TestBank-Lewis-Medical-Surgical-Nursing-11th-2020.pdf

Table of Contents Chapter 01: Professional Nursing Table of Contents 1 3 Chapter 02: Health Equity and Culturally Competent Care Chapter 03: Health History and Physical Examination Chapter 04: Patient and Caregiver Teaching Chapter 05: Chronic Illness and Older Adults Chapter 06: Stress Management Chapter 07: Sleep and Sleep Disorders Chapter 08: Pain Chapter 09: Palliative and End of Life Care Chapter 10: Substance Use Disorders Chapter 11: Inflammation and Healing Chapter 12: Genetics Chapter 13: Immune Responses and Transplantation Chapter 14: Infection Chapter 15: Cancer Chapter 16: Fluid, Electrolyte, and Acid-Base Imbalances Chapter 17: Preoperative Care Chapter 18: Intraoperative Care Chapter 19: Postoperative Care Chapter 20: Assessment and Management: Visual Problems Chapter 21: Assessment and Management: Auditory Problems Chapter 22: Assessment: Integumentary System Chapter 23: Integumentary Problems Chapter 24: Burns Chapter 25: Assessment: Respiratory System Chapter 26: Upper Respiratory Problems Chapter 27: Lower Respiratory Problems Chapter 28: Obstructive Pulmonary Diseases Chapter 29: Assessment: Hematologic System Chapter 30: Hematologic Problems Chapter 31: Assessment: Cardiovascular System Chapter 32: Hypertension Chapter 33: Coronary Artery Disease and Acute Coronary Syndrome Chapter 34: Heart Failure Chapter 35: Dysrhythmias Chapter 36: Inflammatory and Structural Heart Disorders Chapter 37: Vascular Disorders Chapter 38: Assessment: Gastrointestinal System Chapter 39: Nutritional Problems Chapter 40: Obesity Chapter 41: Upper Gastrointestinal Problems Chapter 42: Lower Gastrointestinal Problems Chapter 43: Liver, Biliary Tract, and Pancreas Problems Chapter 44: Assessment: Urinary System Chapter 45: Renal and Urologic Problems Chapter 46: Acute Kidney Injury and Chronic Kidney Disease Chapter 47: Assessment: Endocrine System Chapter 48: Diabetes Mellitus Chapter 49: Endocrine Problems Chapter 50: Assessment: Reproductive System 13 21 28 38 48 54 59 71 79 91 101 105 117 129 148 165 175 184 196 216 227 233 245 259 270 282 305 325 332 353 364 375 394 406 420 435 450 458 469 478 499 523 543 553 573 590 600 622 642 Chapter 51: Breast Disorders Chapter 52: Sexually Transmitted Infections Chapter 53: Female Reproductive Problems Chapter 54: Male Reproductive Problems Chapter 55: Assessment: Nervous System Chapter 56: Acute Intracranial Problems Chapter 57: Stroke Chapter 58: Chronic Neurologic Problems Chapter 59: Dementia and Delirium Chapter 60: Spinal Cord and Peripheral Nerve Problems Chapter 61: Assessment: Musculoskeletal System Chapter 62: Musculoskeletal Trauma and Orthopedic Surgery Chapter 63: Musculoskeletal Problems Chapter 64: Arthritis and Connective Tissue Diseases Chapter 65: Critical Care Chapter 66: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome Chapter 67: Acute Respiratory Failure and Acute Respiratory Distress Syndrome Chapter 68: Emergency and Disaster Nursing 650 662 671 693 708 717 734 747 763 772 787 794 814 825 845 864 877 889 Chapter 01: Professional Nursing Test Bank MULTIPLE CHOICE 1. 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 was successful? a. The nursing process is a scientific-based method of diagnosing the patients 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 biopsychosocial 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 interventions to other health care professionals. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 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 preferences. ANS: D Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician expertise. Clinical judgment based on the nurses 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. DIF: Cognitive Level: Remember (knowledge) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment 3. The nurse completes an admission database and explains that the plan of care and discharge goals will be developed with the patients 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 nurses 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 nurses role in the health care system. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 4. 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 patients 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, 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. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity 5. 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 patients feelings about the child-care arrangements. d. Call the patients parents to determine whether adequate child care is being provided. ANS: C Since a complete assessment is necessary in order to identify a problem and choose an appropriate intervention, the nurses 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. DIF: Cognitive Level: Apply (application) OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 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. Patients bedding is changed when it becomes damp. c. Patient understands the need for increased fluid intake. d. Patients 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. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity 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 patients 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. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Environment 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. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment 9. Which nursing diagnosis statement is written correctly? a. Altered tissue perfusion related to heart failure b. Risk for impaired tissue integrity related to sacral redness c. Ineffective coping related to response to biopsy test results d. Altered urinary elimination related to urinary tract infection ANS: C This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes a patients response to a health problem that can be treated by nursing. The use of a medical diagnosis as an etiology (as in the responses beginning Altered tissue perfusion and Altered urinary elimination) is not appropriate. The response beginning Risk for impaired tissue integrity uses the defining characteristic as the etiology. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care Environment 10. The nurse admits a patient to the hospital and develops a plan of care. What components should the nurse include in the nursing diagnosis statement? a. The problem and the suggested patient goals or outcomes b. The problem with possible causes and the planned interventions c. The problem, its cause, and objective data that support the problem d. The problem with an etiology and the signs and symptoms of the problem ANS: D