Lewis: Medical Surgical Nursing in Canada Test Bank Chapter 1: Nursing Practice in Canada

MULTIPLE CHOICE 1. The nurse explains to the client that together they will plan the clients care and set goals to achieve by discharge. The client asks how this differs from what the physician does. Which of the following statements best describes the difference between the roles of nursing and medicine in planning the clients care and setting goals to achieve discharge? 1. Medicine cures; nursing cares. 2. Nurses assist physicians to diagnose and treat clients with health care problems. 3. There is very little role difference between medicine and nursing; nurses perform many of the procedures done by physicians. 4. Medicine focuses on diagnosis and treatment of the health problem; nursing focuses on diagnosis and treatment of the clients response to the health problem. ANS: 4 PTS: 1 REF: Text Reference: p. 2 DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation

2. A woman with hypertension is concerned that if she sees the nurse practitioner (an advanced practice nurse) she will not be able to get new prescriptions for her blood pressure medication. What should the nurse tell the client regarding the nurse practitioners scope of practice as it relates to prescriptions? 1. They have the same role and scope of practice as physicians. 2. They can prescribe drugs if they are directly supervised by physicians. 3. They can write prescriptions as established by guidelines at the practice setting. 4. They can only prescribe drugs reimbursed by a supplemental drug plan. ANS: 3 PTS: 1 REF: Text Reference: p. 3 3. 1. 2. 3. 4. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation

What does the nurse use when providing client care using evidence-based practice? Clinical judgement based on experience The application of the findings of a clinical research study A clinical practice guideline coupled with clinical expertise Observation of the evidence that client outcomes have been met DIF: Cognitive Level: Comprehension TOP: Nursing Process: Planning

ANS: 3 PTS: 1 REF: Text Reference: p. 4

4. How does the nurse primarily use the nursing process in the care of clients? 1. As a scientific-based process of diagnosing the clients health care problems 2. To establish nursing theory that incorporates the biopsychosocial nature of humans

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2 3. To promote the management of client care in collaboration with other health care professionals 4. As a tool to organize the nurses thinking and clinical decision making about the clients health care needs ANS: 4 PTS: 1 REF: Text Reference: p. 6 DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation

5. An elderly, emaciated client is admitted to the intensive care unit (ICU). The nurse plans a q2h turning schedule to prevent skin breakdown. What type of nursing action is this considered to be? 1. Dependent 3. Independent 2. Cooperative 4. Collaborative ANS: 4 PTS: 1 REF: Text Reference: pp. 910 DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

6. A single mother undergoes gallbladder surgery. She tells the nurse on admission that she is uneasy about being in the hospital and leaving her two preschool children with a neighbour. During the assessment of the client, what is an appropriate nursing action by the nurse? 1. Reassure the client that her children are fine. 2. Call the neighbour to determine whether she is an adequate care provider. 3. Have the client call the children to reassure herself that they are doing well. 4. Gather more data about the clients feelings about the child care arrangements. ANS: 4 PTS: 1 REF: Text Reference: p. 8 DIF: Cognitive Level: Application TOP: Nursing Process: Assessment

7. A client with a stroke is paralyzed on the left side of the body and is not responsive enough to turn or move independently in bed. A pressure ulcer has developed on the clients left hip. What is an appropriate nursing diagnosis for this problem? 1. Impaired physical mobility related to paralysis 2. Impaired skin integrity related to altered circulation and pressure 3. Risk for impaired tissue integrity related to impaired physical mobility 4. Ineffective tissue perfusion related to inability to turn and move self in bed ANS: 2 PTS: 1 REF: Text Reference: pp. 89 DIF: Cognitive Level: Application TOP: Nursing Process: Diagnosis

8. A client with an infection has a nursing diagnosis of fluid volume deficit related to excessive diaphoresis. What is an appropriate client outcome identified by the nurse? 1. Client has a balanced intake and output 2. Client understands the need for increased fluid intake 3. Clients bedding is changed when it becomes damp 4. Clients skin remains cool and dry throughout hospitalization ANS: 1 PTS: 1 REF: Text Reference: pp. 6, 1213 DIF: Cognitive Level: Application TOP: Nursing Process: Planning

Test Bank

9. A client has a nursing diagnosis activity intolerance related to prolonged bed rest as manifested by the clients report of weakness and fatigue. What is an appropriate Nursing Outcomes Classification (NOC) outcome and Nursing Interventions Classification (NIC) intervention for this nursing diagnosis? 1. Activity Tolerance (NOC) and Activity Therapy (NIC) 2. Endurance (NOC) and Body Mechanics Promotion (NIC) 3. Energy Conservation (NOC) and Sleep Enhancement (NIC) 4. Energy Conservation (NOC) and Exercise Therapy: Balance (NIC) ANS: 1 PTS: 1 REF: Text Reference: pp. 6, 1213 DIF: Cognitive Level: Analysis TOP: Nursing Process: Planning

10. The nurse reads on the care plan that a client is at risk for developing an infection. What does the nurse recognize about this clients problem? 1. It is always a nursing diagnosis. 2. It is always a collaborative problem. 3. It may be either a nursing diagnosis or a collaborative problem, depending on the etiology. 4. It should not be addressed as a special problem because all nursing measures should protect clients from infection. ANS: 3 PTS: 1 REF: Text Reference: pp. 910 DIF: Cognitive Level: Comprehension TOP: Nursing Process: Diagnosis

11. Which of the following nursing activities is carried out during the evaluation phase of the nursing process? 1. Documenting the nursing care plan in the progress notes 2. Evaluating whether the clients health problems have been alleviated 3. Asking the client whether the nursing care provided was satisfactory 4. Determining the effectiveness of nursing actions toward meeting client outcomes ANS: 4 PTS: 1 REF: Text Reference: pp. 1112, 16 12. 1. 2. 3. 4. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Evaluation

What does the nurse do during the assessment phase of the nursing process? Obtains data with which to diagnose client problems Teaches interventions to relieve client health problems Evaluates the outcomes of the care that has been provided Helps the client identify realistic outcomes to health problems DIF: Cognitive Level: Knowledge TOP: Nursing Process: Assessment

ANS: 1 PTS: 1 REF: Text Reference: p. 6

13. Which of the following is an example of a correctly written nursing diagnosis statement? 1. Altered tissue perfusion related to congestive heart failure 2. Ineffective coping related to response to positive biopsy test results

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4 3. Altered urinary elimination related to urinary tract infection 4. Risk for impaired tissue integrity related to clients refusal to turn ANS: 2 PTS: 1 REF: Text Reference: pp. 78 14. 1. 2. 3. 4. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Diagnosis

What should a complete nursing diagnosis statement include? A problem, its cause, and objective data that support the problem A problem with all of its possible causes and the planned interventions A projected or possible problem that could occur, with rationales for the diagnosis A problem, its etiology, and the signs and symptoms that define the diagnosis DIF: Cognitive Level: Knowledge TOP: Nursing Process: Diagnosis

ANS: 4 PTS: 1 REF: Text Reference: pp. 89