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Test Bank For Brunner & Suddarth's Textbook of Medical-Surgical Nursing 15th Edition Author(s) Janice L Hinkle, Kerry H. Cheever.

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Test Bank For Brunner & Suddarth's Textbook of Medical-Surgical Nursing 15th Edition Author(s) Janice L Hinkle, Kerry H. Cheever. Chapter 37 Management of Patients With Musculoskeletal Trauma 1. The emergency room nurse delivers a report on a patient that is arriving on the orthopedic floor and states that the patient has a fracture of the nose that has resulted in a skin tear and involvement of the mucous membranes of the nasal passages. The orthopedic nurse is aware that this description likely indicates which type of fracture? A) Compression B) Compound C) Impacted D) Transverse Ans: B Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 3 Patient Needs: D-4 Feedback: A compound fracture involves damage to the skin or mucous membranes and is also called an open fracture. A compression fracture involves compression of bone and is seen in vertebral fractures. An impacted fracture occurs when a bone fragment is driven into another bone fragment. A transverse fracture occurs straight across the bone shaft. 2. The nurse is preparing a care plan for a patient who has sustained a long bone fracture. Which intervention will the nurse include in the care plan to enhance fracture healing? A) Limit weight bearing and exercising B) Monitor color, temperature, and pulses of the affected extremity C) Avoid immobilization of the fracture fragments D) Administer high doses of corticosteroids Ans: B Downloaded by: Kayyh | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material Cognitive Level: Application Difficulty: Difficult Integrated Process: Nursing Process Objective: 6 Patient Needs: D-3 Feedback: The nurse should monitor for sufficient blood supply by assessing the color, temperature, and pulses of the affected extremity, as adequate blood supply enhances the healing of a fracture. Factors that inhibit fracture healing include inadequate or lack of immobilization of the fracture fragments and administration of corticosteroids. Weight-bearing exercises are encouraged for patients with long bone fractures. 3. An athletic patient presents to the ambulatory care facility complaining of pain in the right knee with weight bearing. He states that two days ago he ran 10 miles and woke up the next morning with knee pain. Upon examination, the nurse notes edema, tenderness, muscle spasms and, ecchymosis. Based upon these symptoms, the nurse anticipates the patient has experienced a: A) First-degree strain B) Second-degree strain C) First-degree sprain D) Second-degree sprain Ans: B Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: A second-degree strain involves tearing of muscle fibers and is manifested by notable loss of load-bearing strength with accompanying edema, tenderness, muscle spasm, and Downloaded by: Kayyh | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material ecchymosis. A first-degree strain involves tearing of few muscle fibers and is accompanied by minor edema, tenderness, and mild muscle spasm, without noticeable loss of function. A firstdegree sprain is caused by tearing of few ligamentous fibers and is manifested by mild edema, local tenderness, and pain that is elicited when the joint is moved, but there is no joint instability. A second-degree sprain involves tearing of nerve fibers and results in increased edema, tenderness, pain with motion, joint instability, and partial loss of normal joint function. 4. The nurse preparing the patient who has sustained a sprain of the left ankle for discharge from the emergency room to home correctly instructs the patient to: Downloaded by: Kayyh | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material A) Apply heat for the first 24 to 48 hours after injury. B) Maintain the ankle in a dependent position. C) Exercise hourly by performing rotation exercises of the ankle. D) Apply an elastic compression bandage to the ankle. Ans: D Cognitive Level: Application Difficulty: Easy Integrated Process: Teaching/Learning Objective: 2 Patient Needs: D-3 Feedback: Treatment of a sprain consists of resting and elevating the affected part, applying cold, and using a compression bandage. After the acute inflammatory stage (usually 24 to 48 hours after injury), heat may be applied intermittently. 5. The nurse caring for a patient with an open fracture of the radius is developing a care plan for the patient. The nurse will assign priority to which of the following nursing diagnoses? A) Risk for infection B) Risk for activity intolerance C) Risk for imbalanced nutrition, less than body requirements D) Risk for powerlessness Ans: A Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 4 Patient Needs: D-3 Downloaded by: Kayyh | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material Feedback: All of these nursing diagnoses may be pertinent to the care of a patient with an open fracture of the radius, but the highest priority diagnosis is risk for infection of osteomyelitis and tetanus. The objectives of management are to prevent infection of the wound, soft tissue, and bone and to promote healing. Another priority diagnosis for a patient with an open fracture would be risk for peripheral neurovascular dysfunction.

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Brunner & Suddarth's Textbook of Medical-
Surgical Nursing 15th Edition Author(s): Janice L
Hinkle, Kerry H. Cheever TEST BANK




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Chapter 1: Professional Nursing Practice


MULTIPLE CHOICE

1. The nurse completes an admission database and explains that the plan of care
and discharge goals will be developed with the patient’s 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 nurse’s 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 nurse’s role in the health care system.




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 prefer-
ences.”
ANS: D
Evidence-based practice (EBP) is the use of the best research-based evidence combined with
clinician expertise. Clinical judgment based on the nurse’s 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.




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




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was successful?
a. “The nursing process is a scientific-based method of diagnosing the patient’s 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 biopsychoso-
cial 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 interven-
tions to other health care professionals.




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 patient’s feelings about the child-care arrangements.
d. Call the patient’s parents to determine whether adequate child care is being provid-
ed.
ANS: C
Since a complete assessment is necessary in order to identify a problem and choose an
appropriate intervention, the nurse’s 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.




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 patient’s 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,




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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.




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. Patient’s bedding is changed when it becomes damp.
c. Patient understands the need for increased fluid intake.
d. Patient’s 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.




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 patient’s 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.




8. The nurse interviews a patient while completing the health history and physical
examination. What is the purpose of the assessment phase of the nursing process?
a. To teach interventions that relieve health problems
b. To use patient data to evaluate patient care outcomes
c. To obtain data with which to diagnose patient problems
d. To help the patient identify realistic outcomes for health problems
ANS: C
During the assessment phase, the nurse gathers information about the patient to diagnose
patient problems. The other responses are examples of the planning, intervention, and
evaluation phases of the nursing process.




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