Test Bank for Medical-Surgical Nursing
1st Edition by Bowen, Carey,
Palozie, Reinholdt
ISBN: 9781711472898
OpenStax Medical Surgical Test Bank
Chapter 1: Professional Medical-Surgical Nursing
OpenStax Medical-Surgical Nursing Test Bank
Chapter 1: Professional Medical-Surgical Nursing
Review Questions
Multiple Choice
1. What organizational elements strive to improve delivery of overall quality of care for patients while also reducing negative patient outcomes?
A. Joint Commission Best Practices
B. Quality and Safety Education for Nurses
C. Nurse Practice Act
D. National Patient Safety Goals *
LO: 01.1.2
Difficulty: Easy
Blooms: Remember
AACN: 1.1a
2. While communicating with another member of your interprofessional care team you use the ISBAR technique. You explain via telephone that you have a patient who will receive test results this morning, and their family is en route to help them review the test results and make decisions about their care plan. Which ISBAR technique are you using at this point in the conversation?
A. situation
B. background *
C. assessment
D. recommendations
LO: 01.2.2
Difficulty: Difficult
Blooms: Remember; Understand; Apply; Analyze; Evaluate
AACN: 1.1b
3. While using the ISBAR technique to communicate, you describe the patient’s current condition, the patient’s pain rating, and the medication they received this morning. Which ISBAR technique are you using at this point in the conversation?
A. situation
B. background
C. assessment *
Chapter 1: Professional Medical-Surgical Nursing
D. recommendations
LO: 01.2.2
Difficulty: Difficult
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
4. What are the decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society?
A. collaborative care model
B. patient-centered care
C. health policy *
D. scope of practice
LO: 01.3.1
Difficulty: Moderate
Blooms: Remember; Understand AACN: 1.1a
5. Which principle in the field of nursing ethics acknowledges that patients have the right to maintain control and make their own decisions related to treatment and care?
A. autonomy *
B. beneficence
C. justice
D. nonmaleficence
LO: 01.3.3
Difficulty: Easy
Blooms: Remember; Understand AACN: 1.1a
6. What process involves making clinical decisions based on the best available evidence from the most up-to-date research?
A. nursing research
B. evidence-based practice *
C. quality improvement initiatives
D. nonmaleficence
LO: 01.4.1
Difficulty: Moderate
Blooms: Remember AACN: 1.1a
Chapter 1: Professional Medical-Surgical Nursing
7. What process involves systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, nursing education, and nursing administration?
A. nursing research *
B. evidence-based practice
C. quality improvement initiatives
D. nonmaleficence
LO: 01.4.2
Difficulty: Moderate
Blooms: Remember
AACN: 1.1a
8. What is the framework used in healthcare to systematically improve the ways care is delivered to patients?
A. collaborative care model
B. evidence-based practice
C. nursing best practices
D. quality improvement *
LO: 01.4.4
Difficulty: Easy
Blooms: Remember; Understand
AACN: 1.1a
9. You are trying to determine if your clinic provides effective healthcare. To make this determination, your data include the results of patient satisfaction surveys, as well as information about patients who were readmitted to the clinic. What type of metrics are you reviewing?
A. balancing
B. outcome *
C. process
D. structure
LO: 01.4.4
Difficulty: Difficult
Blooms: Remember; Understand; Apply; Analyze; Evaluate
AACN: 1.1b
10. What approach to healthcare is based on a collection of interdependent elements that interact to achieve a common purpose?
Chapter 1: Professional Medical-Surgical Nursing
A. patient-centered care
B. evidence-based practice
C. collaborative care model
D. systems-based practice *
LO: 01.6.1
Difficulty: Moderate
Blooms: Remember; Understand
AACN: 1.1a
11. What specialty integrates nursing science with information and analytical sciences to use data, information, knowledge, and wisdom to enhance nursing practice?
A. evidence-based practice
B. quality improvement initiatives
C. nursing informatics *
D. nursing research
LO: 01.7.1
Difficulty: Moderate
Blooms: Remember; Understand
AACN: 1.1a
12. In nursing informatics, what component includes patients’ vital signs and laboratory values?
A. data *
B. information
C. knowledge
D. wisdom
LO: 01.7.1
Difficulty: Easy
Blooms: Remember
AACN: 1.1a
13. What component of nursing informatics helps nurses develop quality conclusions and create comprehensive care plans for patients?
A. data
B. information
C. knowledge *
D. wisdom
LO: 01.7.1
Difficulty: Moderate
7/10/2024
Chapter 1: Professional Medical-Surgical Nursing
Blooms: Remember AACN: 1.1a
14. What tool enables nurses to have immediate access to patient information, which helps promote quality decision-making?
A. nursing informatics
B. HIPAA Security Rule
C. electronic health records *
D. evidence-based practice
LO: 01.7.2
Difficulty: Easy
Blooms: Remember; Understand AACN: 1.1a
15. What law protects public health information?
A. nursing informatics
B. HIPAA Security Rule *
C. protected health information
D. HIPAA Privacy Rule
LO: [01.7.3
Difficulty: Easy
Blooms: Remember
AACN: 1.1a
True/False
16. True or false? Nursing is a standardized profession throughout the United States, and once nurses obtain a license, they are eligible to practice in any of the 50 states.
Answer: False. Each state has its own rules and regulations. It is imperative as a licensed professional to be aware of the limitations of your practice in the state in which you work and where to find this information.
LO: 01.1.1
Difficulty: Moderate
Blooms: Remember; Understand AACN: 1.1a
17. True or false? In the field of nursing ethics, provider nonmaleficence refers to the healthcare provider’s responsibility to act in their patient’s best interests.
Answer: False. In the field of nursing ethics, provider beneficence, not nonmaleficence, refers to the healthcare provider’s responsibility to act in their patient’s best interests.
Chapter 1: Professional Medical-Surgical Nursing
LO: 01.3.3
Difficulty: Moderate
Blooms: Remember; Understand AACN: 1.1a
18. True or false? Public health agencies, through government funding, shoulder much of the responsibility of providing care to the poor, the uninsured, and other vulnerable populations.
Answer: True
LO: 01.5.1
Difficulty: Easy
Blooms: Remember
AACN: 1.1a
19. True or false? Access to healthcare is the most important determinant of health, helping to promote health equity and reduce disparities in healthcare.
Answer: False. While access to healthcare is an important determinant of health, it is not the most important. The most important is health insurance, which is an essential factor to accessing routine healthcare and is directly correlated with better health outcomes.
LO: 01.5.3
Difficulty: Difficult
Blooms: Remember; Understand
AACN: 1.1a
20. True or false? In nursing informatics, wisdom focuses on clinical data and knowledge, as well as ethical principles, patient preferences, and long-term implications to provide wellrounded and compassionate care.
Answer: True
LO: 01.7.1
Difficulty: Easy
Blooms: Remember; Understand
AACN: 1.1a
Identification
A. recognize cues
B. analyze cues
C. prioritize hypotheses
D. generate solutions
Chapter 1: Professional Medical-Surgical Nursing
21. You explore options to care for the patient. Which skill in the Clinical Judgment Measurement Model are you using?
Answer: D. generate solutions
LO: 01.2.3
Difficulty: Easy
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
22. You consider the causes for the patient’s situation and determine which of the patient’s issues are the most critical. Which skill in the Clinical Judgment Measurement Model are you using?
Answer: C. prioritize hypotheses
LO: 01.2.3
Difficulty: Moderate
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
23. Your patient was admitted to the emergency room with shortness of breath and a rapid heartbeat. As you examine the patient, you check their vital signs and ask questions about their symptoms. You also gather information about their medical history. Which skill in the Clinical Judgment Measurement Model are you using?
Answer: A. recognize cues
LO: 01.2.3
Difficulty: Easy
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
24. After their medication and other treatment has had time to take effect, you check on the patient and review their vital signs and other data. Which skill in the Clinical Judgment Measurement Model are you using?
Answer: F. evaluate outcomes
LO: 01.2.3
Difficulty: Easy
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
7/10/2024 E. take action F. evaluate outcomes
Chapter 1: Professional Medical-Surgical Nursing
25. You review the patient’s vital signs and other information, organize the data, and strive to comprehend the patient’s situation. Which skill in the Clinical Judgment Measurement Model are you using?
Answer: B. analyze cues
LO: 01.2.3
Difficulty: Difficult
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
26. You talk to the patient about the proposed treatment plan. After they consent, you provide the patient with medication and other treatment. Which skill in the Clinical Judgment Measurement Model are you using?
Answer: E. take action
LO: 01.2.3
Difficulty: Moderate
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
Fill in the Blank
27. ________ is a team-based approach designed to promote person-centered care to improve patient and health system outcomes. This approach which includes shared responsibilities, interactive planning, and collaborative decision-making enables healthcare professionals to provide holistic, ________ focused on all the patient’s needs.
Answer: Interprofessional; whole-person care
LO: 01.2.1
Difficulty: Moderate
Blooms: Remember; Understand AACN: 1.1a
28. The Affordable Care Act was signed into law in 2010 to promote ________ throughout the country. The ACA’s goals include providing health coverage ________ and protecting people who have _______.
Answer: health equity; without limits; preexisting conditions
LO: 01.3.1
Difficulty: Difficult
Blooms: Remember; Understand AACN: 1.1a
Chapter 1: Professional Medical-Surgical Nursing
29. ________ is the study of right and wrong actions, and in nursing, ________ respects the patient’s rights and individuality and ensures equitable treatment and care that aligns with each patient’s beliefs and values.
Answer: Ethics; ethical decision-making
LO: 01.3.3
Difficulty: Moderate
Blooms: Remember; Understand AACN: 1.1a
30. The goal of ________ is to increase a person’s ability to care for themself and to promote as much independence as possible.
Answer: post-acute care
LO: 01.5.1
Difficulty: Easy
Blooms: Remember; Understand AACN: 1.1a
31. A ________ is the culture or society that surrounds smaller systems and gives them structure. Its components include laws, rules and regulations, government agencies, political systems, social policies, and educational resources, all of which have a direct impact on healthcare, public health, health equity, and the systems in which healthcare is delivered.
Answer: macrosystem
LO: 01.6.1
Difficulty: Easy
Blooms: Remember AACN: 1.1a
Short Answer Questions
32. What is the nursing scope of practice and how is it determined?
Sample Answer: The nursing scope of practice refers to the range of activities a licensed nurse is permitted to perform. It is determined at the state level by a two-step process:
1. The state legislature passes a law, known as the Nurse Practice Act.
2. Regulatory bodies, such as the state nursing board, then create and implement rules and regulations intended to protect the public.
LO: 01.1.1
Difficulty: Easy
Chapter 1: Professional Medical-Surgical Nursing
Blooms: Remember; Understand AACN: 1.1a
33. You are part of an intercollaborative care team in a rural area. Members of the team include nurses, physicians, pharmacists, dentists, optometrists, social workers, and dieticians located in three different small towns, spaced about 15 miles apart. What recommendations do you offer to enable this intercollaborative care team to practice PCC efficiently and effectively?
Sample Answer: Key points include the following.
● Each team member in each location must have the ability to work cohesively and in tandem, creating a streamlined workflow of communication and delivery of care.
● To ensure that they can do this, the team should rely on telehealth to enable them to communicate and have regular meetings, coordinating and streamlining the collaborative patient care process to ensure they provide efficient and effective patient care.
● They also should use electronic health records, which will allow each team member to read the notes of other healthcare professionals, avoid duplication, and better implement the patient care plan, as well as avoid potential adverse events like prescribing incompatible medications.
LO: 01.2.1; 01.2.2
Difficulty: Difficult
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
34. Your patient’s health is being impacted by several nonmedical factors, including substandard literacy skills, lack of transportation, low income, and unsafe housing. What are these factors called, how do they affect health, and how can public health organizations overcome these factors to provide better healthcare?
Sample Answer: These factors are called social determinants of health (SDOH). They include environmental and other factors that shape daily life, including access to healthcare and education, economic stability, community development, social and society norms, education, and political systems. SDOH can result in health disparities and inequities. To overcome SDOH and provide better healthcare, public health organizations should partner with education, transportation, and housing sectors to improve underserved residential communities.
LO: 01.3.2
Difficulty: Moderate
Blooms: Remember; Understand; Apply; Analyze; Evaluate AACN: 1.1b
35. Explain the differences among primary, secondary, and tertiary prevention services.
Chapter 1: Professional Medical-Surgical Nursing
Sample Answer: Key points include the following:
● The goal of primary prevention is to prevent disease before it occurs by making lifestyle changes to correct unhealthy choices or unsafe behaviors, preventing exposure to environmental hazards, and taking measures to increase resistance to disease or injury.
● The goal of secondary prevention is to promote early diagnosis and treatment to slow the progression of a disease or injury and reduce its long-term impacts. This process begins with early detection.
● The goal of tertiary prevention is to decrease the impact of an ongoing illness or injury. Effective tertiary treatment can help patients regain mobility and bodily function and maintain a positive quality of life.
LO: 01.5.2
Difficulty: Easy
Blooms: Remember; Understand
AACN: 1.1a
36. What is the focus of systems-based practice and what layers of the healthcare system does SBP recognize?
Sample Answer: In systems-based practice (SBP), a clinician considers the multiple systems that are involved in a patient’s condition and uses evidence about their interactions to develop a treatment plan that incorporates the intricacies involved in the patient’s care. The layers of the healthcare system recognized by SBP include consumers of care, delivery systems such as hospitals and physician networks, insurers of care, providers of care such as nurses, and purchasers of care including individuals and governments.
LO: 01.6.1
Difficulty: Moderate
Blooms: Remember; Understand
AACN: 1.1a
Long Answer Questions
37. What is patient-centered care? As part of your answer, explain the purpose of PCC and list several ways that nurses can practice PCC in nursing.
Sample Answer: Key points include the following information. PCC involves the following:
● requires listening to patients to understand what they value most, then using the information as the catalyst for healthcare decisions
● encourages the patient and family to be a part of the healthcare team, actively collaborating in the decisions that will formulate a customized plan of care and guide treatment decisions for the patient
● ensures the patient’s needs and concerns are at the center of healthcare decisions and treatment plans
● ensures the organization’s mission and values are driven by patient-centered goals
Chapter 1: Professional Medical-Surgical Nursing
● equally values the patient’s emotional well-being and physical comfort, incorporating the patient’s emotional, mental, spiritual, social, and financial perspectives into their care
● focuses on providing the right care at the right time in the right place, respecting the patient’s and family’s values, culture, and socioeconomic status
● promotes sharing information in a timely manner so the patient and their family can make well-informed decisions
● invites family members to become part of the care team by participating during rounds or shift changes
● knows what is most important to the patient and honors their directives
LO: 01.1.3
Difficulty: Easy
Blooms: Remember; Understand
AACN: 1.1a
38. Define critical thinking and clinical judgment and explain how the two concepts are related. Then, describe how you would use critical thinking and clinical judgment to care for a patient with the following data:
● The patient is 42 years old and came to the hospital with a broken arm. They also have bruises on their face and shoulders.
● The patient lives with their spouse and a teenaged son. The police have visited the patient’s home several times when neighbors complained about screaming and yelling.
● The patient’s religious background prohibits them from accepting certain medical treatments.
● The patient is alone but will not make eye contact and mumbles answers. Sample Answer: Key points include the following.
● Critical thinking is a multidimensional, systematic, and organized way of reasoning that involves purposeful, outcome-directed thinking. Critical thinking skills develop over time as foundational knowledge and key concepts combined with nursing experience and require mindfulness, effort, practice, and experience. Critical thinking enables the nurse to draw conclusions that lead to creative and appropriate decisions that promote effective solutions and positive outcomes.
● Clinical judgment is used to make decisions about patient care based on observations, assessments, and interpretations of relevant information that go beyond the application of technical skills and involves the integration of both empirical knowledge and practical wisdom.
● When critical thinking and clinical judgment are used together, this is known as clinical decision-making. Critical thinking enables nurses to sift through all the data and make evidence-backed decisions. Clinical judgment is the synthesis of the information, and clinical decision-making is the result.
7/10/2024
● For the patient in this scenario, the components of critical thinking that apply include asking questions, gathering information, validating and analyzing information, maintaining a flexible attitude, and considering available options. Drawing on past clinical experiences with patients who have similar symptoms and circumstances will help with using clinical judgment to formulate decisions.
LO: 01.2.3
Difficulty: Difficult
Blooms: Remember; Understand; Apply; Analyze; Evaluate
AACN: 1.1b
39. Use examples to explain the concept of an ethical dilemma. As a nurse, how can you recognize an ethical dilemma and what steps can you take to avoid ethical dilemmas?
Sample Answer: Key points include the following.
● Examples of common causes of ethical dilemmas in nursing include assignments that are contradictory to personal, cultural, or religious beliefs or to the Code of Ethics for Nurses; burnout associated with unsafe practices; complicated family dynamics of patients; dishonesty of peers; hostile work environments; life and death decisions that must be made; patients who refuse treatment; and short staffing or staff who fail to meet their responsibilities.
● The best way to recognize an ethical dilemma is to take notice of how a situation causes you to think and feel. You may feel pulled in two directions as you consider two courses of action. Neither course of action may be clearly incorrect; instead, each may emphasize different principles and values. You may feel that you have to choose between right and wrong or that either choice could have negative consequences.
● Your facility should have resources to help you make your decision.
● Avoiding ethical dilemmas is impossible.
● Since it is impossible to avoid ethical dilemmas, nurses must equip themselves with knowledge and resources to face these dilemmas. The most important thing is to deal with each situation in a professional manner that promotes quality care and patient safety.
LO: 01.3.3
Difficulty: Easy
Blooms: Remember; Understand
AACN: 1.1a
40. What is the purpose of research in nursing and what is the purpose of evidence-based practice (EBP) in nursing? In nursing research, what is the difference between qualitative and quantitative research? List and define the five phases of nursing research. Finally, list the seven steps typically involved in EBP.
Sample Answer: Key points include the following.
● The purpose of research in nursing is to evaluate current knowledge and theories to formulate better nursing practices for improved patient outcomes.
● The purpose of EBP in nursing is to use the evidence from research to make informed decisions regarding patient care and outcomes. EBP is vital to providing the highest quality of patient care and safety.
● Qualitative research focuses on personal experiences obtained through observation and interaction with patients.
● Quantitative research uses deduction and generalization from empirical evidence to draw conclusions. Objective data gathered by the senses from observations or experiments are known as empirical evidence. These data are generally depicted by numbers in charts and tables for statistical purposes. Examples include identifying percentages, averages, and the mean of data.
● The five phases of nursing research include the conceptual, design and planning, empirical, analytic, and dissemination phase.
o The conceptual phase in nursing research involves the identification and development of research ideas, hypotheses, and theoretical frameworks. It sets the foundation for the entire research process.
o The design and planning phase focuses on brainstorming and determining which research method is most appropriate for the study.
o Data are collected during the empirical phase.
o During the analytic phase, researchers analyze the data to discern and validate relevant patterns and relationships in the data. Then researchers determine how the study’s findings can best be used in clinical practice.
o In dissemination, the researchers communicate their findings so others can use the information in their clinical practice. This phase also allows other researchers to try to replicate the study to see if they obtain similar results.
● Generally, the seven steps of EBP include encouraging a spirit of inquiry or curiosity, asking questions, searching for evidence, appraising the evidence, integrating the evidence into practice, evaluating outcomes of the practice change, and sharing the results.
LO: 01.4.1; 01.4.2; 01.4.3
Difficulty: Moderate
Blooms: Remember; Understand
AACN: 1.1a
41. What is the assumption of systems-based practice as it regards patients and how does this impact the quality of patient care? Provide at least two examples of SBP in healthcare. How can nurses be change agents in SBP? Finally, how do interdisciplinary teams function in SBP? Sample Answer: Key points include the following.
● SBP assumes that each patient exists in a context of interconnecting, interdependent systems. These systems may be large or small, complex or relatively simple.
Chapter 1: Professional Medical-Surgical Nursing
● The ability to recognize each system and understand how they work together and fit into the overall structure is essential to promoting the quality of patient care while also reducing errors.
● Examples of SBP in healthcare include approaching identified problems with the goal of solving them versus relying on a workaround; developing insight into the legal, political, regulatory, and economic factors that influence the delivery of healthcare; having an understanding of cost containment, resource allocation, patient advocacy, and interdisciplinary collaboration in the delivery of quality care; recognizing the outcome of individual and group actions as it affects quality care and patient safety; understanding how each different care setting works together for patients; and working in interdisciplinary teams to improve patient outcomes.
● As frontline care providers, nurses can effect change because they observe firsthand the impacts of various systems on delivering patient care. These observations can be used to bring about changes to improve patient safety and quality care, which are the goals of SBP.
● Effective teamwork is essential to developing competence in SBP. Bringing together team members with specialized skills and training from a variety of disciplines improves both the delivery of care and the outcomes for each patient. By implementing interdisciplinary patient rounds, team members can brainstorm solutions to identified problems and coordinate their implementation.
LO: 01.6.1; 01.6.2; 01.6.3
Difficulty: Moderate
Blooms: Remember; Understand AACN: 1.1a
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