Lewis’s Medical Surgical Nursing 12th Edition – Test Bank
Chapter 01: Professional Nursing
Harding: Lewis’s Medical Surgical Nursing, 12th Edition
MULTIPLE CHOICE
1. The arse completes an admission database and explains that the plan of care and discharge goals will be developed with the patient’s input. The patient asks “How is this different from what the physician does? Which oriponse would the suave provide?
The role of the more is to administer medications and other treatments geesonbed by your physician”
In addition to caring for youwhale you are sick, the mares will help you plan to maintain your health”
c. “The murse’s job is to collect information and communicate any problems that occur to the physician”
4. Nurses perform many of the same procedures as the physician, but nurses are with the patients for a longer time than the physician”
ANS: B
The American Nurses Association (ANA) definition of nursing describes the role of murnes in promoting health. The other responses describe dependent and collaborative functions of the nursing role but do not accurately describe the nurse’s unique sole in the health care system
DO: Coputive Level: Analyze (Analysis)
TOP Nursing Process: glementation
MSC NCLEX Safe and Effective Care
2. Which statement by the nurse accurately describes the use of evidence-based practice (EBP)?
Patient care is based on clinical judgment, experience, and traditions”
Data are analyzed later to show that the patient outcomes are consistently met.”
Research from all published articles are used as a guide for planning patient care.”
. 4. Recommendations are based on research, clinical expertise, and patient perferences”
ANS: D
Evidence-based practice (EDP) is the use of the best research-based evidence combined with clinician expertise and consideration of patient perferences. Clinical judgment based on the mune’s clinical experience is part of EBP, but clinical decision making should also incorporate current research and research-based guidelines. Evaluation of patient outcomes is important, but data analysis is not required to use EBP. All published articles do not provide research evidence, interventions should be based on credible search, preferably randomized controlled studies with a large number of subjects
DIF: Comitive Level: Understand (Comprehension)
TOP: Nursing Process Planing
MSC NCLEX: Sade Effective Cevironment
3. Which statement by the nurse provides a clear explanation of the mursing process?
The mursing process is a research method of diagnosing the patient’s health care problems.”
The nursing process is used primarily to explain marsing interventions to other health care professionals.”
c. The masing process is a problem-solving tooled to identify and manage the
patients’ health care needs.”
4. The murning process is based on muning theory that incorporates the biopsychosocial nature of humans.”
ANS: C
The marsing process is a problem-solving approach to the identification and treatment of patients’ problemas. Nursing process does not require research methods for diagnosis. The primary use of the mursing process is in patient care, not to establish masing theory or explain susing interventions to other health care professionals
DIF: Cognitive Level Understand (Comprehension)
MSC: NCLEX: Safe and Effective C
TOP Using Processin
4. A patient admitted to the hospital for surgery tells the nurse, “I do not feel comfortable leaving my childern with my parents.” Which action would the mine take mea
Reassure the patient that these feelings are common for parents
Have the patient call the childen to ensure that they are doing well.
Gather information on the patient’s conorms about the child care arrangeιστής
4. Call the patient’s parents to determine whether adequate child care is being provided
ANS: C
Because a complete assessment is necessary in order to identify a problem and choose an appropriate intervention, the name’s finst action should be to obtain more information. The other actions may be appropriate, but more assessment is needed before the best intervention can be chose
DD: Cognitive Level Analyse (Analy
TOP: Nursing Process: Allen
MSC: NCLEX: Prychosocial negrity
5. A patient with a bacterial infection is hypovolemic due to a fever and excessive diaphoresis Which expected outcome would the marse sellect for this poties?
Patient has a balanced intake and output
Patient’s bedding is kept clean and free of moisture
Patient understands the need for increased fluid intake
4. Patient’s skin remains cool and dry throughout hospitalization
ANS: A
Balanced intake and output gives measurable data showing resolution of the problem of deficient fluid volume. The other statements would not indicate that the problem of hypovolemia was resolved.
DD: Cogutive Level Apply (Application) MSC: NCLEX: Physiological lategrity
TOP Nursing Pro: Planning
6. Which statement describes the purpose of the evaluation phase of the nursing process?
To document the marsing care plan in the progress notes of the health record
To determine if interventions have been effective in meeting patient outcomes
To decide whether the patient’s health problems have been completely resolved
4. To establish if the patient agrees that the nursing care provided was satisfactory
ANS: B
Evaluation consists of determining whether the desired patient outcomes have been met and whether the morning interventions were appropriate. The oder responses do not describe the evaluation phase
DO: Cognitive Level: Understand (Comprehension) MSC NCLEX Safe and Effective Care
TOP: Nursing Process: Evaluation
7. Which stanement describes the purpose of the assessment phase of the nursing process?
To teach interventions that relieve health problems
b. To use potest data to evaluate patient care outcomes
To obtain data to diagnose patient strengths and problems
4. To help the patient identify realistic outcomes for health problems
ANS C
During the assessment phase, the nurse gathers information about the potent to diagnose patient strengths and problems. The other responses are examples of the planning, intervention, and evaluation phases of the nursing process.
DIF: Cognitive LevelUnderstand (Compension)
TOP: Nursing Procenk: Азменшит
MSC: NCLEX Safe and Effective Care Event
8. When developing the plan of care, which components would the morse include in the clinical problem statement?
The problem and the suggested patient goals or outcomes
b. The problem, its causes, and the signs and symptoms of the problem
The problem with the pouble etiology and the planned interventions
4. The problem, its pathophysiology, and the expected outcome
ANS B
When writing clinical problems or mursing diagnoses, the subjective as well as objective data to support the problem’s existence should be included Goals, outcomes, and interventions are not included in the problem statement.
DF Cognitive Level Understand (Comprehension)
TOP Nursing Process Diagnosis
MSC: NCLEX Sand Effective Care Environment
9. Which patient care tak would these delegate to experienced assistive personnel (AP)?
Instruct the patient about the need to alternate activity and rest
b. Monitor level of shortness of breath or fatigue ambulation
Obtain the patient’s blood pressure and pulse ifte after ambulation
4. Determine whether the patent is ready to increase the activity level
ANS: C
AP education includes accurate vital sign measurement Assessment and patient teaching require registered use education and scope of practice and cannot be delegated
DIF Comitive Level Apply (Application) MSC: NCLEX: Safe and Effective Care Environment
TOP. Nusing Process Planing
10. A surse is caring for a group of patients on the medical surgical unit with the help of one out registered nurse (RN), one assistive personnel (AP), and one licensed practical vocational (LPN VN) Which assignment if delegated by the mase, would be outside that individual’s scope of practice?
Check for the presence of bowel sounds by AP
Administration of oral medications by LPN VN
Insulin administration by float RN from the pediatric unit
4. Measurement of a patient’s urinary catheter output by AP
ANS A
Assessment requires RN education and scope of practice so it cannot be delegated to an LPN/VN or AP. The other assignments made by the BN are appropriate for the role of the team member.
DIF Cognitive Level Apply (Application)
TOP. Nursing Process Planning
MSC: NCLEX Safe and Effective Care Lavo
11. Which task is appropriate for the mane to delegate to a licensed practical vocational muse (LPN VN)?
Complete the initial admission assessment and plan of care
Measure bedside blood glucose before administering inlin
Document teaching completed before a diagnostic procedure
4. Instruct a patient about low-fat, reduced sodium dietary restrictions
ANS: B
The education and scope of practice of the LPN LVN include activities such as obtrining glicose testing using a finger stick and administering insulin Patient teaching and the initial assessment and development of the plan of care are marsing actions that require registered nurse education and scope of practice.
DIF Copsitive Level Apply (Application) MSC: NCLEX: Safe and Effective Care Evi
TOP. Nusing Proces: Planing
12. A mane is assigned as a case manager for a hospitalized patient who has a spinal cord injury Which activity can the patient expect the nurse in this role to perform?
Care for the patient during hospitalization for the injuries.
b. Assist the patient with home care actrothes duing recovery
Coordinate the services the patient receives in the hospital and at home
4. Determine what medical care the patient needs for optimal rehabilitation
ANS: C
The role of the case manager is to coordinate the patient’s care through multiple settings and levels of care to allow the maximal patient benefit the least cost. The case manager does not provide direct care in the acute or home setting. The case manager coordinates and advocates for care. The HCP determine what medical care in needed
DO: Cognitive Level Apply (Application)
TOP: Nuring Process Imptation
MSC NCLEX Safe and Effective Cover
13. The marse is caring for older adult patient who needs continued mursing care and physical therapy to improve mobility after surgery to repair a fractured hip. There would help to arrange for transfer of the patient to which type of facility?
A skilled care facility
A transitional care facility
A residential care facility
4. An intermediate care facility
ANS: B
Transitional care settings are appropriate for patients who need continued rehabilitation before discharge to home or to long-term care settings. The patient is no longer in need of the more continuous assessment and care given in acute care settings. There is no indication that the patient will need the permanent and ongoing medical and sursing services available in intermediate or skilled care. The patient is not yet independent enough to transfer to a residential care facility.
DIF: Cogitive Level Apply (Application)
TOP Nusing Process Planning
MSC: NOLEX: Safe and Effective Care Environment
14. A home care murve is planning care for a patient who has just been diagnosed with type 2 diabetes. Which tank is appropriate for the mrse to delegate to the home health aide?
Assist the patient to choose appropriate foods
Help the patient with a daily bath and oral care.
c. Check the patient’s feet for signs of berakdown
d. Teach the patient how to monitor blood glucose.
ANS: B
Assisting with patient hygiene is included in home health-aide education and scope of practice. Assessment of the patient and instructing the patient in new skills, such as diet and blood glucose monitoring, are complex skills that are included in registered nurse education and scope of practice
DIF: Cognitive Level Apply (Application)
TOP Ning Process Implementation
MSC NCLEX: Safe and Effective Care
15. The nurse is providing education to sursing staff on quality care initiatives. Which statement is an accurate description of the impact of health care financing on quality care?
If a patient develops a catheter-related infection, the hospital receives additional
Payment for patient care is primarily based on clinical outcomes and patient satisfaction
Hospitals are bursed for all costs incured if care is documented electronically”
4. Because hospitals are accountable for overall care, it is not marsing’s responsibility to monitor care delivered by others.”
ANS: B Payment for health care services programs reimburses hospitals for their performance on overall quality-of-care measures. These meanres include clinical outcomes and patient satisfaction. Nurses are responsible for coordinating complex aspects of patient care, including the care delivered by obes, and identifying vmes that are associated with poor quality care. Payment for care can be withheld if something happens to the patient that is considered preventable (eg, acquiring a catheter-related urinary tract infection)
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