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

Question 1

The nurse is using a specific process to plan smoking cessation activities for a patient. What 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 analysis

Answer 1

Nursing process

Question 2

A nurse working on a quality improvement study wants to evaluate a patient care process. What should the nurse use to evaluate this process?

A) Nursing process
B) Critical pathway
C) Variance analysis
D) Evidence-based practice

Answer 2

Nursing process

Question 3

The nurse prescribes strategies and alternatives to assist a patient achieve expected outcomes. Within which American Nurses Association standard is the nurse practicing?

A) Planning
B) Assessment
C) Diagnosis
D) Implementation

Answer 3

Planning

Question 4

The nurse teaches a patient newly diagnosed with type 2 diabetes mellitus about the importance of an annual dilated-retina eye examination and annual urine tests to measure protein levels. Within which role is the nurse functioning?

A) Educator
B) Researcher
C) Advocate
D) Leader

Question 5

The community health nurse is planning to meet with several community members during a health fair. Which nursing activity exemplifies the core competency patient-centered care?

A) Provide smoking cessation classes and literature.
B) Increase the hours for the physician to see patients.
C) Attend a continuing education program on clean water initiatives.
D) Evaluate the effectiveness of weight reduction strategies.

Question 6

The nurse stops to think about a previous patient care situation before providing care to a current patient. What type of thinking is this nurse performing?

A) Reflective
B) Divergent
C) Systematic
D) Creative

Question 7

The nurse is identifying nursing diagnoses appropriate for a patient's plan of care. What should the nurse use to determine these diagnoses?

A) Diagnostic reasoning
B) Communication techniques
C) Identified outcome criteria
D) Established priorities

Question 8

A patient with a terminal illness is concerned about pain control. If the International Council of Nurses Code of Ethics for Nurses is followed, what should the nurse plan 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 9

The nurse is instructing a patient on weight reduction and smoking cessation. Which code of nursing practice is the nurse implementing?

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

Question 10

The nurse is providing patient care within the American Nurses Association Standards of Professional Performance. Which activity is the nurse implementing?

A) Integrating research findings into practice
B) Implementing a patient's plan of care
C) Evaluating patient progress toward identified outcomes
D) Analyzing assessment data to determine issues

Question 11

The nurse is reviewing data collected from a patient during an assessment. Which activity demonstrates that the nurse is using divergent thinking when analyzing this data?

A) The nurse identifies abnormal data for further analyzing.
B) The nurse focuses on normal data to rule out health problems.
C) The nurse discriminates between facts and guesses.
D) The nurse thinks about the information to determine solutions.

Question 12

A patient says, "I have pain in my leg when I stand too long." As which type of data should the nurse categorize this information?

A) Subjective
B) Evaluative
C) Qualitative
D) Objective

Question 13

The nurse is reviewing the outcome of care that was provided to a patient. Which nursing process step is the nurse implementing?

A) Evaluation
B) Assessment
C) Implementation
D) Planning

Question 14

A patient is angry after waiting over an hour for pain medication. What should the nurse respond to the patient that demonstrates critical thinking?

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."

Question 15

The nurse is instructing a patient on the role of diet, exercise, and medication to control type 2 diabetes mellitus. Which core competency for healthcare professionals is the nurse implementing?

A) Quality improvement
B) Evidence-based practice
C) Patient-centered care
D) Teamwork and collaboration

Question 16

The nurse is planning to utilize the core competency use informatics when providing patient care. Which action should the nurse perform when using this core competency?

A) Change the sharps container in a patient's room.
B) Document the effectiveness of pain medication for a patient.
C) Discuss the effectiveness of bedside physical therapy with the therapist.
D) Search through a database of articles to find current research on wound care.

Question 17

The nurse is providing care within the primary nursing delivery model. Which leadership activities should the nurse perform within this model?

A) Communicate with patients, families, and other care providers.
B) Serve as the team leader by making assignments and being responsible for all care provided.
C) Make referrals and manage 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.
E) Create patient discharge plans.

Question 18

A patient has questions about a required surgical procedure. When performing as a patient advocate, what should the nurse do?

A) Contact the healthcare provider 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 19

The nurse plans and implements care for a patient based on nursing knowledge and skills. In which role is the nurse functioning?

A) Caregiver
B) Advocate
C) Educator
D) Leader

Question 20

The nurse plans to implement evidence-based practice when providing patient care. Which activities should the nurse perform?

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 report a malfunctioning infusion pump.

Question 21

Arrange in order the steps the nurse should take in a focused assessment for a patient with type 2 diabetes mellitus. Standard Text: 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 between hypo- and hyperglycemia.
F) none of the above

Question 22

The nurse is preparing a patient to go home. Which skill should the nurse use when preparing this patient?

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

Question 23

The nurse is assessing a patient with pain in the lower back. Which questions or results indicate the nurse is using divergent thinking during the assessment process?

A) "Tell me about your dietary practices."
B) "Can you tell me on a scale of 1 to 10, with 10 being the worst, how you would rate your pain now?"
C) The nurse notes a cluster of blisters on the patient's scapula.
D) "When was the last time you had a physical?"
E) "Does your eyesight affect your ability to see the insulin you are taking?"

Question 24

While providing care, the nurse stops to assess a new patient problem. What type of assessment is the nurse conducting?

A) Focused
B) Initial
C) Objective
D) Subjective

Question 25

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 should the nurse use at this time?

A) Diagnostic reasoning
B) Evidence-based practice
C) Critical pathway
D) Nursing process

Question 26

The nurse is approached by a patient who offers to provide the nurse with tickets to a sporting event in exchange for free home care for 1 week. The nurse accepts this offer. Which standards did the nurse violate?

A) HIPAA
B) ANA standards
C) Professional boundaries
D) State nurse practice acts
E) Standards pertinent to specific hospital protocols

Question 27

A graduate nurse attends a seminar regarding the role of the nurse as a patient advocate. Which statement 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 28

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) Measure vital signs
D) Provide report to the charge nurse

Question 29

The nurse is identifying nursing diagnoses for a patient's care. In which order should the nurse complete this process? Standard Text: Click and drag the options below to move them up or down.

A) Draw conclusions about the present health status.
B) Determine etiologies and categorize problems.
C) Cluster cues and identify data gaps.
D) Verify the problem or diagnoses.
E) Identify significant cues.
F) none of the above

Question 30

The director of nursing is reviewing situations that require attention. Which situation is an ethical dilemma that might need to be studied by the hospital Ethics Committee?

A) A 20-year-old male patient with an opportunistic disease is HIV positive and does not want to share this information with his sexual partners.
B) The nurse-patient ratio is 5:1 on a medical-surgical care area.
C) A nurse inexperienced with electrocardiogram interpretation was assigned to the telemetry unit to provide care.
D) Nursing staff provide medication to patients after doses are dropped on the floor.

Question 31

The nurse is creating outcome criteria for identified nursing diagnoses for a patient. What characteristics should the nurse include when creating the criteria?

A) Patient-specific, time-specific, and measurable
B) Constructed as nursing goals
C) Structured as statements
D) Focus on psychomotor actions

Question 32

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 33

The nurse is hired to coordinate care in a community health clinic that opened after the implementation of the Affordable Care Act. Which types of care should the nurse expect to provide?

A) Health promotion
B) Disease prevention
C) Chronic disease management
D) Rehabilitation
E) Palliative care

Question 34

The nurse attends interprofessional meetings to discuss the plan of care for a trauma patient who has been transferred to the medical-surgical unit. In what role is this nurse functioning?

A) Caregiver
B) Team leader
C) Delegate
D) Advocate

Question 35

The nurse would like to do a research project that focuses on vending machine choices that patients prefer. What should the nurse question before proceeding with this research study?

A) Is the research valid?
B) Will this promote patient independence?
C) Is this a project that would add value to the hospital experience?
D) Does this research contribute to patient care?

Question 36

The director of nursing is meeting with the hospital administrator to plan an initiative to improve the quality and safety of patient care. After reviewing the Triple Aim approach, which actions should the director recommend?

A) Improve the patient care experience.
B) Improve the health of populations.
C) Reduce the per capita costs of health care.
D) Implement evidence-based practice.
E) Support nursing continuing education plans.

Question 37

A nurse has delegated the collection of vital signs, including blood pressure readings, to two unlicensed assistive personnel. What is the nurse's responsibility for the delegated care?

A) The nurse is accountable for the care that was delegated.
B) The nurse is not responsible for these vital signs.
C) The nurse is not accountable for these vital signs.
D) The nurse is responsible for re-measuring all the vital signs.

Question 38

A seasoned nurse does not want to assist nursing students during clinical rotations and often obstructs the students' learning process. Which standard is this nurse violating?

A) ICN Code of Ethics
B) ANA Standards of Practice
C) ANA Code of Ethics
D) State practice acts

Question 39

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

A) Create an action plan to address any negative findings.
B) Share it with the hospital administrator.
C) Submit it to the agency's accrediting body.
D) Place it in a file to compare with the next set of audits.

Question 40

A patient care issue has been raised about the actions taken by a nurse who provided care to a patient whose healthcare decisions were considered controversial. The unit's nurse manager is concerned that care was not appropriately provided. What 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 41

An interprofessional team is meeting to create a care bundle to prevent the development of contractures in patients with limb paralysis from neurological health problems. Which actions should the committee members include when creating this care bundle?

A) Narrow the patient population in which the bundle will be applied.
B) Define the number and type of range-of-motion exercises to be performed.
C) Identify three interventions proven to reduce the development of contractures.
D) Communicate when the bundle has been completed and ready to for implementation.
E) Emphasize that interventions are recommendations to reduce the incidence of contractures.

Question 42

The nurse is coordinating care for patients within a patient-centered medical home. Which actions should the nurse prepare to complete when functioning in this role?

A) Communicate with the patient after discharge.
B) Monitor the implementation of the plan of care.
C) Manage the accuracy, timeliness, and cost of care.
D) Develop the plan of care with the patient and family.
E) Collaborate with the patient to implement the plan of care.

Question 43

The nurse manager is evaluating the use of evidence-based practice guidelines to guide care on a patient care area. Which observations indicate that these guidelines are being used appropriately?

A) Guidelines are posted on the staff bulletin board in the break room.
B) A guideline was quoted in a narrative note in a patient's medical record.
C) A guideline is placed in the Kardex to support the use of a nursing diagnosis for a patient's health problem.
D) Guidelines are accessed through the clinical documentation system by nurses prior to writing patient care plans.
E) A guideline was referenced prior to implementing skin care interventions for a patient prone to pressure ulcer formation.

Question 44

The nursing instructor is planning activities to help students learn clinical decision making. Which activities should the instructor include to help the students develop foundational knowledge?

A) Time for students to complete a self-assessment tool
B) Access to evidence-based guidelines for assigned patients
C) Expectations for participation in postclinical conferences
D) Office hours and dates when care plans are due for grading
E) Copies of the state practice act and standards of practice