Test Bank for Lewis's Medical-Surgical
1 1 1 1
Nursing, 12th Edition by Mariann M. Ha
1 1 1 1 1 1
rding, Jeffrey Kwong, Debra HaglerCha
1 1 1 1 1
pter 1-69
1
,Chapter101:1Professional1Nursing
Harding:1Lewis’s1Medical-Surgical1Nursing,112th1Edition
MULTIPLE1CHOICE
1. The1nurse1completes1an1admission1database1and1explains1that1the1plan1of1care1and1discharge1
goals1will1be1developed1with1the1patient‘s1input.1The1patient1asks,1“How1is1this1different1from1
what1the1physician1does?”1Which1response1would1the1nurse1provide?
a. “The1role1 of1 the1 nurse1is1 to1 administer1 medications1 and1 other1 treatments1 prescribed1
by1your1physician.”
b. “In1addition1to1 caring1 for1 you1 while1 you1 are1 sick,1the1nurses1 will1 help1 you1 plan1to
1maintain1your1 health.”
c. “The1nurse‘s1job1is1to1collect1information1and1communicate1any1problems1that1o
ccur1to1the1physician.”
d. “Nurses1perform1many1of1the1same1procedures1 as1the1physician,1but1nurses1are
1with1the1patients1for1 a1longer1time1than1the1physician.”
ANS:1 B
The1American1Nurses1Association1(ANA)1definition1of1nursing1describes1the1role1of1nurses1in1pr
omoting1health.1The1other1responses1describe1dependent1and1collaborative1functions1of1the1n
ursing1role1but1do1not1accurately1describe1the1nurse‘s1unique1role1in1the1health1care1system.
DIF:1 Cognitive1Level:1Analyze1(Analysis)
TOP:1 Nursing1Process:1 Implementation1 1 MSC:1 NCLEX:1Safe1and1Effective1Care1Environment
2. Which1 statement1 by1 the1 nurse1 accurately1 describes1 the1 use1 of1 evidence-based1 practice1 (EBP)?
a. “Patient1 care1is1based1on1clinical1judgment,1experience,1and1traditions.”
b. “Data1 are1analyzed1 later1 to1 show1 that1 the1 patient1 outcomes1 are1 consistently1 met.”
c. “Research1from1all1published1articles1are1used1as1a1guide1for1planning1patient1 care.”
d. “Recommendations1are1based1on1research,1clinical1expertise,1and1patient
1preferences.”
ANS:1 D
Evidence-based1 practice1 (EBP)1 is1 the1 use1 of1 the1 best1 research-
based1 evidence1 combined1 with1clinician1expertise1and1consideration1of1patient1preferences.1C
linical1judgment1based1on1the1nurse‘s1clinical1experience1is1part1of1EBP,1but1clinical1decision
1making1should 1also1incorporate1 current1 research1 and1 research-
based1 guidelines.1 Evaluation1 of1 patient1 outcomes1 is1important,1but1data1analysis1is1not1require
d1to1use1EBP.1All1published1articles1do1not1provide1research1 evidence;1 interventions1 should1 be
1 based1 on1 credible1 research,1 preferably1 randomized1controlled 1studies1with1a1large1number1 of1
subjects.
DIF: Cognitive1Level:1Understand1(Comprehension)
TOP:1 Nursing1Process:1Planning1MSC:1 NCLEX:1Safe1and1Effective1Care1Environment
3. Which1 statement1 by1the1 nurse1 provides1 a1 clear1 explanation1 of1 the1 nursing1 process?
a. “The1 nursing1 process1 is1a1 research1 method1 of1diagnosing1the1 patient‘s1 health1 care1
problems.”
b. “The1 nursing1 process1 is1used1 primarily1 to1 explain1 nursing1 interventions1 to1 other1
health1care1professionals.”
c. “The1 nursing1 process1is1a1 problem-solving1 tool1 used1 to1 identify1and1 manage1 the
, patients‘1health1care1needs.”
d. “The1nursing1process1is1based1on1nursing1theory1that1incorporates1the1
biopsychosocial1nature1of1humans.”
ANS:1 C
The1nursing1process1is1a1problem-
solving1approach1to1the1identification1and1treatment1of1patients‘1problems.1Nursing1process1d
oes1not1require1research1methods1for1diagnosis.1The1primary1use1 of1 the1 nursing1 process1 is1 in1 p
atient1 care,1 not1 to1 establish1 nursing1 theory1 or1 explain1nursing1interventions1to1other1 health1care
1professionals.
DIF: Cognitive1Level:1Understand1(Comprehension)
TOP:1 Nursing1Process:1Evaluation1MSC:1 NCLEX:1Safe1and1Effective1Care1Environment
4. A1patient1 admitted1 to1 the1 hospital1 for1 surgery1tells1 the1 nurse,1 “I1 do1 not1 feel1 comfortable1
leaving1my1children1with1my1parents.”1Which1action1would1the1nurse1take1next?
a. Reassure1 the1 patient1 that1 these1 feelings1are1 common1 for1 parents.
b. Have1 the1 patient1 call1 the1 children1 to1 ensure1 that1 they1are1 doing1 well.
c. Gather1 information1 on1 the1 patient‘s1 concerns1 about1 the1 child1 care1 arrangements.
d. Call1 the1 patient‘s1 parents1 to1 determine1 whether1 adequate1 child1 care1 is1 being1
provided.
ANS:1 C
Because1a1complete1assessment1is1necessary1in1order1to1identify1a1problem 1and1choose1an1
appropriate1intervention,1the1nurse‘s1first1action1should1be1to1obtain1more1information.1The
1other1actions1may1be1appropriate,1but1more1assessment1is1needed1before1the1best1intervention1c
an1be1chosen.
DIF: Cognitive1Level:1Analyze1(Analysis)
TOP:1 Nursing1Process:1Assessment MSC:1 NCLEX:1Psychosocial1Integrity
5. A1 patient1 with1a1 bacterial1 infection1 is1 hypovolemic1 due1 to1a1 fever1 and1 excessive1 diaphoresis.1
Which1expected1outcome1would1the1nurse1select1for1this1patient?
a. Patient1 has1 a1 balanced1 intake1and1 output.
b. Patient‘s1bedding1is1kept1clean1and1free1of1moisture.
c. Patient1 understands1 the1 need1 for1 increased1 fluid1 intake.
d. Patient‘s1 skin1 remains1 cool1 and1 dry1 throughout1 hospitalization.
ANS:1 A
Balanced1intake1and1output1gives1measurable1data1showing1resolution1of1the1problem1of1defici
ent1fluid1volume.1The1other1statements1would1not1indicate1that1the1problem1of1hypovolemi
a1 was1resolved.
DIF: Cognitive1Level:1Apply1(Application)
TOP:1 Nursing1Process:1Planning1MSC:1 NCLEX:1Physiological1Integrity
6. Which1 statement1 describes1 the1 purpose1 of1 the1 evaluation1 phase1 of1 the1 nursing1 process?
a. To1document1 the1 nursing1 care1 plan1 in1 the1 progress1 notes1 of1 the1 health1 record
b. To1 determine1 if1 interventions1 have1 been1 effective1 in1 meeting1 patient1 outcomes
c. To1 decide1 whether1 the1 patient‘s1 health1 problems1 have1 been1 completely1 resolved
d. To1establish1 if1 the1 patient1 agrees1 that1 the1 nursing1 care1 provided1 was1 satisfactory
ANS:1 B
, Evaluation1consists1of1determining1whether1the1desired1patient1outcomes1have1been1met1and
1whether1the1nursing 1interventions 1were1appropriate.1The1other1responses 1do1not1describe1the1
evaluation1phase.
DIF: Cognitive1Level:1Understand1(Comprehension)
TOP:1 Nursing1Process:1Evaluation1MSC:1 NCLEX:1Safe1and1Effective1Care1Environment
7. Which1 statement1 describes1 the1 purpose1 of1the1 assessment1 phase1 of1 the1 nursing1 process?
a. To1 teach1 interventions1 that1 relieve1 health1 problems
b. To1use1patient1data1to1evaluate1patient1care1outcomes
c. To1obtain1 data1 to1 diagnose1 patient1 strengths1 and1 problems
d. To1 help1 the1 patient1 identify1 realistic1 outcomes1 for1 health1 problems
ANS:1 C
During1the1assessment1phase,1the1nurse1gathers1information1about1the1patient1to1diagnose1patie
nt1strengths1and1problems.1The1other1responses1are1examples1of1the1planning,1intervention,1a
nd1evaluation1phases1of1the1nursing1process.
DIF: Cognitive1Level:1Understand1(Comprehension)
TOP:1 Nursing1Process:1Assessment MSC:1 NCLEX:1Safe1and1Effective1Care1Environment
8. When1developing1the1plan1of1care,1which1components1would1the1nurse1include1in1the1clinical1pr
oblem1statement?
a. The1problem1and1the1suggested1patient1goals1or1outcomes
b. The1 problem,1 its1 causes,1 and1 the1 signs1 and1 symptoms1 of1 the1 problem
c. The1 problem1 with1 the1 possible1 etiology1 and1 the1 planned1 interventions
d. The1 problem,1 its1 pathophysiology,1 and1 the1 expected1 outcome
ANS:1 B
When1writing1clinical1problems1or1nursing1diagnoses,1the1subjective1as1well1as1objective1dat
a1to1support1the1problem‘s1existence1should1be1included.1Goals,1outcomes,1and1interventions1ar
e1not1included1in1the1problem1statement.
DIF: Cognitive1Level:1Understand1(Comprehension)
TOP:1 Nursing1Process:1 Diagnosis1MSC:1 NCLEX:1Safe1and1Effective1Care1Environment
9. Which1 patient1 care1 task1 would1 the1 nurse1 delegate1 to1 experienced1 assistive1 personnel1 (AP)?
a. Instruct1 the1 patient1 about1 the1 need1 to1 alternate1 activity1and1 rest.
b. Monitor1 level1 of1 shortness1 of1 breath1 or1 fatigue1 after1 ambulation.
c. Obtain1 the1 patient‘s1 blood1 pressure1 and1 pulse1 rate1 after1 ambulation.
d. Determine1 whether1 the1 patient1 is1ready1 to1 increase1 the1 activity1 level.
ANS:1 C
AP1 education1 includes1 accurate1 vital1 sign1 measurement.1 Assessment1 and1 patient1 teaching1requi
re1registered1nurse1education1and1scope1of1practice1and1cannot1be1delegated.
DIF: Cognitive1Level:1Apply1(Application)
TOP:1 Nursing1Process:1Planning1MSC:1 NCLEX:1Safe1and1Effective1Care1Environment