NUR 372 ADVANTAGE FOR UNDERSTANDING
MEDICAL- SURGICAL NURSING Verified
Questions and Answers with Detailed Rationales
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The healthcare provider prescribes high-protein, high-fat, low-carbohydrate diet with limited fluids
during meals for a client recovering from gastric surgery. The client asks the nurse what the purpose is
for this type of diet. Which rationale should be included in the nurse's explanation to this client?
A) It is quickly digested.
B) It does not cause diarrhea.
C) It does not dilate the stomach.
D) It is slow to leave the stomach.
Correct Answer(s): D
Detailed Rationale
This type of diet is slowly digested and is slow to leave the stomach (D). Because of its density from
proteins and fats, and the reduction of fluids with the meal, the possibility of dumping syndrome is
reduced. (A, B, and C) are incorrect rationales.
The nurse is assessing a client with a cuffed tracheostomy tube in place who is breathing
spontaneously. To evaluate if the client can tolerate cuff deflation to promote speaking and
swallowing, what action should the nurse implement?
A) Ask the client to try to speak.
B) Assess for respiratory distress.
C) Auscultate for pulmonary crackles after the client drinks a small amount of clear water.
D) Observe the client for coughing colored sputum after drinking a small amount of colored water.
Correct Answer(s): D
Detailed Rationale
, To evaluate the risk for aspiration after the cuff is deflated, the client should be instructed to swallow
a small amount of colored water, then observed for coughing up colored sputum (D), or the
tracheostomy should be suctioned for the presence of colored water. (A) does not determine if the
client is at risk to aspirate oral intake. Large volumes of oral intake are more likely to cause respiratory
distress (B) or crackles (C), and should not be used to evaluate the client's risk for aspiration.
A client's family asks why their mother with heart failure needs a pulmonary artery (PA) catheter now
that she is in the intensive care unit (ICU). What information should the nurse include in the
explanation to the family?
A) A central monitoring system reduces the risk of complications undetected by observation.
B) A pulmonary artery catheter measures central pressures for monitoring fluid replacement.
A+ TEST BANK 2
,C) Pulmonary artery catheters allow for early detection of lung problems.
D) The healthcare provider should explain the many reasons for its use.
Correct Answer(s): B
Detailed Rationale
Pulmonary artery catheters are used to measure central pressures and fluid balance (B). Even though
all clients in the ICU require close monitoring, they do not all need a PA catheter (A). PA lines do not
detect pulmonary problems (C). (D) avoids the family's question.
An older female client is admitted with atrophic vaginitis and perineal cutaneous candidiasis. What is
the priority nursing diagnosis for this client?
A) Risk for injury.
B) Impaired comfort.
C) Disturbed body image.
D) Ineffective health maintenance.
Correct Answer(s): B
Detailed Rationale
In menopausal women, the vaginal mucous membrane responds to low estrogen levels causing the
vaginal walls to become thinner, drier, and susceptible to infection which leads to atrophic vaginitis.
Perineal cutaneous candidiasis contributes to other manifestations of vaginal infections, such as
vaginal irritation, burning, pruritus, increased leukorrhea, bleeding, and dyspareunia, and support the
primary nursing diagnosis, Impaired comfort (B). Risk for injury (A), body image (C), and ineffective
health maintenance (D) are secondary and linked to impaired comfort.
A male client with a prostatic stent is preparing for discharge. What should the nurse ensure the client
understands?
A) Ongoing antibiotic therapy is needed for one year.
B) The client should not undergo magnetic resonance imaging.
C) Increased frequency of assessment for prostatic cancer is needed.
D) The client should not be catheterized through the stent for at least three months.
A+ TEST BANK 3
, Correct Answer(s): D
Detailed Rationale
To prevent complications, the client should be cautioned against catheterization through the stent
for three months after stent placement (D). Long term antibiotic use for one year (A) is not a part of
illness management. There is no contraindication for magnetic resonance imaging (B). Frequent
assessment of prostate health is part of client teaching for health promotion (C), but is not increased
because of the stent placement.
Which client is at highest risk for compromised psychological adjustment after a hysterectomy?
A) A 46-year-old woman with three children and a recent promotion at work.
B) A 55-year-old woman with abnormal bleeding and pain for 3 years.
C) A 62-year-old widow who has three friends who had uncomplicated hysterectomies.
D) A 29-year-old woman whose uterus ruptured after giving birth to her first child.
Correct Answer(s): D
Detailed Rationale
The client who is a primipara and is still in her childbearing years (D) is at highest risk for unresolved
conflicts about the end of her childbearing opportunities. The client with a family and positive life
events (A), the menopausal client with physical distress (B), the post-menopausal client with support
of peers with similar positive outcomes (C) are less likely to be psychologically distressed.
A client with sickle cell anemia is admitted with severe abdominal pain and the diagnosis is sickle cell
crisis. What is the most important nursing action to implement?
A) Limit the client's intake of oral fluids and food.
B) Evaluate the effectiveness of narcotic analgesics.
C) Encourage the client to ambulate as tolerated.
D) Teach the client about prevention of crises.
A+ TEST BANK 4
MEDICAL- SURGICAL NURSING Verified
Questions and Answers with Detailed Rationales
Already Graded A+ Guaranteed Pass
The healthcare provider prescribes high-protein, high-fat, low-carbohydrate diet with limited fluids
during meals for a client recovering from gastric surgery. The client asks the nurse what the purpose is
for this type of diet. Which rationale should be included in the nurse's explanation to this client?
A) It is quickly digested.
B) It does not cause diarrhea.
C) It does not dilate the stomach.
D) It is slow to leave the stomach.
Correct Answer(s): D
Detailed Rationale
This type of diet is slowly digested and is slow to leave the stomach (D). Because of its density from
proteins and fats, and the reduction of fluids with the meal, the possibility of dumping syndrome is
reduced. (A, B, and C) are incorrect rationales.
The nurse is assessing a client with a cuffed tracheostomy tube in place who is breathing
spontaneously. To evaluate if the client can tolerate cuff deflation to promote speaking and
swallowing, what action should the nurse implement?
A) Ask the client to try to speak.
B) Assess for respiratory distress.
C) Auscultate for pulmonary crackles after the client drinks a small amount of clear water.
D) Observe the client for coughing colored sputum after drinking a small amount of colored water.
Correct Answer(s): D
Detailed Rationale
, To evaluate the risk for aspiration after the cuff is deflated, the client should be instructed to swallow
a small amount of colored water, then observed for coughing up colored sputum (D), or the
tracheostomy should be suctioned for the presence of colored water. (A) does not determine if the
client is at risk to aspirate oral intake. Large volumes of oral intake are more likely to cause respiratory
distress (B) or crackles (C), and should not be used to evaluate the client's risk for aspiration.
A client's family asks why their mother with heart failure needs a pulmonary artery (PA) catheter now
that she is in the intensive care unit (ICU). What information should the nurse include in the
explanation to the family?
A) A central monitoring system reduces the risk of complications undetected by observation.
B) A pulmonary artery catheter measures central pressures for monitoring fluid replacement.
A+ TEST BANK 2
,C) Pulmonary artery catheters allow for early detection of lung problems.
D) The healthcare provider should explain the many reasons for its use.
Correct Answer(s): B
Detailed Rationale
Pulmonary artery catheters are used to measure central pressures and fluid balance (B). Even though
all clients in the ICU require close monitoring, they do not all need a PA catheter (A). PA lines do not
detect pulmonary problems (C). (D) avoids the family's question.
An older female client is admitted with atrophic vaginitis and perineal cutaneous candidiasis. What is
the priority nursing diagnosis for this client?
A) Risk for injury.
B) Impaired comfort.
C) Disturbed body image.
D) Ineffective health maintenance.
Correct Answer(s): B
Detailed Rationale
In menopausal women, the vaginal mucous membrane responds to low estrogen levels causing the
vaginal walls to become thinner, drier, and susceptible to infection which leads to atrophic vaginitis.
Perineal cutaneous candidiasis contributes to other manifestations of vaginal infections, such as
vaginal irritation, burning, pruritus, increased leukorrhea, bleeding, and dyspareunia, and support the
primary nursing diagnosis, Impaired comfort (B). Risk for injury (A), body image (C), and ineffective
health maintenance (D) are secondary and linked to impaired comfort.
A male client with a prostatic stent is preparing for discharge. What should the nurse ensure the client
understands?
A) Ongoing antibiotic therapy is needed for one year.
B) The client should not undergo magnetic resonance imaging.
C) Increased frequency of assessment for prostatic cancer is needed.
D) The client should not be catheterized through the stent for at least three months.
A+ TEST BANK 3
, Correct Answer(s): D
Detailed Rationale
To prevent complications, the client should be cautioned against catheterization through the stent
for three months after stent placement (D). Long term antibiotic use for one year (A) is not a part of
illness management. There is no contraindication for magnetic resonance imaging (B). Frequent
assessment of prostate health is part of client teaching for health promotion (C), but is not increased
because of the stent placement.
Which client is at highest risk for compromised psychological adjustment after a hysterectomy?
A) A 46-year-old woman with three children and a recent promotion at work.
B) A 55-year-old woman with abnormal bleeding and pain for 3 years.
C) A 62-year-old widow who has three friends who had uncomplicated hysterectomies.
D) A 29-year-old woman whose uterus ruptured after giving birth to her first child.
Correct Answer(s): D
Detailed Rationale
The client who is a primipara and is still in her childbearing years (D) is at highest risk for unresolved
conflicts about the end of her childbearing opportunities. The client with a family and positive life
events (A), the menopausal client with physical distress (B), the post-menopausal client with support
of peers with similar positive outcomes (C) are less likely to be psychologically distressed.
A client with sickle cell anemia is admitted with severe abdominal pain and the diagnosis is sickle cell
crisis. What is the most important nursing action to implement?
A) Limit the client's intake of oral fluids and food.
B) Evaluate the effectiveness of narcotic analgesics.
C) Encourage the client to ambulate as tolerated.
D) Teach the client about prevention of crises.
A+ TEST BANK 4
