TEST BANK FOR DAVIS ADVANTAGE FOR MEDICAL SURGICAL NURSING MAKING CONNECTIONS TO PRACTICE 2ND EDITION HOFFMANTEST BANK FOR DAVIS ADVANTAGE FOR MEDICAL SURGICAL NURSING MAKING CONNECTIONS TO PRACTICE 2ND EDITION HOFFMAN
Chapter 1: Foundations for Medical-Surgical Nursing
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. 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 control study
2) Quasi-experimental study
3) Case-control study
4) Cohort study
____ 2. The medical-surgical unit recently implemented a patient-centered care model. Which action implemented by
the nurse supports this model?
1) Evaluating care
2) Assessing needs
3) Diagnosing problems
4) Providing compassion
____ 3. 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 upon admission
4) Decreasing the amount of pain medication administered
____ 4. Which interprofessional role does the nurse often assume when providing patient care in an acute care
setting?
1) Social worker
2) Client advocate
3) Care coordinator
4) Massage therapist
____ 5. The medical-surgical nurse wants to determine if a policy change is needed for an identified clinical problem.
Which is the first action the nurse should implement?
1) Developing a question
2) Disseminating the findings
3) Conducting a review of the literature
4) Evaluating outcomes of practice change
____ 6. 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
____ 7. 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
____ 8. 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
____ 9. 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 9 on a 10-point numeric scale.”
3) “The patient has no significant issues in the medical history.”
4) “The patient was given a prescribed opioid analgesic at 0300.”
____ 10. 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 heartrate is 110.”
2) “I think this patient needs to be transferred to the critical care unit.”
3) “The patient is a 68-year-old male patient admitted last night.”
4) “The patient is complaining of chest pain.”
____ 11. 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 prior to implementing discharge instructions
4) Assessing the right drug prior to administering a prescribed patient medication
____ 12. Which type of nursing is the root of all other nursing practice areas?
1) Pediatric nursing
2) Geriatric nursing
3) Medical-surgical nursing
4) Mental health-psychiatric nursing
____ 13. Which did the Nursing Executive Center of The Advisory Board identify as an academic-practice gap for new
graduate nurses?
1) Patient advocacy
2) Patient education
3) Disease pathophysiology
4) Therapeutic communication
____ 14. 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 4 basic steps: assessment, planning, implementation, evaluation.”
4) “The nursing process is being replaced by the implementation of evidence-based practice.”
____ 15. Which is the basis of nursing care practices and protocols?
1) Assessment
2) Evaluation
3) Diagnosis
4) Research
____ 16. Which is a common theme regarding patient dissatisfaction related to care provided in the hospital setting?
1) Space in hospital rooms
2) Medications received to treat pain
3) Time spent with the health-care team
4) Poor quality food received from dietary
____ 17. The nurse manager is preparing a medical-surgical unit for The Joint Commission (TJC) visit With the nurse
manager presenting staff education focusing on TJC benchmarks, which of the following topics would be
most appropriate?
1) Implementation of evidence-based practice
2) Implementation of patient-centered care
3) Implementation of medical asepsis practices
4) Implementation of interprofessional care
____ 18. Which aspect of patient-centered care should the nurse manager evaluate prior to The Joint Commission site
visit for accreditation?
1) Visitation rights
2) Education level of staff
3) Fall prevention protocol
4) Infection control practices
____ 19. 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) Prior to delivering a meal tray
2) Prior to passive range of motion
3) Prior to medication administration
4) Prior to documenting in the medical record
____ 20. 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
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 21. 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 prior to administering a medication.”
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2) “A hand-off is required during change of shift.”
3) “A hand-off is required for a patient 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 prior to family visitation.”
____ 22. 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 prior to administering the medication
3) Holding a medication if the patient’s diagnosis does not support its use
4) Administering the medication two hours after the scheduled time
5) Having another nurse verify the prescribed dose of insulin the patient is to receive
____ 23. The medical-surgical nurse assumes care for a patient who is receiving continuous cardiopulmonary
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
____ 24. 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
____ 25. 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) Effective clinical reasoning
2) Effective communication skills
3) Effective infection control procedures
4) Effective documentation
5) Effective intravenous skills
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Chapter 1: Foundations for Medical-Surgical Nursing
Answer Section
MULTIPLE CHOICE
1. ANS: 1
Chapter number and title: 1, Foundations for Medical Surgical Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 003-004
Heading: Evidence-Based Nursing Care
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
1 Systematic reviews of randomized control studies (Level I) are the highest level of
evidence because they include data from selected studies that randomly assigned
participants to control and experimental groups. The lower the numerical rating of the
level of evidence indicates the highest level of evidence; therefore, this type of study
provides the strongest evidence to support a practice change.
2 Quasi-experimental studies are considered Level III; therefore, this study does not
provide the strongest evidence to support a practice change.
3 Case-control studies are considered Level IV; therefore, this study does not provide the
strongest evidence to support a practice change.
4 Cohort studies are considered Level IV; therefore, this study does not provide the
strongest evidence to support a practice change.
PTS: 1
CON: Evidence-Based Practice
2. ANS: 4
Chapter number and title: 1, Foundations of Medical-Surgical Practice
Chapter learning objective: Explaining the importance of patient-centered care in the management of medicalsurgical
patients
Chapter
page
reference:
004-005
Heading:
Patient-Centered
Care
in
the
Medical-Surgical
Setting
Integrated
Processes:
Caring
Client
Need:
Psychosocial
Integrity
Cognitive
level:
Application
[Applying]
Concept:
Nursing
Roles
Difficulty:
Moderate
Feedback
1 Evaluation is a step in the nursing process; however, this is not an action that supports
the patient-centered care model.
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2 Assessment is a step in the nursing process; however, this is not an action that supports
the patient-centered care model.
3 Diagnosis is a step in the nursing process; however, this is not an action that supports the
patient-centered care model.
4 Compassion is a competency closely associated with patient-centered care; therefore, this
action supports the patient-centered model of care.
PTS: 1
CON: Nursing Roles
3. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety
Education for Nurses (QSEN) competencies
Chapter page reference: 005-006
Heading: Patient Safety Outcomes
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Safety
Difficulty: Moderate
Feedback
1 Safely using alarms is a NPSG identified by TJC. Silencing a cardiorespiratory monitor
is not nursing action that supports this NPSG.
2 Patient identification using two separate resources is a NPSG identified by TJC.
Identifying a patient using only one source does not support this NPSG.
3
Identification of patient safety risks is a NPSG identified by the TJC. Determining
patient safety issues upon admission supports this NPSG.
4 Safe use of medication is a NPSG identified by the TJC. Decreasing the amount of pain
medication administered does not support this NPSG.
PTS: 1
CON: Safety
4. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role and competencies of medical-surgical nursing
Chapter page reference: 006-007
Heading: Interprofessional Collaboration and Communication
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Nursing Roles
Difficulty: Easy
Feedback
1 The nurse does not often assume the interprofessional role of social worker when
providing patient care in an acute care setting.
2 The nurse does not often assume the interprofessional role of client advocate role when
providing patient care in an acute care setting.
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3 The nurse often assumes the interprofessional role of care coordinator when providing
patient care in an acute care setting.
4 The nurse does not often assume the interprofessional role of massage therapist when
providing patient care in an acute care setting.
PTS: 1
CON: Nursing Roles
5. ANS: 1
Chapter number and title: 1, Foundations of Medical-Surgical Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 003
Heading: Box 1.3 Steps of Evidence-Based Practice
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Analysis [Analyzing]
Concept: Evidence-Based Practice
Difficulty: Difficult
Feedback
1 The first step of evidence-based practice is to develop a question based on the clinical
issue.
2 The last step of evidence-based practice is to disseminate findings.
3 The second step of evidence-based practice is to conduct a review of the literature, or
current evidence, available.
4 The fifth step of evidence-based practice is to evaluate the outcomes associated with the
practice change.
PTS: 1
CON: Evidence-Based Practice
6. ANS: 4
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 004
Heading: Box 1.4 Evaluating Levels of Evidence
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
1 The lower the numeric value of the evidence the greater the support for a change in
practice. Level IV evidence does not carry the lowest level of support for a practice
change.
2 The lower the numeric value of the evidence the greater the support for a change in
practice. Level V evidence does not carry the lowest level of support for a practice
change.
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3 The lower the numeric value of the evidence the greater the support for a change in
practice. Level VI evidence does not carry the lowest level of support for a practice
change.
4 The lower the numeric value of the evidence the greater the support for a change in
practice. Level VII evidence carries the lowest level of support for a practice change.
PTS: 1
CON: Evidence-Based Practice
7. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 004
Heading: Box 1.4 Evaluating Levels of Evidence
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Evidence-Based Practice
Difficulty: Moderate
Feedback
1 A systemic review of randomized controlled studies, not a quasi-experimental research
study, is identified as Level I.
2 Evidence from at least one study randomized control study, not a quasi-experimental
research study, is identified as Level II.
3 A quasi-experimental research study is identified as a Level III.
4 Evidence from case-control or cohort studies, not a quasi-experimental research study, is
identified as a Level IV.
PTS: 1
CON: Evidence-Based Practice
8. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 004
Heading: Box 1.4 Evaluating Levels of Evidence
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Evidence-Based Practice
Difficulty: Moderate
Feedback
1 Evidence from case-control or cohort studies, not a single descriptive research study, is
identified as a Level IV.
2 Evidence from systemic reviews of descriptive or qualitative studies, not a single
descriptive research study, is identified as Level V.
3 Evidence from a single descriptive research study is identified as Level VI.
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4 Evidence from expert individual authorities or committees, not a single descriptive
research study, is identified as Level VII.
PTS: 1
CON: Evidence-Based Practice
9. ANS: 1
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role of interprofessional collaboration and teamwork in the
provision of safe, quality patient care
Chapter page reference: 005
Heading: Box 1.6 The SBAR Approach for Effective Communication
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Communication
Difficulty: Moderate
Feedback
1 The “S” reflects the patient’s current situation which is communicated by providing a
brief statement of the issue. This statement by the nurse exemplifies the current situation.
2 The “A” reflects the patient’s assessment data. This statement by the nurse exemplifies
the patent’s assessment data.
3 The “B” reflects the patient’s medical history. This statement by the nurse exemplifies
communicating the patient’s history related to the current problem.
4 The “R” reflects specific actions needed to address the situation. This statement by the
nurse exemplifies the actions implemented to address current level of pain.
PTS: 1
CON: Communication
10. ANS: 4
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role of interprofessional collaboration and teamwork in the
provision of safe, quality patient care
Chapter page reference: 005
Heading: Box 1.6 The SBAR Approach for Effective Communication
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Analysis [Analyzing]
Concept: Communication
Difficulty: Moderate
Feedback
1 This statement is the “A” in the SBAR communication. This is an assessment finding by
the staff nurse.
2 This statement is the “R” in the SBAR communication. This is the recommendation by
the staff nurse.
3 This statement is the “B” in the SBAR communication. This is the background
information.
4 This statement is the “S” in the SBAR communication. This is the situation information.
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PTS: 1
CON: Communication
11. ANS: 4
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety
Education for Nurses (QSEN) competencies
Chapter page reference: 006
Heading: Box 1.8 Quality and Safety Education for Nursing (QSEN) Competencies
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Safety
Difficulty: Moderate
Feedback
1 Advocating for a patient who is in pain exemplifies the QSEN competency of patientcentered
care,
not
safety.
2 Considering the patient’s cultural background exemplifies the QSEN competency of
patient-centered care, not safety.
3 Evaluating the patient’s learning style prior to implementing discharge instructions
exemplifies the QSEN competency of patient-centered care, not safety.
4 Assessing the right drug prior to administering a prescribed medication exemplifies the
QSEN competency of safety.
PTS: 1
CON: Safety
12. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role and competencies of medical-surgical nursing
Chapter page reference: 002
Heading: Introduction
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Knowledge [Remembering]
Concept: Nursing
Difficulty: Easy
Feedback
1 Pediatric nursing is not the root of all nursing practice areas.
2 Geriatric nursing is not the root of all nursing practice areas.
3 Medical-surgical nursing is the root of all nursing practice as care provided here can be
implemented in all other areas of nursing practice.
4 Mental health-psychiatric nursing is not the root of all nursing practice areas.
PTS: 1
CON: Nursing
13. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role and competencies of medical-surgical nursing
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Chapter page reference: 002-003
Heading: Competencies in Medical-Surgical Nursing
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity/Physiological Adaptation
Cognitive level: Knowledge [Remembering]
Concept: Critical Thinking
Difficulty: Easy
Feedback
1 Patient advocacy is not identified as an academic-practice gap for new graduate nurses.
2 Patient education is not identified as an academic-practice gap for new graduate nurses.
3 Knowledge of pathophysiology of patient conditions is identified as an academicpractice
gap
for
new
graduate
nurses.
4 Therapeutic communication is not identified as an academic-practice gap for new
graduate nurses.
PTS: 1
CON: Critical Thinking
14. ANS: 1
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice”
Chapter learning objective: Describing the role and competencies of medical-surgical nursing
Chapter page reference: 003
Heading: Competencies Related to the Nursing Process
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Critical Thinking
Difficulty: Easy
Feedback
1 The nursing process is closely related to the nurse’s decision-making in the clinical
environment. This statement is accurate.
2 The nursing process is not used by all members of the interprofessional team to plan
care.
3 The nursing process has 5, not 4, basic steps: assessment, diagnosis, planning,
implementation, and evaluation.
4 The nursing process is not being replaced by the implementation of evidence-based
practice.
PTS: 1
CON: Critical Thinking
15. ANS: 4
Chapter number and title: 1, Foundations for Medical-Surgical Nursing Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 003-004
Heading: Evidence-Based Nursing Care
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment/Management of Care
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Cognitive level: Knowledge [Remembering]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
1 Assessment is a step in the nursing process; however, this is not the basis for nursing
care practices and protocols.
2 Evaluation is a step in the nursing process; however, this is not the basis for nursing care
practices and protocols.
3 Diagnosis is a step in the nursing process; however, this is not the basis for nursing care
practices and protocols.
4 Evidence that is obtained through research is the basis for nursing care practices and
protocols.
PTS: 1
CON: Evidence-Based Practice
16. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Explaining the importance of patient-centered care in the management of medicalsurgical
patients
Chapter
page
reference:
004-005
Heading:
Patient-Centered
Care
in
the
Medical-Surgical
Setting
Integrated
Processes:
Teaching
and
Learning
Client
Need:
Safe
and
Effective
Care
Environment/Management
of
Care
Cognitive
level:
Knowledge
[Remembering]
Concept:
Communication
Difficulty:
Easy
Feedback
1 Space in each hospital room is not a common theme of patient dissatisfaction.
2 Medications received for pain management is not a common theme of patient
dissatisfaction.
3 A lack of time with members of the health care team is a common theme of patient
dissatisfaction.
4 Poor food quality is not a common theme of patient dissatisfaction.
PTS: 1
CON: Communication
17. ANS: 2
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Explaining the importance of patient-centered care in the management of medicalsurgical
patients
Chapter
page
reference:
004-005
Heading:
Patient-Centered
Care
in
the
Medical-Surgical
Setting
Integrated
Processes:
Teaching
and
Learning
Client
Need:
Safe
and
Effective
Care
Environment/Management
of
Care
Cognitive
level:
Application
[Applying]
Concept:
Quality
Improvement
Difficulty:
Moderate
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Feedback
1
Implementation of evidence-based practice is not the benchmark in which acute care
facilities are evaluated against.
2
Implementation of patient-centered care is the benchmark in which acute care facilities
are evaluated against.
3
Implementation of medical asepsis practices is not the benchmark in which acute care
facilities are evaluated against.
4
Implementation of interprofessional care is not the benchmark in which acute care
facilities are evaluated against.
PTS: 1
CON: Quality Improvement
18. ANS: 1
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Explaining the importance of patient-centered care in the management of medicalsurgical
patients
Chapter
page
reference:
004-005
Heading:
Patient-Centered
Care
in
the
Medical-Surgical
Setting
Integrated
Processes:
Nursing
Process:
Planning
Client
Need:
Safe
and
Effective
Care
Environment/Management
of
Care
Cognitive
level:
Application
[Applying]
Concept:
Quality
Improvement
Difficulty:
Moderate
Feedback
1 Visitation rights should be evaluated prior to a TJC accreditation site visit as this aspect
of patient-centered care is incorporated into the site evaluation.
2 The education level of staff is not evaluated prior to a TJC accreditation visit. This
information should be evaluated for a hospital that is attempting to earn Magnet status.
3 While the fall prevention program will be reviewed during a TJC accreditation site visit
this is not an aspect of patient-centered care.
4 While infection control practices will be reviewed during a TJC accreditation site visit
this is not an aspect of patient-centered care.
PTS: 1
CON: Quality Improvement
19. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Practice
Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety
Education for Nurses (QSEN) competencies
Chapter page reference: 005-006
Heading: Patient Safety Outcomes
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Safety and Infection Control
Cognitive level: Application [Applying]
Concept: Safety
Difficulty: Moderate
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Feedback
1 While the nurse should take care to deliver the meal tray to the correct patient this
circumstance does not require verification of patient identity through two sources.
2 While the nurse should take care to implement passive range of motion on the correct
patient this circumstance does not require verification of patient identity through two
sources.
3 The nurse should identify a patient using two sources prior to medication administration.
4 While the nurse should take care to document patient care in the correct medical record
this circumstance does not require verification of patient identity through two sources.
PTS: 1
CON: Safety
20. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role of interprofessional collaboration and teamwork in the
provision of safe, quality patient care
Chapter page reference: 005-006
Heading: Patient Safety Outcomes
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Communication, Safety
Difficulty: Moderate
Feedback
1 Effective staff communication is essential to safe patient care, especially during handoffs.
Implementation
of
wound
care
is
not
an
example
of
a
hand-off
situation.
2 Effective staff communication is essential to safe patient care, especially during handoffs.
Discharge
to
home
is
not
an
example
of
a
hand-off
situation.
3 Effective staff communication is essential to safe patient care, especially during handoffs.
Patient
transfer
to
another
unit
of
the
hospital
necessitate
a
change
in
who
is
responsible
for
direct
patient
care;
therefore,
this
situation
would
necessitate
the
need
for
SBAR
during
the
hand-off
process.
4 Effective staff communication is essential to safe patient care, especially during handoffs.
Medication
education
is
not
an
example
of
a
hand-off
situation.
PTS: 1
CON: Communication | Safety
MULTIPLE RESPONSE
21. ANS: 2, 3, 4
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role of interprofessional collaboration and teamwork in the
provision of safe, quality patient care
Chapter page reference: 005-006
Heading: Patient Safety Outcomes
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment/Management of Care
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Cognitive level: Analysis [Analyzing]
Concept: Communication
Difficulty: Difficult
Feedback
1.
This is incorrect. Hand-off communication is not required prior to the administration of
medication. The nurse would, however, verify the patient’s identity using two sources.
2.
This is correct. Hand-off communication is required when patient care is transferred from one
provider to another, such as during the change of shift.
3.
This is correct. Hand-off communication is required when patient care is transferred from one
provider to another, such as when a patient is transferred to the surgical suite.
4.
This is correct. Hand-off communication is required when patient care is transferred from one
provider to another, such as anytime the nurse receives a new patient assignment.
5.
This is incorrect. Hand-off communication is not required prior to family visitation.
PTS: 1
CON: Communication
22. ANS: 2, 3, 5
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety
Education for Nurses (QSEN) competencies
Chapter page reference: 005-006
Heading: Patient Safety Outcomes
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Safety and Infection Control
Cognitive level: Application [Applying]
Concept: Safety
Difficulty: Moderate
Feedback
1.
This is incorrect. Interruptions should be minimized during the medication administration
process; therefore, the nurse should not answer the call bell for another patient while
transporting medications for administration.
2.
This is correct. Verification of the right patient is one of the rights of medication administration;
therefore, the nurse would identify the patient using two sources prior to the administration of
medication.
3.
This is correct. The nurse should ensure that the rationale for all medications are associated
with the patient condition; therefore, this action enhances patient safety during medication
administration.
4.
This is incorrect. One of the rights of medication administration is the right time, which
correlates to 30 minutes before or 30 minutes after the scheduled time. This nursing action
would not enhance patient safety during medication administration.
5.
This is correct. Verifying the dose of a high-risk medication, such as insulin, enhances patient
safety during medication administration.
PTS: 1
CON: Safety
23. ANS: 2, 3, 5
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
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Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety
Education for Nurses (QSEN) competencies
Chapter page reference: 005-006
Heading: Patient Safety Outcomes
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Safety and Infection Control
Cognitive level: Analysis [Analyzing]
Concept: Safety
Difficulty: Difficult
Feedback
1.
This is incorrect. Monitor alarms should be audible even during family visitation. Inaudible
alarms may impede patient safety.
2.
This is correct. The nurse should assess the alarm parameters, comparing to the prescribed
settings, at the start of each shift. This action enhanced patient safety.
3.
This is correct. The nurse should respond to all alarms in a timely fashion, which enhances
patient safety.
4.
This is incorrect. Monitor alarms should be audible at all times, even when the patient is asleep
to enhance patient safety.
5.
This is correct. The nurse should adjust alarm parameters based on specific practitioner
prescriptions. This action enhances safety.
PTS: 1
CON: Safety
24. ANS: 1, 2, 4
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role of interprofessional collaboration and teamwork in the
provision of safe, quality patient care
Chapter page reference: 006-007
Heading: Interprofessional Collaboration and Communication
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Collaboration
Difficulty: Moderate
Feedback
1.
This is correct. The physician is a member of the interprofessional team and should be invited
to participate in the care conference.
2.
This is correct. The pharmacist is a member of the interprofessional team and should be invited
to participate in the care conference.
3.
This is incorrect. The unit secretary is not a member of the interprofssional team; therefore,
would not require an invitation to attend the care conference.
4.
This is correct. The social worker is a member of the interprofessional team; therefore, should
be invited to participate in the care conference.
5.
This is incorrect. The home care aide, while a member of the interprofessional team, would not
benefit from attending a care conference while the patient is hospitalized.
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PTS: 1
CON: Collaboration
25. ANS: 1, 2, 4
Chapter number and title: 1, Foundation of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role of interprofessional collaboration and teamwork in the
provision of safe, quality patient care
Chapter page reference: 006-007
Heading: Interprofessional Collaboration and Communication
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Analysis [Analyzing]
Concept: Collaboration
Difficulty: Difficult
Feedback
1.
This is correct. Effective clinical reasoning is a skill required for the nurse to assume the role of
care coordinator.
2.
This is correct. Effective communication is a skill required for the nurse to assume the role of
care coordinator.
3.
This is incorrect. Effective infection control procedures are expected to meet the standard of
care; however, this skill is not required for the nurse to assume the role of care coordinator.
4.
This is correct. Effective documentation, a form of communication, is a skill required for the
nurse to assume the role of care coordinator.
5.
This is incorrect. Effective intravenous skills are not required for the nurse to assume the role of
care coordinator.
PTS: 1
CON: Collaboration
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Chapter 2: Interprofessional Collaboration and Care Coordination
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The home care nurse is planning care for a diabetic patient requiring an extensive dressing change twice a
day, assistance with activities of daily living (ADLs), and comprehensive education. Which role is the nurse
assuming by coordinating the care this patient requires?
1) Collaborator
2) Case manager
3) Health educator
4) Health promoter
____ 2. The nurse is discussing follow-up care with a patient who is being discharged. The patient and family cross
their arms and state angrily that the team's suggestions are not acceptable. Which response by the nurse is
appropriate?
1) “We only want what's best for you.”
2) “We will leave you alone to discuss your options.”
3) “Perhaps you did not understand the recommendations.”
4) “Let's discuss other options that might work well for you and your family.”
____ 3. The nurse is preparing a patient for discharge who will be requiring physical therapy (PT) to rehabilitate after
a total knee replacement. After reading the health-care provider’s order for PT, which would be the nurse's
initial action?
1) Teach the family the exercises needed for the patient.
2) Call home health and schedule a therapist to visit the home for therapy.
3) Set up appointments according to the order with the hospital PT department.
4) Discuss the various types of settings for therapy and have the patient choose the venue.
____ 4. The nurse is caring for a patient with rheumatoid arthritis who expresses the desire to remain active as long as
possible. In order for the patient to meet this goal, what should the nurse prepare to do?
1) Tell the patient there is no hope.
2) Ask the patient the reason for the decision.
3) Teach the patient nutrition and joint exercises.
4) Refer the patient to the appropriate professionals.
____ 5. A nurse is working as the designated leader of a group of health-care providers in a community clinic setting.
The team members are working to decrease the number of adolescent pregnancies in the community. They
have defined the problem and are now focusing on objectives and considering various viewpoints presented
by the group. The nurse is tasked with helping the team to stay focused in order to address the defined
problem. Which competency of collaboration does this describe?
1) Trust
2) Mutual respect
3) Communication
4) Decision making
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____ 6. The nurse managers in a community hospital have been charged with reviewing job descriptions of unlicensed
assistive personnel (UAPs) and have questions about the delegation of certain patient care activities to UAPs
by nurses. To which group, organization, or individual would committee members direct their questions to
obtain definitive answers about the parameters of nurse delegation to UAPs?
1) The state board of nursing
2) The American Nurses Association
3) The hospital's Chief Nursing Officer
4) The hospital's Chief Executive Officer
____ 7. Which statement is a primary and historical barrier to effective nurse-physician collaboration that has
persisted over time?
1) The view among the general population that nurses’ contributions to patients’ care is less
important to their health and well-being compared to the contribution of physicians
2) The nurses’ and physicians’ perceptions of inequity in their roles, with nurses assuming a
subservient role and physicians assuming leadership and superior role in health-care
settings
3) A general lack of education provided in schools for health professionals about the benefits
on health-care quality linked
4) A lack of published evidence about the effectiveness of collaborative efforts among and
between nurses and physicians to nurse-physician collaboration
____ 8. A patient with Type 1 diabetes mellitus has developed an open sore on the shin and is having trouble meeting
daily goals for exercising. The patient is scheduled for discharge in a couple of days. When planning for this
patient’s continued care, who will the nurse notify regarding the patient’s needs after discharge?
1) The pharmacy
2) The case manager
3) The physical therapist
4) The occupational therapist
____ 9. A patient who is recovering from coronary bypass surgery is placed on a critical pathway for extended care.
Which patient statement indicates appropriate understanding of the plan of care?
1) “I cannot alter the critical pathway plan.”
2) “I must be able to meet goals that are set for me.”
3) “My insurance plan can deny payment if I do not meet goals.”
4) “The chosen critical pathway can be altered to meet my needs.”
____ 10. The case manager interviews an older adult patient hospitalized after hip replacement surgery. The patient
requires in-patient rehabilitation prior to being discharged home. The case manager works with the hospital
nursing staff, the rehabilitation center, the patient’s family members, and other care providers to assist with a
smooth transition. Which is the primary goal of the care management model described here?
1) To provide greater peace of mind for the patient and his or her family members
2) To track a patient’s progress to ensure that appropriate care is provided until discharge
3) To manage concerns that are related to the patient’s medical care and treatment regimen
only
4) To provide a continuum of clinical services in order to help contain costs and improve
patient outcomes
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____ 11. The patient’s case manager, diabetes educator, and dietician meet to discuss the patient’s needs in preparation
for discharge to home. The patient’s primary health-care provider arrives and states, “I will be making all
decisions regarding the patient’s discharge care.” With the primary health-care provider’s decision to lead the
team, the dynamic has shifted between which two types of teams?
1) Intradisciplinary to interdisciplinary team
2) Multidisciplinary to intradisciplinary team
3) Interprofessional to interdisciplinary team
4) Interdisciplinary to multidisciplinary team
____ 12. A school-age patient is admitted to the pediatric intensive care unit (PICU), unconscious and with multiple
traumatic injuries, after a skateboard accident that included a closed head injury. Many health professionals
are involved in the patient’s care and the scene is chaotic. The parents are extremely anxious and want to
know what is happening. The case manager asks for an interdisciplinary team meeting to speak with the
patient’s parents. Which is the rationale for this meeting?
1) To allow for each specialty to practice independently
2) To share and evaluate information for care planning and implementation, and prevent
priority conflicts, redundancy, and omissions in care
3) To all the primary health-care provider to make all the decision regarding the patient’s care
4) To prevent the parents from trying to change the plan of care
____ 13. The Chief Nursing Officer and Chief Medical Officer in an urban teaching hospital are leading a series of
meetings with nurses, physicians, hospital lawyers, and risk managers to review and update hospital
privileging procedures and requirements for advanced practice RNs and physicians new to the hospital. This
is an example of which type of collaborative team?
1) Intradisciplinary
2) Interdisciplinary
3) Multidisciplinary
4) Complementary
____ 14. A local hospital formed a neurotrauma (NT) team with the following members: acute care nurses, physicians,
other care partners (e.g., physical therapists, social workers, case managers, dieticians), and representatives
from the NT outpatient clinic. This team is led by a physician who makes treatment decisions based on the
treatment plans developed by individual team members who each communicate with the patients, asking the
same or similar questions to obtain data needed for their treatment plan. Which type of communication and
action is represented in the scenario described?
1) Parallel communication
2) Parallel functioning
3) Information exchange
4) Coordination and consultation
____ 15. The nurse is caring for a patient who is reporting pain of 8/10 on a 1 to 10 numeric pain scale. The nurse
administers the prescribed pain medication. When the nurse re-evaluates the patient one hour later, the patient
is still reporting pain of 8/10. Which action by the nurse is appropriate at this time?
1) Wait for the health-care provider to make rounds to report the problem.
2) Report to the health-care provider by telephone.
3) Increase the dosage of the medication.
4) Include in the nursing report that the medication is ineffective.
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____ 16. Handoff communication, the transfer of information during transitions in care such as during change-of-shift
report, includes an opportunity to ask questions, clarify, and confirm the information between sender and
receiver. Which is the main objective for ensuring effective communication during a patient handoff?
1) To avoid lawsuits
2) To ensure patient safety
3) To facilitate quality improvement
4) To make sure all documentation is done
____ 17. The nurse is providing care to a patient diagnosed with end-stage renal disease. When planning a care plan
conference for this patient, who does the nurse invite to participate?
1) The oncologist
2) The psychiatrist
3) The hospital CEO
4) The family members
____ 18. Which should be the focus of an educational session for nurses and other members of the interdisciplinary
team when addressing high rates of patient readmission to the health system?
1) Medication errors
2) Coordination of care
3) Adverse clinical events
4) Roles of each member providing care
____ 19. Which patient population should the nurse focus on to increase access to care that is coordinated, safe, and
focused on the patient’s unique needs across all care settings?
1) Pediatric patients
2) Older adult patients
3) Young adult patients
4) Acute needs patients
____ 20. Which is a basic principle of the Patient Protection and Affordable Care Act of 2010 that the nurse should
include in a teaching session for members of the health-care team?
1) Decreased access
2) Decreased cost of care
3) Decreased quality of care
4) Decreased safety
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 21. The hospital’s nurse case manager has been extensively involved with a shooting victim and members of the
patient’s family in coordinating care of providers from many disciplines as the patient progressed from the
emergency department (ED) to the intensive care unit (ICU), and then onto the medical-surgical unit. After
three weeks of hospitalization, the case manager is helping to prepare the patient for discharge to a
rehabilitation center where treatment will continue. Which outcomes have been documented in the literature
as benefits of such collaboration? Select all that apply.
1) Improved patient outcomes
2) Decreased duplication of health-care services
3) Increased overall cost of health-care services
4) Decreased patient morbidity and mortality
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5) Decreased level of job satisfaction
____ 22. The case manager assembles a team of health-care professionals, including the patient’s primary health-care
provider, physical therapist, and social worker, for the purpose of collaborative discharge planning and
decision making. Which type of team did the case manager assemble? Select all that apply.
1) Management
2) Intradisciplinary
3) Interdisciplinary
4) Interprofessional
5) Primary nursing care
____ 23. The nurse is preparing to document care provided to the patient during the day shift. The nurse documents
that the patient experienced an increased pain level while ambulating which required an extra dose of pain
medication; took a shower; visited with family; and ate a small lunch. Which information is important to
include during the oral end-of-shift reporting? Select all that apply.
1) The last antibiotics given
2) The patient’s taking a shower
3) The patient’s visit with family
4) The extra dose of pain medication
5) The patient’s response to ambulation
____ 24. When the nurse receives a telephone order from the health-care provider's office, which guidelines are used to
ensure the order is correct? Select all that apply.
1) Ask the prescriber to speak slowly.
2) Read the order back to the prescriber.
3) Know agency policy for telephone orders.
4) Sign the prescriber’s name and credentials.
5) Ask the prescriber to repeat or spell out medication.
____ 25. When discussing the importance of interprofessional collaboration, which advantages should the nurse
include? Select all that apply.
1) Improved team member satisfaction
2) Increased division among team members
3) Increased safety with medication administration
4) Enhanced communication among team members
5) Increased patient satisfaction with discharge transition process
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Chapter 2: Interprofessional Collaboration and Care Coordination
Answer Section
MULTIPLE CHOICE
1. ANS: 2
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Exploring the role of the registered nurse in patient-centered transitional care
programs
Chapter page reference: 017
Heading: Case Manager
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Collaboration
Difficulty: Easy
Feedback
1 Collaboration means a collegial working relationship with other health-care providers to
supply patient care. Collaborative practice requires the discussion of diagnoses and
management in the delivery of care.
2 Case management involves one or more individuals overseeing the needs and
requirements of a particular individual's health.
3 Health promotion activities include disease prevention and healthy lifestyle
interventions. Health education would be included in this particular situation, but
collaboration is a more inclusive definition of what is occurring with these individuals
and the care they require.
4 Health promotion activities include disease prevention and healthy lifestyle
interventions. Health education would be included in this particular situation, but
collaboration is a more inclusive definition of what is occurring with these individuals
and the care they require.
PTS: 1
CON: Collaboration
2. ANS: 4
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Defining interprofessional collaboration in the health-care setting
Chapter page reference: 010-011
Heading: The Care Transitions Program
Integrated Processes: Communication and Documentation
Client Need: Psychosocial Integrity
Cognitive level: Application [Applying]
Concept: Communication
Difficulty: Moderate
Feedback
1 Telling the patient that the doctor only wants what is best sends the message that the
patient does not know what is best, when, in fact, a well-informed patient does know
what is best and should be able to make the correct choice.
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2 By leaving the room, the nurse and doctor have turned their backs on the patient.
3 The patient may not understand the recommendations, but pointing that out can be seen
as demeaning.
4 The patient is the center of the team, and the goal is to facilitate healing. There are
always other options to consider to reach that goal. The nurse would discuss other
options with the patient, which will most likely increase cooperation by the patient, who
will feel in control as the decision is made.
PTS: 1
CON: Communication
3. ANS: 4
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Exploring the role of the registered nurse in patient-centered transitional care
programs
Chapter page reference: 011
Heading: The Care Transitions Program
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Application [Applying]
Concept: Collaboration
Difficulty: Moderate
Feedback
1 The therapy that the patient requires must be performed by a professional physical
therapist. To teach the family exercises encroaches upon the expertise of the professional
who will be performing the service.
2 Scheduling home PT is leaving the patient out of the decision-making process.
3 The nurse would not refer the patient for outpatient therapy unless the patient requests
that form of therapy.
4 The nurse best exhibits the characteristic that the patient has a right to self-determination
by presenting the methods available for PT and answering the patient's questions about
each so the patient can make an informed decision.
PTS: 1
CON: Collaboration
4. ANS: 4
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Identifying the roles of health-care professionals coordinating care for patients
Chapter page reference: 015-019
Heading: Providers
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Analysis [Analyzing]
Concept: Collaboration
Difficulty: Hard
Feedback
1 The patient with a chronic disease should not be told there is no hope but should be
helped toward reaching desired goals.
2 Asking the patient the reason for the decision is irrelevant to the situation.
3 The nurse can teach some nutrition and exercise but cannot go into the depth that this
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patient would need.
4 The number of patients with chronic diseases with health-care needs is increasing
rapidly, and nurses and primary health-care providers cannot meet all of these patients’
needs. When a patient expresses the desire to live as normally as possible, the nurse
should refer the patient to professionals who can help the patient meet that goal.
PTS: 1
CON: Collaboration
5. ANS: 4
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Defining interprofessional collaboration in the health-care setting
Chapter page reference: 013-015
Heading: Interprofessional Collaboration
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Collaboration
Difficulty: Easy
Feedback
1 Trust occurs when an individual is confident in the actions of another individual. Both
mutual respect and trust imply mutual process and outcome and may be expressed
verbally or nonverbally.
2 Mutual respect occurs when two or more people show or feel honor or esteem toward
one another.
3 Communication is necessary in effective collaboration; it occurs only if the involved
parties are committed to understanding each other's professional roles and appreciating
each other as individuals.
4 Decision making involves shared responsibility for the outcome. The team must follow
specific steps of the decision-making process, beginning with a clear definition of the
problem. Team decision making must be directed at the objectives of the effort and
requires full consideration and respect for various and diverse viewpoints, and often
requires guidance and direction from a group leader.
PTS: 1
CON: Collaboration
6. ANS: 1
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Identifying the roles of health-care professionals coordinating care for patients
Chapter page reference: 014-015
Heading: Interprofessional Education
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Legal
Difficulty: Easy
Feedback
1 Parameters for the delegation of patient care tasks by nurses to UAPs are established by
each state's board of nursing.
2 This organization does not provide definitive answers regarding tasks that nurses can
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delegate to UAPs.
3 This individual does not provide definitive answers regarding tasks that nurses can
delegate to UAPs.
4 This individual does not provide definitive answers regarding tasks that nurses can
delegate to UAPs.
PTS: 1
CON: Legal
7. ANS: 2
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Defining interprofessional collaboration in the health-care setting
Chapter page reference: 013-015
Heading: Interprofessional Collaboration
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Collaboration
Difficulty: Easy
Feedback
1 Evidence does not suggest that the general population views nurses’ contributions to the
care of patients as less important, thus this is not considered a primary barrier to nursephysician
collaboration.
2 A primary and historical barrier to effective nurse-physician collaboration has been
nurses’ and physicians’ perceptions of inequity in their roles, with nurses assuming a
subservient role and medical providers perceiving their role to be superior in the
provision of health-care services.
3 Likewise, because health professional students are in fact educated about the benefits of
collaborative practice and published evidence has documented the effectiveness of
collaboration in improving patient outcomes, these are not barriers to collaboration.
4
In addition, the federal government, as evidenced in particular by the Healthy People
initiative, has promoted collaborative efforts among patients, nurses, physicians, other
health-care providers, and the larger community to improve the health of the U.S.
population.
PTS: 1
CON: Collaboration
8. ANS: 2
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Identifying the roles of health-care professionals coordinating care for patients
Chapter page reference: 017-018
Heading: Case Manager
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Application [Applying]
Concept: Collaboration
Difficulty: Moderate
Feedback
1 The pharmacy is not needed as part of the team at this time.
2 The patient’s needs and progress have changed. The nurse notifies the case manager to
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coordinate changes in care needed after discharge. This patient’s exercise program needs
to be revamped, and the case manager is the individual to coordinate this change.
3 A physical therapist may be needed, but the nurse would coordinate care best by
notifying the case manager.
4 The occupational therapist mainly deals with the upper body areas needing rehabilitation.
PTS: 1
CON: Collaboration
9. ANS: 4
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Exploring unique patient situations requiring or enhanced by interprofessional
collaboration
Chapter page reference: 019-020
Heading: Unique Patient Situations Requiring or Enhanced by Interprofessional Collaboration
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Analysis [Analyzing]
Concept: Management
Difficulty: Difficult
Feedback
1 The patient is included in the discussion of meeting goals.
2 The case manager monitors and works with the patient to alter the pathway as needed
during the recovery process.
3
It is possible to have variances in a critical pathway that, if documented properly, should
be paid for by insurance.
4 Care maps, or critical pathways, are flexible enough to be adjusted and tailored to the
patient's needs and wishes.
PTS: 1
CON: Management
10. ANS: 4
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Describing models of transitional care
Chapter page reference: 010-012
Heading: Evidence-Based Models of Transitional Care
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehensive [Understanding]
Concept: Management
Difficulty: Easy
Feedback
1 Although the involvement of case managers in care typically provides greater peace of
mind for patients and family members, this is not the primary goal of this service.
2 Toward this end, case managers not only with help to coordinate care and treatment
during hospitalization, but also assist with planning for care following discharge.
3 Their focus includes not only medical care, but issues related to health promotion and
disease prevention, the cost of health care received, and planning for the efficient use of
resources.
4 Case managers coordinate patient care to help ensure that a continuum of clinical
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services is provided. The goal of case management is to improve patient outcomes and to
help contain costs.
PTS: 1
CON: Management
11. ANS: 4
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Describing models of transitional care
Chapter page reference: 010-011
Heading: The Transitional Care Model
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Collaboration
Difficulty: Easy
Feedback
1
Intradisciplinary teams include members of the same profession. Interdisciplinary teams
include professionals of varied backgrounds who share in decision making.
2 Multidisciplinary teams include members of varied backgrounds, but treatment decisions
are made by one member–usually the primary health-care provider. Intradisciplinary
teams include members of the same profession.
3 The term interprofessional team is synonymous with interdisciplinary team.
4
Interdisciplinary teams include professionals of varied backgrounds who share in
decision making. Multidisciplinary teams include members of varied backgrounds, but
treatment decisions are made by one member–usually the primary health-care provider.
PTS: 1
CON: Collaboration
12. ANS: 2
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Exploring unique patient situations requiring or enhanced by interprofessional
collaboration
Chapter page reference: 019-020
Heading: Unique Patient Situations Requiring or Enhanced by Interprofessional Collaboration
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Collaboration
Difficulty: Easy
Feedback
1
Interdisciplinary collaboration engages each professional’s contribution to joint care
planning, implementation, and accomplishment of patient goals, with possibly less
redundancy, more efficiency, and fewer care omissions. The parents of a minor child
should be involved in all aspects of care and decision making.
2
Interdisciplinary collaboration engages each professional’s contribution to joint care
planning, implementation, and accomplishment of patient goals, with possibly less
redundancy, more efficiency, and fewer care omissions. The parents of a minor child
should be involved in all aspects of care and decision making.
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3
Interdisciplinary collaboration engages each professional’s contribution to joint care
planning, implementation, and accomplishment of patient goals, with possibly less
redundancy, more efficiency, and fewer care omissions. The parents of a minor child
should be involved in all aspects of care and decision making.
4
Interdisciplinary collaboration engages each professional’s contribution to joint care
planning, implementation, and accomplishment of patient goals, with possibly less
redundancy, more efficiency, and fewer care omissions. The parents of a minor child
should be involved in all aspects of care and decision making.
PTS: 1
CON: Collaboration
13. ANS: 2
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Describing models of transitional care
Chapter page reference: 010-011
Heading: The Transitional Care Model
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Collaboration
Difficulty: Easy
Feedback
1
Intradisciplinary teams comprise members of the same profession working to achieve a
common goal.
2 A team comprising members from different disciplines that is focused on achieving a
common goal is an interdisciplinary team. Their varying professional backgrounds helps
to ensure that other perspectives are represented as the issue is considered.
3 Multidisciplinary teams are more commonly teams whose members work more
autonomously toward the common goal.
4 Complementary is not a type of team, although team members’ efforts can be
complementary and provide a broader perspective of issues.
PTS: 1
CON: Collaboration
14. ANS: 1
Chapter number and title: 2, Interprofessional Collaboration and Care Coordination
Chapter learning objective: Defining interprofessional collaboration in the health-care setting
Chapter page reference: 013-014
Heading: Interprofessional Communication
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment – Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Communication
Difficulty: Easy
Feedback
1 The type of communication and action used by this health-care team is parallel
communication. It is at the lowest level along the continuum of communication and
collaboration among health team members and is characterized by each professional
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