13 edition of Brunner & Suddarth's Textbook of Medical Surgical Nursing Test Bank by Hinkle

13 edition of Brunner & Suddarth’s Textbook of Medical Surgical Nursing Test Bank by Hinkle


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13 edition of Brunner & Suddarth’s Textbook of Medical Surgical Nursing Test Bank by Hinkle

sample chapter 1  

Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice

  1. The public health nurse is presenting a health promotion class to a group of new mothers. How should

the nurse best define health?

  1. A) Health is being disease free.
  2. B) Health is having fulfillment in all domains of life.
  3. C) Health is having psychological and physiological harmony.
  4. D) Health is being connected in body, mind, and spirit.

Ans: D


The World Health Organization (WHO) defines health in the preamble to its constitution as a state of

complete physical, mental, and social well-being and not merely the absence of disease and infirmity.

The other answers are incorrect because they are not congruent with the WHO definition of health.

  1. A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What is

one characteristic the nurse would cite as necessary to possess to be an effective nurse?

  1. A) Sensitivity to cultural differences
  2. B) Team-focused approach to problem-solving
  3. C) Strict adherence to routine
  4. D) Ability to face criticism

Ans: A


To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must be

culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing and strict

adherence to routine are not characteristics needed to be an effective nurse. The ability to handle

criticism is important, but to a lesser degree than cultural competence.

  1. With increases in longevity, people have had to become more knowledgeable about their health and the

professional health care that they receive. One outcome of this phenomenon is the development of

organized self-care education programs. Which of the following do these programs prioritize?

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 3

  1. A) Adequate prenatal care
  2. B) Government advocacy and lobbying
  3. C) Judicious use of online communities
  4. D) Management of illness

Ans: D


Organized self-care education programs emphasize health promotion, disease prevention, management

of illness, self-care, and judicious use of the professional health care system. Prenatal care, lobbying, and

Internet activities are secondary.

  1. The home health nurse is assisting a patient and his family in planning the patients return to work after

surgery and the development of postsurgical complications. The nurse is preparing a plan of care that

addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the

patients need for self-fulfillment relate?

  1. A) Physiologic
  2. B) Transcendence
  3. C) Love and belonging
  4. D) Self-actualization

Ans: D


Maslows highest level of human needs is self-actualization, which includes self-fulfillment, desire to

know and understand, and aesthetic needs. The other answers are incorrect because self-fulfillment does

not relate directly to them.

  1. The view that health and illness are not static states but that they exist on a continuum is central to

professional health care systems. When planning care, this view aids the nurse in appreciating which of

the following?

  1. A) Care should focus primarily on the treatment of disease.
  2. B) A persons state of health is ever-changing.

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 4

  1. C) A person can transition from health to illness rapidly.
  2. D) Care should focus on the patients compliance with interventions.

Ans: B


By viewing health and illness on a continuum, it is possible to consider a person as being neither

completely healthy nor completely ill. Instead, a persons state of health is ever-changing and has the

potential to range from high-level wellness to extremely poor health and imminent death. The other

answers are incorrect because patient care should not focus just on the treatment of disease. Rapid

declines in health and compliance with treatment are not key to this view of health.

  1. A group of nursing students are participating in a community health clinic. When providing care in this

context, what should the students teach participants about disease prevention?

  1. A) It is best achieved through attending self-help groups.
  2. B) It is best achieved by reducing psychological stress.
  3. C) It is best achieved by being an active participant in the community.
  4. D) It is best achieved by exhibiting behaviors that promote health.

Ans: D


Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Health is seen

as resulting from a lifestyle oriented toward wellness. Nurses in community health clinics do not teach

that disease prevention is best achieved through attending self-help groups, by reducing stress, or by

being an active participant in the community, though each of these activities is consistent with a healthy


  1. A nurse on a medical-surgical unit has asked to represent the unit on the hospitals quality committee.

When describing quality improvement programs to nursing colleagues and members of other health

disciplines, what characteristic should the nurse cite?

  1. A) These programs establish consequences for health care professionals actions.
  2. B) These programs focus on the processes used to provide care.
  3. C) These programs identify specific incidents related to quality.
  4. D) These programs seek to justify health care costs and systems.

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 5

Ans: B


Numerous models seek to improve the quality of health care delivery. A commonality among them is a

focus on the processes that are used to provide care. Consequences, a focus on incidents, and

justification for health care costs are not universal characteristics of quality improvement efforts.

  1. Nurses in acute care settings must work with other health care team members to maintain quality care

while facing pressures to care for patients who are hospitalized for shorter periods of time than in the

past. To ensure positive health outcomes when patients return to their homes, what action should the

nurse prioritize?

  1. A) Promotion of health literacy during hospitalization
  2. B) Close communication with insurers
  3. C) Thorough and evidence-based discharge planning
  4. D) Participation in continuing education initiatives

Ans: C


Following discharges that occur after increasingly short hospital stays, nurses in the community care for

patients who need high-technology acute care services as well as long-term care in the home. This is

dependent on effective discharge planning to a greater degree than continuing education, communication

with insurers, or promotion of health literacy.

  1. You are admitting a patient to your medical unit after the patient has been transferred from the

emergency department. What is your priority nursing action at this time?

  1. A) Identifying the immediate needs of the patient
  2. B) Checking the admitting physicians orders
  3. C) Obtaining a baseline set of vital signs
  4. D) Allowing the family to be with the patient

Ans: A


Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 6

Among the nurses important functions in health care delivery, identifying the patients immediate needs

and working in concert with the patient to address them is most important. The other nursing functions

are important, but they are not the most important functions.

  1. A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing

assessments and interventions with the aid of a pathway, the nurse should prioritize what goal?

  1. A) Helping the patient to achieve specific outcomes
  2. B) Balancing risks and benefits of interventions
  3. C) Documenting the patients response to therapy
  4. D) Staying accountable to the interdisciplinary team

Ans: A


Pathways are an EBP tool that is used primarily to move patients toward predetermined outcomes.

Documentation, accountability, and balancing risks and benefits are appropriate, but helping the patient

achieve outcomes is paramount.

  1. Staff nurses in an ICU setting have noticed that their patients required lower and fewer doses of

analgesia when noise levels on the unit were consciously reduced. They informed an advanced practice

RN of this and asked the APRN to quantify the effects of noise on the pain levels of hospitalized

patients. How does this demonstrate a role of the APRN?

  1. A) Involving patients in their care while hospitalized
  2. B) Contributing to the scientific basis of nursing practice
  3. C) Critiquing the quality of patient care
  4. D) Explaining medical studies to patients and RNs

Ans: B


Research is within the purview of the APRN. The activity described does not exemplify explaining

studies to RNs, critiquing care, or involving patients in their care.

  1. Nurses now have the option to practice in a variety of settings and one of the fastest growing venues of

practice for the nurse in todays health care environment is home health care. What is the main basis for

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 7

the growth in this health care setting?

  1. A) Chronic nursing shortage
  2. B) Western focus on treatment of disease
  3. C) Nurses preferences for day shifts instead of evening or night shifts
  4. D) Discharge of patients who are more critically ill

Ans: D


With shorter hospital stays and increased use of outpatient health care services, more nursing care is

provided in the home and community setting. The other answers are incorrect because they are not the

basis for the growth in nursing care delivered in the home setting.

  1. Nurses have different educational backgrounds and function under many titles in their practice setting. If

a nurse practicing in an oncology clinic had the goal of improving patient outcomes and nursing care by

influencing the patient, the nurse, and the health care system, what would most accurately describe this

nurses title?

  1. A) Nursing care expert
  2. B) Clinical nurse specialist
  3. C) Nurse manager
  4. D) Staff nurse

Ans: B


Clinical nurse specialists are prepared as specialists who practice within a circumscribed area of care

(e.g., cardiovascular, oncology). They define their roles as having five major components: clinical

practice, education, management, consultation, and research. The other answers are incorrect because

they are not the most accurate titles for this nurse.

  1. Nursing continues to recognize and participate in collaboration with other health care disciplines to meet

the complex needs of the patient. Which of the following is the best example of a collaborative practice


  1. A) The nurse and the physician jointly making clinical decisions.

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 8

  1. B) The nurse accompanying the physician on rounds.
  2. C) The nurse making a referral on behalf of the patient.
  3. D) The nurse attending an appointment with the patient.

Ans: A


The collaborative model, or a variation of it, promotes shared participation, responsibility, and

accountability in a health care environment that is striving to meet the complex health care needs of the

public. The other answers are incorrect because they are not examples of a collaborative practice model.

  1. A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of

needs, what dimension of care should the nurse consider primary in importance when caring for a dying


  1. A) Spiritual
  2. B) Social
  3. C) Physiologic
  4. D) Emotional

Ans: C


Maslow ranked human needs as follows: physiologic needs; safety and security; sense of belonging and

affection; esteem and self-respect; and self-actualization, which includes self-fulfillment, desire to know

and understand, and aesthetic needs. Such a hierarchy of needs is a useful framework that can be applied

to the various nursing models for assessment of a patients strengths, limitations, and need for nursing

interventions. The other answers are incorrect because they are not of primary importance when caring

for a dying patient, though each should certainly be addressed.

  1. A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within

this framework of understanding, what would be the nurses first priority?

  1. A) Allowing the family to see a newly admitted patient
  2. B) Ambulating the patient in the hallway
  3. C) Administering pain medication

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 9

  1. D) Teaching the patient to self-administer insulin safely

Ans: C


In Maslows hierarchy of needs, pain relief addresses the patients basic physiologic need. Activity, such

as ambulation, is a higher level need above the physiologic need. Allowing the patient to see family

addresses a higher level need related to love and belonging. Teaching the patient is also a higher level

need related to the desire to know and understand and is not appropriate at this time, as the basic

physiologic need of pain control must be addressed before the patient can address these higher level


  1. A medical-surgical nurse is aware of the scope of practice as defined in the state where the nurse

provides care. This nurses compliance with the nurse practice act demonstrates adherence to which of

the following?

  1. A) National Council of Nursings guidelines for care
  2. B) National League for Nursings Code of Conduct


American Nurses Associations Social Policy Statement


Department of Health and Human Services White Paper on Nursing

Ans: C


Nurses have a responsibility to carry out their role as described in the Social Policy Statement to comply

with the nurse practice act of the state in which they practice and to comply with the Code of Ethics for

Nurses as spelled out by the ANA (2001) and the International Council of Nurses (International Council

of Nurses [ICN], 2006). The other answers are incorrect; the Code of Ethics for nursing is not included

in the ANAs white paper. The DHHS has not published a white paper on nursing nor has the NLN

published a specific code of conduct.

  1. Nursing is, by necessity, a flexible profession. It has adapted to meet both the expectations and the

changing health needs of our aging population. What is one factor that has impacted the need for

certified nurse practitioners (CNPs)?

  1. A) The increased need for primary care providers
  2. B) The need to improve patient diagnostic services
  3. C) The push to drive institutional excellence

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 10

  1. D) The need to decrease the number of medical errors

Ans: A


CNPs who are educationally prepared with a population focus in adult-gerontology or pediatrics receive

additional focused training in primary care or acute care. CNPs help meet the need for primary care

providers. Diagnostic services, institutional excellence, and reduction of medical errors are congruent

with the CNP role, but these considerations are the not primary impetus for the increased role for CNPs.

  1. A nurse is providing care for a patient who is postoperative day one following a bowel resection for the

treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency of quality


  1. A) By liaising with the members of the interdisciplinary care team
  2. B) By critically appraising the outcomes of care that is provided
  3. C) By integrating the patients preferences into the plan of care
  4. D) By documenting care in the electronic health record in a timely fashion

Ans: B


Evaluation of outcomes is central to the QSEN competency of quality improvements. Each of the other

listed activities is a component of quality nursing care, but none clearly exemplifies quality improvement


  1. Professional nursing expands and grows because of factors driven by the changing needs of health care

consumers. Which of the following is a factor that nurses should reflect in the planning and provision of

health care?

  1. A) Decreased access to health care information by individuals
  2. B) Gradual increases in the cultural unity of the American population
  3. C) Increasing mean and median age of the American population
  4. D) Decreasing consumer expectations related to health care outcomes

Ans: C


Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 11

The decline in birth rate and the increase in lifespan due to improved health care have resulted in fewer

school-age children and more senior citizens, many of whom are women.

The population has become more culturally diverse as increasing numbers of people from different

national backgrounds enter the country. Access to information and consumer expectations continue to


  1. A public health nurse has been commissioned to draft a health promotion program that meets the health

care needs and expectations of the community. Which of the following focuses is most likely to

influence the nurses choice of interventions?

  1. A) Management of chronic conditions and disability
  2. B) Increasing need for self-care among a younger population
  3. C) A shifting focus to disease management
  4. D) An increasing focus on acute conditions and rehabilitation

Ans: A


In response to current priorities, health care must focus more on management of chronic conditions and

disability than in previous times. The other answers are incorrect because the change in focus of health

care is not an increasing need for self-care among our aging population; our focus is shifting away from

disease management, not toward it; and we are moving away from the management of acute conditions

to managing chronic conditions.

  1. A community health nurse has witnessed significant shifts in patterns of disease over the course of a

four-decade career. Which of the following focuses most clearly demonstrates the changing pattern of

disease in the United States?

  1. A) Type 1 diabetes management
  2. B) Treatment of community-acquired pneumonia
  3. C) Rehabilitation from traumatic brain injuries
  4. D) Management of acute Staphylococcus aureus infections

Ans: A


Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 12

Management of chronic diseases such as diabetes is a priority focus of the current health care

environment. This supersedes the treatment of acute infections and rehabilitation needs.

  1. The ANA has identified several phenomena toward which the focus of nursing care should be directed,

and a nurse is planning care that reflects these priorities. Which of the nurses actions best demonstrates

these priorities?

  1. A) Encouraging the patients dependence on caregivers
  2. B) Fostering the patients ability to make choices
  3. C) Teaching the patient about nurses roles in the health care system
  4. D) Assessing the patients adherence to treatment

Ans: B


The ANA identifies several focuses for nursing care and research, including the ability to make choices.

The other answers are incorrect because they are not phenomena identified by the ANA.

  1. The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all levels of

health care. Which of the following activities are considered integral to the CNP role? Select all that


  1. A) Educating patients and family members
  2. B) Coordinating care with other disciplines
  3. C) Using direct provision of interventions
  4. D) Educating registered nurses and practical nurses
  5. E) Coordinating payment plans for patients

Ans: A, B, C


This role is a dominant one for nurses in primary, secondary, and tertiary health care settings and in

home care and community nursing. Nurses help patients meet their needs by using direct intervention,

by teaching patients and family members to perform care, and by coordinating and collaborating with

other disciplines to provide needed services. The other answers are incorrect because NPs do not

commonly perform education of nurses and they do not focus on matters related to payment.

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 13

  1. The ANA has identified central characteristics of nursing practice that are applicable across the wide

variety of contexts in which nurses practice. A nurse can best demonstrate these principles by

performing which of the following actions?

  1. A) Teaching the public about the role of nursing
  2. B) Taking action to control the costs of health care
  3. C) Ensuring that all of his or her actions exemplify caring
  4. D) Making sure to carry adequate liability insurance

Ans: C


The ANA emphasizes the fact that caring is central to the practice of the registered nurse. The ANA

does not identify teaching the public about nursing, controlling costs, or maintaining insurance as a

central tenet of nursing practice.

  1. A nurse has accepted a position as a clinical nurse leader (CNL), a new role that has been launched

within the past decade. In this role, the nurse should prioritize which of the following activities?

  1. A) Acting as a spokesperson for the nursing profession
  2. B) Generating and disseminating new nursing knowledge
  3. C) Diagnosing and treating health problems that have a predictable course
  4. D) Helping patients to navigate the health care system

Ans: D


The CNL is a nurse generalist with a masters degree in nursing and a special background in clinical

leadership, educated to help patients navigate through the complex health care system. The other

answers are incorrect because they are not what nursing has identified as the CNL role.

  1. Our world is connected by a sophisticated communication system that makes much health information

instantly accessible, no matter where the patient is being treated. This instant access to health

information has impacted health care delivery strategies, including the delivery of nursing care. What is

one way the delivery of health care has been impacted by this phenomenon?

  1. A) Brisk changes as well as swift obsolescence

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 14

  1. B) Rapid change that is nearly permanent
  2. C) Limitations on the settings where care can be provided
  3. D) Increased need for social acceptance

Ans: A


The sophisticated communication systems that connect most parts of the world, with the capability of

rapid storage, retrieval, and dissemination of information, have stimulated brisk change as well as swift

obsolescence in health care delivery strategies. The other answers are incorrect because, although we

have rapid change in the delivery of nursing care, it does not last a long time; it is evolving as health care

itself evolves. Giving nursing care has not become easier, it becomes more complex with every change;

and it does not need to be more socially acceptable; it needs to be more culturally sensitive.

  1. With the changing population of health care consumers, it has become necessary for nurses to work

more closely with other nurses, as when acute care nurses collaborate with public health and home

health nurses. What nursing function has increased in importance because of this phenomenon?

  1. A) Prescribing medication
  2. B) Performing discharge planning
  3. C) Promoting family involvement
  4. D) Forming collegial relationships

Ans: B


The importance of effective discharge planning and quality improvement cannot be overstated. The

other answers are incorrect because giving medication and family involvement in the patients care have

not grown in importance. Making and maintaining collegial relationships has become a necessity in

working in the health care delivery system. Effective discharge planning aids in getting patients out of

the inpatient setting sooner, cutting costs, and making rehabilitation in the community and home setting


  1. A nurse has integrated the principles of evidence-based practice into care. EBP has the potential to help

the nurse achieve what goal?

  1. A) Increasing career satisfaction
  2. B) Obtaining federal grant money

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 15


Ensuring high quality patient care

  1. D) Enhancing the publics esteem for nursing

Ans: C


Quality improvement is the ultimate goal of EBP. Career satisfaction, public esteem, and grant money

are not priorities.

  1. A case manager has been hired at a rural hospital that has a combined medical-surgical unit. When

defining this new role, which of the following outcomes should be prioritized by the hospitals


  1. A) Decreased need for physician services
  2. B) Improved patient and family education
  3. C) Increased adherence to the principles of EBP
  4. D) Increased coordination of health services

Ans: D


Case management is a system of coordinating health care services to ensure cost-effectiveness,

accountability, and quality care. The case manager coordinates the care of a caseload of patients through

facilitating communication between nurses, other health care personnel who provide care, and insurance

companies. Reducing the need for physician services is not a central goal. Education and EBP are

consistent with case management, but they are not central to this particular role.

  1. A hospitals current quality improvement program has integrated the principles of the Institute for

Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the

campaign goals of reducing preventable harm and death?

  1. A) By adhering to EBP guidelines
  2. B) By reducing nurse-to-patient ratios and increasing accountability
  3. C) By having researchers from outside the facility evaluate care
  4. D) By involving patients and families in their care planning

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 16

Ans: A


The 5 Million Lives Campaign posits that if evidence-based guidelines it advocated were voluntarily

implemented by U.S. hospitals, 5 million lives would be saved from either harm or death over a twoyear

period. Nurse-to-patient ratios, family participation, and independent evaluation are not stated

components of the campaign.

  1. Over the past several decades, nursing roles have changed and expanded in many ways. Which of the

following factors has provided the strongest impetus for this change?

  1. A) The need to decrease the cost of health care
  2. B) The need to improve the quality of nursing education
  3. C) The need to increase the number of nursing jobs available
  4. D) The need to increase the public perception of nursing

Ans: A


The role of the nurse has expanded to improve the distribution of health care services and to decrease the

cost of health care. The other answers are incorrect because the expansion of roles in nursing did not

occur to improve education, increase the number of nursing jobs, or increase public perception.

  1. Advanced practice nursing roles have grown in number and in visibility in recent years. What

characteristic sets these nurses apart from the registered nurse?

  1. A) Collaboration with other health care providers
  2. B) Education that goes beyond that of the RN
  3. C) Advanced documentation skills
  4. D) Ability to provide care in the surgical context

Ans: B


There is wide variety in APRN roles. However, a commonality is that they require education beyond that

of the professional RN. All nurses collaborate with other health care providers to provide nursing care to

Test Bank – Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e (Hinkle 2013) 17

their patients. Advanced documentation skills are not what sets advanced practice nurses apart from the

staff nurse. RNs have the ability to provide care in the operating room.

  1. CNPs are educated as specialists in areas such as family care, pediatrics, or geriatrics. In most states,

what right do CNPs have that RNs do not possess?

  1. A) Perform health interventions independently
  2. B) Make referrals to members of other health disciplines
  3. C) Prescribe medications
  4. D) Perform surgery independently

Ans: C

13 edition of Brunner & Suddarth’s Textbook of Medical Surgical Nursing Test Bank by Hinkle

13 edition of Brunner & Suddarth’s Textbook of Medical Surgical Nursing Test Bank by Hinkle