Contents
Section 1: Concepts in Nursing Practice
1 Professional Nursing Practice, 1
2 Health Disparities and Culturally Competent Care, 5
3 Health History and Physical Examination, 8
4 Patient and Caregiver Teaching, 11
5 Chronic Illness and Older Adults, 15
6 Complementary and Alternative Therapies, 19
7 Stress and Stress Management, 22
8 Sleep and Sleep Disorders, 26
9 Pain, 29
10 Palliative Care at End of Life, 33
11 Substance Abuse, 36
Section 2: Pathophysiologic Mechanisms of Disease
12 Inflammation and Wound Healing, 40
13 Genetics and Genomics, 44
14 Altered Immune Responses and Transplantation, 47
15 Infection and Human Immunodeficiency Virus Infection, 51
16 Cancer, 55
17 Fluid, Electrolyte, and Acid-Base Imbalances, 60
Section 3: Perioperative Care
18 Nursing Management: Preoperative Care, 66
19 Nursing Management: Intraoperative Care, 69
20 Nursing Management: Postoperative Care, 72
Section 4: Problems Related to Altered Sensory Input
21 Nursing Assessment: Visual and Auditory Systems, 75
22 Nursing Management: Visual and Auditory Problems, 80
23 Nursing Assessment: Integumentary System, 85
24 Nursing Management: Integumentary Problems, 88
25 Nursing Management: Burns, 92
Section 5: Problems of Oxygenation: Ventilation
26 Nursing Assessment: Respiratory System, 97
27 Nursing Management: Upper Respiratory Problems, 101
28 Nursing Management: Lower Respiratory Problems, 105
29 Nursing Management: Obstructive Pulmonary Diseases, 111
Section 6: Problems of Oxygenation: Transport
30 Nursing Assessment: Hematologic System, 117
31 Nursing Management: Hematologic Problems, 120
Section 7: Problems of Oxygenation: Perfusion
32 Nursing Assessment: Cardiovascular System, 127
33 Nursing Management: Hypertension, 134
34 Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome, 138
35 Nursing Management: Heart Failure, 145
36 Nursing Management: Dysrhythmias, 149
37 Nursing Management: Inflammatory and Structural Heart Disorders, 156
38 Nursing Management: Vascular Disorders, 161
iii
,iv Contents
Section 8: Problems of Ingestion, Digestion, Absorption, and Elimination
39 Nursing Assessment: Gastrointestinal System, 167
40 Nursing Management: Nutritional Problems, 171
41 Nursing Management: Obesity, 175
42 Nursing Management: Upper Gastrointestinal Problems, 179
43 Nursing Management: Lower Gastrointestinal Problems, 185
44 Nursing Management: Liver, Pancreas, and Biliary Tract Problems, 192
Section 9: Problems of Urinary Function
45 Nursing Assessment: Urinary System, 199
46 Nursing Management: Renal and Urologic Problems, 203
47 Nursing Management: Acute Kidney Injury and Chronic Kidney Disease, 208
Section 10: Problems Related to Regulatory and Reproductive Mechanisms
48 Nursing Assessment: Endocrine System, 214
49 Nursing Management: Diabetes Mellitus, 218
50 Nursing Management: Endocrine Problems, 224
51 Nursing Assessment: Reproductive System, 229
52 Nursing Management: Breast Disorders, 234
53 Nursing Management: Sexually Transmitted Infections, 238
54 Nursing Management: Female Reproductive Problems, 241
55 Nursing Management: Male Reproductive Problems, 246
Section 11: Problems Related to Movement and Coordination
56 Nursing Assessment: Nervous System, 250
57 Nursing Management: Acute Intracranial Problems, 256
58 Nursing Management: Stroke, 261
59 Nursing Management: Chronic Neurologic Problems, 265
60 Nursing Management: Alzheimer’s Disease, Dementia, and Delirium, 270
61 Nursing Management: Peripheral Nerve and Spinal Cord Problems, 274
62 Nursing Assessment: Musculoskeletal System, 279
63 Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery, 284
64 Nursing Management: Musculoskeletal Problems, 290
65 Nursing Management: Arthritis and Connective Tissue Diseases, 293
Section 12: Nursing Care in Critical Care Settings
66 Nursing Management: Critical Care, 298
67 Nursing Management: Shock, Systemic Inflammatory Response Syndrome,
and Multiple Organ Dysfunction Syndrome, 304
68 Nursing Management: Respiratory Failure and Acute Respiratory Distress Syndrome, 309
69 Nursing Management: Emergency, Terrorism, and Disaster Nursing, 313
Answers to Worksheets, 317
,CHAPTER
1 Professional Nursing Practice
1. Using the American Nurses Association’s definition of nursing, which activities are within the domain of nursing
(select all that apply)?
a. Implementing intake and output for a patient who is vomiting
b. Establishing and implementing a stress management program for family caregivers of patients with
Alzheimer’s disease
c. Explaining the risks associated with the planned surgical procedure when a preoperative patient inquires
about risks
d. Developing and performing a study to compare the health status of older patients who live alone with the
status of older patients who live with family members
e. Identifying the effect of an investigational drug on patients’ hemoglobin levels
f. Using a biofeedback machine to teach a patient with cancer how to manage chronic pain
g. Preventing pneumonia in an immobile patient by implementing frequent turning, coughing, and deep
breathing
h. Determining and administering fluid replacement therapy needed for a patient with serious burns
i. Testifying to legislative bodies regarding the effect of health policies on culturally, socially, and
economically diverse populations
2. A nurse who has worked on an orthopedic unit for several years is encouraged by the nurse manager to become
certified in orthopedic nursing. What will certification in nursing require and/or provide (select all that apply)?
a. A certain amount of clinical experience
b. Successful completion of an examination
c. Membership in specialty nursing organizations
d. Professional recognition of expertise in a specialty area
e. An advanced practice role that requires graduate education
3. What accurately describes the health care system in which future nurses will be employed?
a. With improvements in medicine there will be fewer patients with chronic illnesses.
b. Rapidly changing technology and expanding knowledge will simplify the health care environment.
c. The Quality and Safety Education for Nurses (QSEN) project measures the ability of nursing graduates to be
prepared for the reality of practice.
d. The Joint Commission establishes National Patient Safety Goals and evidence-based solutions for nurses to
promote meeting these goals by all caring for the patient.
4. What are the six competencies from Quality and Safety Education for Nurses (QSEN) that are expected of new
nursing graduates?
a.
b.
c.
d.
e.
f.
Copyright © 2014 Mosby, an imprint of Elsevier Inc. All rights reserved. 1
, 2 Chapter 1 Professional Nursing Practice
5. Place the steps of the evidence-based practice (EBP) process in order (0 being the first step; 6 being the last step).
Make recommendations for practice or generate data
Ask a clinical question
Critically analyze the evidence
Find and collect the evidence
Evaluate the outcomes in the clinical setting
Create a spirit of inquiry
Use evidence, clinical expertise, and patient preferences to determine care
6. The following is an example of an evidence-based practice (EBP) clinical question. “In adult seizure patients,
is restraint or medication more effective in protecting them from injury during a seizure?” Which word(s) in the
question identify(ies) the C part of the PICOT format?
a. Restraint
b. Or medication
c. During a seizure
d. Adult seizure patients
e. Protecting them from injury
7. Two nurses are establishing a smoking cessation program to assist patients with chronic lung disease to stop
smoking. To offer the most effective program with the best outcomes, the nurses should initially
a. search for an article that describes nursing interventions that are effective for smoking cessation.
b. develop a clinical question that will allow them to compare different cessation methods during the program.
c. keep comprehensive records that detail each patient’s progress and ultimate outcomes from participation in the
program.
d. use evidence-based clinical practice guidelines developed from reviews of randomized controlled trials of
smoking cessation methods.
8. Which standardized nursing terminologies specifically relate to the steps of the nursing process (select all that apply)?
a. Omaha System
b. Nursing Minimum Data Set (NMDS)
c. Perioperative Nursing Data Set (PNDS)
d. Nursing Outcomes Classification (NOC)
e. Nursing Interventions Classification (NIC)
f. NANDA International: Nursing Diagnoses
9. The nurse working in a health care facility where uniform electronic health records are used explains to the patient
that the primary purpose of such a record is to
a. reduce the cost of health care by eliminating paper records.
b. prevent medical errors associated with traditional paper records and handwritten orders and prescriptions.
c. force the use of standardized medical vocabularies and nursing terminologies so that outcomes of patient care can
be measured.
d. provide a single record in which all aspects of a patient’s medical information are readily available to any health
care provider involved in the patient’s care.
10. Which actions are done primarily by an informatics nurse (select all that apply)?
a. Designs and builds computer systems
b. Studies the validity of nursing information
c. Trains health care providers to provide nursing care
d. Communicates and accesses information for nursing staff
e. Builds systems that support the processing of nursing information
Copyright © 2014 Mosby, an imprint of Elsevier Inc. All rights reserved.
Section 1: Concepts in Nursing Practice
1 Professional Nursing Practice, 1
2 Health Disparities and Culturally Competent Care, 5
3 Health History and Physical Examination, 8
4 Patient and Caregiver Teaching, 11
5 Chronic Illness and Older Adults, 15
6 Complementary and Alternative Therapies, 19
7 Stress and Stress Management, 22
8 Sleep and Sleep Disorders, 26
9 Pain, 29
10 Palliative Care at End of Life, 33
11 Substance Abuse, 36
Section 2: Pathophysiologic Mechanisms of Disease
12 Inflammation and Wound Healing, 40
13 Genetics and Genomics, 44
14 Altered Immune Responses and Transplantation, 47
15 Infection and Human Immunodeficiency Virus Infection, 51
16 Cancer, 55
17 Fluid, Electrolyte, and Acid-Base Imbalances, 60
Section 3: Perioperative Care
18 Nursing Management: Preoperative Care, 66
19 Nursing Management: Intraoperative Care, 69
20 Nursing Management: Postoperative Care, 72
Section 4: Problems Related to Altered Sensory Input
21 Nursing Assessment: Visual and Auditory Systems, 75
22 Nursing Management: Visual and Auditory Problems, 80
23 Nursing Assessment: Integumentary System, 85
24 Nursing Management: Integumentary Problems, 88
25 Nursing Management: Burns, 92
Section 5: Problems of Oxygenation: Ventilation
26 Nursing Assessment: Respiratory System, 97
27 Nursing Management: Upper Respiratory Problems, 101
28 Nursing Management: Lower Respiratory Problems, 105
29 Nursing Management: Obstructive Pulmonary Diseases, 111
Section 6: Problems of Oxygenation: Transport
30 Nursing Assessment: Hematologic System, 117
31 Nursing Management: Hematologic Problems, 120
Section 7: Problems of Oxygenation: Perfusion
32 Nursing Assessment: Cardiovascular System, 127
33 Nursing Management: Hypertension, 134
34 Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome, 138
35 Nursing Management: Heart Failure, 145
36 Nursing Management: Dysrhythmias, 149
37 Nursing Management: Inflammatory and Structural Heart Disorders, 156
38 Nursing Management: Vascular Disorders, 161
iii
,iv Contents
Section 8: Problems of Ingestion, Digestion, Absorption, and Elimination
39 Nursing Assessment: Gastrointestinal System, 167
40 Nursing Management: Nutritional Problems, 171
41 Nursing Management: Obesity, 175
42 Nursing Management: Upper Gastrointestinal Problems, 179
43 Nursing Management: Lower Gastrointestinal Problems, 185
44 Nursing Management: Liver, Pancreas, and Biliary Tract Problems, 192
Section 9: Problems of Urinary Function
45 Nursing Assessment: Urinary System, 199
46 Nursing Management: Renal and Urologic Problems, 203
47 Nursing Management: Acute Kidney Injury and Chronic Kidney Disease, 208
Section 10: Problems Related to Regulatory and Reproductive Mechanisms
48 Nursing Assessment: Endocrine System, 214
49 Nursing Management: Diabetes Mellitus, 218
50 Nursing Management: Endocrine Problems, 224
51 Nursing Assessment: Reproductive System, 229
52 Nursing Management: Breast Disorders, 234
53 Nursing Management: Sexually Transmitted Infections, 238
54 Nursing Management: Female Reproductive Problems, 241
55 Nursing Management: Male Reproductive Problems, 246
Section 11: Problems Related to Movement and Coordination
56 Nursing Assessment: Nervous System, 250
57 Nursing Management: Acute Intracranial Problems, 256
58 Nursing Management: Stroke, 261
59 Nursing Management: Chronic Neurologic Problems, 265
60 Nursing Management: Alzheimer’s Disease, Dementia, and Delirium, 270
61 Nursing Management: Peripheral Nerve and Spinal Cord Problems, 274
62 Nursing Assessment: Musculoskeletal System, 279
63 Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery, 284
64 Nursing Management: Musculoskeletal Problems, 290
65 Nursing Management: Arthritis and Connective Tissue Diseases, 293
Section 12: Nursing Care in Critical Care Settings
66 Nursing Management: Critical Care, 298
67 Nursing Management: Shock, Systemic Inflammatory Response Syndrome,
and Multiple Organ Dysfunction Syndrome, 304
68 Nursing Management: Respiratory Failure and Acute Respiratory Distress Syndrome, 309
69 Nursing Management: Emergency, Terrorism, and Disaster Nursing, 313
Answers to Worksheets, 317
,CHAPTER
1 Professional Nursing Practice
1. Using the American Nurses Association’s definition of nursing, which activities are within the domain of nursing
(select all that apply)?
a. Implementing intake and output for a patient who is vomiting
b. Establishing and implementing a stress management program for family caregivers of patients with
Alzheimer’s disease
c. Explaining the risks associated with the planned surgical procedure when a preoperative patient inquires
about risks
d. Developing and performing a study to compare the health status of older patients who live alone with the
status of older patients who live with family members
e. Identifying the effect of an investigational drug on patients’ hemoglobin levels
f. Using a biofeedback machine to teach a patient with cancer how to manage chronic pain
g. Preventing pneumonia in an immobile patient by implementing frequent turning, coughing, and deep
breathing
h. Determining and administering fluid replacement therapy needed for a patient with serious burns
i. Testifying to legislative bodies regarding the effect of health policies on culturally, socially, and
economically diverse populations
2. A nurse who has worked on an orthopedic unit for several years is encouraged by the nurse manager to become
certified in orthopedic nursing. What will certification in nursing require and/or provide (select all that apply)?
a. A certain amount of clinical experience
b. Successful completion of an examination
c. Membership in specialty nursing organizations
d. Professional recognition of expertise in a specialty area
e. An advanced practice role that requires graduate education
3. What accurately describes the health care system in which future nurses will be employed?
a. With improvements in medicine there will be fewer patients with chronic illnesses.
b. Rapidly changing technology and expanding knowledge will simplify the health care environment.
c. The Quality and Safety Education for Nurses (QSEN) project measures the ability of nursing graduates to be
prepared for the reality of practice.
d. The Joint Commission establishes National Patient Safety Goals and evidence-based solutions for nurses to
promote meeting these goals by all caring for the patient.
4. What are the six competencies from Quality and Safety Education for Nurses (QSEN) that are expected of new
nursing graduates?
a.
b.
c.
d.
e.
f.
Copyright © 2014 Mosby, an imprint of Elsevier Inc. All rights reserved. 1
, 2 Chapter 1 Professional Nursing Practice
5. Place the steps of the evidence-based practice (EBP) process in order (0 being the first step; 6 being the last step).
Make recommendations for practice or generate data
Ask a clinical question
Critically analyze the evidence
Find and collect the evidence
Evaluate the outcomes in the clinical setting
Create a spirit of inquiry
Use evidence, clinical expertise, and patient preferences to determine care
6. The following is an example of an evidence-based practice (EBP) clinical question. “In adult seizure patients,
is restraint or medication more effective in protecting them from injury during a seizure?” Which word(s) in the
question identify(ies) the C part of the PICOT format?
a. Restraint
b. Or medication
c. During a seizure
d. Adult seizure patients
e. Protecting them from injury
7. Two nurses are establishing a smoking cessation program to assist patients with chronic lung disease to stop
smoking. To offer the most effective program with the best outcomes, the nurses should initially
a. search for an article that describes nursing interventions that are effective for smoking cessation.
b. develop a clinical question that will allow them to compare different cessation methods during the program.
c. keep comprehensive records that detail each patient’s progress and ultimate outcomes from participation in the
program.
d. use evidence-based clinical practice guidelines developed from reviews of randomized controlled trials of
smoking cessation methods.
8. Which standardized nursing terminologies specifically relate to the steps of the nursing process (select all that apply)?
a. Omaha System
b. Nursing Minimum Data Set (NMDS)
c. Perioperative Nursing Data Set (PNDS)
d. Nursing Outcomes Classification (NOC)
e. Nursing Interventions Classification (NIC)
f. NANDA International: Nursing Diagnoses
9. The nurse working in a health care facility where uniform electronic health records are used explains to the patient
that the primary purpose of such a record is to
a. reduce the cost of health care by eliminating paper records.
b. prevent medical errors associated with traditional paper records and handwritten orders and prescriptions.
c. force the use of standardized medical vocabularies and nursing terminologies so that outcomes of patient care can
be measured.
d. provide a single record in which all aspects of a patient’s medical information are readily available to any health
care provider involved in the patient’s care.
10. Which actions are done primarily by an informatics nurse (select all that apply)?
a. Designs and builds computer systems
b. Studies the validity of nursing information
c. Trains health care providers to provide nursing care
d. Communicates and accesses information for nursing staff
e. Builds systems that support the processing of nursing information
Copyright © 2014 Mosby, an imprint of Elsevier Inc. All rights reserved.
