Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care
11th edition by Donna D. Ignatavicius ISBN: 978-0323878265 COMPLETE GUIDE.
Questions 1-20: Professional Nursing Concepts & Clinical Judgment
1. A 62-year-old postoperative patient develops mild respiratory distress on the
med-surg unit. The charge nurse asks you to notify the respiratory therapist (RT).
Which nursing action best demonstrates effective interprofessional collaboration
before contacting the RT?
A. Document the patient's oxygen saturation trend and call the RT.
B. Start supplemental oxygen via nasal cannula and then call the RT.
C. Assess respiratory rate, work of breathing, and recent vital sign trends, then
call the RT.
D. Ask nursing assistive personnel (NAP) to recheck the oxygen saturation and
report back.
Correct Answer: C
Rationale: Effective collaboration requires the nurse to gather relevant
assessment data to provide a clear clinical picture to the RT, supporting timely
decision-making. Options A and B bypass a necessary assessment, while D
delegates a professional assessment to NAP, which is outside their scope .
,2. An 82-year-old patient is taking multiple medications and reports new dizziness
when standing. What is the best initial nursing action?
A. Instruct the patient to sit slowly and avoid standing quickly.
B. Review the medication list for antihypertensives or sedatives that cause
orthostatic hypotension.
C. Obtain a blood pressure and pulse while the patient is lying, sitting, and
standing.
D. Increase the patient's oral fluid intake to 3 L/day.
Correct Answer: C
Rationale: Orthostatic (postural) hypotension is a common cause of dizziness in
older adults, often due to polypharmacy. The initial action is to obtain orthostatic
vital signs to confirm the diagnosis and assess severity before implementing
interventions like medication review or patient teaching .
3. A patient admitted with suspected Clostridioides difficile diarrhea requires
contact precautions. Which action by the nurse best reduces transmission risk?
A. Use a standard surgical mask during care.
B. Wear a gown and gloves and wash hands with soap and water after care.
C. Use alcohol-based hand rub after patient contact.
D. Place the patient in a negative-pressure room.
,Correct Answer: B
Rationale: C. difficile spores are not killed by alcohol-based hand rubs; soap and
water must be used for hand hygiene after glove removal. Gown and gloves are
required for contact precautions. A mask is for droplet/airborne precautions, and
a negative-pressure room is for airborne illnesses like tuberculosis .
4. A patient who identifies as nonbinary uses the name Alex and they/them
pronouns. Which nursing statement best reflects culturally competent care?
A. "What name should I use — your legal name or the one you prefer?"
B. "I'll call you Alex, but I must document your legal name in the chart."
C. "We'll use Alex and they/them pronouns during your stay."
D. "Please bring a family member who can confirm your preferred name."
Correct Answer: C
Rationale: Using the patient's stated name and pronouns demonstrates respect,
affirms their identity, and builds trust. The legal name can be documented
separately without verbally prioritizing it over the patient's identity. Asking for
family confirmation is unnecessary and potentially invalidating .
, 5. A 45-year-old with acute pancreatitis rates pain 9/10 and has nausea. Which
analgesic plan aligns best with multimodal pain management and safety?
A. Give large-dose opioid PRN only when pain is 8–10/10.
B. Administer scheduled acetaminophen and add IV opioid for breakthrough pain.
C. Provide a benzodiazepine for anxiety and withhold analgesics until anxiety is
controlled.
D. Offer only nonpharmacologic measures (heat, distraction) because of nausea.
Correct Answer: B
Rationale: Multimodal analgesia uses different classes of analgesics (non-opioid
and opioid) to improve pain control while reducing opioid-related adverse effects.
Scheduled non-opioids provide a baseline of pain control, and IV opioids are
appropriate for severe breakthrough pain. Withholding analgesia for anxiety is
not appropriate .
6. A terminally ill patient with metastatic cancer is experiencing refractory
dyspnea despite maximal oxygen and bronchodilators. The patient requests
increased opioid dosing for comfort. What is the most appropriate nursing
response?
A. Explain that opioids are not permitted because of respiratory depression risk.
B. Collaborate with the provider to titrate opioids for symptom relief per palliative
protocol.
11th edition by Donna D. Ignatavicius ISBN: 978-0323878265 COMPLETE GUIDE.
Questions 1-20: Professional Nursing Concepts & Clinical Judgment
1. A 62-year-old postoperative patient develops mild respiratory distress on the
med-surg unit. The charge nurse asks you to notify the respiratory therapist (RT).
Which nursing action best demonstrates effective interprofessional collaboration
before contacting the RT?
A. Document the patient's oxygen saturation trend and call the RT.
B. Start supplemental oxygen via nasal cannula and then call the RT.
C. Assess respiratory rate, work of breathing, and recent vital sign trends, then
call the RT.
D. Ask nursing assistive personnel (NAP) to recheck the oxygen saturation and
report back.
Correct Answer: C
Rationale: Effective collaboration requires the nurse to gather relevant
assessment data to provide a clear clinical picture to the RT, supporting timely
decision-making. Options A and B bypass a necessary assessment, while D
delegates a professional assessment to NAP, which is outside their scope .
,2. An 82-year-old patient is taking multiple medications and reports new dizziness
when standing. What is the best initial nursing action?
A. Instruct the patient to sit slowly and avoid standing quickly.
B. Review the medication list for antihypertensives or sedatives that cause
orthostatic hypotension.
C. Obtain a blood pressure and pulse while the patient is lying, sitting, and
standing.
D. Increase the patient's oral fluid intake to 3 L/day.
Correct Answer: C
Rationale: Orthostatic (postural) hypotension is a common cause of dizziness in
older adults, often due to polypharmacy. The initial action is to obtain orthostatic
vital signs to confirm the diagnosis and assess severity before implementing
interventions like medication review or patient teaching .
3. A patient admitted with suspected Clostridioides difficile diarrhea requires
contact precautions. Which action by the nurse best reduces transmission risk?
A. Use a standard surgical mask during care.
B. Wear a gown and gloves and wash hands with soap and water after care.
C. Use alcohol-based hand rub after patient contact.
D. Place the patient in a negative-pressure room.
,Correct Answer: B
Rationale: C. difficile spores are not killed by alcohol-based hand rubs; soap and
water must be used for hand hygiene after glove removal. Gown and gloves are
required for contact precautions. A mask is for droplet/airborne precautions, and
a negative-pressure room is for airborne illnesses like tuberculosis .
4. A patient who identifies as nonbinary uses the name Alex and they/them
pronouns. Which nursing statement best reflects culturally competent care?
A. "What name should I use — your legal name or the one you prefer?"
B. "I'll call you Alex, but I must document your legal name in the chart."
C. "We'll use Alex and they/them pronouns during your stay."
D. "Please bring a family member who can confirm your preferred name."
Correct Answer: C
Rationale: Using the patient's stated name and pronouns demonstrates respect,
affirms their identity, and builds trust. The legal name can be documented
separately without verbally prioritizing it over the patient's identity. Asking for
family confirmation is unnecessary and potentially invalidating .
, 5. A 45-year-old with acute pancreatitis rates pain 9/10 and has nausea. Which
analgesic plan aligns best with multimodal pain management and safety?
A. Give large-dose opioid PRN only when pain is 8–10/10.
B. Administer scheduled acetaminophen and add IV opioid for breakthrough pain.
C. Provide a benzodiazepine for anxiety and withhold analgesics until anxiety is
controlled.
D. Offer only nonpharmacologic measures (heat, distraction) because of nausea.
Correct Answer: B
Rationale: Multimodal analgesia uses different classes of analgesics (non-opioid
and opioid) to improve pain control while reducing opioid-related adverse effects.
Scheduled non-opioids provide a baseline of pain control, and IV opioids are
appropriate for severe breakthrough pain. Withholding analgesia for anxiety is
not appropriate .
6. A terminally ill patient with metastatic cancer is experiencing refractory
dyspnea despite maximal oxygen and bronchodilators. The patient requests
increased opioid dosing for comfort. What is the most appropriate nursing
response?
A. Explain that opioids are not permitted because of respiratory depression risk.
B. Collaborate with the provider to titrate opioids for symptom relief per palliative
protocol.
