Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams

Test Bank for Understanding Medical-Surgical Nursing, 6th Edition, Linda S. Williams, Paula D. Hopper, ISBN-10: 0803668988, ISBN-13: 9780803668980

Test Bank for Understanding

Medical-Surgical Nursing 6th

Edition Linda S. Williams Paula D.

Hopper

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TABLE OF CONTENTS

Unit 1 Understanding Health Care Issues

1. Critical Thinking and the Nursing Process

2. Evidence-Based Practice

3. Issues in Nursing Practice

4. Cultural Influences on Nursing Care

5. Complementary and Alternative Modalities

Unit 2 Understanding Health and Illness

6. Nursing Care of Patients with Fluid, Electrolyte, and Acid-Base Imbalances

7. Nursing Care of Patients Receiving Intravenous Therapy

8. Nursing Care of Patients with Infections

9. Nursing Care of Patients in Shock

10. Nursing Care of Patients in Pain

11. Nursing Care of Patients With Cancer

12. Nursing Care of Patients Having Surgery

13. Nursing Care of Patients with Emergent Conditions and Disaster/Bioterrorism Response

Unit 3 Understanding Life Span Influences on Health and Illness

14. Developmental Considerations and Chronic Illness in the Nursing Care of Adults

15. Nursing Care of Older Adult Patients

16. Patient Care Settings

17. Nursing Care of Patients at the End of Life

Unit 4 Understanding the Immune System

18. Immune System Function, Assessment and Therapeutic Measures

19. Nursing Care of Patients With Immune Disorders

20. Nursing Care of Patients With HIV Disease and AIDS

Unit 5 Understanding the Cardiovascular System

21. Cardiovascular System Function, Assessment and Therapeutic Measures

22. Nursing Care of Patients With Hypertension

23. Nursing Care of Patients With Valvular, Inflammatory and Infectious Cardiac or Venous Disorders

24. Nursing Care of Patients With Occlusive Cardiovascular Disorders

25. Nursing Care of Patients With Cardiac Arrhythmias

26. Nursing Care of Patients With Heart Failure

Unit 6 Understanding the Hematologic and Lymphatic Systems

27. Hematologic and Lymphatic System Function, Assessment, and Therapeutic Measures

28. Nursing Care of Patients With Hematologic and Lymphatic Disorders

Unit 7 Understanding the Respiratory System

29. Respiratory System Function, Assessment, and Therapeutic Measures

30. Nursing Care of Patients With Upper Respiratory Tract Disorders

31. Nursing Care of Patients With Lower Respiratory Tract Disorders

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Unit 8 Understanding the Gastrointestinal, Hepatic, and Pancreatic Systems

32. Gastrointestinal, Hepatobiliary, and Pancreatic Systems Function, Assessment and Therapeutic

Measures

33. Nursing Care of Patients With Upper Gastrointestinal Disorders

34. Nursing Care of Patients With Lower Gastrointestinal Disorders

35. Nursing Care of Patients With Liver, Pancreatic, and Gallbladder Disorders

Unit 9 Understanding the Urinary System

36. Urinary System Function, Assessment, and Therapeutic Measures

37. Nursing Care of Patients With Disorders of the Urinary System

Unit 10 Understanding the Endocrine System

38. Endocrine System Function and Assessment

39. Nursing Care of Patients With Endocrine Disorders

40. Nursing Care of Patients With Disorders of the Endocrine Pancreas

Unit 11 Understanding the Genitourinary and Reproductive System

41. Genitourinary and Reproductive System Function and Assessment

42. Nursing Care of Women With Reproductive System Disorders

43. Nursing Care of Male Patients With Genitourinary Disorders

44. Nursing Care of Patients With Sexually Transmitted Infections

Unit 12 Understanding the Musculoskeletal System

45. Musculoskeletal Function and Assessment

46. Nursing Care of Patients With Musculoskeletal and Connective Tissue Disorders

Unit 13 Understanding the Neurologic System

47. Neurologic System Function, Assessment, and Therapeutic Measures

48. Nursing Care of Patients With Central Nervous System Disorders

49. Nursing Care of Patients With Cerebrovascular Disorders

50. Nursing Care of Patients With Peripheral Nervous System Disorders

Unit 14 Understanding the Sensory System

51. Sensory System Function, Assessment, and Therapeutic Measures: Vision and Hearing

52. Nursing Care of Patients With Sensory Disorders: Vision and Hearing

Unit 15 Understanding the Integumentary System

53. Integumentary System Function, Assessment and Therapeutic Measures

54. Nursing Care of Patients With Skin Disorders

55. Nursing Care of Patients With Burns

Unit 16 Understanding Mental Health Care

56. Mental Health Function, Assessment, and Therapeutic Measures

57. Nursing Care of Patients With Mental Health Disorders

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Chapter 1. Critical Thinking and the Nursing Process

MULTIPLE CHOICE

1. The nurse is caring for a group of patients on a medical-surgical unit. Which patient should

the licensed practical nurse/licensed vocational nurse (LPN/LVN) assess first?

1. A patient with a blood glucose of 42 mg/dL

2. A patient who reports a pain level of 2

3. A patient who has just received a diagnosis of cancer

4. A patient who has a respiratory rate of 22

ANS: 1

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 7. Prioritize patient care activities based on the Maslow hierarchy of human

needs.

Pages: 6–7

Heading: Prioritize Care

Integrated Process: Clinical Problem-Solving Process (Nursing Process)

Client Need: SECE—Coordinated Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Difficult

Feedback

1 This patient has a dangerously low blood glucose level and requires immediate

intervention.

2 This patient will need to be assessed, but is not as high a priority.

3 According to Maslow, psychosocial needs are not as high of a priority as

physiological needs.

4 A respiratory rate of 22 is within normal range.

PTS: 1 CON: Patient-Centered Care

2. The LPN/LVN enters the room of a patient who is angry and yells, ―I asked 5 minutes ago

for my pain medication. I’m going to call the CEO of the hospital if you don’t get it for me

now.‖ Which statement by the nurse demonstrates intellectual empathy?

1. ―We are short-staffed today, so it will take me longer to meet your needs.‖

2. ―I am sorry you had to wait, I know you must be in a lot of pain.‖

3. ―I had another patient who had severe pain, and I had to get to them first.‖

4. ―I will get you the number for the CEO, but he is aware of how busy we are.‖

ANS: 2

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 2. Describe attitudes and skills that promote good critical thinking

Page: 2

Heading: Intellectual Empathy

Integrated Process: Communication and Documentation

Client Need: Psychosocial Integrity

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Cognitive Level: Application [Applying]

Concept: Communication

Difficulty: Moderate

Feedback

1 This statement does not consider an individual’s situation.

2 This statement demonstrates intellectual empathy by considering this patient’s

situation and will likely alleviate the patient’s anger.

3 This statement does not consider a patient’s situation and does not demonstrate

intellectual empathy.

4 This statement addresses the patient’s statement of wanting to call the CEO, but

does not demonstrate intellectual empathy by considering the patient’s situation.

PTS: 1 CON: Communication

3. The nurse is collecting data on a patient. Which data are described as subjective?

1. Respiratory rate of 26 per minute

2. Patient report of shortness of breath

3. Coarse lung sounds bilaterally

4. Cough producing green sputum

ANS: 2

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 5. Differentiate between objective and subjective data.

Page: 4

Heading: Subjective Data

Integrated Process: Communication and Documentation

Client Need: Communication and Documentation

Cognitive Level: Application (Applying)

Concept: Communication

Difficulty: Moderate

Feedback

1 Respiratory rate of 26 per minute is an example of objective data.

2 A patient reporting symptoms to the nurse is an example of subjective data.

3 Coarse lung sounds is an example of objective data.

4 A productive cough is an example of objective data.

PTS: 1 CON: Communication

4. A patient with a newly fractured femur reports a pain level of 8/10 and analgesic medication

is not due for another 50 minutes. Which action should the nurse take first?

1. Reposition the patient.

2. Give the medication in 30 minutes.

3. Notify the registered nurse (RN) or physician.

4. Tell the patient it is too early for pain medication.

ANS: 3

Chapter: Chapter 1 Critical Thinking and the Nursing Process

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Objective: 4. Identify the role of a licensed practical nurse/licensed vocational nurse in using

the nursing process.

Page: 3

Heading: Clinical Judgement

Integrated Process: Clinical Problem-solving Process (Nursing Process)

Client Need: SECE—Coordinated Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Moderate

Feedback

1 The patient who has a fractured femur is having acute pain. Repositioning a

patient with a new fracture is not likely to relieve pain.

2 Giving the medication before the prescribed time is beyond the nurse’s scope of

practice.

3 The patient should not have to wait for pain relief, so the LPN should inform the

RN or physician so new pain relief orders can be obtained.

4 The nurse needs to do more than expect the patient to wait for pain relief.

PTS: 1 CON: Patient-Centered Care

5. The nurse is prioritizing care based on Maslow hierarchy of needs. Which need does the

nurse identify as having the highest priority?

1. Job-related stress

2. Feeling of loneliness

3. Pain level of 9 on 0-to-10 scale

4. Lack of confidence

ANS: 3

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 7. Prioritize patient care activities based on the Maslow hierarchy of human

needs

Page: 7

Heading: Prioritize Care

Integrated Process: Caring

Client Need: SECE – Coordinated Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Moderate

Feedback

1 Job-related stress falls under safety according to Maslow and is addressed after

physiological needs.

2 According to Maslow, loneliness is addressed under social needs following

physiological and safety.

3 Pain is a physiological need and is the highest priority.

4 Lack of confidence falls under esteem according to Maslow and is addressed

following physiological, safety, and social needs.

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PTS: 1 CON: Patient-Centered Care

6. The nurse is planning care and setting goals for a newly admitted patient. Who should the

nurse include when conducting these nursing actions?

1. Patient

2. Nurse manager

3. Hospital chaplain

4. Patient’s health care provider (HCP)

ANS: 1

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 4. Identify the role of a licensed practical nurse/licensed vocational nurse is using

the nursing process.

Page: 6

Heading: Prioritize Care

Integrated Process: Communication and Documentation

Client Need: SECE—Management of Care

Cognitive Level: Application [Applying]

Concept: Communication

Difficulty: Moderate

Feedback

1 Planning care and setting goals is an action performed with the patient. The

patient must be in agreement with the plan for it to be successful in meeting the

desired outcomes.

2 The nurse manager may or may not be aware of the patient’s care needs.

3 The hospital chaplain may not be aware of the patient’s needs.

4 The focus of nursing care is different from that of the HCP.

PTS: 1 CON: Communication

7. While caring for a patient 4 hours after a surgical procedure, the LPN/LVN notes

serosanguineous drainage on the dressing. Which statement should the nurse use to

document this finding?

1. ―Normal drainage noted.‖

2. ―Moderate drainage recently noted.‖

3. ―Scant serosanguineous drainage seen on dressing.‖

4. ―Pale pink drainage 2 cm by 1 cm noted on dressing.‖

ANS: 4

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 6. Document subjective and objective data.

Page: 5

Heading: Documentation of Data

Integrated Process: Communication and Documentation

Client Need: PHYS—Physiological Adaptation

Cognitive Level: Application [Applying]

Concept: Communication

Difficulty: Moderate

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Feedback

1 These statements are interpretations of the data and use words that have vague

meanings, which should be avoided when documenting.

2 These statements are interpretations of the data and use words that have vague

meanings, which should be avoided when documenting.

3 These statements are interpretations of the data and use words that have vague

meanings, which should be avoided when documenting.

4 Objective data are pieces of factual information obtained through physical

assessment and diagnostic tests that are observable or knowable through the five

senses. The nurse should document exactly what is seen.

PTS: 1 CON: Communication

8. The nurse is caring for a patient using the nursing process. Which step should the nurse take

first?

1. Implementation

2. Planning

3. Nursing diagnosis

4. Assessment

ANS: 4

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 4. Identify the role of a licensed practical nurse/licensed vocational nurse in using

the nursing process.

Page: 4

Heading: Data Collection

Integrated Process: Clinical Problem-Solving Process (Nursing Process)

Client Need: SECE: Coordinated Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Moderate

Feedback

1 The steps of the nursing process are data collection/assessment, nursing

diagnosis, planning, implementation, and evaluation.

2 The steps of the nursing process are data collection/assessment, nursing

diagnosis, planning, implementation, and evaluation.

3 The steps of the nursing process are data collection/assessment, nursing

diagnosis, planning, implementation, and evaluation.

4 Assessment, or data collection, is the first step in the nursing process and is used

to evaluate a patient’s condition before providing care. The other steps, in order,

are nursing diagnosis, planning, implementation, and evaluation.

PTS: 1 CON: Patient-Centered Care

9. The nurse is administering morphine to a patient reporting a pain level of 8 on a 0-to-10

scale. This describes which step of the nursing process?

1. Assessment

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2. Nursing diagnosis

3. Implementation

4. Evaluation

ANS: 3

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 4. Identify the role of a licensed practical nurse/licensed vocational nurse in using

the nursing process.

Page: 8

Heading: Identify Interventions

Integrated Process: Clinical Problem-Solving Process (Nursing Process)

Client Need: SECE – Coordination of Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Moderate

Feedback

1 Administering medication does not describe assessment.

2 Administering medication does not describe nursing diagnosis.

3 Administering medication describes the implementation process, since an action

is being taken to help the patient meet a desired outcome.

4 Administering medication does not describe the evaluation phase of the nursing

process.

PTS: 1 CON: Patient-Centered Care

10. The nurse is developing an outcome for a patient with exacerbation of asthma. Which is the

most appropriate outcome for this patient?

1. The patient will not experience shortness of breath.

2. The patient will have a respiratory rate of 16 to 20 per minute.

3. The patient will ambulate without reporting shortness of breath.

4. The patient will not require use of an inhaler.

ANS: 2

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 3. Describe the thinking that occurs in each step of the nursing process.

Page: 8

Heading: Establish Outcomes

Integrated Process: Clinical Problem-solving (Nursing Process)

Client Need: SECE: Coordinated Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Moderate

Feedback

1 This is a vague outcome and is not measurable.

2 This is a measurable outcome and is not vague.

3 This is a vague outcome and is not measurable.

4 This is a vague outcome and is not measurable.

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PTS: 1 CON: Patient-Centered Care

11. The nurse suspects a patient is experiencing adverse effects to a newly prescribed

antihypertensive medication. After being informed that the effects are expected, the nurse

remains concerned and conducts an Internet search on the patient’s manifestations. Which

critical thinking behavior did the nurse implement?

1. Sense of justice

2. Intellectual courage

3. Intellectual empathy

4. Intellectual perseverance

ANS: 4

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 2. Describe attitudes and skills that promote critical thinking.

Page: 2

Heading: Intellectual Perseverance

Integrated Process: Caring

Client Need: Psychosocial Integrity

Cognitive Level: Analysis [Analyzing]

Concept: Patient-Centered Care

Difficulty: Moderate

Feedback

1 A sense of justice examines motives when making decisions.

2 Intellectual courage looks at other points of view, even when the nurse does not

agree with them.

3 Intellectual empathy understands how another person feels when making

decisions.

4 Intellectual perseverance is not giving up.

PTS: 1 CON: Patient-Centered Care

12. The nurse is identifying outcomes for a patient with fluid volume deficit. Which outcome

should the nurse use to guide this patient’s care?

1. Patient’s intake will be measured daily.

2. Patient’s intake will be 3,000 mL daily.

3. Fluids will be at the bedside for the patient.

4. Fluids the patient likes will be at the bedside.

ANS: 2

Chapter: Chapter 1 Critical Thinking and the Nursing Process

Objective: 3. Describe the thinking that occurs in each step of the nursing process.

Page: 7

Heading: Establish Outcomes

Integrated Process: Clinical Problem-solving (Nursing Process)

Client Need: SECE: Coordinated Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

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Chapter 1. Critical Thinking and the Nursing Process MULTIPLE CHOICE 1. The nurse is caring for a group of patients on a medical-surgical unit. Which patient should the licensed practical nurse/licensed vocational nurse (LPN/LVN) assess first? 1. A patient with a blood glucose of 42 mg/dL 2. A patient who reports a pain level of 2 3. A patient who has just received a diagnosis of cancer 4. A patient who has a respiratory rate of 22 ANS: 1 Chapter: Chapter 1 Critical Thinking and the Nursing Process Objective: 7. Prioritize patient care activities based on the Maslow hierarchy of human needs. Pages: 6–7 Heading: Prioritize Care Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: SECE—Coordinated Care Cognitive Level: Application [Applying] Concept: Patient-Centered Care Difficulty: Difficult Feedback 1 This patient has a dangerously low blood glucose level and requires immediate intervention. 2 This patient will need to be assessed, but is not as high a priority. 3 According to Maslow, psychosocial needs are not as high of a priority as physiological needs. 4 A respiratory rate of 22 is within normal range. PTS: 1 CON: Patient-Centered Care 2. The LPN/LVN enters the room of a patient who is angry and yells, “I asked 5 minutes ago for my pain medication. I’m going to call the CEO of the hospital if you don’t get it for me now.” Which statement by the nurse demonstrates intellectual empathy? 1. “We are short-staffed today, so it will take me longer to meet your needs.” 2. “I am sorry you had to wait, I know you must be in a lot of pain.” 3. “I had another patient who had severe pain, and I had to get to them first.” 4. “I will get you the number for the CEO, but he is aware of how busy we are.” ANS: 2 Chapter: Chapter 1 Critical Thinking and the Nursing Process Objective: 2. Describe attitudes and skills that promote good critical thinking Page: 2 Heading: Intellectual Empathy Integrated Process: Communication and Documentation Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 This statement does not consider an individual’s situation. 2 This statement demonstrates intellectual empathy by considering this patient’s situation and will likely alleviate the patient’s anger. 3 This statement does not consider a patient’s situation and does not demonstrate intellectual empathy. 4 This statement addresses the patient’s statement of wanting to call the CEO, but does not demonstrate intellectual empathy by considering the patient’s situation. PTS: 1 CON: Communication 3. The nurse is collecting data on a patient. Which data are described as subjective? 1. Respiratory rate of 26 per minute 2. Patient report of shortness of breath 3. Coarse lung sounds bilaterally 4. Cough producing green sputum ANS: 2 Chapter: Chapter 1 Critical Thinking and the Nursing Process Objective: 5. Differentiate between objective and subjective data. Page: 4 Heading: Subjective Data Integrated Process: Communication and Documentation Client Need: Communication and Documentation Cognitive Level: Application (Applying) Concept: Communication Difficulty: Moderate Feedback 1 Respiratory rate of 26 per minute is an example of objective data. 2 A patient reporting symptoms to the nurse is an example of subjective data. 3 Coarse lung sounds is an example of objective data. 4 A productive cough is an example of objective data. PTS: 1 CON: Communication 4. A patient with a newly fractured femur reports a pain level of 8/10 and analgesic medication is not due for another 50 minutes. Which action should the nurse take first? 1. Reposition the patient. 2. Give the medication in 30 minutes. 3. Notify the registered nurse (RN) or physician. 4. Tell the patient it is too early for pain medication. ANS: 3 Chapter: Chapter 1 Critical Thinking and the Nursing Process Objective: 4. Identify the role of a licensed practical nurse/licensed vocational nurse in using the nursing process. Page: 3 Heading: Clinical Judgement Integrated Process: Clinical Problem-solving Process (Nursing Process) Client Need: SECE—Coordinated Care Cognitive Level: Application [Applying] Concept: Patient-Centered Care Difficulty: Moderate Feedback 1 The patient who has a fractured femur is having acute pain. Repositioning a patient with a new fracture is not likely to relieve pain. 2 Giving the medication before the prescribed time is beyond the nurse’s scope of practice. 3 The patient should not have to wait for pain relief, so the LPN should inform the RN or physician so new pain relief orders can be obtained. 4 The nurse needs to do more than expect the patient to wait for pain relief. PTS: 1 CON: Patient-Centered Care