Test Bank for Understanding Medical-
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
Chapter 1 l
1. Thelnurselislcaringlforlfourlclientslonlalmedical–
surgicallunit.lWhichlclient lshould lthelnurselseelinitially?
1. Alclient ladmitted lwithlhepatitislAlwholhaslhad lsevereldiarrhealforlthellast l24lh
ours
2. Alclient ladmitted lwithlpneumonialwholislhaslsmalllamountslof lyellow lpro
ductivelsputum
3. Alclient ladmitted lwithlfeverloflunknownloriginl(FUO)lwholhaslbeenlwit
hout lfeverlforlthellast l48lhours
4. Alclient ladmitted lwithlalwound linfectionlwhoselWBClisl8,500lmm3
Answer:l1
Rationale:lThelnurselmust ldecidelwhichlclient lshould lbelseenlonlthelinitiallroundslof ltheld ay.l
Thelnurselmust lrememberlthat lthelfirst lclient ltolbelseenlshould lbelthelclient lwholneedsl
thelattentionlof lthelnurselinitially.lAlclient lwithlhepatitislAldoeslexperienceldiarrhea,l
but ldiarrhealforlthellast l24lhourslcould lcauselthelclient ltolhavelalproblemlwithldehydr
ationland lexperiencelalstatelof lfluid lvolumeldeficit.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lPlanning
2. Thelnurselislpreparingltoladministerlinfluenzalvaccinesltolalmassldrive-
throughlclinic.lWhichlstatement lbylalclient lwould lindicatelfurtherlquestioninglpriorltolgiving
lthelclient lthelinfluenzalvaccine?
1. “I lamlallergicltolhorselhair.”
2. “I ltryltolget lmylvaccineleverylyear.”
3. “I lamlnot lallergicltolanythinglexcept leggs.”
4. “Mylhusband lhad lalseverelallergiclreactionlafterlhelreceived lhislinfluenzalvac
cine.”
Answer:l3
Rationale:lInfluenzalvaccineslarelrecommended lforlpersonlat lhighlrisklforlseriouslsequelaelo
f linfluenza.lThelnurselshould lbelawarelthat lclient lwithlalsensitivityltoleggslshould lnot lr
eceivelthelvaccine.lVaccineslprepared lfromlchickenlorlducklembryoslarelcontraindic
ated linlclientslwholarelallergicltoleggs.
CognitivelLevel:lApplication
downloadlfulllfilelatlhttp://testbankinstant.com
, Test Bank for Understanding Medical-
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lAssessment
3. Thelnurselislcaringlforlfourlclientslonlalmedical–
surgicallunit.lThelsecretarylgiveslthelnurselthelmorningllabs.lWhichlof lthelfollowingllabslwo
uld lrequirelthat lthelnurselcalllthelphysicianland linformlthelhealthcarelproviderlabout lthelclien
t’slabnormalities?
1.l WBCl14,600lmm3
2. Serumlproteinl6.9lg/dL
3. I l&lDl(incisionland ldrainage)lshowinglnolgrowthlforlthellast l24lhours
4. Albuminl4.2lg/dL
Answer:l1
Rationale:lWhenlthelnurselislcaringlforlseverallclients,lalllof lthellabslshould lbelchecked lf requent
lylthroughout lthelshift ltolassesslforlanylabnormalities.lThelWBClinloptionl1lislabnormal.l(Nor
mallWBCl4,000–
10,000lmm3 .)lAlllof lthelotherllablresultslarelwithinlacceptablelrange;ltherefore,lthelresultslshou
ld lnot lbelcalled linltolthelphysician.
CognitivelLevel:lApplicationlClient l
Needs:lPhysiologiclIntegritylNursin
glProcess:lAssessment
4. Thelnurselislorientinglalnew lgraduate.lThelnurselislreinforcinglthelimportancelof lstanda
rd lprecautions.lWhichlof lthelfollowinglobservationslbylthelnurselwould lrequirelf urtherled
ucationlregardinglstandard lprecautions?
1. Thelgraduatelnurselunderstandsltolwashlhandslwhenlenteringland lexitinglt hel
client’slroom.
2. Thelgraduatelnurselwearslgloveslwhenlservinglbreakfast ltraysltolvariouslcli
ents.
3. Thelgraduatelnurselwearslalgown,lgloves,land lgoggleslwhenlsuctioninglalclie
nt.
4. Thelgraduatelnurselleaveslalllsupplieslinlthelroomlof lalclient lwholislinlcont
act lisolation.
Answer:l2
Rationale:lThelnurselmust lhavelanlunderstandinglof lstandard lprecautions.lPreventionlislthel
most limportant lmeasureltolprevent lnosocomiallinfections.lStandard lprecautionslwer
elpublished linl1996lthat lprovidelguidelineslforlthelhandlinglof lblood landlotherlbodylfl
uids.lTheselguidelineslarelused lwithlalllclients,lregardlesslof lwhetherltheylhavelalkno
wnlinfectiousldisease.lStandard lprecautionslarelused
downloadlfulllfilelatlhttp://testbankinstant.com
, Test Bank for Understanding Medical-
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
bylalllhealthcarelworkerslwholhaveldirect lcontact lwithlclientslorlwithltheirlbodylf luid
s.lIt lislnot lnecessarylforlthelnurseltolwearlgloveslwhileldeliveringlfood ltrayslt olthelclie
nt,lbecauseltherelislnot lcontact lwithlthelclient.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lEvaluation
5. Theladmittingldepartment lalertslthelnurselonlalmedical–
surgicallunit lthat lalclient lwithlactiveltuberculosisl(TB)lislbeingladmitted ltolthelunit.lWhichlty
pelof lisolationlislappropriatelbased lonlthelclient’sldiagnosis?
1. Standard lprecautions
2. Airbornelprecautions
3. Droplet lprecautions
4. Contact lprecautions
Answer:l2
Inladditionltolhandwashingland lstandardlprecautions,lthelnaturelandlspread loflsomelinfect
iousldiseaseslrequirelthat lspecialltechniqueslbelused ltolprotect luninfected lclientsland lwork
ers.lThelclient lwithlpulmonaryltuberculosislwilllbelplaced linlairbornelprecautions.lThelcli
ent lshould lbelplaced linlalprivatelroomlwithlspeciallventilationlthat ld oeslnot lallow lairltolcirc
ulateltolgenerallhospitallventilation;lalmasklorlspeciallfilterlrespiratorslwilllbelused lforleve
ryonelenteringlthelroom.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lAssessment
6. Alclient lislreceivinglIVlvancomycinlforltheltreatment lof lClostridiumldifficile.lThelnurs
elunderstandslthat lthelclient lwholdevelopslflushing,ltachycardia,land lhypotensionld uringlt
helinfusionlof lvancomycinlindicates:
1. Ototoxicityleffect.
2. Superinfection.
3. Red lmanlsyndrome.
4. Hives.
Answer:l3
Rationale:lVancomycinlinhibitslcelllwalllsynthesis,land lislused lforlseriouslinfections.lIt lislonlyle
ffectivelagainst lgram-positivelbacteria,lespeciallylStaphylococcuslaureusland
downloadlfulllfilelatlhttp://testbankinstant.com
, Test Bank for Understanding Medical-
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
Staphylococcuslepidermidis.lThelnurselshould linfuselthislmedicationlslowlyloverl60lminuteslo
rlmoreltolavoid l“red lman”lsyndrome.lThelsyndromelislcharacterized lbylerythematouslrash,lflus
hing,ltachycardia,land lhypotension.lClientslcanlbecomeldizzyland lagitated.
CognitivelLevel:lApplication
Client lNeeds:lPhysiologicallIntegrityl
NursinglProcess:lEvaluation
7. Thelphysicianlhaslordered lforlthelclient ltolreceivelaltroughlblood llevelltolevaluatelthelt hera
peuticleffect lof lanlantibiotic.lThelnurselunderstandslthat ltheltroughlshould lbelordered:
1. Alfew lminuteslbeforelthelnext lscheduled ldoselof lmedication.
2. 1–2lhourslafterltheloralladministrationlof lthelmedication.
3. 30lminuteslafterlthelIVladministration.
4. Duringlthelinfusionlof lthelantibiotic.
Answer:l1
Rationale:lAntibioticlpeakland ltroughllevelslmonitorltherapeuticlblood llevelslof lthelprescribe
d lmedication.lTheltherapeuticlrange—
thelminimumland lmaximumlblood llevelslat lwhichltheldruglisleffective—
islknownlforlalgivenldrug.lBylmeasuringlblood llevelslat lthelpredicted lpeakl(1–
2lhourslafterloralladministration,l1lhourlafterlintramuscularladministration,land l30lminuteslaft
erlIV ladministration)land ltroughl(usuallylalfew lminuteslbeforelthelnextlscheduledldose),lit lislal
solpossibleltoldeterminelwhetherltheldruglislreachinglaltoxiclorlharmfulllevellduringltherapy,li
ncreasinglthellikelihood lof ladverseleffects.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lAssessment
8. Thelnurselneedsltolchangelaldressinglonlthelclient’slabdomen.lWhichlof lthelfollowinglt ech
niqueslshould lbelimplemented?
1. Contact lprecautions
2. Standard lprecautions
3. Droplet lprecautions
4. Airbornelprecautions
Answer:l2
downloadlfulllfilelatlhttp://testbankinstant.com
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
Chapter 1 l
1. Thelnurselislcaringlforlfourlclientslonlalmedical–
surgicallunit.lWhichlclient lshould lthelnurselseelinitially?
1. Alclient ladmitted lwithlhepatitislAlwholhaslhad lsevereldiarrhealforlthellast l24lh
ours
2. Alclient ladmitted lwithlpneumonialwholislhaslsmalllamountslof lyellow lpro
ductivelsputum
3. Alclient ladmitted lwithlfeverloflunknownloriginl(FUO)lwholhaslbeenlwit
hout lfeverlforlthellast l48lhours
4. Alclient ladmitted lwithlalwound linfectionlwhoselWBClisl8,500lmm3
Answer:l1
Rationale:lThelnurselmust ldecidelwhichlclient lshould lbelseenlonlthelinitiallroundslof ltheld ay.l
Thelnurselmust lrememberlthat lthelfirst lclient ltolbelseenlshould lbelthelclient lwholneedsl
thelattentionlof lthelnurselinitially.lAlclient lwithlhepatitislAldoeslexperienceldiarrhea,l
but ldiarrhealforlthellast l24lhourslcould lcauselthelclient ltolhavelalproblemlwithldehydr
ationland lexperiencelalstatelof lfluid lvolumeldeficit.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lPlanning
2. Thelnurselislpreparingltoladministerlinfluenzalvaccinesltolalmassldrive-
throughlclinic.lWhichlstatement lbylalclient lwould lindicatelfurtherlquestioninglpriorltolgiving
lthelclient lthelinfluenzalvaccine?
1. “I lamlallergicltolhorselhair.”
2. “I ltryltolget lmylvaccineleverylyear.”
3. “I lamlnot lallergicltolanythinglexcept leggs.”
4. “Mylhusband lhad lalseverelallergiclreactionlafterlhelreceived lhislinfluenzalvac
cine.”
Answer:l3
Rationale:lInfluenzalvaccineslarelrecommended lforlpersonlat lhighlrisklforlseriouslsequelaelo
f linfluenza.lThelnurselshould lbelawarelthat lclient lwithlalsensitivityltoleggslshould lnot lr
eceivelthelvaccine.lVaccineslprepared lfromlchickenlorlducklembryoslarelcontraindic
ated linlclientslwholarelallergicltoleggs.
CognitivelLevel:lApplication
downloadlfulllfilelatlhttp://testbankinstant.com
, Test Bank for Understanding Medical-
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lAssessment
3. Thelnurselislcaringlforlfourlclientslonlalmedical–
surgicallunit.lThelsecretarylgiveslthelnurselthelmorningllabs.lWhichlof lthelfollowingllabslwo
uld lrequirelthat lthelnurselcalllthelphysicianland linformlthelhealthcarelproviderlabout lthelclien
t’slabnormalities?
1.l WBCl14,600lmm3
2. Serumlproteinl6.9lg/dL
3. I l&lDl(incisionland ldrainage)lshowinglnolgrowthlforlthellast l24lhours
4. Albuminl4.2lg/dL
Answer:l1
Rationale:lWhenlthelnurselislcaringlforlseverallclients,lalllof lthellabslshould lbelchecked lf requent
lylthroughout lthelshift ltolassesslforlanylabnormalities.lThelWBClinloptionl1lislabnormal.l(Nor
mallWBCl4,000–
10,000lmm3 .)lAlllof lthelotherllablresultslarelwithinlacceptablelrange;ltherefore,lthelresultslshou
ld lnot lbelcalled linltolthelphysician.
CognitivelLevel:lApplicationlClient l
Needs:lPhysiologiclIntegritylNursin
glProcess:lAssessment
4. Thelnurselislorientinglalnew lgraduate.lThelnurselislreinforcinglthelimportancelof lstanda
rd lprecautions.lWhichlof lthelfollowinglobservationslbylthelnurselwould lrequirelf urtherled
ucationlregardinglstandard lprecautions?
1. Thelgraduatelnurselunderstandsltolwashlhandslwhenlenteringland lexitinglt hel
client’slroom.
2. Thelgraduatelnurselwearslgloveslwhenlservinglbreakfast ltraysltolvariouslcli
ents.
3. Thelgraduatelnurselwearslalgown,lgloves,land lgoggleslwhenlsuctioninglalclie
nt.
4. Thelgraduatelnurselleaveslalllsupplieslinlthelroomlof lalclient lwholislinlcont
act lisolation.
Answer:l2
Rationale:lThelnurselmust lhavelanlunderstandinglof lstandard lprecautions.lPreventionlislthel
most limportant lmeasureltolprevent lnosocomiallinfections.lStandard lprecautionslwer
elpublished linl1996lthat lprovidelguidelineslforlthelhandlinglof lblood landlotherlbodylfl
uids.lTheselguidelineslarelused lwithlalllclients,lregardlesslof lwhetherltheylhavelalkno
wnlinfectiousldisease.lStandard lprecautionslarelused
downloadlfulllfilelatlhttp://testbankinstant.com
, Test Bank for Understanding Medical-
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
bylalllhealthcarelworkerslwholhaveldirect lcontact lwithlclientslorlwithltheirlbodylf luid
s.lIt lislnot lnecessarylforlthelnurseltolwearlgloveslwhileldeliveringlfood ltrayslt olthelclie
nt,lbecauseltherelislnot lcontact lwithlthelclient.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lEvaluation
5. Theladmittingldepartment lalertslthelnurselonlalmedical–
surgicallunit lthat lalclient lwithlactiveltuberculosisl(TB)lislbeingladmitted ltolthelunit.lWhichlty
pelof lisolationlislappropriatelbased lonlthelclient’sldiagnosis?
1. Standard lprecautions
2. Airbornelprecautions
3. Droplet lprecautions
4. Contact lprecautions
Answer:l2
Inladditionltolhandwashingland lstandardlprecautions,lthelnaturelandlspread loflsomelinfect
iousldiseaseslrequirelthat lspecialltechniqueslbelused ltolprotect luninfected lclientsland lwork
ers.lThelclient lwithlpulmonaryltuberculosislwilllbelplaced linlairbornelprecautions.lThelcli
ent lshould lbelplaced linlalprivatelroomlwithlspeciallventilationlthat ld oeslnot lallow lairltolcirc
ulateltolgenerallhospitallventilation;lalmasklorlspeciallfilterlrespiratorslwilllbelused lforleve
ryonelenteringlthelroom.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lAssessment
6. Alclient lislreceivinglIVlvancomycinlforltheltreatment lof lClostridiumldifficile.lThelnurs
elunderstandslthat lthelclient lwholdevelopslflushing,ltachycardia,land lhypotensionld uringlt
helinfusionlof lvancomycinlindicates:
1. Ototoxicityleffect.
2. Superinfection.
3. Red lmanlsyndrome.
4. Hives.
Answer:l3
Rationale:lVancomycinlinhibitslcelllwalllsynthesis,land lislused lforlseriouslinfections.lIt lislonlyle
ffectivelagainst lgram-positivelbacteria,lespeciallylStaphylococcuslaureusland
downloadlfulllfilelatlhttp://testbankinstant.com
, Test Bank for Understanding Medical-
l l l l
Surgical Nursing 6th Edition Linda S. Williams Paul
l l l l l l l
a D. Hopper l l
Staphylococcuslepidermidis.lThelnurselshould linfuselthislmedicationlslowlyloverl60lminuteslo
rlmoreltolavoid l“red lman”lsyndrome.lThelsyndromelislcharacterized lbylerythematouslrash,lflus
hing,ltachycardia,land lhypotension.lClientslcanlbecomeldizzyland lagitated.
CognitivelLevel:lApplication
Client lNeeds:lPhysiologicallIntegrityl
NursinglProcess:lEvaluation
7. Thelphysicianlhaslordered lforlthelclient ltolreceivelaltroughlblood llevelltolevaluatelthelt hera
peuticleffect lof lanlantibiotic.lThelnurselunderstandslthat ltheltroughlshould lbelordered:
1. Alfew lminuteslbeforelthelnext lscheduled ldoselof lmedication.
2. 1–2lhourslafterltheloralladministrationlof lthelmedication.
3. 30lminuteslafterlthelIVladministration.
4. Duringlthelinfusionlof lthelantibiotic.
Answer:l1
Rationale:lAntibioticlpeakland ltroughllevelslmonitorltherapeuticlblood llevelslof lthelprescribe
d lmedication.lTheltherapeuticlrange—
thelminimumland lmaximumlblood llevelslat lwhichltheldruglisleffective—
islknownlforlalgivenldrug.lBylmeasuringlblood llevelslat lthelpredicted lpeakl(1–
2lhourslafterloralladministration,l1lhourlafterlintramuscularladministration,land l30lminuteslaft
erlIV ladministration)land ltroughl(usuallylalfew lminuteslbeforelthelnextlscheduledldose),lit lislal
solpossibleltoldeterminelwhetherltheldruglislreachinglaltoxiclorlharmfulllevellduringltherapy,li
ncreasinglthellikelihood lof ladverseleffects.
CognitivelLevel:lApplication
Client lNeeds:lSafe,lEffectivelCarelEnvironmentlN
ursinglProcess:lAssessment
8. Thelnurselneedsltolchangelaldressinglonlthelclient’slabdomen.lWhichlof lthelfollowinglt ech
niqueslshould lbelimplemented?
1. Contact lprecautions
2. Standard lprecautions
3. Droplet lprecautions
4. Airbornelprecautions
Answer:l2
downloadlfulllfilelatlhttp://testbankinstant.com
