Medical Surgical Nursing Ignatavicius 7th Edition-Test Bank

Chapter 1: Introduction to Medical-Operative Nursing
Question Bank

MULTIPLE CHOICE

1. What behavior indicates that the nurse comprehends the purpose of the Swift Response Team?
a. Notifying the physician of the client’s fluctuating blood pressure
b. Maintaining a post-operative record of observed changes
c. Monitoring the client’s restlessness post-medication alteration
d. Informing the physician of the client’s decline in blood pressure

ANS: C
The Swift Response Team (SRT) acts promptly to provide care to clients before a cardiac or respiratory arrest occurs. While not a replacement for the Code Team, the SRT intervenes swiftly when clients begin to decline clinically. It would be appropriate for the SRT to address a 52-point drop in blood pressure. Monitoring the client post-operatively, maintaining records, and reporting restlessness would not align with the SRT’s responsibilities.

DIF: Cognitive Level: Comprehension/Understanding REF: pp. 2-3
TOP: Client Needs Category: Safe and Effective Patient Environment (Care Management—Interdisciplinary Collaboration)
MSC: Integrated Process: Nursing Process (Assessment)

2. The Joint Commission emphasizes safety in healthcare. Which action illustrates The Joint Commission’s primary goal by the nurse?
a. Evaluating the client’s respirations while giving opioids
b. Administering range-of-motion exercises thrice daily
c. Ensuring the client consumes all meals fully
d. Delegating bathing responsibilities to a nursing assistant

ANS: A
It is crucial for the nurse to assess the client’s respirations during opioid administration to prevent respiratory depression. The other tasks may or may not be essential for the client’s care and do not focus primarily on safety.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Patient Environment (Safety and Infection Prevention)
MSC: Integrated Process: Nursing Process (Assessment)

3. What demonstrates the nurse’s understanding of self-determination principle?
a. Permitting a post-operative client to opt for medication with fruit juice instead of water
b. Allowing a teenager to refuse clinic attendance despite profuse vaginal bleeding
c. Letting a parent decline a life-saving operation for a 12-year-old
d. Enabling an elderly client with dementia to refuse cardiac medication

ANS: A
Respecting autonomy is a fundamental ethical principle guiding clinical decision-making. Autonomy implies that clients are capable of making informed decisions about their care. This client independence, known as self-determination, is best shown by permitting a client to choose medication with fruit juice. The other options do not appropriately illustrate self-determination and may jeopardize the client’s well-being.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Patient Environment (Care Management—Ethical Practice) MSC: Integrated Process: Nursing Process (Assessment)

4. Prior to commencing a series of teaching sessions with an elderly client, what is the nurse’s most critical, client-focused step?
a. Verify the presence and participation of the client’s family
b. Ensure the client has their glasses on
c. Prepare printed handouts for the session
d. Schedule the session post-evening meal

ANS: B
The most crucial client-centered action is to confirm that the client is wearing their glasses. Vision clarity outweighs family attendance, handouts, or meal timing.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Health Promotion and Maintenance (Teaching/Learning Principles)
MSC: Integrated Process: Teaching/Learning

5. Which action embodies client-centered care when planning a menu for a Vietnamese client diagnosed with diabetes?
a. Enquiring about the client’s typical diabetic meal choices
b. Asking family members to decide from a diabetic menu
c. Ordering a standard diabetic meal for the client
d. Researching Vietnamese culture before discussing diabetic meals

ANS: D
Patient-centered care is best demonstrated by the nurse researching Vietnamese culture before meal planning discussions. This indicates the nurse’s involvement and care. Subsequently, the nurse can propose standard diabetic menu items to the client and family.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Nutrition and Oral Hydration) MSC: Integrated Process: Teaching/Learning

6. The Institute for Healthcare Improvement (IHI) identified measures to save lives. Which interventions fall under the nursing domain to enhance care quality?
a. Inserting a central line for intravenous hydration
b. Using sterile techniques when changing dressings
c. Intubating a client with low oxygen saturation
d. Prescribing medication for a myocardial infarction

ANS: B
Sterile technique use is the only nursing practice intervention among those listed. Central line insertion, intubation, and prescription are physician roles.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Patient Environment (Legal Rights and Duties)
MSC: Integrated Process: Nursing Process (Implementation)

7. What is the best practice for nursing documentation on a computerized system?
a. Deleting all record errors
b. Using red font for significant events
c. Postponing summarization until shift end
d. Documenting assessments at care point

ANS: D
Recording assessments immediately is the best practice. The other practices are ineffective and discouraged.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Patient Environment (Legal Rights and Duties)
MSC: Integrated Process: Communication and Documentation

8. A client scheduled for mastectomy changes her mind and requests a lumpectomy pre-medication. Which response advocates for the client?
a. Praising the surgeon’s expertise
b. Asking the surgeon to explain treatment options
c. Offering to pray for a positive outcome
d. Organizing a visit from a cancer survivor

ANS: B
Clients possess the right to be fully informed about treatments. The nurse should advocate for the client’s wishes. Notifying the surgeon to discuss different treatment options is the best way to support the client. Providing vague reassurances, hosting a cancer survivor, or offering prayers do not address the client’s request.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Patient Environment (Care Management—Ethical Practice) MSC: Integrated Process: Caring

9. What assessment data is critical to share with the team for a client with a lacerated artery?
a. Information for next of kin
b. Current medication regimen
c. Blood pressure and pulse measures
d. Respiratory rate and depth assessment

ANS: C
During an emergency database check, the emphasis is on the immediate issue, notably with life-threatening implications. Assessing vital signs such as blood pressure and pulse is crucial to understanding the client’s hemodynamic status. Knowledge of medications, notifying kin, or respiratory assessment is secondary.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Medical Emergencies) MSC: Integrated Process: Nursing Process (Assessment)

10. What service can a client expect from a medical-operative nurse in an outpatient setting?
a. Phlebotomy for routine testing
b. Teaching incision dressing changes
c. Signing surgical consent
d. Conducting a health examination

ANS: B
Patient education is a primary role in medical-operative nursing. Consent signing typically belongs to the surgeon. Phlebotomy and physicals are within nursing scope but not primary responsibilities.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Patient Environment (Care Management—Continuity of Care) MSC: Integrated Process: Nursing Process (Planning)

11. During transfer, the ED nurse advises the floor nurse concerning suicide risk, recommending a sitter and behavioral health. Which aspect of the SBAR hand-off does this pertain to?
a. Situation
b. Background
c. Assessment
d. Recommendation

ANS: D
The ED nurse’s suggestions are recommendations for the transitioning client, aligning with the Recommendation phase of the SBAR report. The information provided is not about the Situation, Background, or Assessment.

DIF: Cognitive Level: Knowledge/Remembering REF: p. 4
TOP: Client Needs Category: Safe and Effective Patient Environment (Care Management—Continuity of Care)
MSC: Integrated Process: Communication and Documentation

12. The doctor discusses chemotherapy effects with a cancer client, comparing benefits to adverse events. This analysis exemplifies which ethical principle?
a. Paternalism
b. Beneficence
c. Justice
d. Autonomy

ANS: B
Beneficence prioritizes client welfare and avoiding harm. Evaluating benefits versus drawbacks empowers a client to decide in their best interest. Autonomy relates to self-determination, justice focuses on fairness, and paternalism denotes decision-making authority.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 4
TOP: Client Needs Category: Safe and Effective Patient Environment (Care Management—Ethical Practice) MSC: Integrated Process: Caring

13. The physician prescribes a high dose compared to the client’s requirement. What does the nurse do first?
a. Administer the dose and report concerns
b. Seek pharmacy consultation
c. Question the physician
d. Withhold the medication

ANS: C
Communication with the physician is the initial step to ensure safe medication. Pharmacy consults are secondary. Administering or withholding medication without clarification can compromise safety.

DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Patient Environment (Error Prevention)
MSC: Integrated Process: Communication and Documentation; Nursing Process (Evaluation)