Med-Surg Success: A Q&A Review Applying Critical Thinking to Test Taking Second Edition

Med-Surg Success: A Q&A Review Applying Critical Thinking to Test Taking Second Edition1 Test Taking ..................................................................................................................................1 INTRODUCTION................................................................................................................................1 GUIDELINES FOR USING THIS BOOK.......................................................................................1 PREPARING FOR LECTURE ..........................................................................................................2 PREPARING FOR AN EXAMINATION ..........................................................................................3 TAKING THE EXAM..........................................................................................................................4 THE RACE MODEL: THE APPLICATION OF CRITICAL THINKING TO MULTIPLE- CHOICE QUESTIONS.......................................................................................6 2 Neurological Disorders.......................................................................................................7 KEYWORDS/ABBREVIATIONS.......................................................................................................7 PRACTICE QUESTIONS ..................................................................................................................8 Cerebrovascular Accident (Stroke)..........................................................................................8 Head Injury...................................................................................................................................9 Spinal Cord Injury (SCI)..........................................................................................................11 Seizures.......................................................................................................................................13 Brain Tumors..............................................................................................................................15 Meningitis...................................................................................................................................16 Parkinson’s Disease..................................................................................................................18 Substance Abuse ......................................................................................................................19 Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s Disease).......................................21 Encephalitis ...............................................................................................................................23 PRACTICE QUESTIONS ANSWERS AND RATIONALES.......................................................25 NEUROLOGICAL DISORDERS COMPREHENSIVE EXAMINATION....................................55 NEUROLOGICAL DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES..................................................................................................63 3 Cardiac Disorders ................................................................................................................73 KEYWORDS/ABBREVIATIONS.....................................................................................................73 PRACTICE QUESTIONS................................................................................................................74 Congestive Heart Failure.........................................................................................................74 Angina/Myocardial Infarction.................................................................................................75 Coronary Artery Disease ..........................................................................................................77 Valvular Heart Disease.............................................................................................................79 Dysrhythmias and Conduction Problems ............................................................................80 Inflammatory Cardiac Disorders ............................................................................................82 PRACTICE QUESTIONS ANSWERS AND RATIONALES.......................................................84 CARDIAC DISORDERS COMPREHENSIVE EXAMINATION ...............................................102 CARDIAC DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................107 Table of Contents xi xii TABLE OF CONTENTS 4 Peripheral Vascular Disorders.................................................................................113 KEYWORDS/ABBREVIATIONS...................................................................................................113 PRACTICE QUESTIONS..............................................................................................................114 Arterial Hypertension.............................................................................................................114 Arterial Occlusive Disease....................................................................................................115 Atherosclerosis ........................................................................................................................117 Abdominal Aortic Aneurysm ................................................................................................119 Deep Vein Thrombosis...........................................................................................................120 Peripheral Venous Disease ...................................................................................................122 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................124 PERIPHERAL VASCULAR DISORDERS COMPREHENSIVE EXAMINATION .................141 PERIPHERAL VASCULAR DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES...................................................................146 5 Hematological Disorders .............................................................................................151 KEYWORDS/ABBREVIATIONS...................................................................................................151 PRACTICE QUESTIONS..............................................................................................................152 Leukemia..................................................................................................................................152 Lymphoma................................................................................................................................153 Anemia......................................................................................................................................155 Bleeding Disorders .................................................................................................................157 Blood Transfusions.................................................................................................................158 Sickle Cell Anemia.................................................................................................................160 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................162 HEMATOLOGICAL DISORDERS COMPREHENSIVE EXAMINATION ...............................180 HEMATOLOGICAL DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................185 6 Respiratory Disorders.....................................................................................................191 KEYWORDS/ABBREVIATIONS...................................................................................................191 PRACTICE QUESTIONS..............................................................................................................192 Upper Respiratory Infection (URI).....................................................................................192 Lower Respiratory Infection .................................................................................................193 Chronic Obstructive Pulmonary Disease (COPD)............................................................195 Reactive Airway Disease (Asthma).....................................................................................197 Lung Cancer.............................................................................................................................199 Cancer of the Larynx..............................................................................................................202 Pulmonary Embolus...............................................................................................................204 Chest Trauma...........................................................................................................................205 Acute Respiratory Distress Syndrome................................................................................207 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................209 RESPIRATORY DISORDERS COMPREHENSIVE EXAMINATION .....................................235 RESPIRATORY DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................243 7 Gastrointestinal Disorders..........................................................................................253 KEYWORDS/ABBREVIATIONS...................................................................................................253 PRACTICE QUESTIONS..............................................................................................................254 Gastroesophageal Reflux (GERD) .......................................................................................254 Inflammatory Bowel Disease................................................................................................255 Peptic Ulcer Disease .............................................................................................................257 Colorectal Disease..................................................................................................................259 Diverticulosis/Diverticulitis...................................................................................................260 Gallbladder Disorders ............................................................................................................262 Liver Failure.............................................................................................................................263 Hepatitis ...................................................................................................................................265 Gastroenteritis .........................................................................................................................266 Abdominal Surgery.................................................................................................................268 Eating Disorders .....................................................................................................................269 Constipation/Diarrhea Disorders..........................................................................................271 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................274 GASTROINTESTINAL DISORDERS COMPREHENSIVE EXAMINATION............................................................................................................................308 GASTROINTESTINAL DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES...................................................................316 8 Endocrine Disorders .......................................................................................................325 KEYWORDS/ABBREVIATIONS...................................................................................................325 PRACTICE QUESTIONS..............................................................................................................326 Diabetes Mellitus....................................................................................................................326 Pancreatitis..............................................................................................................................329 Cancer of the Pancreas.........................................................................................................331 Adrenal Disorders ...................................................................................................................332 Pituitary Disorders..................................................................................................................334 Thyroid Disorders....................................................................................................................336 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................338 ENDOCRINE DISORDERS COMPREHENSIVE EXAMINATION.........................................357 ENDOCRINE DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................362 9 Genitourinary Disorders ...............................................................................................367 KEYWORDS/ABBREVIATIONS...................................................................................................367 PRACTICE QUESTIONS..............................................................................................................368 Acute Renal Failure (ARF)...................................................................................................368 Chronic Kidney Disease (CKD)............................................................................................369 Fluid and Electrolyte Disorders...........................................................................................371 Urinary Tract Infection (UTI)...............................................................................................372 Benign Prostatic Hypertrophy..............................................................................................374 Renal Calculi ...........................................................................................................................375 Cancer of the Bladder...........................................................................................................377 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................379 GENITOURINARY DISORDERS COMPREHENSIVE EXAMINATION................................399 GENITOURINARY DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................403 10 Reproductive Disorders................................................................................................409 KEYWORDS/ABBREVIATIONS...................................................................................................409 PRACTICE QUESTIONS..............................................................................................................410 Breast Disorders .....................................................................................................................410 Pelvic Floor Relaxation Disorders .......................................................................................411 Uterine Disorders....................................................................................................................413 Ovarian Disorders ...................................................................................................................414 Prostate Disorders ..................................................................................................................416 Testicular Disorders................................................................................................................418 Sexually Transmitted Diseases ............................................................................................419 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................422 REPRODUCTIVE DISORDERS COMPREHENSIVE EXAMINATION..................................441 REPRODUCTIVE DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................447 11 Musculoskeletal Disorders.........................................................................................453 KEYWORDS/ABBREVIATIONS...................................................................................................453 PRACTICE QUESTIONS..............................................................................................................454 Degenerative/Herniated Disk Disease................................................................................454 Osteoarthritis ...........................................................................................................................455 TABLE OF CONTENTS xiii Osteoporosis.............................................................................................................................457 Amputation ..............................................................................................................................458 Fractures...................................................................................................................................460 Joint Replacements ...............................................................................................................461 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................464 MUSCULOSKELETAL DISORDERS COMPREHENSIVE EXAMINATION.........................480 MUSCULOSKELETAL DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................485 12 Integumentary Disorders.............................................................................................491 KEYWORDS/ABBREVIATIONS...................................................................................................491 PRACTICE QUESTIONS..............................................................................................................491 Burns.........................................................................................................................................491 Pressure Ulcers.......................................................................................................................493 Skin Cancer .............................................................................................................................495 Bacterial Skin Infection........................................................................................................496 Viral Skin Infection ................................................................................................................498 Fungal/Parasitic Skin Infection...........................................................................................499 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................502 INTEGUMENTARY DISORDERS COMPREHENSIVE EXAMINATION ..............................519 INTEGUMENTARY DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................523 13 Immune System Disorders ........................................................................................529 KEYWORDS/ABBREVIATIONS...................................................................................................529 PRACTICE QUESTIONS..............................................................................................................530 Multiple Sclerosis...................................................................................................................530 Guillain-Barré Syndrome ......................................................................................................532 Myasthenia Gravis ..................................................................................................................533 Systemic Lupus Erythematosus ..........................................................................................535 Acquired Immunodeficiency Syndrome ............................................................................536 Allergies and Allergic Reactions .........................................................................................538 Rheumatoid Arthritis (RA)....................................................................................................540 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................542 IMMUNE SYSTEM DISORDERS COMPREHENSIVE EXAMINATION ..............................561 IMMUNE SYSTEM DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................566 14 Sensory Deficits .................................................................................................................571 KEYWORDS/ABBREVIATIONS...................................................................................................571 PRACTICE QUESTIONS..............................................................................................................572 Eye Disorders...........................................................................................................................572 Ear Disorders ...........................................................................................................................573 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................575 SENSORY DEFICITS COMPREHENSIVE EXAMINATION...................................................581 SENSORY DEFICITS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES.................................................................................................................................585 15 Emergency Nursing.........................................................................................................591 KEYWORDS/ABBREVIATIONS...................................................................................................591 PRACTICE QUESTIONS..............................................................................................................592 Shock ........................................................................................................................................592 Bioterrorism .............................................................................................................................593 Codes.........................................................................................................................................595 Disasters/Triage .......................................................................................................................596 Poisoning..................................................................................................................................598 Violence, Physical Abuse, and Neglect.............................................................................599 xiv TABLE OF CONTENTS PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................602 EMERGENCY NURSING COMPREHENSIVE EXAMINATION ............................................620 EMERGENCY NURSING COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................624 16 Perioperative Care............................................................................................................629 KEYWORDS/ABBREVIATIONS...................................................................................................629 PRACTICE QUESTIONS..............................................................................................................630 Preoperative.............................................................................................................................630 Intraoperative ..........................................................................................................................631 Postoperative ...........................................................................................................................633 Acute Pain................................................................................................................................635 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................637 PERIOPERATIVE CARE COMPREHENSIVE EXAMINATION ..............................................648 PERIOPERATIVE CARE COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................652 17 Cultural Nursing and Alternative Health Care...........................................657 KEYWORDS/ABBREVIATIONS...................................................................................................657 PRACTICE QUESTIONS..............................................................................................................657 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................662 CULTURAL NURSING AND ALTERNATIVE HEALTH CARE COMPREHENSIVE EXAMINATION........................................................................................668 CULTURAL NURSING AND ALTERNATIVE HEALTH CARE COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES...............................672 18 End-of-Life Issues ............................................................................................................677 ABBREVIATIONS..........................................................................................................................677 PRACTICE QUESTIONS..............................................................................................................677 Advance Directives.................................................................................................................677 Death and Dying.....................................................................................................................679 Chronic Pain............................................................................................................................681 Ethical/Legal Issues...............................................................................................................682 Organ/Tissue Donation...........................................................................................................684 PRACTICE QUESTIONS ANSWERS AND RATIONALES.....................................................686 END-OF-LIFE ISSUES COMPREHENSIVE EXAMINATION................................................701 END-OF-LIFE ISSUES COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ...............................................................................................706 19 Pharmacology.......................................................................................................................711 KEYWORDS/ABBREVIATIONS...................................................................................................711 TEST-TAKING HINTS FOR PHARMACOLOGY QUESTIONS..............................................711 SAMPLE DRUG CARDS..............................................................................................................714 MEDICATIONS ADMINISTRATION IN A MEDICAL-SURGICAL SETTING COMPREHENSIVE EXAMINATION .....................................................................716 MEDICATIONS ADMINISTRATION IN A MEDICAL-SURGICAL SETTING COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES ..............................................................................................................................731 20 Comprehensive Final Examination .....................................................................749 COMPREHENSIVE FINAL EXAMINATION .............................................................................749 COMPREHENSIVE FINAL EXAMINATION ANSWERS AND RATIONALES ....................763 Glossary of English Words Commonly Encountered on Nursing Examinations ...........................................................................................781 Appendix..................................................................................................................................785 Index ...........................................................................................................................................787 TABLE OF CONTENTS xv Test Taking 1 1 INTRODUCTION This book is the second in a series of books published by the F.A. Davis Company designed to assist the student nurse to be successful in nursing school. This book focuses on critical thinking in regard to test taking. There are the usual test questions found in review books, but the test taker will also find test-taking hints in 19 out of 20 chapters. A compact disc containing 265 questions which follow the National Council Licensing Examination–RN (NCLEX-RN) blueprint has been added to enhance the student’s ability to test via a computer. Each question contains coding designations according to the NCLEX blueprint. Table 1–1 indicates the breakdown of the content found on the NCLEX-RN. This book has attempted to follow this blueprint. The 2010 NCLEX-RN blueprint now includes additional types of alternative test questions. The end of each chapter includes these new graphic types of test question. F.A. Davis has instituted a Web site the test taker can visit to access audio-type test questions, where the individual test taker can listen to questions regarding heart and lung sounds and the like, at DavisP. The most important aspect of taking any examination is to become knowledgeable about the subject matter the test will cover. There is no substitute for studying the material. Book one of this series—Fundamentals of Success: A Course Review Applying Critical Thinking to Test Taking, 2nd edition, by Patricia M. Nugent and Barbara A. Vitale—defines critical thinking and the RACE model for applying critical thinking to test-taking skills, and the specific topics in that volume will not be repeated in this book. This book will also assist the test taker to apply critical thinking skills directly to the questions found on nursing examinations. GUIDELINES FOR USING THIS BOOK This book is designed to assist the nursing student when preparing for and taking medicalsurgical examinations as well as the graduate nurse who is preparing to take the national licensure examination. The book is divided into chapters according to body systems and includes chapters on pharmacology, end-of-life issues, emergency nursing, and alternative therapy; a 100-question final examination; and the compact disc containing 265 questions. Chapters 2 through 18 are further divided into disease processes to more easily help the test taker identify specific content. A comprehensive final including other content areas as well as disease processes is included at the end of each chapter. In the Answers and Rationales sections of the chapters, an explanation for the correct answer as well as the incorrect distracters is provided. In Chapters 2 through 18, a Test-Taking Hint is provided for every question in the content area. Each question is coded as per Bloom’s Taxonomy for categorizing levels of abstraction required for the test taker to arrive at the correct answer. As per the National Council of State Boards of Nursing (NCSBN) testing information, the questions are coded by Content, Category of Health Alteration, Integrated Nursing Process, Client Needs, and Cognitive Level (Bloom’s Taxonomy). There are no test-taking hints provided for the comprehensive fin