescribed Opioid
Pain Medication. Which Statement Comprises The Background Portion Of The SBAR
Format Forcommunication?
a. ―I Would Like You To Order A Different Pain Medication.‖
b. ―This Client Has Allergies To Morphine And Codeine.‖
c. ―Dr. Smith Doesn‘t Like Nonsteroidal Anti-Inflammatorymeds.‖
d. ―This Client Had A Vaginal Hysterectomy 2 Days Ago.‖
ANS: B
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, SBAR Is A Recommended Form Of Communication, And The Acronym Stands For
Situation, Background, Assessment, And Recommendation. Appropriate Background
Information Includes Allergies To Medications The On-Call Health Care Provider Might
Order. Situation Describes What Is Happening Right Now That Must Be Communicated; The
Client‘s Surgery 2 DaysAgo Would Be Considered Background. Assessment Would Include
An Analysis Of The Client‘s Problem; None Of The Options Has Assessment Information.
Asking For A Different Pain Medication Is A Recommendation. Recommendation Is A
Statement Of What Is Needed Or What Outcome Is Desired.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, SBAR
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
11. A Nurse Working On A Cardiac Unit Delegated Taking Vital Signs To An Experienced
Assistive Personnel (AP). Four Hours Later, The Nurse Notes That The Client‘s Blood
Pressure Taken By The AP Was Much Higher Than Previous Readings, And The Client‘s
Mental Status Has Changed. WhatAction By The Nurse Would Most Likely Have Prevented
This Negative Outcome?
a. Determining If The AP Knew How To Take Blood Pressure
b. Double-Checking The AP By Taking Another Blood Pressure
c. Providing More Appropriate Supervision Of The AP
d. Taking The Blood Pressure Instead Of Delegating The Task
ANS: C
Supervision Is One Of The Five Rights Of Delegation And Includes Directing, Evaluating,
And Following Up On Delegated Tasks. The Nurse Would Either Have Asked The AP
About The Vital Signs Or Instructed The AP To Report Them Right Away. An Experienced
AP Would Know How ToTake Vital Signs And The Nurse Would Not Have To Assess This
At This Point. Double-Checking TheWork Defeats The Purpose Of Delegation. Vital Signs
Are Within The Scope Of Practice For A AP And Are Permissible To Delegate. The Only
Appropriate Answer Is That The Nurse Did Not ProvideAdequate Instruction To The AP.
DIF: Analyzing TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, Delegation
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
12. A Newly Graduated Nurse In The Hospital States That Because Of Being So New,
Participation In Quality Improvement (QI) Projects Is Not Wise. What Response By The
Precepting Nurse Is Best?
a. ―All Staff Nurses Are Required To Participate In Quality Improvementhere.‖
b. ―Even Being New, You Can Implement Activities Designed To Improvecare.‖
c. ―It‘s Easy To Identify What Indicators Would Be Used To Measurequality.‖
d. ―You Should Ask To Be Assigned To The Research And Quality Committee.‖
ANS: B
The Preceptor Would Try To Reassure The Nurse That Implementing QI Measures Is Not Out
Of LineFor A Newly Licensed Nurse. Simply Stating That All Nurses Are Required To
Participate Does Not Help The Nurse Understand How That Is Possible And Is Dismissive.
Identifying Indicators Of Quality Is Not An Easy, Quick Process And Would Not Be The Best
Place To Suggest A New Nurse ToStart. Asking To Be Assigned To The QI Committee Does
Not Give The Nurse Information About How To Implement QI In Daily Practice.
DIF: Applying TOP: Integrated Process: Communication And Documentation
8
, KEY: Systems Thinking, Quality Improvement
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
13. A Nurse Is Talking With A Co-Worker Who Is Moving To A New State And Needs To
Find NewEmployment There. What Advice By The Nurse Is Best?
a. Ask The Hospitals There About Standard Nurse–Client Ratios.
b. Choose The Hospital That Has The Newest Technology.
c. Find A Hospital That Has Achieved Magnet Status.
d. Work In A Facility Affiliated With A Medical Or NURSING School.
ANS: C
Client Magnet Status Is Awarded By The Joint Commission (TJC) And Certifies That
Nurses CanDemonstrate How Best Current Evidence Guides Their Practice. New
Technology Doesn‘t Necessarily Mean That The Hospital Is Safe. Affiliation With A Health
Profession School Has Several Advantages, But Safety Is Most Important.
DIF: Understanding
TOP: Integrated Process: Communication And
DocumentationKEY: Evidence-Based Practice, Magnet
Status
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
MULTIPLE RESPONSE
1. A Nurse Manager Wishes To Ensure That The Nurses On The Unit Are Practicing At Their
Highest Levels Of Competency. Which Areas Would The Manager Assess To Determine If
The NURSINGStaffdemonstrate Competency According To The Institute Of Medicine
(IOM) Report Health Professions Education: A Bridge To Quality? (Select All That Apply.)
a. Collaborating With An Interprofessional Team
b. Implementing Evidence-Based Care
c. Providing Family-Focused Care
d. Routinely Using Informatics In Practice
e. Using Quality Improvement In Client Care
f. Formalizing Systems Thinking When Implementing Care
ANS: A, B, D, E
The IOM Report Lists Five Broad Core Competencies That All Health Care Providers
Should Practice. These Include Collaborating With The Interprofessional Team,
Implementing Evidence-Based Practice, Providing Patient-Focused Care, Using Informatics
In Client Care, AndUsing Quality Improvement In Client Care. Systems Thinking Is
Required For Quality Improvement But Is Not A Specified Part Of The IOM Report.
DIF: Remembering TOP: Integrated Process: NURSING Process:
Assessmentkey: Competencies, Institute Of Medicine (IOM)
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
2. A Nurse Is Interested In Making Interprofessional Work A High Priority. Which Actions
By TheNurse Best Demonstrate This Skill? (Select All That Apply.)
a. Consults With Other Disciplines On Client Care.
b. Coordinates Discharge Planning For Home Safety.
c. Participates In Comprehensive Client Rounding.
d. Routinely Asks Other Disciplines About Clientprogress.
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, e. Shows The NURSING Care Plans To Other Disciplines.
f. Delegate Tasks To Unlicensed Personnel Appropriately.
ANS: A, B, C, D, F
Collaborating With The Interprofessional Team Involves Planning, Implementing, And
Evaluating Client Care As A Team With All Other Involved Disciplines Included. Simply
ShowingOther Caregivers The NURSING Care Plan Is Not Actively Involving Them Or
Collaborating With Them.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, Interprofessional Team
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
3. The Nurse Utilizing Evidence-Based Practice (EBP) Considers Which Factors When
PlanningCare? (Select All That Apply.)
a. Cost-Saving Measures
b. Nurse‘s Expertise
c. Client Preferences
d. Research Findings
e. Values Of The Client
f. Plan-Do-Study-Act Model
ANS: B, C, D, E
EBP Consists Of Utilizing Current Evidence, The Client‘s Values And Preferences, And The
Nurse‘s Expertise When Planning Care. It Does Not Include Cost-Saving Measures. The
PDSA Model Is A Systematic Model For Quality Improvement, But Is Not A Specific
Component Of EBP.
DIF: Remembering TOP: Integrated Process: NURSING Process:
Planningkey: Evidence-Based Practice (EBP)
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of Care
4. A Nurse Manager Wants To Improve Hand-Off Communication Among The Staff. What
Actions ByThe Manager Would Best Help Achieve This Goal? (Select All That Apply.)
a. Attend Hand-Off Rounds To Coach And Mentor.
b. Create A Template Of Suggested Topics To Include In Report.
c. Encourage Staff To Ask Questions During Hand-Off.
d. Give Raises Based On Compliance With Reporting.
e. Provide Education On The SBAR Method Of Communication
ANS: A, B, C, E
The SBAR Method Of Communication Has Been Identified As An Excellent Method Of
Communication Between Health Care Professionals. It Is A Formalized Structure Consisting
Of Situation, Background, Assessment, And Recommendation/Request. Using A Formalized
Mechanism For Communication Helps Ensure Successful Hand-Off And Fewer Client Errors.
WhenEstablishing This New Format For Report, The Most Helpful Actions By The Manager
Would Be To Provide Initial Education On The Process, Develop A Template With Suggested
Topics Under Each Heading, Attend Rounds To Coach And Mentor, And Encourage Staff To
Ask Questions To Clarify Information. Basing Raises On Compliance Would Not Be The
Most Helpful Method Because Raises Are Often Determined Only Once A Year And Are
Based On Multiple Criteria.
DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Teamwork And Collaboration, Communication
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