Test Bank for Understanding Medical-
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
Chapter 1 k
1. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kWhichkclientkshouldktheknursekseekinitially?
1. AkclientkadmittedkwithkhepatitiskAkwhokhaskhadkseverekdiarrheakforktheklastk2
4khours
2. Akclientkadmittedkwithkpneumoniakwhokiskhasksmallkamountskofkyellowkp
roductiveksputum
3. Akclientkadmittedkwithkfeverkofkunknownkorigink(FUO)kwhokhaskbeenk
withoutkfeverkforktheklastk48khours
4. AkclientkadmittedkwithkakwoundkinfectionkwhosekWBCkisk8,500kmm3
Answer:k1
Rationale:kTheknursekmustkdecidekwhichkclientkshouldkbekseenkonkthekinitialkroundskofkthekd
ay.kTheknursekmustkrememberkthatkthekfirstkclientktokbekseenkshouldkbekthekclientkwh
okneedskthekattentionkofktheknursekinitially.kAkclientkwithkhepatitiskAkdoeskexperienc
ekdiarrhea,kbutkdiarrheakforktheklastk24khourskcouldkcausekthekclientktokhavekakproble
mkwithkdehydrationkandkexperiencekakstatekofkfluidkvolumekdeficit.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kPlanning
2. Theknursekiskpreparingktokadministerkinfluenzakvaccinesktokakmasskdrive-
throughkclinic.kWhichkstatementkbykakclientkwouldkindicatekfurtherkquestioningkpriorktokgiv
ingkthekclientkthekinfluenzakvaccine?
1. “Ikamkallergicktokhorsekhair.”
2. “Iktryktokgetkmykvaccinekeverykyear.”
3. “Ikamknotkallergicktokanythingkexceptkeggs.”
4. “Mykhusbandkhadkakseverekallergickreactionkafterkhekreceivedkhiskinfluenzakv
accine.”
Answer:k3
Rationale:kInfluenzakvaccineskarekrecommendedkforkpersonkatkhighkriskkforkseriousksequela
ekofkinfluenza.kTheknursekshouldkbekawarekthatkclientkwithkaksensitivityktokeggskshoul
dknotkreceivekthekvaccine.kVaccineskpreparedkfromkchickenkorkduckkembryoskarekco
ntraindicatedkinkclientskwhokarekallergicktokeggs.
CognitivekLevel:kApplication
downloadkfullkfilekatkhttp://testbankinstant.com
, Test Bank for Understanding Medical-
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kAssessment
3. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kTheksecretarykgivesktheknursekthekmorningklabs.kWhichkofkthekfollowingklabsk
wouldkrequirekthatktheknursekcallkthekphysiciankandkinformkthekhealthcarekproviderkaboutkth
ekclient’skabnormalities?
1.k WBCk14,600kmm3
2. Serumkproteink6.9kg/dL
3. Ik&kDk(incisionkandkdrainage)kshowingknokgrowthkforktheklastk24khours
4. Albumink4.2kg/dL
Answer:k1
Rationale:kWhenktheknursekiskcaringkforkseveralkclients,kallkofktheklabskshouldkbekcheckedkfreq
uentlykthroughoutkthekshiftktokassesskforkanykabnormalities.kThekWBCkinkoptionk1kiskabnorma
l.k(NormalkWBCk4,000–
10,000kmm3.)kAllkofkthekotherklabkresultskarekwithinkacceptablekrange;ktherefore,kthekresultsks
houldknotkbekcalledkinktokthekphysician.
CognitivekLevel:kApplicationkClien
tkNeeds:kPhysiologickIntegritykNursi
ngkProcess:kAssessment
4. Theknursekiskorientingkaknewkgraduate.kTheknursekiskreinforcingkthekimportancekofksta
ndardkprecautions.kWhichkofkthekfollowingkobservationskbyktheknursekwouldkrequirekfurt
herkeducationkregardingkstandardkprecautions?
1. Thekgraduateknursekunderstandsktokwashkhandskwhenkenteringkandkexitingkt
hekclient’skroom.
2. Thekgraduateknursekwearskgloveskwhenkservingkbreakfastktraysktokvariouskc
lients.
3. Thekgraduateknursekwearskakgown,kgloves,kandkgoggleskwhenksuctioningkakc
lient.
4. Thekgraduateknursekleaveskallksupplieskinkthekroomkofkakclientkwhokiskinkc
ontactkisolation.
Answer:k2
Rationale:kTheknursekmustkhavekankunderstandingkofkstandardkprecautions.kPreventionkiskth
ekmostkimportantkmeasurektokpreventknosocomialkinfections.kStandardkprecautionsk
werekpublishedkink1996kthatkprovidekguidelineskforkthekhandlingkofkbloodkandkotherk
bodykfluids.kThesekguidelineskarekusedkwithkallkclients,kregardlesskofkwhetherktheykh
avekakknownkinfectiouskdisease.kStandardkprecautionskarekused
downloadkfullkfilekatkhttp://testbankinstant.com
, Test Bank for Understanding Medical-
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
bykallkhealthcarekworkerskwhokhavekdirectkcontactkwithkclientskorkwithktheirkbodykfl
uids.kItkisknotknecessarykforktheknursektokwearkgloveskwhilekdeliveringkfoodktraysktokt
hekclient,kbecausektherekisknotkcontactkwithkthekclient.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kEvaluation
5. Thekadmittingkdepartmentkalertsktheknursekonkakmedical–
surgicalkunitkthatkakclientkwithkactivektuberculosisk(TB)kiskbeingkadmittedktokthekunit.kWhic
hktypekofkisolationkiskappropriatekbasedkonkthekclient’skdiagnosis?
1. Standardkprecautions
2. Airbornekprecautions
3. Dropletkprecautions
4. Contactkprecautions
Answer:k2
Inkadditionktokhandwashingkandkstandardkprecautions,ktheknaturekandkspreadkofksomekinf
ectiouskdiseaseskrequirekthatkspecialktechniqueskbekusedktokprotectkuninfectedkclientskandk
workers.kThekclientkwithkpulmonaryktuberculosiskwillkbekplacedkinkairbornekprecautions.
kThekclientkshouldkbekplacedkinkakprivatekroomkwithkspecialkventilationkthatkdoesknotkallo
wkairktokcirculatektokgeneralkhospitalkventilation;kakmaskkorkspecialkfilterkrespiratorskwillk
bekusedkforkeveryonekenteringkthekroom.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kAssessment
6. AkclientkiskreceivingkIVkvancomycinkforkthektreatmentkofkClostridiumkdifficile.kThekn
ursekunderstandskthatkthekclientkwhokdevelopskflushing,ktachycardia,kandkhypotensionkdu
ringkthekinfusionkofkvancomycinkindicates:
1. Ototoxicitykeffect.
2. Superinfection.
3. Redkmanksyndrome.
4. Hives.
Answer:k3
Rationale:kVancomycinkinhibitskcellkwallksynthesis,kandkiskusedkforkseriouskinfections.kItkiskonl
ykeffectivekagainstkgram-positivekbacteria,kespeciallykStaphylococcuskaureuskand
downloadkfullkfilekatkhttp://testbankinstant.com
, Test Bank for Understanding Medical-
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
Staphylococcuskepidermidis.kTheknursekshouldkinfusekthiskmedicationkslowlykoverk60kminute
skorkmorektokavoidk“redkman”ksyndrome.kTheksyndromekiskcharacterizedkbykerythematouskras
h,kflushing,ktachycardia,kandkhypotension.kClientskcankbecomekdizzykandkagitated.
CognitivekLevel:kApplication
ClientkNeeds:kPhysiologicalkIntegrityk
NursingkProcess:kEvaluation
7. Thekphysiciankhaskorderedkforkthekclientktokreceivekaktroughkbloodklevelktokevaluatekthekt
herapeutickeffectkofkankantibiotic.kTheknursekunderstandskthatkthektroughkshouldkbekordere
d:
1. Akfewkminuteskbeforektheknextkscheduledkdosekofkmedication.
2. 1–2khourskafterkthekoralkadministrationkofkthekmedication.
3. 30kminuteskafterkthekIVkadministration.
4. Duringkthekinfusionkofkthekantibiotic.
Answer:k1
Rationale:kAntibiotickpeakkandktroughklevelskmonitorktherapeutickbloodklevelskofkthekprescri
bedkmedication.kThektherapeutickrange—
thekminimumkandkmaximumkbloodklevelskatkwhichkthekdrugkiskeffective—
iskknownkforkakgivenkdrug.kBykmeasuringkbloodklevelskatkthekpredictedkpeakk(1–
2khourskafterkoralkadministration,k1khourkafterkintramuscularkadministration,kandk30kminutes
kafterkIVkadministration)kandktroughk(usuallykakfewkminuteskbeforektheknextkscheduledkdose),
kitkiskalsokpossiblektokdeterminekwhetherkthekdrugkiskreachingkaktoxickorkharmfulklevelkduringk
therapy,kincreasingktheklikelihoodkofkadversekeffects.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kAssessment
8. Theknursekneedsktokchangekakdressingkonkthekclient’skabdomen.kWhichkofkthekfollowingkt
echniqueskshouldkbekimplemented?
1. Contactkprecautions
2. Standardkprecautions
3. Dropletkprecautions
4. Airbornekprecautions
Answer:k2
downloadkfullkfilekatkhttp://testbankinstant.com
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
Chapter 1 k
1. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kWhichkclientkshouldktheknursekseekinitially?
1. AkclientkadmittedkwithkhepatitiskAkwhokhaskhadkseverekdiarrheakforktheklastk2
4khours
2. Akclientkadmittedkwithkpneumoniakwhokiskhasksmallkamountskofkyellowkp
roductiveksputum
3. Akclientkadmittedkwithkfeverkofkunknownkorigink(FUO)kwhokhaskbeenk
withoutkfeverkforktheklastk48khours
4. AkclientkadmittedkwithkakwoundkinfectionkwhosekWBCkisk8,500kmm3
Answer:k1
Rationale:kTheknursekmustkdecidekwhichkclientkshouldkbekseenkonkthekinitialkroundskofkthekd
ay.kTheknursekmustkrememberkthatkthekfirstkclientktokbekseenkshouldkbekthekclientkwh
okneedskthekattentionkofktheknursekinitially.kAkclientkwithkhepatitiskAkdoeskexperienc
ekdiarrhea,kbutkdiarrheakforktheklastk24khourskcouldkcausekthekclientktokhavekakproble
mkwithkdehydrationkandkexperiencekakstatekofkfluidkvolumekdeficit.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kPlanning
2. Theknursekiskpreparingktokadministerkinfluenzakvaccinesktokakmasskdrive-
throughkclinic.kWhichkstatementkbykakclientkwouldkindicatekfurtherkquestioningkpriorktokgiv
ingkthekclientkthekinfluenzakvaccine?
1. “Ikamkallergicktokhorsekhair.”
2. “Iktryktokgetkmykvaccinekeverykyear.”
3. “Ikamknotkallergicktokanythingkexceptkeggs.”
4. “Mykhusbandkhadkakseverekallergickreactionkafterkhekreceivedkhiskinfluenzakv
accine.”
Answer:k3
Rationale:kInfluenzakvaccineskarekrecommendedkforkpersonkatkhighkriskkforkseriousksequela
ekofkinfluenza.kTheknursekshouldkbekawarekthatkclientkwithkaksensitivityktokeggskshoul
dknotkreceivekthekvaccine.kVaccineskpreparedkfromkchickenkorkduckkembryoskarekco
ntraindicatedkinkclientskwhokarekallergicktokeggs.
CognitivekLevel:kApplication
downloadkfullkfilekatkhttp://testbankinstant.com
, Test Bank for Understanding Medical-
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kAssessment
3. Theknursekiskcaringkforkfourkclientskonkakmedical–
surgicalkunit.kTheksecretarykgivesktheknursekthekmorningklabs.kWhichkofkthekfollowingklabsk
wouldkrequirekthatktheknursekcallkthekphysiciankandkinformkthekhealthcarekproviderkaboutkth
ekclient’skabnormalities?
1.k WBCk14,600kmm3
2. Serumkproteink6.9kg/dL
3. Ik&kDk(incisionkandkdrainage)kshowingknokgrowthkforktheklastk24khours
4. Albumink4.2kg/dL
Answer:k1
Rationale:kWhenktheknursekiskcaringkforkseveralkclients,kallkofktheklabskshouldkbekcheckedkfreq
uentlykthroughoutkthekshiftktokassesskforkanykabnormalities.kThekWBCkinkoptionk1kiskabnorma
l.k(NormalkWBCk4,000–
10,000kmm3.)kAllkofkthekotherklabkresultskarekwithinkacceptablekrange;ktherefore,kthekresultsks
houldknotkbekcalledkinktokthekphysician.
CognitivekLevel:kApplicationkClien
tkNeeds:kPhysiologickIntegritykNursi
ngkProcess:kAssessment
4. Theknursekiskorientingkaknewkgraduate.kTheknursekiskreinforcingkthekimportancekofksta
ndardkprecautions.kWhichkofkthekfollowingkobservationskbyktheknursekwouldkrequirekfurt
herkeducationkregardingkstandardkprecautions?
1. Thekgraduateknursekunderstandsktokwashkhandskwhenkenteringkandkexitingkt
hekclient’skroom.
2. Thekgraduateknursekwearskgloveskwhenkservingkbreakfastktraysktokvariouskc
lients.
3. Thekgraduateknursekwearskakgown,kgloves,kandkgoggleskwhenksuctioningkakc
lient.
4. Thekgraduateknursekleaveskallksupplieskinkthekroomkofkakclientkwhokiskinkc
ontactkisolation.
Answer:k2
Rationale:kTheknursekmustkhavekankunderstandingkofkstandardkprecautions.kPreventionkiskth
ekmostkimportantkmeasurektokpreventknosocomialkinfections.kStandardkprecautionsk
werekpublishedkink1996kthatkprovidekguidelineskforkthekhandlingkofkbloodkandkotherk
bodykfluids.kThesekguidelineskarekusedkwithkallkclients,kregardlesskofkwhetherktheykh
avekakknownkinfectiouskdisease.kStandardkprecautionskarekused
downloadkfullkfilekatkhttp://testbankinstant.com
, Test Bank for Understanding Medical-
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
bykallkhealthcarekworkerskwhokhavekdirectkcontactkwithkclientskorkwithktheirkbodykfl
uids.kItkisknotknecessarykforktheknursektokwearkgloveskwhilekdeliveringkfoodktraysktokt
hekclient,kbecausektherekisknotkcontactkwithkthekclient.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kEvaluation
5. Thekadmittingkdepartmentkalertsktheknursekonkakmedical–
surgicalkunitkthatkakclientkwithkactivektuberculosisk(TB)kiskbeingkadmittedktokthekunit.kWhic
hktypekofkisolationkiskappropriatekbasedkonkthekclient’skdiagnosis?
1. Standardkprecautions
2. Airbornekprecautions
3. Dropletkprecautions
4. Contactkprecautions
Answer:k2
Inkadditionktokhandwashingkandkstandardkprecautions,ktheknaturekandkspreadkofksomekinf
ectiouskdiseaseskrequirekthatkspecialktechniqueskbekusedktokprotectkuninfectedkclientskandk
workers.kThekclientkwithkpulmonaryktuberculosiskwillkbekplacedkinkairbornekprecautions.
kThekclientkshouldkbekplacedkinkakprivatekroomkwithkspecialkventilationkthatkdoesknotkallo
wkairktokcirculatektokgeneralkhospitalkventilation;kakmaskkorkspecialkfilterkrespiratorskwillk
bekusedkforkeveryonekenteringkthekroom.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kAssessment
6. AkclientkiskreceivingkIVkvancomycinkforkthektreatmentkofkClostridiumkdifficile.kThekn
ursekunderstandskthatkthekclientkwhokdevelopskflushing,ktachycardia,kandkhypotensionkdu
ringkthekinfusionkofkvancomycinkindicates:
1. Ototoxicitykeffect.
2. Superinfection.
3. Redkmanksyndrome.
4. Hives.
Answer:k3
Rationale:kVancomycinkinhibitskcellkwallksynthesis,kandkiskusedkforkseriouskinfections.kItkiskonl
ykeffectivekagainstkgram-positivekbacteria,kespeciallykStaphylococcuskaureuskand
downloadkfullkfilekatkhttp://testbankinstant.com
, Test Bank for Understanding Medical-
k k k k
Surgical Nursing 6th Edition Linda S. Williams Pa
k k k k k k k
ula D. Hopper k k
Staphylococcuskepidermidis.kTheknursekshouldkinfusekthiskmedicationkslowlykoverk60kminute
skorkmorektokavoidk“redkman”ksyndrome.kTheksyndromekiskcharacterizedkbykerythematouskras
h,kflushing,ktachycardia,kandkhypotension.kClientskcankbecomekdizzykandkagitated.
CognitivekLevel:kApplication
ClientkNeeds:kPhysiologicalkIntegrityk
NursingkProcess:kEvaluation
7. Thekphysiciankhaskorderedkforkthekclientktokreceivekaktroughkbloodklevelktokevaluatekthekt
herapeutickeffectkofkankantibiotic.kTheknursekunderstandskthatkthektroughkshouldkbekordere
d:
1. Akfewkminuteskbeforektheknextkscheduledkdosekofkmedication.
2. 1–2khourskafterkthekoralkadministrationkofkthekmedication.
3. 30kminuteskafterkthekIVkadministration.
4. Duringkthekinfusionkofkthekantibiotic.
Answer:k1
Rationale:kAntibiotickpeakkandktroughklevelskmonitorktherapeutickbloodklevelskofkthekprescri
bedkmedication.kThektherapeutickrange—
thekminimumkandkmaximumkbloodklevelskatkwhichkthekdrugkiskeffective—
iskknownkforkakgivenkdrug.kBykmeasuringkbloodklevelskatkthekpredictedkpeakk(1–
2khourskafterkoralkadministration,k1khourkafterkintramuscularkadministration,kandk30kminutes
kafterkIVkadministration)kandktroughk(usuallykakfewkminuteskbeforektheknextkscheduledkdose),
kitkiskalsokpossiblektokdeterminekwhetherkthekdrugkiskreachingkaktoxickorkharmfulklevelkduringk
therapy,kincreasingktheklikelihoodkofkadversekeffects.
CognitivekLevel:kApplication
ClientkNeeds:kSafe,kEffectivekCarekEnvironmentk
NursingkProcess:kAssessment
8. Theknursekneedsktokchangekakdressingkonkthekclient’skabdomen.kWhichkofkthekfollowingkt
echniqueskshouldkbekimplemented?
1. Contactkprecautions
2. Standardkprecautions
3. Dropletkprecautions
4. Airbornekprecautions
Answer:k2
downloadkfullkfilekatkhttp://testbankinstant.com
