Deck 1: Foundations for Medical-Surgical Nursing

Question 1

The nurse is evaluating the level of evidence found during a recent review of the literature. Which evidence carries the lowest level of support for a practice change?
1)Level IV
2)Level V
3)Level VI
4)Level VII

Answer 1

4

Question 2

The nurse develops a research question based on observations noted while providing care to patients on the medical-surgical unit. Which step does the nurse implement next during the process of evidence-based practice?
1)Search for the best evidence.
2)Evaluate the quality of the evidence.
3)Integrate the evidence into unit practice.
4)Disseminate the evidence to the staff on the unit.

Answer 2

1

Question 3

The medical-surgical nurse is providing patient care. Which circumstance would necessitate the nurse verifying the patient's identification using at least two sources?
1)Before delivering a meal tray
2)Before passive range of motion
3)Before medication administration
4)Before documenting in the medical record

Answer 3

3

Question 4

Which action should the nurse implement when providing patient care in order to support The Joint Commission's (TJC) National Patient Safety Goals (NPSG)?
1)Silencing a cardiorespiratory monitor
2)Identifying each patient using one source
3)Determining patient safety issues on admission
4)Decreasing the amount of pain medication administered

Question 5

Which statement regarding the use of the nursing process in clinical practice is accurate?
1)"The nursing process is closely related to clinical decision making."
2)"The nursing process is used by all members of the interprofessional team to plan care."
3)"The nursing process has four basic steps: assessment, planning, implementation, and evaluation."
4)"The nursing process is being replaced by the implementation of evidence-based practice."

Question 6

The nurse is providing care to several patients on a medical-surgical unit. Which situation would necessitate the nurse to use SBAR during the hand-off process?
1)Wound care
2)Discharge to home
3)Transfer to radiology
4)Medication education

Question 7

The medical-surgical nurse identifies a clinical practice issue and wants to determine if there is sufficient evidence to support a change in practice. Which type of study provides the strongest evidence to support a practice change?
1)Randomized controlled study
2)Quasi-experimental study
3)Case-control study
4)Cohort study

Question 8

Which competency did the Nursing Executive Center of the Advisory Board identify as the greatest academic-practice gap for new graduate nurses?
1)Knowledge of pharmacology
2)Interpretation of assessment data
3)Knowledge of pathophysiology
4)Decision making

Question 9

The medical-surgical nurse prepares to transfer a patient to the rehabilitation unit. Which is the best nursing action to enhance patient safety in this situation?
1)Identify the patient using two identifiers.
2)Perform hand hygiene before touching the patient.
3)Conduct a time-out when handing off care to the new unit.
4)Provide a written handoff communication using the SBAR method.

Question 10

The nurse is reviewing evidence from a quasi-experimental research study. Which level of evidence should the nurse identify for this research study?
1)Level I
2)Level II
3)Level III
4)Level IV

Question 11

The nurse manager is preparing a staff education presentation in preparation for The Joint Commission (TJC) visit. Which data does the nurse manager include that specifically address aspects of patient-centered care?
1)Licensure requirements of staff
2)Patient participation in plan of care
3)Communication between providers and staff
4)Staffing ratios

Question 12

To deliver patient-centered care, the nurse needs to understand the implications of findings from which organization that provides a standardized approach to the collection of data from patients regarding their experiences within the healthcare system?
1)The Joint Commission (TJC)
2)Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
3)The Nursing Executive Center of the Advisory Board
4)American Nurse Credentialing Center Magnet^® Recognition program

Question 13

The medical-surgical nurse transports a patient to the surgical suite for a hip replacement surgery. Which action does the nurse complete during the "time-out" process with the surgical team?
1)Verifying the patient's informed consent is signed
2)Identifying the patient by asking, "Are you Mrs. Smith?"
3)Asking the patient, "Which side are you having surgery on today?"
4)Ensuring the patient's surgical checklist is complete and placed on the medical record

Question 14

Which statement should the nurse make when communicating the "S" in the SBAR approach for effective communication?
1)"The patient presented to the emergency department at 0200 with lower left abdominal pain."
2)"The patient rated the pain upon admission as a 3 on a 10-point numerical scale."
3)"The patient has no significant issues in the medical history."
4)"I believe the patient needs to be prescribed a medication for pain."

Question 15

The staff nurse is communicating with the change nurse about the change of status of the patient. The nurse would begin her communication with which statement if correctly using the SBAR format?
1)"The patient's heart rate is 110."
2)"I think this patient needs to be transferred to the critical care unit."
3)"The patient is a 68-year-old man admitted last night."
4)"The patient is complaining of chest pain."

Question 16

Which level of evidence should the nurse identify when reviewing evidence from a single descriptive research study?
1)Level IV
2)Level V
3)Level VI
4)Level VII

Question 17

Which nursing action exemplifies the Quality and Safety Education for Nursing (QSEN) competency of safety?
1)Advocating for a patient who is experiencing pain
2)Considering the patient's culture when planning care
3)Evaluating patient learning style before implementing discharge instructions
4)Assessing the right drug before administering a prescribed patient medication

Question 18

In the Nursing Executive Center of the Advisory Board report, what recommendations are made to address the academic practice gap for new graduate nurses?
1)Mandatory number of clinical hours
2)Increased credits in all entry level courses
3)Residency programs
4)Additional science prerequisite courses

Question 19

The medical-surgical nurse wants to determine if a policy change is needed for an identified clinical problem. Which is the nurse's first action?
1)Developing a question
2)Disseminating the findings
3)Conducting a review of the literature
4)Evaluating outcomes of practice change

Question 20

Which type of nursing is the root of all other nursing practice areas?
1)Pediatric nursing
2)Maternal child nursing
3)Medical-surgical nursing
4)Mental health-psychiatric nursing

Question 21

Which interprofessional role does the nurse often assume when providing patient care in an acute care setting?
1)Social worker
2)Primary healthcare provider
3)Care coordinator
4)Rehabilitation specialist

Question 22

The nurse manager wants to designate a member of the nursing team as the care coordinator for a patient who will require significant care during the hospitalization. Which skills should this nurse possess in order to assume this role? Select all that apply.
1)Clinical reasoning
2)Communication skills
3)Advanced life support training
4)Documentation skills
5)Intravenous therapy skills

Question 23

The staff nurse is teaching a group of student nurses the situations that necessitate hand-off communication. Which student responses indicate the need for further education related to this procedure? Select all that apply.
1)"A hand-off is required before administering a medication."
2)"A hand-off is required during change of shift."
3)"A hand-off is required for a patient who is transferred to the surgical suite."
4)"A hand-off is required whenever the nurse receives a new patient assignment."
5)"A hand-off is required before family visitation."

Question 24

In preparing an educational program on Quality and Safety Education for Nursing (QSEN), the nurse incorporates which competencies? Select all that apply.
1)Patient-centered care
2)Legal implications of nursing care
3)Evidence-based practice
4)Informatics
5)Cost containment measures

Question 25

Which professional nursing organizations provide certification in medical-surgical nursing? Select all that apply.
1)Academy of Medical Surgical Nursing
2)American Nurse Credentialing Center
3)Beryl Institute
4)Medical Surgical Nursing Certification Board
5)Nursing Executive Center

Question 26

The nurse provides care to patients on the medical-surgical unit. Which nursing actions support the Joint Commission's National Patient Safety Goals when providing patient care? Select all that apply.
1)Silencing a patient's cardiorespiratory monitor while the family visits
2)Asking the unlicensed assistive personnel to remove clutter from the patient's room
3)Using the SBAR method to provide patient information to radiology before transfer
4)Encouraging the patient's healthcare provider to wash the hands before assessing a surgical wound
5)Identifying the patient before administering medication by asking, "What is your date of birth?"

Question 27

The nurse is planning an interprofessional care conference for a patient who is approaching discharge from the hospital. Which members of the interprofessional team should the nurse invite to attend? Select all that apply.
1)Physician
2)Pharmacist
3)Unit secretary
4)Social worker
5)Home care aide

Question 28

The medical-surgical nurse assumes care for a patient who is receiving continuous cardiac monitoring. Which actions by the nurse enhance safety for this patient? Select all that apply.
1)Silencing the alarm during family visitation
2)Assessing the alarm parameters at the start of the shift
3)Responding to the alarm in a timely fashion
4)Decreasing the alarm volume to enhance restful sleep
5)Adjusting alarm parameters based on specified practitioner prescription

Question 29

Which actions by the nurse enhance patient safety during medication administration? Select all that apply.
1)Answering the call bell while transporting medications for a different patient
2)Identifying the patient using two sources before administering the medication
3)Holding a medication if the patient's diagnosis does not support its use
4)Holding a medication because it arrived from the pharmacy 2 hours after the scheduled administration time
5)Having another nurse verify the prescribed dose of insulin the patient is to receive