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Test Bank for Medical Surgical Nursing
Preparation for Practice, 1st Edition:
Osborn
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[Osborn] chapter 1
1. The nurse plans care for a patient with the intention of bringing about a positive change. The
nurse is functioning within which of the following roles?
1. Caregiver
2. Advocate
3. Educator
4. Leader
Rationale: In 1988, Jean Watson stated that the necessary conditions for caring to occur are
knowledge and awareness about the need for care, an intention to act, actions based on
knowledge, and a positive change that results from caring. A nurse serving as an advocate
provides education, communicates with other health care team members, and participates in
health policy formulation. The nurse who is functioning in the role of educator focuses on health
promotion and maintenance. A nurse leader ties together the support, collaboration, and
enthusiasm of people to meet specific goals and objectives, whether it is a patient and his family
or an entire organization.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
Cognitive Level: Analyzing
Nursing Process: Planning
Client Need: Safe, Effective Care Environment
LO: 1
2. A patient tells the nurse that he does not understand the surgical procedure the health care
provider told him he needed. Which of the following should the nurse do to advocate for this
patient?
1. Contact the health care provider and ask that the procedure be explained to the patient.
2. Explain the procedure to the patient.
3. Document that the patient does not understand the proposed surgical procedure.
4. Instruct the patient in alternatives to the surgical procedure.
Correct Answer: Contact the health care provider and ask that the procedure be explained to the
patient.
Rationale: As an advocate, the nurse should communicate with other members of the health care
team so that the patient can make an autonomous, informed decision about the surgical procedure.
The nurse should not explain the procedure to the patient. The nurse should not do anything
beyond documenting the patient’s lack of understanding about the procedure. The nurse should not
provide alternatives to the surgical procedure.
3. The nurse is talking with a patient about his new diagnosis of type 2 diabetes and reminds the
patient that he should have an annual dilated retinal eye examination in addition to annual urine
tests to measure protein levels. The nurse is functioning within which of the following roles with
this patient?
1. Educator
2. Researcher
3. Advocate
4. Leader
Rationale: Teaching is a function of nursing practice; the nurse is instructing this patient in health
initiatives included with the diagnosis of type 2 diabetes. As a researcher, the nurse would be
investigating issues of relevance to the practice of nursing. As an advocate, the nurse would help
facilitate the patient’s right to autonomy to make informed decisions regarding care. As a leader,
the nurse would strive to influence the patient to meet a specific goal or objective.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
Cognitive Level: Analyzing
Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
LO: 1
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
4. A patient, seen laughing and talking with visitors, asks the nurse for pain medication. Which
of the following responses would demonstrate the nurse is functioning within the component of
conscious nursing care?
Correct Answer: Provide the medication as requested and according to organizational policies.
Rationale: The component of conscious nursing is defined as possessing a moral sense of what is
right and wrong. The nurse’s conscience serves as a guide to provide minimal or inappropriate
care or provide quality care. The nurse should provide the requested medication according to
organizational policy and not make the patient wait or confront the patient regarding the current
pain level.
5. The nurse manager of a care area asks that a new intravenous-therapy monitoring device not
be used for any patients until the entire staff has received appropriate instruction on its use. The
nurse manager is demonstrating which of the following components of caring?
1. Commitment
2. Conscience
3. Confidence
4. Comportment
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
6. The nurse is concerned about new scheduling changes and the impact on staffing levels. If
applying the component of comportment, in which of the following ways should the nurse
respond?
1. Request to talk about the proposed changes with the nurse manager in a quiet
environment.
2. Discuss the changes with other staff members in the unit hallway.
3. Shake her head and laugh while saying, “Here we go again.”
4. Call a friend in another care area and discuss the changes in the unit station.
Correct Answer: Request to talk about the proposed changes with the nurse manager in a quiet
environment.
Rationale: Comportment means that one is aware of one’s conduct and behavior around others.
The nurse should behave professionally and request to talk about the changes with the nurse
manager in a quiet environment. Talking with others about the changes within earshot of patients
would not demonstrate comportment. Shaking one’s head, laughing, and making snide comments
would not be professional or polite. Calling friends and discussing the changes in the unit station
would not demonstrate comportment.
7. A nurse is assessing the competency of a group of orthopedic care nurses. This nurse is most
likely functioning within which of the following roles of the professional nurse?
1. Nurse educator
2. Acute care
3. Nurse manager
4. Parish nurse
Rationale: The ultimate goal of a nurse educator is to ensure quality patient care by providing
education to patients and nurses and assessing the competency of those who practice. Acute care
nurses practice in the hospital setting. Nurse managers coordinate and ensure the delivery of
quality nursing care in their area of responsibility. Parish nursing concentrates on the population
of a church and the members of the congregation.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
LO: 3
8. A staffing issue and lack of patient care supplies causes a nurse to cancel planned evening
activities and stay on the care area until all issues are resolved. This nurse is most likely
functioning in the role of a(n):
1. Manager.
2. Researcher.
3. Administrator.
4. Educator.
Rationale: The role of the nurse manager is to coordinate and ensure the delivery of quality care
within the area of responsibility. The role includes personnel management and ensuring the
availability of supplies. Nurse managers usually have 24-hour accountability for the area. Nurse
researchers investigate, manage data, and monitor patient responses to care. Nurse administrators
support the organizational goals for patient care. Nurse educators can either teach patients and
staff, direct patient care, or deliver educational content.
9. A nurse with community-health nursing experience provides monthly blood pressure checks
for members of her religious group. This nurse is most likely functioning within which of the
following roles?
1. Parish nurse
2. Occupational health nurse
3. Clinic nurse
4. Gerontologic nurse
Rationale: Parish nursing is a form of community nursing that concentrates on the health care
needs of the church and members of the congregation. Many parish nurse programs provide
preventive health screenings such as blood pressure checks. Occupational health nurses manage
the health of workers and ensure compliance with OSHA standards. Clinic nurses are typically
found in health care provider practices. Gerontologic nurses provide for the physical and
psychosocial needs of the older adult population.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
Client Need: Safe, Effective Care Environment
LO: 3
10. The nurse is providing care to several patients within one smaller section of a larger unit. The
nurse is near the patients’ bedsides and has responsibility for all of the patients’ care needs. This
approach to patient care would be considered:
1. Modular nursing.
2. Functional nursing.
3. Primary nursing.
4. Case method.
Rationale: Modular nursing is a type of team nursing where the nurse is able to be closer to the
patient’s bedside because of structural design. Nurses have a wider range of responsibilities with
this type of nursing. Functional nursing is the assignment of tasks and not individualized care.
Primary nursing is the 24-hour responsibility for planning the care of one or more patients from
admission to discharge. Case method is the oldest model of care where the nurse provides total
care for the patient during the scheduled time on duty.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
11. The nurse is referring to a document that identifies the care a patient is planned to receive
according to specific time frames and reflects the best utilization of resources. The nurse is
functioning within the care delivery model of:
1. Case management.
2. Primary nursing.
3. Functional nursing.
4. Case method.
Rationale: Case management is a delivery system that focuses on the achievement of patient
outcomes within effective and appropriate time frames and resources. Primary nursing is a
delivery system where the nurse has 24-hour accountability for a group of patients, from
admission to discharge. Functional nursing is the assignment of tasks to accomplish patient care.
Case method is the responsibility for patient care while assigned or while on duty.
12. The nurse is working with a group of patients with the same chronic health problem. Care of
these patients is focused on reducing exacerbations of the illness. This nurse is functioning
within the care delivery model of:
1. Disease management.
2. Community-health nursing.
3. Case management.
4. Case method.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
13. The nurse is providing care to a patient of Asian descent. Which of the following behaviors
should this nurse possess to work effectively in a cross-cultural situation?
1. Cultural competence
2. Patience
3. Understanding about the health care system
4. Comprehension
Rationale: The four identified components of cultural competence are cultural awareness,
cultural knowledge, cultural skill, and cultural encounters. It is important for health care
professionals to apply the concepts of cultural competence to the patients they care for. The other
answer choices are qualities of a good nurse, but are not specific to working in a cross-cultural
situation.
14. A patient is admitted to a patient care area. The nurse has never provided care to a patient
from this patient’s culture before and is concerned. Which of the following would be beneficial
to the nurse at this time?
1. Briefly review the patient’s culture and its expectations of health care providers.
2. Locate an interpreter to assist with communication.
3. Approach the care of this patient as with any other patient admitted to the care area.
4. Have another nurse provide care to this patient.
Correct Answer: Briefly review the patient’s culture and its expectations of health care providers.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
15. A nurse of Hispanic descent is assigned to provide care to patients of the same culture. The
patients would benefit because:
Rationale: Cultural competence is achieved when behaviors and attitudes are consistent so
professionals can work together to work effectively in a cross-cultural situation. The patients
would benefit from having a nurse from the same culture because the nurse is competent about
the culture. There is no evidence to support that the nurse will provide expert care. There is no
evidence to support that the nurse will not make any errors. There is no evidence to support that
the nurse will ensure the patients have a timely discharge.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
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caserón del tiempo de los virreyes, con puertas macizas, ventanas de hierros
forjados, patios con enredaderas, en que anidaban las arañas, y un aljibe! ¡Y
convencerle de que edificase un hotelito en el Retiro, cerca del palacio de
los Paz, que representaba entonces para Juana María el tipo de la vivienda
señorial! Al recuerdo de tales luchas, la señora de Alava tenía una sonrisa
fatigada. No, no habían sido inútiles tantos esfuerzos. La visión del trozo de
mesa con el infante, el embajador y el obispo le iluminó interiormente. Pero
al mismo tiempo pensó que su victoria no sería nunca absoluta ni definitiva.
Había en su vida algo irreductible, que le amargaba los momentos más
brillantes, que la mantenía en perpetua zozobra. ¿Qué podía ella en contra
de su padre? Volvió a sentir la vergüenza de aquel almuerzo y recordó con
qué furor contenido ordenó secretamente, antes de salir para Buenos Aires,
la destrucción de la odiosa máquina de afilar.
Sólo al recibir, algunos días después, la noticia de que aquel inanimado
compañero de andanzas de su padre había sido despedazado y aventados
sus restos tuvo conciencia de cuánto y qué antiguo era su aborrecimiento.
CAPITULO V
LA VUELTA AL COLONIAL
CAPITULO VI
Por fin había muerto. Su mucamo, un viejo criado, el único que tenía
derecho a violar el sanctasantórum de su dormitorio, extrañado de que
siguiera durmiendo después de las ocho, entró en la habitación y le halló
arrebujado en las ropas del lecho, todo encogido, en una actitud de momia,
blanco y rígido ya.
Debía de haber muerto pocas horas antes, mientras dormía; pero por la
expresión de su fisonomía hubiérase dicho que era un cadáver muy antiguo
que perdiera desde muchos años atrás todo contacto con el mundo. La
muerte había acentuado en su mascarilla aquel aire de reserva que tuviera
durante toda su vida; la agonía le había hecho apretar aún más sus labios,
subrayando el visaje habitual con que recataba sus sentimientos íntimos.
Don Juan Martín parecía ocultar un secreto. Y en verdad que se llevaba el
secreto de sus fatigas, del heroico esfuerzo de voluntad desplegado durante
medio siglo, de los sufrimientos soportados, de las decepciones aguantadas
noblemente en silencio... ¡Todo perdido, hundido en la nada, anegado en el
misterio, como están perdidos para nosotros los infinitos sufrimientos de las
razas primitivas que en centenares de miles de años fueron elevándose
lentamente sobre el nivel de la animalidad!
El mucamo se cercioró de la muerte. Iba a llamar, a conmover a la casa,
cuando se acordó de la señora y salió, cerrando tras sí suavemente la puerta
del aposento como para no despertar al dormido. Bajó al piso inmediato, y
después de conferenciar con dos doncellas, le hicieron pasar al tocador. De
espaldas, hablándole al espejo, Juana María le preguntó:
—¿Qué pasa, Julián?
Julián dió la noticia:
—Señora, creo que el señor Martín está mal.
—¿Se ha levantado?
—No, señora; todavía no. Me parece que es algo grave. Si la señora
quisiera subir...
—¡Inmediatamente!—contestó Juana María poniéndose de pie.
Las doncellas se precipitaron hacia ella y con una destreza de esclavas
de harén le arreglaron rápidamente el cabello y le ajustaron su ropaje
matinal. Subió presurosa la escalera seguida del mucamo.
Al ver al padre todo blanco y encogido tuvo de inmediato la evidencia de
la verdad. Fué como si le dieran un fuerte golpe en la frente; echó la cabeza
hacia atrás y permaneció un momento atontada. Pero pronto se sobrepuso al
brutal choque. Comenzó a reflexionar: las ideas, las imágenes, los proyectos
desfilaron velozmente por su espíritu. Sentía una especie de vértigo al
pensar tan rápidamente. Se apoyó en el respaldo de una silla y procuró fijar
sus ideas. ¿Qué debía hacer? Como siempre, cuando podía ser necesario,
Alava estaba en la estancia. En el chico no se podía confiar. Ante todo había
que evitar el escándalo. Debía prolongarse la agonía del padre...
Se volvió hacia el mucamo. Pálida, con un temblor en la voz, le dijo:
—Es un síncope.
El sonido de sus propias palabras la reanimó. Recobrando algo de su
capacidad ejecutiva, dijo luego:
—Julián, vaya usted en seguida a buscar al doctor...—vaciló entre dos
nombres, decidiéndose por el médico más anciano—; pero vaya usted
mismo, sin decir nada a nadie, para no alarmar... Yo esperaré aquí...
Al quedarse sola, Juana María dió un vistazo a la habitación: muebles
modestos, viejos, desparejos; la alfombra sucia; ropas en desorden. Todo
con un aspecto sórdido que sobrecogía el corazón. En una pared, el retrato
de la madre: una horrible ampliación al carbón con un grueso marco
dorado.
Esto, más que el cadáver infantilmente encogido en el lecho, la
impresionó hasta el punto de hacerle subir las lágrimas a los ojos. Fué una
impresión que, comenzada en el estómago, ascendió atenazándole la
garganta y obligándole a romper en un sollozo: «¡Dios mío! ¡Qué miseria!»
La doncella de confianza, que, inquieta por su ausencia, subió a ofrecerle
auxilio, la halló en medio de la estancia, anonadada, llorando
silenciosamente las últimas lágrimas de vergüenza que le hacía derramar el
padre...
Cuando Julián volvió con el médico, casi no pudo reconocer la
habitación. Faltaban muchos muebles, se había mudado la alfombra y el
retrato de la madre había desaparecido.
CAPITULO VII
TRANSFIGURACIÓN
CAPITULO VIII
LUTO LIVIANO
CAPITULO IX
EN EL CUAL LA SEÑORA DE ALAVA RECONOCE QUE EL
UNIVERSO ESTÁ PERFECTAMENTE BIEN ORGANIZADO
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