Full file at http://testbankinstant.CH/Test-Bank-for-Medical-Surgical-
k k k
k Nursing-Critical-Thinking-in-Client-Care,-4th-Edition-Priscilla-
kLeMone-download full file at http://testbankinstant.com
k k k k
Medical Surgical k
Nursing
Critical Thinking in Client Care
k k k k
k Test Bank
k
downloadkfullkfilekatkhttp://testbankinstant.com
,Chapter 1 k
1. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kWhichkclientkshouldktheknursekseekinitially?
1. AkclientkadmittedkwithkhepatitiskAkwhokhaskhadkseverekdiarrheakforkthekl
astk24khours
2. Akclientkadmittedkwithkpneumoniakwhokiskhasksmallkamountskofkyellowk
productiveksputum
3. Akclientkadmittedkwithkfeverkofkunknownkorigink(FUO)kwhokhaskbeenk
withoutkfeverkforktheklastk48khours
4. AkclientkadmittedkwithkakwoundkinfectionkwhosekWBCkisk8,500kmm3
Answer:k1
Rationale:kTheknursekmustkdecidekwhichkclientkshouldkbekseenkonkthekinitialkroundskofkthek
day.kTheknursekmustkrememberkthatkthekfirstkclientktokbekseenkshouldkbekthekclient
kwhokneedskthekattentionkofktheknursekinitially.kAkclientkwithkhepatitiskAkdoeskexper
iencekdiarrhea,kbutkdiarrheakforktheklastk24khourskcouldkcausekthekclientktokhavekak
problemkwithkdehydrationkandkexperiencekakstatekofkfluidkvolumekdeficit.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentkNursingk
Process:kPlanning
2. Theknursekiskpreparingktokadministerkinfluenzakvaccinesktokakmasskdrive-
throughkclinic.kWhichkstatementkbykakclientkwouldkindicatekfurtherkquestioningkpriorktokgi
vingkthekclientkthekinfluenzakvaccine?
1. “Ikamkallergicktokhorsekhair.”
2. “Iktryktokgetkmykvaccinekeverykyear.”
3. “Ikamknotkallergicktokanythingkexceptkeggs.”
4. “Mykhusbandkhadkakseverekallergickreactionkafterkhekreceivedkhiski
nfluenzakvaccine.”
,Answer:k3
Rationale:kInfluenzakvaccineskarekrecommendedkforkpersonkatkhighkriskkforkseriousksequel
aekofkinfluenza.kTheknursekshouldkbekawarekthatkclientkwithkaksensitivityktokeggsksh
ouldknotkreceivekthekvaccine.kVaccineskpreparedkfromkchickenkorkduckkembryoskar
ekcontraindicatedkinkclientskwhokarekallergicktokeggs.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentkN
ursingkProcess:kAssessment
3. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kTheksecretarykgivesktheknursekthekmorningklabs.kWhichkofkthekfollowingklabsk
wouldkrequirekthatktheknurse
callkthekphysiciankandkinformkthekhealthcarekproviderkaboutkthekclient’skabnormalities?
1.k WBCk14,600kmm3
2. Serumkproteink6.9kg/dL
3. Ik&kDk(incisionkandkdrainage)kshowingknokgrowthkforktheklastk24khours
4. Albumink4.2kg/dL
Answer:k1
Rationale:kWhenktheknursekiskcaringkforkseveralkclients,kallkofktheklabskshouldkbekcheckedkf
requentlykthroughoutkthekshiftktokassesskforkanykabnormalities.kThekWBCkinkoptionk1kiskab
normal.k(NormalkWBCk4,000–
10,000kmm3.)kAllkofkthekotherklabkresultskarekwithinkacceptablekrange;ktherefore,kthekresu
ltskshouldknotkbekcalledkinktokthekphysician.
CognitivekLevel:kApplication
ClientkNeeds:kPhysiologickIntegrityk
NursingkProcess:kAssessment
4. Theknursekiskorientingkaknewkgraduate.kTheknursekiskreinforcingkthekimportancekofks
tandardkprecautions.kWhichkofkthekfollowingkobservationskbyktheknursekwouldkrequirekfur
therkeducationkregardingkstandardkprecautions?
1. Thekgraduateknursekunderstandsktokwashkhandskwhenkenteringkand
exitingkthekclient’skroom.
2. Thekgraduateknursekwearskgloveskwhenkservingkbreakfastktraysktokvariousk
clients.
, 3. Thekgraduateknursekwearskakgown,kgloves,kandkgoggleskwhenksuctioningkak
client.
4. Thekgraduateknursekleaveskallksupplieskinkthekroomkofkakclientkwhokiskinkc
ontactkisolation.
Answer:k2
Rationale:kTheknursekmustkhavekankunderstandingkofkstandardkprecautions.kPreventionkiskt
hekmostkimportantkmeasurektokpreventknosocomialkinfections.kStandardkprecautio
nskwerekpublishedkink1996kthatkprovidekguidelineskforkthekhandlingkofkbloodkandkot
herkbodykfluids.kThesekguidelineskarekusedkwithkallkclients,kregardlesskofkwhetherkth
eykhavekakknownkinfectiouskdisease.kStandardkprecautionskarekusedkbykallkhealthca
rekworkerskwhokhavekdirectkcontactkwithkclientskorkwithktheirkbodykfluids.kItkisknotkn
ecessarykforktheknursektokwearkgloveskwhilekdeliveringkfoodktraysktokthekclient,kbec
ausektherekisknotkcontactkwithkthekclient.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentkN
ursingkProcess:kEvaluation
5. Thekadmittingkdepartmentkalertsktheknursekonkakmedical–
surgicalkunitkthatkakclientkwithkactivektuberculosisk(TB)kiskbeingkadmittedktokthekunit.kWhic
hktypekofkisolationkiskappropriatekbasedkonkthekclient’skdiagnosis?
1. Standardkprecautions
2. Airbornekprecautions
3. Dropletkprecautions
4. Contactkprecautions
Answer:k2
Inkadditionktokhandwashingkandkstandardkprecautions,ktheknaturekandkspreadkofksomekinfec
tiouskdiseaseskrequirekthatkspecialktechniqueskbekusedktokprotectkuninfectedkclientskandkwor
kers.kThekclientkwithkpulmonaryktuberculosiskwillkbekplacedkinkairbornekprecautions.kThekcli
entkshouldkbekplacedkinkakprivatekroomkwithkspecialkventilationkthatkdoesknotkallowkairktokcir
culatektokgeneralkhospitalkventilation;kakmaskkorkspecialkfilterkrespiratorskwillkbekusedkforkev
eryonekenteringkthekroom.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironment
k k k
k Nursing-Critical-Thinking-in-Client-Care,-4th-Edition-Priscilla-
kLeMone-download full file at http://testbankinstant.com
k k k k
Medical Surgical k
Nursing
Critical Thinking in Client Care
k k k k
k Test Bank
k
downloadkfullkfilekatkhttp://testbankinstant.com
,Chapter 1 k
1. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kWhichkclientkshouldktheknursekseekinitially?
1. AkclientkadmittedkwithkhepatitiskAkwhokhaskhadkseverekdiarrheakforkthekl
astk24khours
2. Akclientkadmittedkwithkpneumoniakwhokiskhasksmallkamountskofkyellowk
productiveksputum
3. Akclientkadmittedkwithkfeverkofkunknownkorigink(FUO)kwhokhaskbeenk
withoutkfeverkforktheklastk48khours
4. AkclientkadmittedkwithkakwoundkinfectionkwhosekWBCkisk8,500kmm3
Answer:k1
Rationale:kTheknursekmustkdecidekwhichkclientkshouldkbekseenkonkthekinitialkroundskofkthek
day.kTheknursekmustkrememberkthatkthekfirstkclientktokbekseenkshouldkbekthekclient
kwhokneedskthekattentionkofktheknursekinitially.kAkclientkwithkhepatitiskAkdoeskexper
iencekdiarrhea,kbutkdiarrheakforktheklastk24khourskcouldkcausekthekclientktokhavekak
problemkwithkdehydrationkandkexperiencekakstatekofkfluidkvolumekdeficit.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentkNursingk
Process:kPlanning
2. Theknursekiskpreparingktokadministerkinfluenzakvaccinesktokakmasskdrive-
throughkclinic.kWhichkstatementkbykakclientkwouldkindicatekfurtherkquestioningkpriorktokgi
vingkthekclientkthekinfluenzakvaccine?
1. “Ikamkallergicktokhorsekhair.”
2. “Iktryktokgetkmykvaccinekeverykyear.”
3. “Ikamknotkallergicktokanythingkexceptkeggs.”
4. “Mykhusbandkhadkakseverekallergickreactionkafterkhekreceivedkhiski
nfluenzakvaccine.”
,Answer:k3
Rationale:kInfluenzakvaccineskarekrecommendedkforkpersonkatkhighkriskkforkseriousksequel
aekofkinfluenza.kTheknursekshouldkbekawarekthatkclientkwithkaksensitivityktokeggsksh
ouldknotkreceivekthekvaccine.kVaccineskpreparedkfromkchickenkorkduckkembryoskar
ekcontraindicatedkinkclientskwhokarekallergicktokeggs.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentkN
ursingkProcess:kAssessment
3. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kTheksecretarykgivesktheknursekthekmorningklabs.kWhichkofkthekfollowingklabsk
wouldkrequirekthatktheknurse
callkthekphysiciankandkinformkthekhealthcarekproviderkaboutkthekclient’skabnormalities?
1.k WBCk14,600kmm3
2. Serumkproteink6.9kg/dL
3. Ik&kDk(incisionkandkdrainage)kshowingknokgrowthkforktheklastk24khours
4. Albumink4.2kg/dL
Answer:k1
Rationale:kWhenktheknursekiskcaringkforkseveralkclients,kallkofktheklabskshouldkbekcheckedkf
requentlykthroughoutkthekshiftktokassesskforkanykabnormalities.kThekWBCkinkoptionk1kiskab
normal.k(NormalkWBCk4,000–
10,000kmm3.)kAllkofkthekotherklabkresultskarekwithinkacceptablekrange;ktherefore,kthekresu
ltskshouldknotkbekcalledkinktokthekphysician.
CognitivekLevel:kApplication
ClientkNeeds:kPhysiologickIntegrityk
NursingkProcess:kAssessment
4. Theknursekiskorientingkaknewkgraduate.kTheknursekiskreinforcingkthekimportancekofks
tandardkprecautions.kWhichkofkthekfollowingkobservationskbyktheknursekwouldkrequirekfur
therkeducationkregardingkstandardkprecautions?
1. Thekgraduateknursekunderstandsktokwashkhandskwhenkenteringkand
exitingkthekclient’skroom.
2. Thekgraduateknursekwearskgloveskwhenkservingkbreakfastktraysktokvariousk
clients.
, 3. Thekgraduateknursekwearskakgown,kgloves,kandkgoggleskwhenksuctioningkak
client.
4. Thekgraduateknursekleaveskallksupplieskinkthekroomkofkakclientkwhokiskinkc
ontactkisolation.
Answer:k2
Rationale:kTheknursekmustkhavekankunderstandingkofkstandardkprecautions.kPreventionkiskt
hekmostkimportantkmeasurektokpreventknosocomialkinfections.kStandardkprecautio
nskwerekpublishedkink1996kthatkprovidekguidelineskforkthekhandlingkofkbloodkandkot
herkbodykfluids.kThesekguidelineskarekusedkwithkallkclients,kregardlesskofkwhetherkth
eykhavekakknownkinfectiouskdisease.kStandardkprecautionskarekusedkbykallkhealthca
rekworkerskwhokhavekdirectkcontactkwithkclientskorkwithktheirkbodykfluids.kItkisknotkn
ecessarykforktheknursektokwearkgloveskwhilekdeliveringkfoodktraysktokthekclient,kbec
ausektherekisknotkcontactkwithkthekclient.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentkN
ursingkProcess:kEvaluation
5. Thekadmittingkdepartmentkalertsktheknursekonkakmedical–
surgicalkunitkthatkakclientkwithkactivektuberculosisk(TB)kiskbeingkadmittedktokthekunit.kWhic
hktypekofkisolationkiskappropriatekbasedkonkthekclient’skdiagnosis?
1. Standardkprecautions
2. Airbornekprecautions
3. Dropletkprecautions
4. Contactkprecautions
Answer:k2
Inkadditionktokhandwashingkandkstandardkprecautions,ktheknaturekandkspreadkofksomekinfec
tiouskdiseaseskrequirekthatkspecialktechniqueskbekusedktokprotectkuninfectedkclientskandkwor
kers.kThekclientkwithkpulmonaryktuberculosiskwillkbekplacedkinkairbornekprecautions.kThekcli
entkshouldkbekplacedkinkakprivatekroomkwithkspecialkventilationkthatkdoesknotkallowkairktokcir
culatektokgeneralkhospitalkventilation;kakmaskkorkspecialkfilterkrespiratorskwillkbekusedkforkev
eryonekenteringkthekroom.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironment
