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Test Bank for Brunner & Suddarth’s Textbook of
Medical-Surgical Nursing 15th Edition by Janice L.
Hinkle & Kerry H. Cheever – Updated 2025/2026
Comprehensive Adult Health Nursing Exam Resource.
The nurse receives all of the following stat orders for Mr. Palmer. Which
one should the nurse question?
1) Oxygen per nasal cannula at 4 L per minute.
2) Enoxaparin (Lovenox) 40 mg subcutaneously.
3) Troponin level.
4) Computed tomography (CT) angiogram. - ANSWER-Rationale: The
nurse should questions the order for Lovenox because the patient is
receiving a heparin drip.
Christine Warren, 45 years old, has a long history of ulcerative colitis,
and non-surgical treatment no longer relieved her symptoms. She
underwent a total proctocolectomy and a permanent ileostomy 12 hours
ago.
The nurse should contact the physician immediately if Mrs. Warren has
which of these findings?
1) The stoma appears pale and dry.
2) The stoma appears red and shiny.
3) There is 200 mL of dark green output from the stoma.
4) There is 50 mL of serosanguinous drainage from the stoma. -
ANSWER-1) The stoma appears pale and dry.
Rationale: If there is an adequate blood supply to the stoma, the color is
pink or red, and the stoma is moist as a result of mucous production. A
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pale dry color suggests ischemia of the stoma or bowel and must be
reported immediately to the physician. With an ileostomy initially after
surgery, the output is a loose, dark green liquid that may contain some
blood. The ileostomy usually begins to drain within 24 of surgery at
more than one liter per day.
When changing Mrs. Warren's ileostomy bag, the nurse notices that the
peristomal skin is irritated.
Which of these actions by the nurse would be appropriate before
reapplying the appliance?
1) Wash the area with antiseptic soap and water.
2) Clean the site with Dakin's solution.
3) Use a solid skin barrier.
4) Obtain an order for a topical antibiotic. - ANSWER-3) Use a solid
skin barrier.
Rationale: The drainage from the stoma can quickly irritate the
surrounding tissue. Therefore, a solid skin barrier, with a pectin base or
karaya wafer that has a measurable thickness and hydrocolloid adhesive
properties, should be applied.
Which of these comments, if made by Mrs. Warren before her surgery,
would indicate that she had concerns about her body image?
1) "I will have to stop my aerobics classes."
2) "I'm so afraid I may not survive the surgery."
3) "I need to go shopping for some loose, baggy clothes."
4) "I'm concerned that this may be only the first of many surgeries." -
ANSWER-3) "I need to go shopping for some loose, baggy clothes."
Rationale:Body image refers to a person's perception of self and
determines how the person interacts with others. One does not need to
purchase special clothing after ileostomy surgery, although some minor
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adjustments may be needed for comfort, e.g., stretch underwear or
pantyhose for support.
Lewis Palmer, 45 years old, has a history of multiple myocardial
infarctions and is a heavy smoker. He takes warfarin sodium
(Coumadin) daily. Two weeks ago, he had a right femoral-popliteal
bypass, which became occluded 24 hours ago. He is admitted following
an angioplasty of the femoral-popliteal bypass graft. Mr. Palmer is
receiving continuous IV heparin.
Because Mr. Palmer is receiving heparin, it is essential for the nurse to
1) monitor his prothrombin time.
2) observe him for signs of pulmonary embolism.
3) limit his intake of foods high in vitamin K.
4) check the femoral puncture site at frequent intervals. - ANSWER-4)
check the femoral puncture site at frequent intervals.
Rationale: Since bleeding is a common side effect of heparin, it is vital
to check the operative site, the femoral puncture area, for signs of
bleeding.
Attempts to revascularize Mr. Palmer's leg are unsuccessful, and Mr.
Palmer has a below-knee amputation (BKA) of his right extremity and is
returned to the medical-surgical unit with an intravenous infusion in
place. His orders include: heparin drip, morphine sulfate 10 mg IV push
q4h prn for pain, and ampicillin sodium g 1 IV q6h.
Twelve hours postoperatively, Mr. Palmer is found to be short of breath
and diaphoretic. He says, "My chest hurts." His pulse is 140/min,
compared to a baseline of 80/min. His blood pressure is105/60 mm Hg,
compared to a baseline of 138/70 mm Hg. His respirations are 32/min,
compared to a baseline of 16/min. His O2 saturation is 85%. The nurse
immediately calls for help. Which of the following questions is most
important for the nurse to ask?
1) "Have you ever had this type of chest pain before?"
2) "How long have you had this pain?"
3) "What pain medication do you usually take?"
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4) "What - ANSWER-1) "Have you ever had this type of chest pain
before?"
Rationale: Because of the patient's symptoms and his history of
myocardial infarctions, the nurse should find out if the patient has had
this time of pain previously.
Maggie Clark, a 42-year-old female, was admitted with newly diagnosed
type 2 diabetes mellitus. Her blood glucose has been stabilized, and the
nurse is preparing her for discharge. Her discharge orders will include
metformin (Glucophage). Mrs. Clark is also being treated for
hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is
important to
1) monitor her glomerular filtration rate.
2) check her serum amylase routinely.
3) obtain her red blood cell count periodically.
4) examine her urine for casts. - ANSWER-1) monitor her glomerular
filtration rate.
Rationale: The estimated glomerular filtration rate (eGFR) is one way to
measure the adequacy of kidney function. Glucophage is excreted by the
kidney and the risk of lactic acidosis increases in patients with impaired
kidney function. The drug may be used if the eGFR is between 45 and
60 mL/min/1.73 m2, i.e., in mild chronic kidney disease. Glucophage is
absolutely contraindicated if the eGFR is below 30 mL/min/1.73 m2.
Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for
hypertension. Which symptom of hypoglycemia would be masked by
Lopressor?
1) Diaphoresis.
2) Tingling.
3) Diplopia.
4) Tachycardia. - ANSWER-4) Tachycardia.
Test Bank for Brunner & Suddarth’s Textbook of
Medical-Surgical Nursing 15th Edition by Janice L.
Hinkle & Kerry H. Cheever – Updated 2025/2026
Comprehensive Adult Health Nursing Exam Resource.
The nurse receives all of the following stat orders for Mr. Palmer. Which
one should the nurse question?
1) Oxygen per nasal cannula at 4 L per minute.
2) Enoxaparin (Lovenox) 40 mg subcutaneously.
3) Troponin level.
4) Computed tomography (CT) angiogram. - ANSWER-Rationale: The
nurse should questions the order for Lovenox because the patient is
receiving a heparin drip.
Christine Warren, 45 years old, has a long history of ulcerative colitis,
and non-surgical treatment no longer relieved her symptoms. She
underwent a total proctocolectomy and a permanent ileostomy 12 hours
ago.
The nurse should contact the physician immediately if Mrs. Warren has
which of these findings?
1) The stoma appears pale and dry.
2) The stoma appears red and shiny.
3) There is 200 mL of dark green output from the stoma.
4) There is 50 mL of serosanguinous drainage from the stoma. -
ANSWER-1) The stoma appears pale and dry.
Rationale: If there is an adequate blood supply to the stoma, the color is
pink or red, and the stoma is moist as a result of mucous production. A
,2|Page
pale dry color suggests ischemia of the stoma or bowel and must be
reported immediately to the physician. With an ileostomy initially after
surgery, the output is a loose, dark green liquid that may contain some
blood. The ileostomy usually begins to drain within 24 of surgery at
more than one liter per day.
When changing Mrs. Warren's ileostomy bag, the nurse notices that the
peristomal skin is irritated.
Which of these actions by the nurse would be appropriate before
reapplying the appliance?
1) Wash the area with antiseptic soap and water.
2) Clean the site with Dakin's solution.
3) Use a solid skin barrier.
4) Obtain an order for a topical antibiotic. - ANSWER-3) Use a solid
skin barrier.
Rationale: The drainage from the stoma can quickly irritate the
surrounding tissue. Therefore, a solid skin barrier, with a pectin base or
karaya wafer that has a measurable thickness and hydrocolloid adhesive
properties, should be applied.
Which of these comments, if made by Mrs. Warren before her surgery,
would indicate that she had concerns about her body image?
1) "I will have to stop my aerobics classes."
2) "I'm so afraid I may not survive the surgery."
3) "I need to go shopping for some loose, baggy clothes."
4) "I'm concerned that this may be only the first of many surgeries." -
ANSWER-3) "I need to go shopping for some loose, baggy clothes."
Rationale:Body image refers to a person's perception of self and
determines how the person interacts with others. One does not need to
purchase special clothing after ileostomy surgery, although some minor
,3|Page
adjustments may be needed for comfort, e.g., stretch underwear or
pantyhose for support.
Lewis Palmer, 45 years old, has a history of multiple myocardial
infarctions and is a heavy smoker. He takes warfarin sodium
(Coumadin) daily. Two weeks ago, he had a right femoral-popliteal
bypass, which became occluded 24 hours ago. He is admitted following
an angioplasty of the femoral-popliteal bypass graft. Mr. Palmer is
receiving continuous IV heparin.
Because Mr. Palmer is receiving heparin, it is essential for the nurse to
1) monitor his prothrombin time.
2) observe him for signs of pulmonary embolism.
3) limit his intake of foods high in vitamin K.
4) check the femoral puncture site at frequent intervals. - ANSWER-4)
check the femoral puncture site at frequent intervals.
Rationale: Since bleeding is a common side effect of heparin, it is vital
to check the operative site, the femoral puncture area, for signs of
bleeding.
Attempts to revascularize Mr. Palmer's leg are unsuccessful, and Mr.
Palmer has a below-knee amputation (BKA) of his right extremity and is
returned to the medical-surgical unit with an intravenous infusion in
place. His orders include: heparin drip, morphine sulfate 10 mg IV push
q4h prn for pain, and ampicillin sodium g 1 IV q6h.
Twelve hours postoperatively, Mr. Palmer is found to be short of breath
and diaphoretic. He says, "My chest hurts." His pulse is 140/min,
compared to a baseline of 80/min. His blood pressure is105/60 mm Hg,
compared to a baseline of 138/70 mm Hg. His respirations are 32/min,
compared to a baseline of 16/min. His O2 saturation is 85%. The nurse
immediately calls for help. Which of the following questions is most
important for the nurse to ask?
1) "Have you ever had this type of chest pain before?"
2) "How long have you had this pain?"
3) "What pain medication do you usually take?"
, 4|Page
4) "What - ANSWER-1) "Have you ever had this type of chest pain
before?"
Rationale: Because of the patient's symptoms and his history of
myocardial infarctions, the nurse should find out if the patient has had
this time of pain previously.
Maggie Clark, a 42-year-old female, was admitted with newly diagnosed
type 2 diabetes mellitus. Her blood glucose has been stabilized, and the
nurse is preparing her for discharge. Her discharge orders will include
metformin (Glucophage). Mrs. Clark is also being treated for
hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is
important to
1) monitor her glomerular filtration rate.
2) check her serum amylase routinely.
3) obtain her red blood cell count periodically.
4) examine her urine for casts. - ANSWER-1) monitor her glomerular
filtration rate.
Rationale: The estimated glomerular filtration rate (eGFR) is one way to
measure the adequacy of kidney function. Glucophage is excreted by the
kidney and the risk of lactic acidosis increases in patients with impaired
kidney function. The drug may be used if the eGFR is between 45 and
60 mL/min/1.73 m2, i.e., in mild chronic kidney disease. Glucophage is
absolutely contraindicated if the eGFR is below 30 mL/min/1.73 m2.
Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for
hypertension. Which symptom of hypoglycemia would be masked by
Lopressor?
1) Diaphoresis.
2) Tingling.
3) Diplopia.
4) Tachycardia. - ANSWER-4) Tachycardia.
