1/18/23, 4:56 AM Medical-Surgical Nursing 13th Edition Test Bank Chapter 4
1. A nurse has been working with Mrs. Griffin, a 71-year-old patient whose poorly
controlled type 1 diabetes has led to numerous health problems. Over the past several
years Mrs. Griffin has had several admissions to the hospital medical unit, and the
nurse has often carried out health promotion interventions. Who is ultimately
responsible for maintaining and promoting Mrs. Griffin's health?
A) The medical nurse
B) The community health nurse who has also worked with Mrs. Griffin
C) Mrs. Griffin's primary care provider
D) Mrs. Griffin
Ans: D
Feedback:
American society places a great importance on health and the responsibility that each of
us has to maintain and promote our own health. Therefore, the other options are
incorrect.
2. An elderly female patient has come to the clinic for a scheduled follow-up appointment.
The nurse learns from the patient's daughter that the patient is not following the
instructions she received upon discharge from the hospital last month. What is the most
likely factor causing the patient not to adhere to her therapeutic regimen?
A) Ethnic background of health care provider
B) Costs of the prescribed regimen
C) Presence of a learning disability
D) Personality of the physician
Ans: B
Feedback:
Variables that appear to influence the degree of adherence to a prescribed therapeutic
regimen include gender, race, education, illness, complexity of the regimen, and the
cost of treatments. The ethnic background of the health care provider and the
personality of the physician are not considered variables that appear to influence the
degree of adherence to a prescribed therapeutic regimen. A learning disability could
greatly affect adherence, but cost is a more likely barrier.
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,1/18/23, 4:56 AM Medical-Surgical Nursing 13th Edition Test Bank Chapter 4
3. A gerontologic nurse has observed that patients often fail to adhere to a therapeutic
regimen. What strategy should the nurse adopt to best assist an older adult in adhering
to a therapeutic regimen involving wound care?
A) Demonstrate a dressing change and allow the patient to practice.
B) Provide a detailed pamphlet on a dressing change.
C) Verbally instruct the patient how to change a dressing and check for
comprehension.
D) Delegate the dressing change to a trusted family member.
Ans: A
Feedback:
The nurse must consider that older adults may have deficits in the ability to draw
inferences, apply information, or understand major teaching points. Demonstration and
practice are essential in meeting their learning needs. The other options are incorrect
because the elderly may have problems reading and/or understanding a written
pamphlet or verbal instructions. Having a family member change the dressing when the
patient is capable of doing it impedes self-care and independence.
4. A 20-year-old man newly diagnosed with type 1 diabetes needs to learn how to
self-administer insulin. When planning the appropriate educational interventions and
considering variables that will affect his learning, the nurse should prioritize which of
the following factors?
A) Patient's expected lifespan
B) Patient's gender
C) Patient's occupation
D) Patient's culture
Ans: D
Feedback:
One of the major variables that influences a patient's readiness to learn is the patient's
culture, because it affects how a person learns and what information is learned. Other
variables include illness states, values, emotional readiness, and physical readiness.
Lifespan, occupation, and gender are variables that are usually less salient.
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, 1/18/23, 4:56 AM Medical-Surgical Nursing 13th Edition Test Bank Chapter 4
5. The nurse is planning to teach a 75-year-old patient with coronary artery disease about
administering her prescribed antiplatelet medication. How can the nurse best enhance
the patient's ability to learn?
A) Provide links to Web sites that contain evidence-based information.
B) Exclude family members from the session to prevent distraction.
C) Use color-coded materials that are succinct and engaging.
D) Make the information directly relevant to the patient's condition.
Ans: D
Feedback:
Studies have shown that older adults can learn and remember if the information is
paced appropriately, relevant, and followed by appropriate feedback. Family members
should be included in health education. The nurse should not assume that the patient's
color vision is intact or that the patient possesses adequate computer skills.
6. A nurse is planning care for an older adult who lives with a number of chronic health
problems. For which of the following nursing diagnoses would education of the patient
be the nurse's highest priority?
A) Risk for impaired physical mobility related to joint pain
B) Functional urinary incontinence related decreased mobility
C) Activity intolerance related to contractures
D) Risk for ineffective health maintenance related to nonadherence to therapeutic
regimen
Ans: D
Feedback:
For some nursing diagnoses, education is a primary nursing intervention. These
diagnoses include risk for ineffective management of therapeutic regimen, risk for
impaired home management, health-seeking behaviors, and decisional conflict. The
other options do not have patient education as the highest priority, though each
necessitates a certain degree of education.
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1. A nurse has been working with Mrs. Griffin, a 71-year-old patient whose poorly
controlled type 1 diabetes has led to numerous health problems. Over the past several
years Mrs. Griffin has had several admissions to the hospital medical unit, and the
nurse has often carried out health promotion interventions. Who is ultimately
responsible for maintaining and promoting Mrs. Griffin's health?
A) The medical nurse
B) The community health nurse who has also worked with Mrs. Griffin
C) Mrs. Griffin's primary care provider
D) Mrs. Griffin
Ans: D
Feedback:
American society places a great importance on health and the responsibility that each of
us has to maintain and promote our own health. Therefore, the other options are
incorrect.
2. An elderly female patient has come to the clinic for a scheduled follow-up appointment.
The nurse learns from the patient's daughter that the patient is not following the
instructions she received upon discharge from the hospital last month. What is the most
likely factor causing the patient not to adhere to her therapeutic regimen?
A) Ethnic background of health care provider
B) Costs of the prescribed regimen
C) Presence of a learning disability
D) Personality of the physician
Ans: B
Feedback:
Variables that appear to influence the degree of adherence to a prescribed therapeutic
regimen include gender, race, education, illness, complexity of the regimen, and the
cost of treatments. The ethnic background of the health care provider and the
personality of the physician are not considered variables that appear to influence the
degree of adherence to a prescribed therapeutic regimen. A learning disability could
greatly affect adherence, but cost is a more likely barrier.
Page 1
about:blank 1/19
,1/18/23, 4:56 AM Medical-Surgical Nursing 13th Edition Test Bank Chapter 4
3. A gerontologic nurse has observed that patients often fail to adhere to a therapeutic
regimen. What strategy should the nurse adopt to best assist an older adult in adhering
to a therapeutic regimen involving wound care?
A) Demonstrate a dressing change and allow the patient to practice.
B) Provide a detailed pamphlet on a dressing change.
C) Verbally instruct the patient how to change a dressing and check for
comprehension.
D) Delegate the dressing change to a trusted family member.
Ans: A
Feedback:
The nurse must consider that older adults may have deficits in the ability to draw
inferences, apply information, or understand major teaching points. Demonstration and
practice are essential in meeting their learning needs. The other options are incorrect
because the elderly may have problems reading and/or understanding a written
pamphlet or verbal instructions. Having a family member change the dressing when the
patient is capable of doing it impedes self-care and independence.
4. A 20-year-old man newly diagnosed with type 1 diabetes needs to learn how to
self-administer insulin. When planning the appropriate educational interventions and
considering variables that will affect his learning, the nurse should prioritize which of
the following factors?
A) Patient's expected lifespan
B) Patient's gender
C) Patient's occupation
D) Patient's culture
Ans: D
Feedback:
One of the major variables that influences a patient's readiness to learn is the patient's
culture, because it affects how a person learns and what information is learned. Other
variables include illness states, values, emotional readiness, and physical readiness.
Lifespan, occupation, and gender are variables that are usually less salient.
Page 2
about:blank 2/19
, 1/18/23, 4:56 AM Medical-Surgical Nursing 13th Edition Test Bank Chapter 4
5. The nurse is planning to teach a 75-year-old patient with coronary artery disease about
administering her prescribed antiplatelet medication. How can the nurse best enhance
the patient's ability to learn?
A) Provide links to Web sites that contain evidence-based information.
B) Exclude family members from the session to prevent distraction.
C) Use color-coded materials that are succinct and engaging.
D) Make the information directly relevant to the patient's condition.
Ans: D
Feedback:
Studies have shown that older adults can learn and remember if the information is
paced appropriately, relevant, and followed by appropriate feedback. Family members
should be included in health education. The nurse should not assume that the patient's
color vision is intact or that the patient possesses adequate computer skills.
6. A nurse is planning care for an older adult who lives with a number of chronic health
problems. For which of the following nursing diagnoses would education of the patient
be the nurse's highest priority?
A) Risk for impaired physical mobility related to joint pain
B) Functional urinary incontinence related decreased mobility
C) Activity intolerance related to contractures
D) Risk for ineffective health maintenance related to nonadherence to therapeutic
regimen
Ans: D
Feedback:
For some nursing diagnoses, education is a primary nursing intervention. These
diagnoses include risk for ineffective management of therapeutic regimen, risk for
impaired home management, health-seeking behaviors, and decisional conflict. The
other options do not have patient education as the highest priority, though each
necessitates a certain degree of education.
Page 3
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