TEST BANK MEDICAL SURGICAL NURSING Concepts for Interprofessional 9TH EDITION Ignatavicius M. Linda Workman Cherie RebarContents
Chapter 01: Overview of Professional Nursing Concepts for Medical- Surgical Nursing ................................................................................... 2...
Contents
Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing................................................................................... 2
Chapter 02: Overview of Health Concepts for Medical-Surgical Nursing ............................................................................................................ 7
Chapter 03: Common Health Problems of Older Adults .......................................................................................................................................12
Chapter 04: Assessment and Care of Patients with Pain .........................................................................................................................................19
Chapter 05: Genetic Concepts for Medical-Surgical Nursing ................................................................................................................................31
Chapter 06: Rehabilitation Concepts for Chronic and Disabling HealthProblems ...........................................................................................36
Chapter 07: End-of-Life Care........................................................................................................................................................................................42
Chapter 08: Concepts of Emergency and Trauma Nursing....................................................................................................................................48
Chapter 09: Care of Patients with Common Environmental Emergencies ........................................................................................................54
Chapter 10: Concepts of Emergency and Disaster Preparedness .........................................................................................................................60
Chapter 11: Assessment and Care of Patients with Fluid and ElectrolyteImbalances ......................................................................................66
Chapter 12: Assessment and Care of Patients with Acid-Base Imbalances ........................................................................................................73
Chapter 13: Infusion Therapy .......................................................................................................................................................................................80
Chapter 14: Care of Preoperative Patients..................................................................................................................................................................90
Chapter 15: Care of Intraoperative Patients ...............................................................................................................................................................99
Chapter 16: Care of Postoperative Patients ............................................................................................................................................................. 105
Chapter 17: Inflammation and Immunity ................................................................................................................................................................ 112
Chapter 18: Care of Patients with Arthritis and Other Connective TissueDiseases ...................................................................................... 117
Chapter 19: Care of Patients with HIV Disease ..................................................................................................................................................... 133
Chapter 20: Care of Patients with Hypersensitivity (Allergy) andAutoimmunity ............................................................................................ 141
Chapter 21: Cancer Development ............................................................................................................................................................................. 145
Chapter 22: Care of Patients with Cancer................................................................................................................................................................ 149
Chapter 23: Care of Patients with Infection ............................................................................................................................................................ 159
Chapter 24: Assessment of the Skin, Hair, and Nails............................................................................................................................................ 166
Chapter 25: Care of Patients with Skin Problems .................................................................................................................................................. 170
Chapter 26: Care of Patients with Burns.................................................................................................................................................................. 186
Chapter 27: Assessment of the Respiratory System .............................................................................................................................................. 202
Chapter 28: Care of Patients Requiring Oxygen Therapy orTracheostomy ..................................................................................................... 208
Chapter 29: Care of Patients with Noninfectious Upper RespiratoryProblems .............................................................................................. 214
Chapter 30: Care of Patients with Noninfectious Lower RespiratoryProblems .............................................................................................. 220
Chapter 31: Care of Patients with Infectious Respiratory Problems ................................................................................................................. 232
Chapter 32: Care of Critically Ill Patients with Respiratory Problems .............................................................................................................. 242
Chapter 33: Assessment of the Cardiovascular System ........................................................................................................................................ 255
Chapter 34: Care of Patients with Dysrhythmias ................................................................................................................................................... 264
Chapter 35: Care of Patients with Cardiac Problems ............................................................................................................................................ 272
Chapter 36: Care of Patients with Vascular Problems .......................................................................................................................................... 283
Chapter 37: Care of Patients with Shock ................................................................................................................................................................. 295
Chapter 38: Care of Patients with Acute Coronary Syndromes.......................................................................................................................... 301
Chapter 39: Assessment of the Hematologic System ............................................................................................................................................ 311
Chapter 40: Care of Patients with Hematologic Problems .................................................................................................................................. 315
Chapter 41: Assessment of the Nervous System.................................................................................................................................................... 326
Chapter 42: Care of Patients with Problems of the CNS: The Brain ................................................................................................................ 336
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,Chapter 43: Care of Patients with Problems of the CNS: The Spinal Cord .................................................................................................... 346
Chapter 44: Care of Patients with Problems of the Peripheral NervousSystem ............................................................................................. 356
Chapter 45: Care of Critically Ill Patients with Neurologic Problems ............................................................................................................... 361
Chapter 46: Assessment of the Eye and Vision ..................................................................................................................................................... 374
Chapter 47: Care of Patients with Eye and Vision Problems .............................................................................................................................. 377
Chapter 48: Assessment and Care of Patients with Ear and HearingProblems .............................................................................................. 383
Chapter 49: Assessment of the Musculoskeletal System ...................................................................................................................................... 390
Chapter 50: Care of Patients with Musculoskeletal Problems ............................................................................................................................. 394
Chapter 51: Care of Patients with Musculoskeletal Trauma ................................................................................................................................ 402
Chapter 52: Assessment of the Gastrointestinal System ...................................................................................................................................... 413
Chapter 53: Care of Patients with Oral Cavity Problems ..................................................................................................................................... 418
Chapter 54: Care of Patients with Esophageal Problems ..................................................................................................................................... 422
Chapter 55: Care of Patients with Stomach Disorders ......................................................................................................................................... 431
Chapter 56: Care of Patients with Noninflammatory Intestinal Disorders ...................................................................................................... 438
Chapter 57: Care of Patients with Inflammatory Intestinal Disorders .............................................................................................................. 447
Chapter 58: Care of Patients with Liver Problems ................................................................................................................................................ 457
Chapter 59: Care of Patients with Problems of the Biliary System andPancreas ............................................................................................ 465
Chapter 60: Care of Patients with Malnutrition: Undernutrition andObesity.................................................................................................. 473
Chapter 61: Assessment of the Endocrine System ................................................................................................................................................ 481
Chapter 62: Care of Patients with Pituitary and Adrenal Gland Problems ...................................................................................................... 487
Chapter 63: Care of Patients with Problems of the Thyroid andParathyroid Glands .................................................................................... 495
Chapter 64: Care of Patients with Diabetes Mellitus............................................................................................................................................. 501
Chapter 65: Assessment of the Renal/Urinary System ......................................................................................................................................... 523
Chapter 66: Care of Patients with Urinary Problems ............................................................................................................................................ 530
Chapter 67: Care of Patients with Kidney Disorders ............................................................................................................................................ 541
Chapter 68: Care of Patients with Acute Kidney Injury and ChronicKidney Disease ................................................................................... 548
Chapter 69: Assessment of the Reproductive System ........................................................................................................................................... 559
Chapter 70: Care of Patients with Breast Disorders .............................................................................................................................................. 563
Chapter 71: Care of Patients with Gynecologic Problems ................................................................................................................................... 570
Chapter 72: Care of Patients with Male Reproductive Problems ....................................................................................................................... 576
Chapter 73: Care of Transgender Patients ............................................................................................................................................................... 585
Chapter 74: Care of Patients with Sexually Transmitted Diseases ..................................................................................................................... 589
Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
MULTIPLE CHOICE
1. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse
best demonstrates this concept?
a. Assesses for cultural influences affecting health care
b. Ensures that all the clients basic needs are met
c. Tells the client and family about all upcoming tests
d. Thoroughly orients the client and family to the room
ANS: A
Competency in client-focused care is demonstrated when the nurse focuses on communication, culture,
respect compassion, client education, and empowerment. By assessing the effect of the clients culture on
health care, this nurse is practicing client-focused care. Providing for basic needs does not demonstrate this
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, competence.
Simply telling the client about all upcoming tests is not providing empowering education. Orienting the client
and family to the room is an important safety measure, but not directly related to demonstrating client-
centered care.
2. A nurse is caring for a postoperative client on the surgical unit. The clients blood pressure was 142/76
mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best?
a. Call the Rapid Response Team.
b. Document and continue to monitor.
c. Notify the primary care provider.
d. Repeat blood pressure measurement in 15 minutes.
ANS: A
The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they
suffer either respiratory or cardiac arrest. Since the client has manifested a significant change, the nurse should
call the RRT. Changes in blood pressure, mental status, heart rate, and pain are particularly significant.
Documentation is vital, but the nurse must do more than document. The primary care provider should
be notified, but this is not the priority over calling the RRT. The clients blood pressure should be
reassessedfrequently, but the priority is getting the rapid care to the client.
DIF: Applying/Application REF: 3
KEY: Rapid Response Team (RRT)| medical emergencies
MSC: Integrated Process: Communication and
Documentation
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
3. A nurse is orienting a new client and family to the inpatient unit. What information does the nurse provide
to help the client promote his or her own safety?
a. Encourage the client and family to be active partners.
b. Have the client monitor hand hygiene in caregivers.
c. Offer the family the opportunity to stay with the client.
d. Tell the client to always wear his or her armband.
ANS: A
Each action could be important for the client or family to perform. However, encouraging the client to be
active in his or her health care as a partner is the most critical. The other actions are very limited in scope and
do not provide the broad protection that being active and involved does.
MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
4. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises
the student that which is the priority when working as a professional nurse?
a. Attending to holistic client needs
b. Ensuring client safety
c. Not making medication errors
d. Providing client-focused care
ANS: B
All actions are appropriate for the professional nurse. However, ensuring client safety is the priority. Up to
98,000 deaths result each year from errors in hospital care, according to the 2000 Institute of Medicine report.
Many more clients have suffered injuries and less serious outcomes. Every nurse has the responsibility to
guard the clients safety.
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, DIF: Understanding/Comprehension REF: 2
KEY: Patient safety
MSC: Integrated Process: Nursing Process: Intervention
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
5. A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain
isthe most important thing the client can do to protect against errors?
a. Bring a list of all medications and what they are for.
b. Keep the doctors phone number by the telephone.
c. Make sure all providers wash hands before entering the room.
d. Write down the name of each caregiver who comes in the room.
ANS: A
Medication errors are the most common type of health care mistake. The Joint Commissions Speak Up
campaign encourages clients to help ensure their safety. One recommendation is for clients to know all their
medications and why they take them. This will help prevent medication errors.
DIF: Applying/Application REF: 4
KEY: Speak Up campaign| patient safety MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control
6. Which action by the nurse working with a client best demonstrates respect for autonomy?
a. Asks if the client has questions before signing a consent
b. Gives the client accurate information when questioned
c. Keeps the promises made to the client and family
d. Treats the client fairly compared to other clients
ANS: A
Autonomy is self-determination. The client should make decisions regarding care. When the nurse obtains a
signature on the consent form, assessing if the client still has questions is vital, because without full
information the client cannot practice autonomy. Giving accurate information is practicing with veracity.
Keeping promises is upholding fidelity. Treating the client fairly is providing social justice.
DIF: Applying/Application REF: 4
KEY: Autonomy| ethical principles MSC: Integrated Process: Caring
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
7. A student nurse asks the faculty to explain best practices when communicating with a person from the
lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. What answer by the faculty
is most accurate?
a. Avoid embarrassing the client by asking questions.
b. Dont make assumptions about their health needs.
c. Most LGBTQ people do not want to share information.
d. No differences exist in communicating with this population.
ANS: B
Many members of the LGBTQ community have faced discrimination from health care providers and may be
reluctant to seek health care. The nurse should never make assumptions about the needs of members of this
population. Rather, respectful questions are appropriate. If approached with sensitivity, the client with any
health care need is more likely to answer honestly.
8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago and has pain
that is unrelieved by the prescribed narcotic pain medication. Which statement is part of the SBAR format
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