Chapter 01: Aspects of Medical-Surgical Nursing Linton: Medical-Surgical Nursing, 7th Edition MULTIPLE CHOICE 1. What provides direction for individualized care and assures the delivery of accurate, safe care through a definitive pathway that promotes the client’s and the support persons’ progress toward positive outcomes? a. Physician’s orders b. Progress notes c. Nursing care plan d. Client health history ANS: C The nursing care plan provides direction for individualized care and assures the delivery of accurate, safe care through a definitive pathway that promotes the client’s and the support persons’ progress toward positive outcomes. DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: 1 TOP: Nursing Care Plan KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk 2. The nurse is performing behaviors and actions that assist clients and significant others in meeting their needs and the identified outcomes of the plan of care. What is the correct term for these nursing behaviors? a. Assessments b. Interventions c. Planning d. Evaluation ANS: B Caring interventions are those nursing behaviors and actions that assist clients and significant others in meeting their needs and the identified outcomes of the plan of care. DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 TOP: Interventions KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk 3. The nurse understands the importance of being answerable for all actions and the possibility of being called on to explain or justify them. What term best describes this concept? a. Reliability b. Maturity c. Accountability d. Liability ANS: C Accountability means that a person is answerable for his or her actions and may be called on to explain or justify them. DIF: Cognitive Level: Comprehension REF: pp. 6-7 OBJ: 3 | 5 | 7 TOP: Accountability KEY: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity: Reduction of Risk MULTIPLE RESPONSE 1. The nurse manager is providing an inservice about conflict resolution. What modes of conflict resolution should be addressed? (Select all that apply.) a. Suppression b. Accommodation c. Compromise d. Avoidance e. Collaboration f. Competition ANS: B, C, D, E, F The modes of conflict resolution include accommodation, collaboration, compromise, avoidance, and competition. DIF: Cognitive Level: Knowledge REF: p. 7|p. 8|Table 1.1 OBJ: 7 TOP: Conflict Resolution KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. What are the characteristics of an effective leader? (Select all that apply.) a. Effective communication b. Rigid rules and regulations c. Delegates appropriately d. Acts as a role model e. Consistently handles conflict f. Focuses on individual development ANS: A, C, D, E Characteristics of an effective leader include effective communication, consistency in managing conflict, knowledge and competency in all aspects of delivery of care, effective role model for staff, uses participatory approach in decision making, shows appreciation for a job well done, delegates work appropriately, sets objectives and guides staff, displays caring, understanding, and empathy for others, motivates and empowers others, is proactive and flexible, and focuses on team development. DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5 TOP: Leadership KEY: Nursing Process Step: N/A MSC: NCLEX: N/A COMPLETION 1. _________ is defined as the process by which information is exchanged between individuals verbally, nonverbally, and/or in writing or through information technology. ANS: Communication Communication is defined as the process by which information is exchanged between individuals verbally, nonverbally, and/or in writing or through information technology. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 2 TOP: Communication KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. _________ is the collection and processing of relevant data for the purpose of appraising the client’s health status. ANS: Assessment Assessment is the collection and processing of relevant data for the purpose of appraising the client’s health status. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1 | 2 TOP: Assessment KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. _________ is concerned with the ethical questions that arise in the context of health care. ANS: Bioethics Bioethics is concerned with the ethical questions that arise in the context of health care. DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 3 TOP: Bioethics KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. Place the corresponding letter to each stage of conflict in the correct order. _________ (Place the events in the appropriate sequence with capital letters. Do not separate answers with a space or punctuation. Example: ABCD.) a. Outcomes b. Conceptualization c. Frustration d. Action ANS: CBDA The stages of conflict in order are frustration, conceptualization, action, and outcomes. DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 7 TOP: Conflict KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 5. Place the corresponding letter to each key step in solving an ethical dilemma in the correct order. _________ (Place the events in the appropriate sequence. Do not separate answers with a space or punctuation. Example: ABCD.) a. Negotiate a plan. b. Clarify values. c. Ask if it is an ethical dilemma. d. Verbalize the problem. e. Gather information. f. Identify possible courses of action. g. Evaluate the plan over time. ANS: CEBDFAG The key step of solving an ethical dilemma in order are ask the question, is it an ethical dilemma, gather information, clarify values, verbalize the problem, identify possible course of action, negotiate a plan, and evaluate the plan over time. DIF: Cognitive Level: Analysis REF: p. 4 OBJ: 3 TOP: Ethical Dilemma KEY: Nursing Process Step: N/A MSC: NCLEX: N/A Chapter 02: Medical-Surgical Practice Settings Linton: Medical-Surgical Nursing, 7th Edition MULTIPLE CHOICE 1. While a home health nurse is making the entry to a service assessment on a homebound patient, the spouse of the patient asks whether Medicare will cover the patient’s ventilator therapy and insulin injections. What is the best response by the nurse? a. “Yes, Medicare will cover both the ventilator therapy and the insulin injections.” b. “No, Medicare will not cover either of these ongoing therapies.” c. “Medicare will cover the ventilator therapy, but it does not cover the insulin injections.” d. “Medicare will cover the ongoing insulin therapy, but it does not cover a highly technical skill such as ventilator therapy.” ANS: C Medicare will cover skilled nursing tasks such as ventilator therapy, but common tasks that can be taught to the family or the patient are not covered. DIF: Cognitive Level: Application REF: pp. 12-13 OBJ: 3 | 4 TOP: Medicare Coverage for Home Health KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 2. The wife of a patient asks the nurse whether her husband would be considered for placement in a skilled nursing care facility when he is discharged from the general hospital. The patient is incontinent, has mild dementia but is able to ambulate with a walker, and must have help to eat and dress himself. What is the nurse’s most appropriate response? a. “Yes, your husband would qualify for a skilled care facility because of his inability to feed and dress himself.” b. “No, your husband’s disabilities would not qualify him for a skilled facility.” c. “Yes, your husband qualifies for placement in a skilled care facility because of his dementia.” d. “Yes, anyone who is willing to pay can be placed in a skilled nursing facility.” ANS: B Placement in a skilled nursing facility must be authorized by a physician. A clear need for rehabilitation must be evident, or severe deficits in self-care that have a potential for improvement and require the services of a registered nurse, a physical therapist, or a speech therapist must exist. DIF: Cognitive Level: Analysis REF: p. 13 OBJ: 6 TOP: Placement Qualifications for Skilled Nursing Facility KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 3. A nurse has noted that a newly admitted resident to an extended care facility stays in her room, does not take active part in activities, and leaves the meal table after having eaten very little. The nurse should analyze this relocation response as a. regression. b. social withdrawal. c. depersonalization. d. passive aggressive. ANS: B Social withdrawal is a frequent response to relocation. DIF: Cognitive Level: Application REF: p. 21 OBJ: 10 TOP: Relocation Response KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 4. A nurse clarifies to a new patient in a rehabilitation center what rehabilitation means. What statement made by the patient indicates a correct understanding? a. “I will return to my previous level of functioning.” b. “I will be counseled into a new career.” c. “I will develop better coping skills to accept his disability.” d. “I will attain the greatest degree of independence possible.” ANS: D The rehabilitation process works to promote independence at whatever level the patient is capable of achieving. DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: 7 TOP: Rehabilitation Goals KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care 5. A nurse assesses a patient who needs to be reminded to take premeasured oral medications, wash, go to meals, and undress and come to bed at night, but coming and going as he pleases is considered safe for him. What facility placement would be most appropriate for this patient? a. Skilled care b. Intermediate care c. Sheltered housing d. Domiciliary care ANS: D Domiciliary care provides room, board, and supervision, and residents may come and go as they please. Sheltered housing does not provide 24-hour care.