Test Bank for Understanding Medical-
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
Chapter 1 n
1. Then nursen isncaringn forn fourn clientsn onnanmedical–
surgicalnunit.n Whichnclient n should n then nursen seen initially?
1. Anclient n admitted nwithnhepatitisnAnwhon hasnhadnseverendiarrhean fornthenlastn2
4n hours
2. Anclient n admittedn withnpneumonian whon isn hasnsmalln amountsn of nyellow n
productiven sputum
3. Anclient n admitted nwithnfevern ofnunknownnoriginn (FUO)n whon hasnbeenn
without n fevern forn then last n 48n hours
4. Anclient n admitted n withnan wound n infectionnwhosen WBCn isn 8,500n mm3
Answer:n 1
Rationale:n Then nursen must n deciden whichnclient n should nbenseennonnthen initialn roundsn ofnthenda
y.n Then nursen must n remembern that n then first n client n ton benseennshould nben thenclient n whon
needsn then attentionn ofn then nursen initially.n An client n withnhepatitisn An doesn experiencen
diarrhea,n but n diarrhean forn thenlast n 24nhoursn could ncausen then client n tonhaven anproblemn
withn dehydrationn and n experiencen an staten of n fluid n volumen deficit.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Planning
2. Then nursen isnpreparingnton administern influenzan vaccinesn ton anmassn drive-
throughnclinic.n Whichn statement n byn an client n wouldn indicaten furthern questioningn priorn ton giv
ingn then client n then influenzan vaccine?
1. “I n amnallergicn ton horsen hair.”
2. “I n trynton get n myn vaccinen everyn year.”
3. “I n amnnot n allergicn ton anythingn except n eggs.”
4. “Mynhusband n had n anseverenallergicn reactionn aftern henreceived n hisn influenzan
vaccine.”
Answer:n 3
Rationale:n Influenzan vaccinesn aren recommended n forn personn at nhighn riskn fornseriousn sequela
en of n influenza.n Then nursenshould nbenawaren that nclient n withnansensitivitynton eggsn shou
ld n not n receiven then vaccine.n Vaccinesn prepared n fromn chickenn orn duckn embryosn aren c
ontraindicated n inn clientsn whon aren allergicn ton eggs.
Cognitiven Level:n Application
downloadn fulln filenatnhttp://testbankinstant.com
, Test Bank for Understanding Medical-
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Assessment
3. Then nursen isn caringn forn fourn clientsn onn an medical–
surgicaln unit.n Then secretaryngivesn then nursenthen morningn labs.n Whichn of nthen followingn labsn
wouldn requiren thatnthen nursencalln then physiciann andn informnthen healthcaren providern aboutn th
en client’sn abnormalities?
1. WBCn 14,600n mm3
2. Serumn proteinn 6.9n g/dL
3. I n &n Dn (incisionn and n drainage)n showingn non growthn fornthen last n 24n hours
4. Albuminn 4.2n g/dL
Answer:n 1
Rationale:n Whenn thennursen isn caringn forn severalnclients,n allnof nthenlabsn shouldn bencheckednfrequen
tlyn throughout n thenshift ntonassessn fornanyn abnormalities.n Then WBCn inn optionn 1nisn abnormal.n (Nor
maln WBCn 4,000–
10,000n mm3 .)n Alln of n then othern labn resultsn aren withinn acceptablen range;n therefore,n then resultsn sho
uld n not n ben called n inn ton then physician.
Cognitiven Level:n Applicationn Clien
t nNeeds:nPhysiologicnIntegrityn Nursi
ngn Process:n Assessment
4. Then nursen isn orientingn an new n graduate.n Then nursen isn reinforcingn then importancen of nsta
ndard n precautions.n Whichnof nthenfollowingn observationsn bynthen nursenwouldnrequiren furt
hern educationn regardingn standard n precautions?
1. Then graduatennursenunderstandsn tonwashnhandsnwhennenteringn andnexitingnt
hen client’sn room.
2. Then graduatennursenwearsnglovesn whennservingn breakfast n traysn ton variousn
clients.
3. Then graduaten nursen wearsn angown,ngloves,n andngogglesn whennsuctioningnanc
lient.
4. Then graduatennursen leavesn alln suppliesn inn then roomnof nanclient nwhonisn inn c
ontact n isolation.
Answer:n 2
Rationale:n Then nursen must n haven ann understandingn ofnstandardn precautions.n Preventionnisn th
en most n important n measuren ton prevent n nosocomialn infections.n Standard n precautionsn
weren published n inn 1996n that nproviden guidelinesn forn then handlingn ofn bloodnandnothern
bodynfluids.n Thesenguidelinesn aren used nwithnallnclients,n regardlessn of n whethern theyn h
aven an knownn infectiousn disease.n Standard n precautionsn aren used
downloadn fulln filenatnhttp://testbankinstant.com
, Test Bank for Understanding Medical-
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
byn alln healthcaren workersn whon havendirect n contactn withn clientsn orn withntheirn bodynfl
uids.nItn isn not n necessarynforn then nursenton wearn glovesn whilendeliveringn foodn traysnton
then client,n becausen theren isn not n contact n withn then client.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Evaluation
5. Thenadmittingn department n alertsnthen nursen onnanmedical–
surgicalnunit n that n anclient n withn activen tuberculosisn (TB)n isn beingn admitted ntonthen unit.nWhic
hn typen of n isolationn isn appropriaten based n onn then client’sn diagnosis?
1. Standard n precautions
2. Airbornen precautions
3. Droplet n precautions
4. Contact n precautions
Answer:n 2
Inn additionntonhandwashingn andn standard nprecautions,n thennaturenand nspread nofn somen infect
iousn diseasesn requiren that n specialntechniquesn ben usedn tonprotect nuninfectednclientsn andn work
ers.n Then client n withn pulmonaryn tuberculosisn willn ben placed n inn airbornen precautions.n Then cli
ent n should n benplaced n innanprivaten roomnwithnspecialn ventilationn thatndoesn not nallow n airn ton cir
culaten ton generaln hospitaln ventilation;n an maskn orn specialn filtern respiratorsn willn ben used n forn e
veryonen enteringn then room.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Assessment
6. Anclient n isn receivingn IVn vancomycinn forn thentreatment n ofnClostridiumn difficile.n Then n
ursenunderstandsnthat nthenclient nwhondevelopsn flushing,n tachycardia,n and n hypotensionn d
uringn then infusionn of n vancomycinn indicates:
1. Ototoxicityneffect.
2. Superinfection.
3. Red n mann syndrome.
4. Hives.
Answer:n 3
Rationale:nVancomycinninhibitsncellnwallnsynthesis,n and n isnused n forn seriousninfections.n Itnisn o
nlyn effectiven against n gram-positiven bacteria,n especiallyn Staphylococcusn aureusn and
downloadn fulln filenatnhttp://testbankinstant.com
, Test Bank for Understanding Medical-
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
Staphylococcusn epidermidis.n Then nursen should n infusen thisn medicationn slowlyn overn 60n min
utesn orn moren ton avoid n “redn man”n syndrome.n Then syndromen isn characterized n byn erythemato
usnrash,n flushing,n tachycardia,n and n hypotension.n Clientsn cannbecomen dizzynand n agitated.
Cognitiven Level:n Application
Client nNeeds:nPhysiologicalnIntegrityn Nursin
gn Process:n Evaluation
7. Then physiciann hasn ordered n fornthenclient n tonreceiven an troughnbloodnleveln ton evaluatenthen t
herapeuticn effect n of nann antibiotic.n Then nursen understandsn that nthen troughn should n ben ordere
d:
1. Anfew n minutesn beforen then next n scheduled n dosenof n medication.
2. 1–2n hoursn aftern then oraln administrationn of nthen medication.
3. 30n minutesn aftern then IVnadministration.
4. Duringn then infusionn of nthen antibiotic.
Answer:n 1
Rationale:n Antibioticn peakn and n troughn levelsn monitorn therapeuticn bloodnlevelsn of n then prescr
ibed n medication.n Then therapeuticn range—
then minimumn and n maximumn blood n levelsn at n whichn then drugn isn effective—
isn knownn forn an givenn drug.n Byn measuringn blood n levelsn at n then predicted n peakn (1–
2n hoursn aftern oraln administration,n 1n hourn aftern intramuscularn administration,n and n30nminutes
n aftern IVnadministration)n and ntroughn(usuallynan fewn minutesn beforen then nextn scheduled ndose)
,n it n isn alson possiblen ton determinen whethern thendrugn isn reachingn an toxicn orn harmfuln leveln durin
gn therapy,n increasingn then likelihood n of n adversen effects.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Assessment
8. Then nursen needsnton changen andressingn onnthenclient’sn abdomen.nWhichnof nthenfollowingn t
echniquesn should n ben implemented?
1. Contact n precautions
2. Standard n precautions
3. Droplet n precautions
4. Airbornen precautions
Answer:n 2
downloadn fulln filenatnhttp://testbankinstant.com
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
Chapter 1 n
1. Then nursen isncaringn forn fourn clientsn onnanmedical–
surgicalnunit.n Whichnclient n should n then nursen seen initially?
1. Anclient n admitted nwithnhepatitisnAnwhon hasnhadnseverendiarrhean fornthenlastn2
4n hours
2. Anclient n admittedn withnpneumonian whon isn hasnsmalln amountsn of nyellow n
productiven sputum
3. Anclient n admitted nwithnfevern ofnunknownnoriginn (FUO)n whon hasnbeenn
without n fevern forn then last n 48n hours
4. Anclient n admitted n withnan wound n infectionnwhosen WBCn isn 8,500n mm3
Answer:n 1
Rationale:n Then nursen must n deciden whichnclient n should nbenseennonnthen initialn roundsn ofnthenda
y.n Then nursen must n remembern that n then first n client n ton benseennshould nben thenclient n whon
needsn then attentionn ofn then nursen initially.n An client n withnhepatitisn An doesn experiencen
diarrhea,n but n diarrhean forn thenlast n 24nhoursn could ncausen then client n tonhaven anproblemn
withn dehydrationn and n experiencen an staten of n fluid n volumen deficit.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Planning
2. Then nursen isnpreparingnton administern influenzan vaccinesn ton anmassn drive-
throughnclinic.n Whichn statement n byn an client n wouldn indicaten furthern questioningn priorn ton giv
ingn then client n then influenzan vaccine?
1. “I n amnallergicn ton horsen hair.”
2. “I n trynton get n myn vaccinen everyn year.”
3. “I n amnnot n allergicn ton anythingn except n eggs.”
4. “Mynhusband n had n anseverenallergicn reactionn aftern henreceived n hisn influenzan
vaccine.”
Answer:n 3
Rationale:n Influenzan vaccinesn aren recommended n forn personn at nhighn riskn fornseriousn sequela
en of n influenza.n Then nursenshould nbenawaren that nclient n withnansensitivitynton eggsn shou
ld n not n receiven then vaccine.n Vaccinesn prepared n fromn chickenn orn duckn embryosn aren c
ontraindicated n inn clientsn whon aren allergicn ton eggs.
Cognitiven Level:n Application
downloadn fulln filenatnhttp://testbankinstant.com
, Test Bank for Understanding Medical-
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Assessment
3. Then nursen isn caringn forn fourn clientsn onn an medical–
surgicaln unit.n Then secretaryngivesn then nursenthen morningn labs.n Whichn of nthen followingn labsn
wouldn requiren thatnthen nursencalln then physiciann andn informnthen healthcaren providern aboutn th
en client’sn abnormalities?
1. WBCn 14,600n mm3
2. Serumn proteinn 6.9n g/dL
3. I n &n Dn (incisionn and n drainage)n showingn non growthn fornthen last n 24n hours
4. Albuminn 4.2n g/dL
Answer:n 1
Rationale:n Whenn thennursen isn caringn forn severalnclients,n allnof nthenlabsn shouldn bencheckednfrequen
tlyn throughout n thenshift ntonassessn fornanyn abnormalities.n Then WBCn inn optionn 1nisn abnormal.n (Nor
maln WBCn 4,000–
10,000n mm3 .)n Alln of n then othern labn resultsn aren withinn acceptablen range;n therefore,n then resultsn sho
uld n not n ben called n inn ton then physician.
Cognitiven Level:n Applicationn Clien
t nNeeds:nPhysiologicnIntegrityn Nursi
ngn Process:n Assessment
4. Then nursen isn orientingn an new n graduate.n Then nursen isn reinforcingn then importancen of nsta
ndard n precautions.n Whichnof nthenfollowingn observationsn bynthen nursenwouldnrequiren furt
hern educationn regardingn standard n precautions?
1. Then graduatennursenunderstandsn tonwashnhandsnwhennenteringn andnexitingnt
hen client’sn room.
2. Then graduatennursenwearsnglovesn whennservingn breakfast n traysn ton variousn
clients.
3. Then graduaten nursen wearsn angown,ngloves,n andngogglesn whennsuctioningnanc
lient.
4. Then graduatennursen leavesn alln suppliesn inn then roomnof nanclient nwhonisn inn c
ontact n isolation.
Answer:n 2
Rationale:n Then nursen must n haven ann understandingn ofnstandardn precautions.n Preventionnisn th
en most n important n measuren ton prevent n nosocomialn infections.n Standard n precautionsn
weren published n inn 1996n that nproviden guidelinesn forn then handlingn ofn bloodnandnothern
bodynfluids.n Thesenguidelinesn aren used nwithnallnclients,n regardlessn of n whethern theyn h
aven an knownn infectiousn disease.n Standard n precautionsn aren used
downloadn fulln filenatnhttp://testbankinstant.com
, Test Bank for Understanding Medical-
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
byn alln healthcaren workersn whon havendirect n contactn withn clientsn orn withntheirn bodynfl
uids.nItn isn not n necessarynforn then nursenton wearn glovesn whilendeliveringn foodn traysnton
then client,n becausen theren isn not n contact n withn then client.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Evaluation
5. Thenadmittingn department n alertsnthen nursen onnanmedical–
surgicalnunit n that n anclient n withn activen tuberculosisn (TB)n isn beingn admitted ntonthen unit.nWhic
hn typen of n isolationn isn appropriaten based n onn then client’sn diagnosis?
1. Standard n precautions
2. Airbornen precautions
3. Droplet n precautions
4. Contact n precautions
Answer:n 2
Inn additionntonhandwashingn andn standard nprecautions,n thennaturenand nspread nofn somen infect
iousn diseasesn requiren that n specialntechniquesn ben usedn tonprotect nuninfectednclientsn andn work
ers.n Then client n withn pulmonaryn tuberculosisn willn ben placed n inn airbornen precautions.n Then cli
ent n should n benplaced n innanprivaten roomnwithnspecialn ventilationn thatndoesn not nallow n airn ton cir
culaten ton generaln hospitaln ventilation;n an maskn orn specialn filtern respiratorsn willn ben used n forn e
veryonen enteringn then room.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Assessment
6. Anclient n isn receivingn IVn vancomycinn forn thentreatment n ofnClostridiumn difficile.n Then n
ursenunderstandsnthat nthenclient nwhondevelopsn flushing,n tachycardia,n and n hypotensionn d
uringn then infusionn of n vancomycinn indicates:
1. Ototoxicityneffect.
2. Superinfection.
3. Red n mann syndrome.
4. Hives.
Answer:n 3
Rationale:nVancomycinninhibitsncellnwallnsynthesis,n and n isnused n forn seriousninfections.n Itnisn o
nlyn effectiven against n gram-positiven bacteria,n especiallyn Staphylococcusn aureusn and
downloadn fulln filenatnhttp://testbankinstant.com
, Test Bank for Understanding Medical-
n n n n
Surgical Nursing 6th Edition Linda S. Williams P
n n n n n n n
aula D. Hopper n n
Staphylococcusn epidermidis.n Then nursen should n infusen thisn medicationn slowlyn overn 60n min
utesn orn moren ton avoid n “redn man”n syndrome.n Then syndromen isn characterized n byn erythemato
usnrash,n flushing,n tachycardia,n and n hypotension.n Clientsn cannbecomen dizzynand n agitated.
Cognitiven Level:n Application
Client nNeeds:nPhysiologicalnIntegrityn Nursin
gn Process:n Evaluation
7. Then physiciann hasn ordered n fornthenclient n tonreceiven an troughnbloodnleveln ton evaluatenthen t
herapeuticn effect n of nann antibiotic.n Then nursen understandsn that nthen troughn should n ben ordere
d:
1. Anfew n minutesn beforen then next n scheduled n dosenof n medication.
2. 1–2n hoursn aftern then oraln administrationn of nthen medication.
3. 30n minutesn aftern then IVnadministration.
4. Duringn then infusionn of nthen antibiotic.
Answer:n 1
Rationale:n Antibioticn peakn and n troughn levelsn monitorn therapeuticn bloodnlevelsn of n then prescr
ibed n medication.n Then therapeuticn range—
then minimumn and n maximumn blood n levelsn at n whichn then drugn isn effective—
isn knownn forn an givenn drug.n Byn measuringn blood n levelsn at n then predicted n peakn (1–
2n hoursn aftern oraln administration,n 1n hourn aftern intramuscularn administration,n and n30nminutes
n aftern IVnadministration)n and ntroughn(usuallynan fewn minutesn beforen then nextn scheduled ndose)
,n it n isn alson possiblen ton determinen whethern thendrugn isn reachingn an toxicn orn harmfuln leveln durin
gn therapy,n increasingn then likelihood n of n adversen effects.
Cognitiven Level:n Application
Client n Needs:nSafe,nEffectivenCarenEnvironment n Nurs
ingn Process:n Assessment
8. Then nursen needsnton changen andressingn onnthenclient’sn abdomen.nWhichnof nthenfollowingn t
echniquesn should n ben implemented?
1. Contact n precautions
2. Standard n precautions
3. Droplet n precautions
4. Airbornen precautions
Answer:n 2
downloadn fulln filenatnhttp://testbankinstant.com
