Deck 1: Medical-Surgical Nursing in the 21st Century

Question 1

A patient angrily tells the nurse that he has been waiting over an hour for pain medication. When applying critical thinking, with which of the following should the nurse respond to this patient?

A)"I understand your anger and am sorry for the delay.I have your pain medication now."
B)"I had other patients who needed my attention first so I did a few things before getting the pain medication."
C)"I needed to find out what your medication is and if you can have more when you asked."
D)"It seems that you always ask for pain medication when I am trying to do other things."

Answer 1

"I understand your anger and am sorry for the delay.I have your pain medication now."

Question 2

The nurse is instructing a patient on the role of diet, exercise, and medication to control type 2 diabetes. The nurse is practicing which of the following core competencies for healthcare professionals?

A)provide patient-centered care
B)work in interdisciplinary teams
C)use evidence-based practice
D)apply quality improvement

Answer 2

provide patient-centered care

Question 3

The nurse who plans to implement evidence-based practice when providing patient care would include which of the following activities? Select all that apply.

A)Participate in education and research activities when possible.
B)Integrate research findings with clinical care to maximize patient outcomes.
C)Serve on the committee to create critical pathways for patient care.
D)Reinforce hand hygiene techniques with unlicensed assistive personnel.
E)Contact Environmental Services to inform of a malfunctioning infusion pump.

Answer 3

Participate in education and research activities when possible.
Integrate research findings with clinical care to maximize patient outcomes.

Question 4

The nurse, instructing a patient newly diagnosed with type 2 diabetes, reminds the patient about an annual dilated retinal eye examination in addition to annual urine tests to measure protein levels. The nurse is functioning within which of the following roles with this patient?

A)educator
B)researcher
C)advocate
D)leader

Question 5

The nurse is using a specific process to plan smoking cessation activities for a patient. Which of the following is this nurse most likely using to plan the care for this patient?

A)nursing process
B)critical pathways
C)evidence-based practice
D)variance analyzing

Question 6

The nurse who prescribes strategies and alternatives to assist a patient achieve expected outcomes is practicing within which of the American Nurses Association Standards of Practice?

A)planning
B)assessment
C)diagnosis
D)implementation

Question 7

A new nurse tells her mentor, "You always seem so poised when you interact with the patient. It is as if you always know what to do. Can you teach me how to do that?" What characteristic does this mentor possess in relation to critical thinking?

A)self-confidence
B)independent thinking
C)empathy
D)discipline

Question 8

To practice within the American Nurses Association Standards of Professional Practice, the nurse would implement which of the following activities?

A)Integrate research findings into practice.
B)Implement a patient's plan of care.
C)Evaluate patient progress toward identified outcomes.
D)Analyze assessment data to determine issues.

Question 9

Which of the following best demonstrates a nurse using critical thinking when providing patient care?

A)A nurse lists alternative interventions available to provide patient care.
B)A nurse checks a laboratory manual before providing care.
C)A nurse is confused when the only planned intervention fails to help a patient.
D)A nurse checks every intervention with the charge nurse before providing care.

Question 10

Which of the following activities would the community health nurse implement to exemplify the core competency provide patient-centered care?

A)smoking cessation classes and literature for members in the community
B)increasing the hours for the physician to see patients in the community
C)attending a continuing education program on clean water initiatives
D)evaluating the effectiveness of weight reduction strategies for community members

Question 11

A patient tells the nurse that he does not understand the surgical procedure the physician told him he needed. Which of the following should the nurse do to advocate for this patient?

A)Contact the physician and ask that the procedure be explained to the patient.
B)Explain the procedure to the patient.
C)Document that the patient does not understand the proposed surgical procedure.
D)Instruct the patient in alternatives to the surgical procedure.

Question 12

The nurse, instructing a patient on weight reduction and smoking cessation, is implementing which of the following codes of nursing practice?

A)International Council of Nurses Code for Nurses
B)American Nurses Association Standards of Professional Practice
C)American Nurses Association Code of Ethics for Nurses
D)State Board of Nursing

Question 13

The nurse plans and implements care for a patient based upon nursing knowledge and skills. The nurse is functioning within which of the following roles?

A)caregiver
B)advocate
C)educator
D)leader

Question 14

The nurse, utilizing critical-thinking behaviors when providing patient care, would demonstrate which of the following? Select all that apply.

A)think independently
B)creativity
C)make decisions based on feelings
D)easily influenced
E)find easy answers to problems

Question 15

The nurse is identifying nursing diagnoses appropriate for a patient's plan of care. Which of the following would the nurse use to determine the nursing diagnoses?

A)diagnostic reasoning
B)effective communication techniques
C)identify outcome criteria
D)set priorities

Question 16

Which of the following is an example of the nurse who is utilizing the core competency use informatics when providing patient care?

A)searching through a database of articles to find current research on wound care
B)documenting the effectiveness of pain medication for a patient
C)discussing the effectiveness of bedside physical therapy with the therapist
D)changing the sharps container in a patient's room

Question 17

The nurse stops to think about a previous patient care situation before providing care to a current patient. This nurse is using what critical-thinking skill?

A)reflection
B)divergent thinking
C)reasoning
D)clarifying

Question 18

Which of the following leadership activities would the nurse perform when providing care within the primary nursing care delivery model?

A)Communicate with patients, families, other care providers, and plans patient discharge.
B)Serve as the team leader by making assignments and being responsible for all care provided.
C)Make referrals and manages the quality of care to include timeliness and cost.
D)Manage a caseload of patients and the health team members providing care to the patients.

Question 19

Which of the following should the nurse do with patient admission assessment data that would demonstrate divergent thinking?

A)Identify abnormal data for further analyzing.
B)Focus on normal data to rule out health problems
C)Discriminate information as facts or guesses
D)Think about the information to determine solutions

Question 20

A terminally ill patient says that the only thing he fears about dying is the pain. The nurse, following the International Council of Nurses Code for Nurses, would plan which of the following for the patient?

A)measures to alleviate suffering
B)modified activities of daily living
C)enforcement of strict bed rest
D)dietary interventions to maximize strength

Question 21

A patient tells the nurse, "I have an advance directive that I want you to follow." Which of the following will this document provide for the nurse?

A)the patient's preferences for health care should the patient become mentally incapacitated
B)a complete plan of care for the patient
C)the answers to any care dilemmas for the patient
D)directions regarding when to use universal precautions for the patient

Question 22

The nurse is reviewing the outcome of patient care that was provided. Which of the following nursing process steps should the nurse use next?

A)evaluation
B)assessment
C)implementation
D)planning

Question 23

Choose the Select all that apply.

A)"Tell me about your dietary practices."
B)"When did the pain start and can you tell me on a scale of 1-10, with 10 being the worst, what your pain rating is now?"
C)The nurse notes a cluster of blisters on patient's scapula.
D)"When is the last time you had a physical?"
E)"Does your eyesight affect your ability to see the insulin that you are taking?"

Question 24

Arrange in order the steps the nurse would take to create a focused assessment for a patient with type II diabetes. Click and drag the options below to move them up or down.

A)Nurse notes patient is reluctant to draw up insulin in syringe.
B)Nurse assesses what the patient already knows.
C)Nurse has patient practice drawing up insulin.
D)Nurse calls in diabetic educator.
E)Nurse notes patient is not aware of differences of hypo- and hyperglycemia.

Question 25

A patient tells the nurse, "I have pain in my leg when I stand too long." This information would be considered which of the following?

A)subjective data
B)evaluative data
C)qualitative data
D)objective data

Question 26

The nurse is implementing a plan of care for a patient. After providing care, what should the nurse do as the final step in the process?

A)Document.
B)Reassess the patient.
C)Nothing.
D)Give the charge nurse a report.

Question 27

The nurse is preparing to provide patient care information to a group of unlicensed assistive personnel. Which type of care delivery system is this nurse most likely using to provide patient care?

A)team nursing
B)functional nursing
C)primary nursing
D)case management

Question 28

The nurse is consulting a critical pathway to help make patient care decisions. Which type of care delivery model is this nurse most likely using to provide patient care?

A)case management
B)primary nursing
C)functional nursing
D)team nursing

Question 29

While providing care to a patient, the nurse stops to assess a new patient problem. The assessment in this situation would be which of the following?

A)a focused assessment
B)an initial assessment
C)an objective assessment
D)a subjective assessment

Question 30

The nurse working on a quality improvement study wants to evaluate a patient care process. Which of the following can the nurse use to evaluate this process?

A)nursing process
B)critical pathway
C)variance analyzing
D)evidence-based practice

Question 31

Evaluate the following scenarios and choose the one that best describes an ethical nursing dilemma.

A)A 20-year-old male patient comes in the hospital with an opportunistic disease and has HIV.He is sexually irresponsible and is sleeping with two girls and does not want this information given out.
B)You are a charge nurse and the patient ratio is greater than 5:
C)You are assigned to a cardiac unit but are not capable of interpreting EKG results.You take the assignment anyway.
D)You drop the patient's medication on the floor but give it to the patient anyway.
E)A co-worker has hung the wrong antibiotic on the patient.You find the error.

Question 32

A graduate nurse is attending a seminar regarding the role of the nurse as a patient advocate. After the session, the students engage in a discussion. Which of the following statements by the graduate nurse indicates the need for further education?

A)"Patient advocates have the authority to make decisions for the patient."
B)"Being a patient advocate entails making efforts to improve patient outcomes."
C)"Providing education to the patient and family is a key way to be a positive patient advocate."
D)"Communicating patient needs to the members of the healthcare team is a role of the patient advocate."

Question 33

Patient chart audits provide the nurses with information that impacts the future outcomes of patient care. What should the nurses do with this information?

A)Use the information to create an action plan to address any negative findings.
B)Nothing.
C)Submit it to the agency's accrediting body.
D)Place it in a file to compare with the next set of audits.

Question 34

A patient care issue has been raised about the actions taken by a nurse who was asked to provide care to a patient whose healthcare decisions were considered controversial. The unit's nurse manager is concerned that care was not appropriately provided. Which of the following should be consulted to protect the patient and to evaluate the care in question?

A)nursing code of ethics
B)hospital quality improvement guidelines
C)nurse practice act
D)critical pathway

Question 35

The nurse is creating outcome criteria for the nursing diagnoses for a patient. Which of the following should the nurse include when creating the criteria?

A)They should be written to address the patient, and be time-specific and measurable.
B)They should be written as nursing goals.
C)They should be written as statements.
D).They should be written as psychomotor only.

Question 36

A nurse has delegated the collection of vital signs, including blood pressure readings, to two unlicensed assistive personnel. The delegation of this work means the nurse is

A)accountable for the care that was delegated.
B)not responsible for these vital signs.
C)not accountable for these vital signs.
D)responsible to re-measure all of the vital signs.

Question 37

The nurse is preparing a patient to go home. Which of the following skills are the most important for the nurse in order to adequately prepare this patient?

A)familiarity with adult learning principles
B)the ability to follow written orders
C)the ability to use critical thinking
D)the ability to support patient decision making

Question 38

At the completion of an assessment, the nurse chooses a nursing diagnosis that best defines the patient's health problems. Which type of clinical judgment will this nurse use?

A)diagnostic reasoning
B)evidence-based practice
C)critical pathway
D)nursing process

Question 39

Core competencies in nursing are essential to meet the challenges of upcoming patient populations and expanding technologies to provide safe and effective nursing care. All of the following choices are parts of core competencies. Choose the best description that designates the competency of providing patient centered-care.

A)Design and test interventions to change processes and systems of care, with the objective of improving quality.
B)Communicate, manage knowledge, decrease error, and support.Decision-making (critical thinking) using information technology.
C)Identify, respect and communicate patient's differences, values, preferences, and expressed needs.
D)Clarify roles and responsibilities of team members, collaborating and integrating care.
E)Use organizational systems to report near misses and errors.

Question 40

A nurse has met a patient who can provide season passes for the upcoming football season at a discounted price. The nurse offers to provide home care for one week in exchange for the discounted tickets as a present to her boyfriend. The nurse is in violation of which standard(s)? Select all that apply.

A)HIPPA
B)ANA standards
C)professional boundaries
D)state nurse practice acts
E)standards pertinent to specific hospital protocols

Question 41

To ensure the quality and safety of patient care the nurse must understand the following concepts. Select all that apply.

A)training, experience and competence of each member of the healthcare team
B)monitor care provided and give constructive evaluation
C)ensure quality and safety that patients receive
D)the demographics of the patient
E)the number of previous hospitalizations and satisfaction scores

Question 42

The nurse attends multidisciplinary meetings to discuss the plan of care for a trauma patient who has been transferred to the medical-surgical unit. In this role the nurse is acting in the role of which of the following?

A)caregiver
B)team leader
C)delegate
D)advocate
E)manager

Question 43

A nurse would like to do a research project that determines that patients are able to walk to the beverage vending machine and have choices that fulfill their needs. This research project is

A)valid but not realistic.
B)not valid and not pertinent.
C)a nice idea and should be explored further.
D)realistic but not valid.
E)does not contribute to patient care and therefore is not a good research project.

Question 44

Put the process of making a nursing diagnosis in the correct order. Click and drag the options below to move them up or down.

A)Choose the standardized problem label.
B)Draw conclusions about the present health status.
C)Compare data to standards and norms.
D)Cluster clues to look for patterns and relationships.
E)Identify the problem.

Question 45

Nurse Lynn has been in the profession for over 10 years. When students come on the medical-surgical unit, Lynn is often grumpy, mean, and non-compliant when it comes to helping the students stating, "I had to pay my dues, they must pay theirs." She does not want the students on the floor and is often obstructive in having them gain experiences or sharing insights that may benefit them. Nurse Lynn is guilty of violating which standard?

A)ICN Code of Ethics
B)ANA Standards of Practice
C)ANA Code of Ethics
D)state practice acts
E)APNA Code of Ethics