Lewis's Medical-Surgical Nursing
Assessment and Management of
Clinical Problems
13th Edition
• Author(s)Mariann M. Harding;
Jeffrey Kwong; Debra Hagler;
Courtney Reinisch
TEST BANK
Question 1
A newly licensed registered nurse is caring for four clients.
Which action best demonstrates patient-centered care?
A. Completing tasks in the same order for every assignment
B. Including the client and family in planning care goals
C. Following unit routines without modification
,D. Prioritizing documentation before speaking with the client
Correct Answer: B
Rationale:
Patient-centered care focuses on respecting the client's values,
preferences, and needs while involving them in decision-
making. Collaborating with the client and family promotes
individualized care and improves outcomes. Completing tasks
according to routine may overlook unique needs, and delaying
communication to complete documentation can interfere with
therapeutic relationships.
Question 2
A nurse is preparing to administer a medication and notices
that the prescribed dose is significantly higher than the usual
range. What is the nurse's priority action?
A. Administer the medication as prescribed
B. Ask another nurse to give the medication
C. Verify the prescription with the prescribing provider
D. Document the concern after administration
Correct Answer: C
Rationale:
Professional nursing practice requires the nurse to question
prescriptions that appear unsafe. Verifying the order helps
,prevent medication errors and protects the client.
Administering the medication without clarification may cause
harm, and transferring responsibility to another nurse is
inappropriate.
Question 3
A nurse is participating in a quality improvement project aimed
at reducing client falls. Which actions should the nurse include?
Select all that apply.
A. Report near-miss incidents.
B. Review unit fall data.
C. Encourage staff to conceal errors to avoid blame.
D. Participate in evaluating outcomes.
E. Suggest evidence-based interventions.
Correct Answers: A, B, D, E
Rationale:
Quality improvement relies on accurate reporting, data
analysis, evaluation of outcomes, and implementation of
evidence-based strategies. Near-miss reporting identifies
system vulnerabilities before harm occurs. Concealing errors
undermines safety initiatives and prevents organizational
learning.
, Question 4
A nurse is caring for a client whose condition suddenly
deteriorates. The client's blood pressure decreases from
126/74 mm Hg to 86/50 mm Hg, heart rate increases to 124
beats/min, and the client becomes confused.
Question:
What is the nurse's best immediate action?
Answer:
Activate the appropriate rapid response process and perform
focused reassessment while notifying the provider.
Rationale:
The changes indicate potential clinical instability requiring
prompt intervention. Early recognition and escalation of care
are essential components of safe nursing practice. Delaying
intervention to complete documentation or waiting for
additional symptoms may increase the risk of adverse
outcomes.
Question 5
Which activity is within the scope of evidence-based practice?
A. Performing interventions solely because they have always
been used
B. Combining current research, clinical expertise, and client
preferences
Assessment and Management of
Clinical Problems
13th Edition
• Author(s)Mariann M. Harding;
Jeffrey Kwong; Debra Hagler;
Courtney Reinisch
TEST BANK
Question 1
A newly licensed registered nurse is caring for four clients.
Which action best demonstrates patient-centered care?
A. Completing tasks in the same order for every assignment
B. Including the client and family in planning care goals
C. Following unit routines without modification
,D. Prioritizing documentation before speaking with the client
Correct Answer: B
Rationale:
Patient-centered care focuses on respecting the client's values,
preferences, and needs while involving them in decision-
making. Collaborating with the client and family promotes
individualized care and improves outcomes. Completing tasks
according to routine may overlook unique needs, and delaying
communication to complete documentation can interfere with
therapeutic relationships.
Question 2
A nurse is preparing to administer a medication and notices
that the prescribed dose is significantly higher than the usual
range. What is the nurse's priority action?
A. Administer the medication as prescribed
B. Ask another nurse to give the medication
C. Verify the prescription with the prescribing provider
D. Document the concern after administration
Correct Answer: C
Rationale:
Professional nursing practice requires the nurse to question
prescriptions that appear unsafe. Verifying the order helps
,prevent medication errors and protects the client.
Administering the medication without clarification may cause
harm, and transferring responsibility to another nurse is
inappropriate.
Question 3
A nurse is participating in a quality improvement project aimed
at reducing client falls. Which actions should the nurse include?
Select all that apply.
A. Report near-miss incidents.
B. Review unit fall data.
C. Encourage staff to conceal errors to avoid blame.
D. Participate in evaluating outcomes.
E. Suggest evidence-based interventions.
Correct Answers: A, B, D, E
Rationale:
Quality improvement relies on accurate reporting, data
analysis, evaluation of outcomes, and implementation of
evidence-based strategies. Near-miss reporting identifies
system vulnerabilities before harm occurs. Concealing errors
undermines safety initiatives and prevents organizational
learning.
, Question 4
A nurse is caring for a client whose condition suddenly
deteriorates. The client's blood pressure decreases from
126/74 mm Hg to 86/50 mm Hg, heart rate increases to 124
beats/min, and the client becomes confused.
Question:
What is the nurse's best immediate action?
Answer:
Activate the appropriate rapid response process and perform
focused reassessment while notifying the provider.
Rationale:
The changes indicate potential clinical instability requiring
prompt intervention. Early recognition and escalation of care
are essential components of safe nursing practice. Delaying
intervention to complete documentation or waiting for
additional symptoms may increase the risk of adverse
outcomes.
Question 5
Which activity is within the scope of evidence-based practice?
A. Performing interventions solely because they have always
been used
B. Combining current research, clinical expertise, and client
preferences
