TEST BANK FOR
Lewis's Medical-Surgical Nursing: Assessment and
Management of Clinical Problems 11th Edition
Authors: Mariann M. Harding, Jeffrey Kwong, Dottie Roberts, Debra Hagler, Courtney Reinisch
Table of Contents
Section One – Concepts in Nursing Practice
Chapter 1: Professional Nursing
Chapter 2: Health Equity and Culturally Competent Care
Chapter 3: Health History and Physical Examination
Chapter 4: Patient and Caregiver Teaching
Chapter 5: Chronic Illness and Older Adults
Section Two – Problems Related to Comfort and
Coping
Chapter 6: Stress Management
Chapter 7: Sleep and Sleep Disorders
Chapter 8: Pain
Chapter 9: Palliative and End-of-Life Care
Chapter 10: Substance Use Disorders
Section Three – Problems Related to Homeostasis and Protection
Chapter 11: Inflammation and Healing
Chapter 12: Genetics
Chapter 13: Immune Responses and Transplantation
Chapter 14: Infection
Chapter 15: Cancer
Chapter 16: Fluid, Electrolyte, and Acid-Base Imbalances
Section Four – Perioperative Care
Chapter 17: Management: Preoperative Care
Chapter 18: Management: Intraoperative Care
Chapter 19: Management: Postoperative Care
Section Five – Problems Related to Altered Sensory Input
Chapter 20: Assessment and Management: Visual Problems
Chapter 21: Assessment and Management: Auditory Problems
Chapter 22: Assessment: Integumentary System
Chapter 23: Management: Integumentary Problems
Chapter 24: Management: Burns
Section Six – Problems of Oxygenation: Ventilation
Chapter 25: Assessment: Respiratory System
Chapter 26: Management: Upper Respiratory Problems
Chapter 27: Management: Lower Respiratory Problems
Chapter 28: Management: Obstructive Pulmonary Diseases
Section Seven – Problems of Oxygenation: Transport
Chapter 29: Assessment: Hematologic System
Chapter 30: Management: Hematologic Problems
Section Eight – Problems of Oxygenation: Perfusion
Chapter 31: Assessment: Cardiovascular System
Chapter 32: Management: Hypertension
Chapter 33: Management: Coronary Artery Disease and Acute Coronary Syndrome
Chapter 34: Management: Heart Failure
Chapter 35: Management: Dysrhythmias
Chapter 36: Management: Inflammatory and Structural Heart Disorders
Chapter 37: Management: Vascular Disorders
,Section Nine – Problems of Ingestion, Digestion, Absorption, and Elimination
Chapter 38: Assessment: Gastrointestinal System
Chapter 39: Management: Nutritional Problems
Chapter 40: Management: Obesity
Chapter 41: Management: Upper Gastrointestinal Problems
Chapter 42: Management: Lower Gastrointestinal Problems
Chapter 43: Management: Liver, Biliary Tract, Pancreas
Section Ten – Problems of Urinary Function
Chapter 44: Assessment: Urinary System
Chapter 45: Management: Renal and Urologic Problems
Chapter 46: Management: Acute Renal Failure and Chronic Kidney Disease
Section Eleven – Problems Related to Regulatory and Reproductive Mechanisms
Chapter 47: Assessment: Endocrine System
Chapter 48: Management: Diabetes Mellitus
Chapter 49: Management: Endocrine Problems
Chapter 50: Assessment: Reproductive System
Chapter 51: Management: Breast Disorders
Chapter 52: Management: Sexually Transmitted Infections
Chapter 53: Management: Female Reproductive Problems
Chapter 54: Management: Male Reproductive Problems
Section Twelve – Problems Related to Movement and Coordination
Chapter 55: Assessment: Nervous System
Chapter 56: Management: Acute Intracranial Problems
Chapter 57: Management: Stroke
Chapter 58: Management: Chronic Neurologic Problems
Chapter 59: Management: Alzheimer’s Disease and Dementia
Chapter 60: Management: Peripheral Nerve and Spinal Cord Problems
Chapter 61: Assessment: Musculoskeletal System
Chapter 62: Management: Musculoskeletal Trauma and Orthopedic Surgery
Chapter 63: Management: Musculoskeletal Problems
Chapter 64: Management: Arthritis and Connective Tissue Diseases
Section Thirteen – Nursing Care in Specialized Settings
Chapter 65: Management: Critical Care
Chapter 66: Management: Shock, Systemic Inflammatory Response Syndrome, and Multiple Organ
Dysfunction Syndrome
Chapter 67: Management: Respiratory Failure and Acute Respiratory Distress Syndrome
Chapter 68: Management: Emergency Care Situations
Chapter 1. Professional Nursing
MULTIPLE CHOICE
1. The nurse completes an admission database and explains that the plan of care and
discharge goals will be developed with the patients input. The patient states, How is this different
from what the doctor does? Which response would be most appropriate for the nurse to make?
a. The role of the nurse is to administer medications and other treatments prescribed by your
doctor.
b. The nurses job is to help the doctor by collecting information and communicating any
problems that occur.
c. Nurses perform many of the same procedures as the doctor, but nurses are with the
patients for a longer time than the doctor.
d. In addition to caring for you while you are sick, the nurses will assist you to develop an
individualized plan to maintain your health.
ANS: D
,This response is consistent with the American Nurses Association (ANA) definition of nursing,
which describes the role of nurses in promoting health. The other responses describe some of the
dependent and collaborative functions of the nursing role but do not accurately describe the
nurses role in the health care system.
DIF: Cognitive Level: Understand (comprehension) REF: 3
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
2. The nurse describes to a student nurse how to use evidence-based practice guidelines
when caring for patients. Which statement, if made by the nurse, would be the most accurate?
a. Inferences from clinical research studies are used as a guide.
b. Patient care is based on clinical judgment, experience, and traditions.
c. Data are evaluated to show that the patient outcomes are consistently met.
d. Recommendations are based on research, clinical expertise, and patient preferences.
ANS: D
Evidence-based practice (EBP) is the use of the best research-based evidence combined with
clinician expertise. Clinical judgment based on the nurses clinical experience is part of EBP, but
clinical decision making should also incorporate current research and research-based guidelines.
Evaluation of patient outcomes is important, but interventions should be based on research from
randomized control studies with a large number of subjects.
DIF: Cognitive Level: Remember (knowledge) REF: 11
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
3. The nurse teaches a student nurse about how to apply the nursing process when providing
patient care. Which statement, if made by the student nurse, indicates that teaching was
successful?
a. The nursing process is a scientific-based method of diagnosing the patients health care
problems.
b. The nursing process is a problem-solving tool used to identify and treat patients health
care needs.
c. The nursing process is based on nursing theory that incorporates the biopsychosocial
nature of humans.
d. The nursing process is used primarily to explain nursing interventions to other health care
professionals.
ANS: B
The nursing process is a problem-solving approach to the identification and treatment of patients
problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing
process is in patient care, not to establish nursing theory or explain nursing interventions to other
health care professionals.
DIF: Cognitive Level: Understand (comprehension) REF: 7
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
4. A patient has been admitted to the hospital for surgery and tells the nurse, I do not feel
comfortable leaving my children with my parents. Which action should the nurse take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing well.
c. Gather more data about the patients feelings about the child-care arrangements.
d. Call the patients parents to determine whether adequate child care is being provided.
ANS: C
, Since a complete assessment is necessary in order to identify a problem and choose an
appropriate intervention, the nurses first action should be to obtain more information. The other
actions may be appropriate, but more assessment is needed before the best intervention can be
chosen.
DIF: Cognitive Level: Apply (application) REF: 6-7
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
MSC: NCLEX: Psychosocial Integrity
5. A patient who is paralyzed on the left side of the body after a stroke develops a pressure
ulcer on the left hip. Which nursing diagnosis is most appropriate?
a. Impaired physical mobility related to left-sided paralysis
b. Risk for impaired tissue integrity related to left-sided weakness
c. Impaired skin integrity related to altered circulation and pressure
d. Ineffective tissue perfusion related to inability to move independently
ANS: C
The patients major problem is the impaired skin integrity as demonstrated by the presence of a
pressure ulcer. The nurse is able to treat the cause of altered circulation and pressure by
frequently repositioning the patient. Although left-sided weakness is a problem for the patient,
the nurse cannot treat the weakness. The risk for diagnosis is not appropriate for this patient, who
already has impaired tissue integrity. The patient does have ineffective tissue perfusion, but the
impaired skin integrity diagnosis indicates more clearly what the health problem is.
DIF: Cognitive Level: Apply (application) REF: 7-9
TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity
6. A patient with a bacterial infection has a nursing diagnosis of deficient fluid volume
related to excessive diaphoresis. Which outcome would the nurse recognize as most appropriate
for this patient?
a. Patient has a balanced intake and output.
b. Patients bedding is changed when it becomes damp.
c. Patient understands the need for increased fluid intake.
d. Patients skin remains cool and dry throughout hospitalization.
ANS: A
This statement gives measurable data showing resolution of the problem of deficient fluid
volume that was identified in the nursing diagnosis statement. The other statements would not
indicate that the problem of deficient fluid volume was resolved.
DIF: Cognitive Level: Apply (application) REF: 7-9
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
7. A nurse asks the patient if pain was relieved after receiving medication. What is the
purpose of the evaluation phase of the nursing process?
a. To determine if interventions have been effective in meeting patient outcomes
b. To document the nursing care plan in the progress notes of the medical record
c. To decide whether the patients health problems have been completely resolved
d. To establish if the patient agrees that the nursing care provided was satisfactory
ANS: A
Evaluation consists of determining whether the desired patient outcomes have been met and
whether the nursing interventions were appropriate. The other responses do not describe the
evaluation phase.
DIF: Cognitive Level: Understand (comprehension) REF: 7-9
Lewis's Medical-Surgical Nursing: Assessment and
Management of Clinical Problems 11th Edition
Authors: Mariann M. Harding, Jeffrey Kwong, Dottie Roberts, Debra Hagler, Courtney Reinisch
Table of Contents
Section One – Concepts in Nursing Practice
Chapter 1: Professional Nursing
Chapter 2: Health Equity and Culturally Competent Care
Chapter 3: Health History and Physical Examination
Chapter 4: Patient and Caregiver Teaching
Chapter 5: Chronic Illness and Older Adults
Section Two – Problems Related to Comfort and
Coping
Chapter 6: Stress Management
Chapter 7: Sleep and Sleep Disorders
Chapter 8: Pain
Chapter 9: Palliative and End-of-Life Care
Chapter 10: Substance Use Disorders
Section Three – Problems Related to Homeostasis and Protection
Chapter 11: Inflammation and Healing
Chapter 12: Genetics
Chapter 13: Immune Responses and Transplantation
Chapter 14: Infection
Chapter 15: Cancer
Chapter 16: Fluid, Electrolyte, and Acid-Base Imbalances
Section Four – Perioperative Care
Chapter 17: Management: Preoperative Care
Chapter 18: Management: Intraoperative Care
Chapter 19: Management: Postoperative Care
Section Five – Problems Related to Altered Sensory Input
Chapter 20: Assessment and Management: Visual Problems
Chapter 21: Assessment and Management: Auditory Problems
Chapter 22: Assessment: Integumentary System
Chapter 23: Management: Integumentary Problems
Chapter 24: Management: Burns
Section Six – Problems of Oxygenation: Ventilation
Chapter 25: Assessment: Respiratory System
Chapter 26: Management: Upper Respiratory Problems
Chapter 27: Management: Lower Respiratory Problems
Chapter 28: Management: Obstructive Pulmonary Diseases
Section Seven – Problems of Oxygenation: Transport
Chapter 29: Assessment: Hematologic System
Chapter 30: Management: Hematologic Problems
Section Eight – Problems of Oxygenation: Perfusion
Chapter 31: Assessment: Cardiovascular System
Chapter 32: Management: Hypertension
Chapter 33: Management: Coronary Artery Disease and Acute Coronary Syndrome
Chapter 34: Management: Heart Failure
Chapter 35: Management: Dysrhythmias
Chapter 36: Management: Inflammatory and Structural Heart Disorders
Chapter 37: Management: Vascular Disorders
,Section Nine – Problems of Ingestion, Digestion, Absorption, and Elimination
Chapter 38: Assessment: Gastrointestinal System
Chapter 39: Management: Nutritional Problems
Chapter 40: Management: Obesity
Chapter 41: Management: Upper Gastrointestinal Problems
Chapter 42: Management: Lower Gastrointestinal Problems
Chapter 43: Management: Liver, Biliary Tract, Pancreas
Section Ten – Problems of Urinary Function
Chapter 44: Assessment: Urinary System
Chapter 45: Management: Renal and Urologic Problems
Chapter 46: Management: Acute Renal Failure and Chronic Kidney Disease
Section Eleven – Problems Related to Regulatory and Reproductive Mechanisms
Chapter 47: Assessment: Endocrine System
Chapter 48: Management: Diabetes Mellitus
Chapter 49: Management: Endocrine Problems
Chapter 50: Assessment: Reproductive System
Chapter 51: Management: Breast Disorders
Chapter 52: Management: Sexually Transmitted Infections
Chapter 53: Management: Female Reproductive Problems
Chapter 54: Management: Male Reproductive Problems
Section Twelve – Problems Related to Movement and Coordination
Chapter 55: Assessment: Nervous System
Chapter 56: Management: Acute Intracranial Problems
Chapter 57: Management: Stroke
Chapter 58: Management: Chronic Neurologic Problems
Chapter 59: Management: Alzheimer’s Disease and Dementia
Chapter 60: Management: Peripheral Nerve and Spinal Cord Problems
Chapter 61: Assessment: Musculoskeletal System
Chapter 62: Management: Musculoskeletal Trauma and Orthopedic Surgery
Chapter 63: Management: Musculoskeletal Problems
Chapter 64: Management: Arthritis and Connective Tissue Diseases
Section Thirteen – Nursing Care in Specialized Settings
Chapter 65: Management: Critical Care
Chapter 66: Management: Shock, Systemic Inflammatory Response Syndrome, and Multiple Organ
Dysfunction Syndrome
Chapter 67: Management: Respiratory Failure and Acute Respiratory Distress Syndrome
Chapter 68: Management: Emergency Care Situations
Chapter 1. Professional Nursing
MULTIPLE CHOICE
1. The nurse completes an admission database and explains that the plan of care and
discharge goals will be developed with the patients input. The patient states, How is this different
from what the doctor does? Which response would be most appropriate for the nurse to make?
a. The role of the nurse is to administer medications and other treatments prescribed by your
doctor.
b. The nurses job is to help the doctor by collecting information and communicating any
problems that occur.
c. Nurses perform many of the same procedures as the doctor, but nurses are with the
patients for a longer time than the doctor.
d. In addition to caring for you while you are sick, the nurses will assist you to develop an
individualized plan to maintain your health.
ANS: D
,This response is consistent with the American Nurses Association (ANA) definition of nursing,
which describes the role of nurses in promoting health. The other responses describe some of the
dependent and collaborative functions of the nursing role but do not accurately describe the
nurses role in the health care system.
DIF: Cognitive Level: Understand (comprehension) REF: 3
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
2. The nurse describes to a student nurse how to use evidence-based practice guidelines
when caring for patients. Which statement, if made by the nurse, would be the most accurate?
a. Inferences from clinical research studies are used as a guide.
b. Patient care is based on clinical judgment, experience, and traditions.
c. Data are evaluated to show that the patient outcomes are consistently met.
d. Recommendations are based on research, clinical expertise, and patient preferences.
ANS: D
Evidence-based practice (EBP) is the use of the best research-based evidence combined with
clinician expertise. Clinical judgment based on the nurses clinical experience is part of EBP, but
clinical decision making should also incorporate current research and research-based guidelines.
Evaluation of patient outcomes is important, but interventions should be based on research from
randomized control studies with a large number of subjects.
DIF: Cognitive Level: Remember (knowledge) REF: 11
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
3. The nurse teaches a student nurse about how to apply the nursing process when providing
patient care. Which statement, if made by the student nurse, indicates that teaching was
successful?
a. The nursing process is a scientific-based method of diagnosing the patients health care
problems.
b. The nursing process is a problem-solving tool used to identify and treat patients health
care needs.
c. The nursing process is based on nursing theory that incorporates the biopsychosocial
nature of humans.
d. The nursing process is used primarily to explain nursing interventions to other health care
professionals.
ANS: B
The nursing process is a problem-solving approach to the identification and treatment of patients
problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing
process is in patient care, not to establish nursing theory or explain nursing interventions to other
health care professionals.
DIF: Cognitive Level: Understand (comprehension) REF: 7
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
4. A patient has been admitted to the hospital for surgery and tells the nurse, I do not feel
comfortable leaving my children with my parents. Which action should the nurse take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing well.
c. Gather more data about the patients feelings about the child-care arrangements.
d. Call the patients parents to determine whether adequate child care is being provided.
ANS: C
, Since a complete assessment is necessary in order to identify a problem and choose an
appropriate intervention, the nurses first action should be to obtain more information. The other
actions may be appropriate, but more assessment is needed before the best intervention can be
chosen.
DIF: Cognitive Level: Apply (application) REF: 6-7
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
MSC: NCLEX: Psychosocial Integrity
5. A patient who is paralyzed on the left side of the body after a stroke develops a pressure
ulcer on the left hip. Which nursing diagnosis is most appropriate?
a. Impaired physical mobility related to left-sided paralysis
b. Risk for impaired tissue integrity related to left-sided weakness
c. Impaired skin integrity related to altered circulation and pressure
d. Ineffective tissue perfusion related to inability to move independently
ANS: C
The patients major problem is the impaired skin integrity as demonstrated by the presence of a
pressure ulcer. The nurse is able to treat the cause of altered circulation and pressure by
frequently repositioning the patient. Although left-sided weakness is a problem for the patient,
the nurse cannot treat the weakness. The risk for diagnosis is not appropriate for this patient, who
already has impaired tissue integrity. The patient does have ineffective tissue perfusion, but the
impaired skin integrity diagnosis indicates more clearly what the health problem is.
DIF: Cognitive Level: Apply (application) REF: 7-9
TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity
6. A patient with a bacterial infection has a nursing diagnosis of deficient fluid volume
related to excessive diaphoresis. Which outcome would the nurse recognize as most appropriate
for this patient?
a. Patient has a balanced intake and output.
b. Patients bedding is changed when it becomes damp.
c. Patient understands the need for increased fluid intake.
d. Patients skin remains cool and dry throughout hospitalization.
ANS: A
This statement gives measurable data showing resolution of the problem of deficient fluid
volume that was identified in the nursing diagnosis statement. The other statements would not
indicate that the problem of deficient fluid volume was resolved.
DIF: Cognitive Level: Apply (application) REF: 7-9
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
7. A nurse asks the patient if pain was relieved after receiving medication. What is the
purpose of the evaluation phase of the nursing process?
a. To determine if interventions have been effective in meeting patient outcomes
b. To document the nursing care plan in the progress notes of the medical record
c. To decide whether the patients health problems have been completely resolved
d. To establish if the patient agrees that the nursing care provided was satisfactory
ANS: A
Evaluation consists of determining whether the desired patient outcomes have been met and
whether the nursing interventions were appropriate. The other responses do not describe the
evaluation phase.
DIF: Cognitive Level: Understand (comprehension) REF: 7-9
