Medical-Surgical Nursing 11th Edition By Ignatavicius – Test Bank

Medical-Surgical Nursing 11th Edition By Ignatavicius – Test Bank

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 the newmuse that which is the priority when working as agrod

Attending to holistic client needs

Ensuring client safety

Not making medicationers

Providing client-focused care

ANS: B

All actions are appropriate for the professional nurse. However, ensuring client safety is the priority. Health care errors have been widely reported for 25 years, many of which realtin chiest injury, death, and increased bealth care costs. There are several national and international organizations that have either recommended or mandated safery initiatives Every marse has the responsibility to guard the cent’s safety. The other actions are important for quality muning, but they are not as vital as providing safety. Not making medication emors does provide safety, but is too narrow in scope to be the best ver

DIF: Undertanding

TOP lategrated Procuring Procreation

KEY: Client safety

MSC: Client Needs Category: Safe and Effective Care Event Safety and Infection Control

2. Aisting a new client and family to the medical-surgical unit. What information does the une provide to best help the chent promote his or her own safety?

Encourage the client and family to be active partners b. Have the client monitor hand hygiene in caregivers

Offer the Demily the opportunity to stay with the client

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 chient to be active in his or her health care as a safety partner is the most critical. The offer actions are very limited in scope and do not provide the broad protection that being active and involved does.

DIF: Undertanding

TOP lategrated Process Teaching Learning

MSC: Client Needs Category: Safe and Effective Care avise: Safety and fection Costol

3. Amare 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 88/50mmHg. What action would there kefirst?

Call the Rapid Response Team

b. Document and continue to monitor

Notify the primary health care proviδες

4. Repeat the blood pressure 15 mi

ANS: A

The purpose of the Rapid Response Team (RRT) is to intervene whes clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the client has manifested a supificant change, the man would call the RRT Changes in blood gerne, mental status, beart rate, temperature, oxygen saturation, and last 2 hours urine output are porticulty significant and are part of the Modified Early Warning System guide. Documentationis vstall but there must do more than document. The primary health care provider would be notified, but this is not more importint than calling the RRT. The client’s blood pressure would be reassessed frequently, but the priority is getting the rapid care to the client

DOP: Applying

KEY: Rapid Rep

(UT), Clic

TOP Integrated Process Communication and Doct

MSC: Chest Needs Category: Physiological lategy Physiological

4. A nurse wishes to provide client-centered care in all interactions. Which action by the surve

best demonstrates this concept? Assesses for cultural influences affecting bealth care.

Ensures that all the client’s basic needs are met.

Tells the client and family about all upcoming tests

4. Thoroughly crents the client and family to the room

ANS: A

Showing respect for the client and femily’s perferences and needs is essential to ensure a holistic or “whole-person” approach to care. By assessing the effect of the client’s culture on health care, this muse is practicing chen-focused care. Providing for our needs does not demonstrate this competence. Samply telling the client about all upcoming tests is not providing empowering education. Orienting the client and family to the room is an important safety measure, but not directly related to demonstrating client-centered care

DO: Understanding

TOP

KEY: Chen-c

MSC: Chet Needs Category: Prychosocial legity

5. A client is going to be admitted for a scheduled surgicall grocedure. Which action does the mane explain is the most important thing the client can do to protect against errors?

Being a list of all medications and what they are for

Keep the provider’s phone number by the telephone.

Make sure that all providers wash hands before entering the room

4. 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 medications are compared to the prescribed medications at the time of admission, transfer, or discharge. This National client Safety Goulis important to reduce medication errors. The client wou not have to be responsible for providers washing their hands, and even if the chent does so this is too namow to be the most important action to prevent emors. Keeping the provider’s phone number nearby and documenting everyone who enters the room also do not guarantee safety.

DO: Applying

TOP lategrated Processing

KEY: Cheney,domatic

6. Which action by the sure working with a client best demonstrates respect for autonomy?

Asks if the client has questions before signing a consent.

Gives the client accurate information when questioned

Korps the promises made to the client and family

4. Treats the client fairly compared to other clients

ANS: A

Autonomy is self-determination. The chest would make decisions regarding care. When the mune 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. Geving accurate information is practicing with veracity. Keeping promises is upholding fidelity. Tresting the clientily is providing social justice

DIF: Applying

TOP etedPrice: Caring

KEY: Econo

MSC: Chested

grade and Effect

7. Are asks a more seasoned colleague to explain best practions when communicating with a person from the lesbian, gay, bisenal, transgender, and questioning queer (LGBTQ)

community. What answer by the faculty is most accurate?

Avoid embarrassing the chent by asking questions

Don’t make assumptions about his or her health needs

Most LGBTQ people do not want to share information

4. No difflmmons exist in communicating with this population

ANS:

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, respecto appropriate. If approached with sensitivity, the bent with any health care need is more likely to wer honestly.

DIF: Uddin

KET: Healthcare LGBTQ

TOP lategrated Process Teaching Lew MSC: Client Needs Category: Prychosociality

Are is calling the on-call health care provide about a client who had a hysterectomy 2 days ago and has pain that is unrelieved by the presonbed opioid pain medication. Which statement comprises the background portion of the SBAR form for communication?

“I would like you to order a different pain medication”

b. This client has allergies to morphine and codeine.”

Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds”

4. “This client had a vaginal hysterectomy 2 days ago

ANS: B

SBAR is a recommended form of communication, and the acronym stands for Station Background, Assessment and Recommendation Appropriate background infomation includes allergies to medications the on-call health care provider might order. Sination describes what is happening night now that must be communicated, the client’s surgery 2 days ago would be considered background winchade an analysis of the client’s problem, none of the options has assessment information. Acking for a different pain medication is a recommendation. Recommendation is a statement of what is needed or what outcome is desized

DO: Applying

TOP Process Communication and Doct

MSC: Client Needs Category: Safe and Effective Care Envirom: Маш of Ce

9. 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 pradings, and the client’s mental status has changed. What

action by the marse would most likely have pervested this negative outcome? Determining if the AP knew how to take blood pressure

Double-checking the AP by taking another blood pressure

Providing more appropriate superion of the AP

4. Taking the blood pressure instead of delegating the tink

ANS C Supervision is one of the five rights of delegation and inchodes directing, evaluating, and following up on delegated tasks. The marse 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 to nike vital signs and the nurse would not have to assess this at this point. Double-checking the work defeats the purpose of delegation Vital signs are within the scope of practice for a AP and are permissible to delegate. The only appropriate aves is that the une did not provide adequate instruction to the AP.

DIF: Analyzing TOP and Prosec: Сольской Docstatio

KEY: Tacollaboration Delegatio

MSC: Client Needs Category: Safe and Effective Carvio: Мадеше of Cue

10. A newly graduated use in the hospital states that because of being so new, participation in quality improvement (Q) projects is not wise. What response by the pororpting me is best?

“All stiff nurses are required to participate in quality improvement here.”

“Even being new, you can implement activities designed to improve care.”

“It’s easy to identify what indicators would be used to meae quality.”

4. “You should ask to be assigned to the research and quality committee.”

ANS B

The preceptor would try to reassure the nurse that implementing of measures is not out of line for a newly licensed nurse. Simply stating that all murves are reqared to participate does not help the surse 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 are to start. Asking to be assigned to the Of committee does not give the surve information about how to implement Qf in daily practice

TOP Prosen: Сованайско

KEY: ShinkingQuliyevent

MSC: Client Needs Category: Send Efective Care

: Mazarin of the Cape

11. Ae is talking with a co-worker who is moving to a new state and needs to find new

employment there. What advice by the muse is best?

Ask the hospitals there about standardsure client ratios

Choose the hospital that has the newest technology

Find a hospital that has achieved Magnet status

4. Work in a facility affiliated with a medical or nursing school

ANS: C

Client Magnet status is awarded by The Joint Commission (TIC) and certifies that murses can demonstrate how best carent 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: edg

TOP teed Process: Comication and Docuses

КЕТ: Есе-асеd practice, Mag

MSC: Chint Needs Category: Safe and Effective Safety and section Control

MULTIPLE RESPONSE

1. A se manager wishes to ensure that the surses on the unit are practicing at their highest levels of competency. Which areas would the manager assess to determine if the morning stoff demonstrate competency according to the Institute of Medicine (0) report Mal

Professions Education Bridge to Quality? (Select all that app):) Collaborating with an interprofessionale

Implementing evidence-based care

Providing family-focused care

Routinely using informatics in practior

Using quality improvement in client care

Formalizing systems thinking when implementing care

ANS: AB.DE

The 10% orport 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 focusedcare, using informatics inclient care, and using quality improvement in client care. Systems thinking is required for quality improvement but is not a specified part of the 10M report

DIF: Remembering

TOP

KEY: Competencies of Medicine 0000 MSC: Client Needs Category: Safe and Effect Care Safety and lafection Cosmol