Franklyn A Plus Pass
Test Bank for Davis Advantage for
Understanding Medical-Surgical Nursing 7th
Edition
by Paula D. Williams, Linda S. & Hopper
Chapter 1-51 expert verified
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, Franklyn A Plus Pass
CHAPTER 1
1. The nurse is caring for four clients on a medical–surgical unit. Which client should the nurse see initially?
1. A client admitted with hepatitis A who has had severe diarrhea for the last 24 hours
2. A client admitted with pneumonia who is has small amounts of yellow productive sputum
3. A client admitted with fever of unknown origin (FUO) who has been without fever for the last 48 hours
4. A client admitted with a wound infection whose WBC is 8,500 mm3
Answer: 1
Rationale: The nurse must decide which client should be seen on the initial rounds of the day. The nurse must
remember that the first client to be seen should be the client who needs the attention of the nurse initially. A client
with hepatitis A does experience diarrhea, but diarrhea for the last 24 hours could cause the client to have a problem
with dehydration and experience a state of fluid volume deficit.
Cognitive Level: Application
Client Needs: Safe, Effective Care Environment Nursing Process: Planning
2. The nurse is preparing to administer influenza vaccines to a mass drive-through clinic. Which statement by a
client would indicate further questioning prior to giving the client the influenza vaccine?
1. ―I am allergic to horse hair.‖
2. ―I try to get my vaccine every year.‖
3. ―I am not allergic to anything except eggs.‖
4. ―My husband had a severe allergic reaction after he received his influenza vaccine.‖
Answer: 3
Fr
Rationale: Influenza vaccines are recommended for person at high risk for serious sequelae of influenza. The nurse
should be aware that client with a sensitivity to eggs should not receive the vaccine. Vaccines prepared from chicken
an
or duck embryos are contraindicated in clients who are allergic to eggs.
Cognitive Level: Application
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yn
Client Needs: Safe, Effective Care Environment Nursing Process: Assessment
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3. The nurse is caring for four clients on a medical–surgical unit. The secretary gives the nurse the morning labs.
Which of the following labs would require that the nurse call the physician and inform the healthcare provider about
the client‘s abnormalities?
1. WBC 14,600 mm3
2. Serum protein 6.9 g/dL
3. I & D (incision and drainage) showing no growth for the last 24 hours
4. Albumin 4.2 g/dL
Answer: 1
Rationale: When the nurse is caring for several clients, all of the labs should be checked frequently throughout the
shift to assess for any abnormalities. The WBC in option 1 is abnormal. (Normal WBC 4,000–10,000 mm3.) All of
the other lab results are within acceptable range; therefore, the results should not be called in to the physician.
Cognitive Level: Application Client Needs: Physiologic Integrity Nursing Process: Assessment
4. The nurse is orienting a new graduate. The nurse is reinforcing the importance of standard precautions. Which of
the following observations by the nurse would require further education regarding standard precautions?
1. The graduate nurse understands to wash hands when entering and exiting the client‘s room.
2. The graduate nurse wears gloves when serving breakfast trays to various clients.
3. The graduate nurse wears a gown, gloves, and goggles when suctioning a client.
4. The graduate nurse leaves all supplies in the room of a client who is in contact isolation.
Answer: 2
Rationale: The nurse must have an understanding of standard precautions. Prevention is the most important measure
to prevent nosocomial infections. Standard precautions were published in 1996 that provide guidelines for the
handling of blood and other body fluids. These guidelines are used with all clients, regardless of whether they have a
Fr
known infectious disease. Standard precautions are used by all healthcare workers who have direct contact with
clients or with their body fluids. It is not necessary for the nurse to wear gloves while delivering food trays to the
an
client, because there is not contact with the client.
kl
Cognitive Level: Application
yn
Client Needs: Safe, Effective Care Environment Nursing Process: Evaluation
e
A
5. The admitting department alerts the nurse on a medical–surgical unit that a client with active tuberculosis (TB) is
being admitted to the unit. Which type of isolation is appropriate based on the client‘s diagnosis?
pl
1. Standard precautions
us
2. Airborne precautions
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3. Droplet precautions
4. Contact precautions
Answer: 2
In addition to handwashing and standard precautions, the nature and spread of some infectious diseases require that
special techniques be used to protect uninfected clients and workers. The client with pulmonary tuberculosis will be
placed in airborne precautions. The client should be placed in a private room with special ventilation that does not
allow air to circulate to general hospital ventilation; a mask or special filter respirators will be used for everyone
entering the room.
Cognitive Level: Application
Client Needs: Safe, Effective Care Environment Nursing Process: Assessment
6. A client is receiving IV vancomycin for the treatment of Clostridium difficile. The nurse understands that the
client who develops flushing, tachycardia, and hypotension during the infusion of vancomycin indicates:
1. Ototoxicity effect.
2. Superinfection.
3. Red man syndrome.
4. Hives.
Answer: 3
Rationale: Vancomycin inhibits cell wall synthesis, and is used for serious infections. It is only effective against
gram-positive bacteria, especially Staphylococcus aureus and Staphylococcus epidermidis. The nurse should infuse
this medication slowly over 60 minutes or more to avoid ―red man‖ syndrome. The syndrome is characterized by
erythematous rash, flushing, tachycardia, and hypotension. Clients can become dizzy and agitated.
Cognitive Level: Application
Fr
Client Needs: Physiological Integrity Nursing Process: Evaluation
an
7. The physician has ordered for the client to receive a trough blood level to evaluate the therapeutic effect of an
kl
antibiotic. The nurse understands that the trough should be ordered:
yn
1. A few minutes before the next scheduled dose of medication.
e
2. 1–2 hours after the oral administration of the medication.
A
3. 30 minutes after the IV administration.
pl
4. During the infusion of the antibiotic.
us
Answer: 1
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Page | 4
as
s
Test Bank for Davis Advantage for
Understanding Medical-Surgical Nursing 7th
Edition
by Paula D. Williams, Linda S. & Hopper
Chapter 1-51 expert verified
Fr
an
kl
yn
e
A
pl
us
P
Page | 1
as
s
, Franklyn A Plus Pass
CHAPTER 1
1. The nurse is caring for four clients on a medical–surgical unit. Which client should the nurse see initially?
1. A client admitted with hepatitis A who has had severe diarrhea for the last 24 hours
2. A client admitted with pneumonia who is has small amounts of yellow productive sputum
3. A client admitted with fever of unknown origin (FUO) who has been without fever for the last 48 hours
4. A client admitted with a wound infection whose WBC is 8,500 mm3
Answer: 1
Rationale: The nurse must decide which client should be seen on the initial rounds of the day. The nurse must
remember that the first client to be seen should be the client who needs the attention of the nurse initially. A client
with hepatitis A does experience diarrhea, but diarrhea for the last 24 hours could cause the client to have a problem
with dehydration and experience a state of fluid volume deficit.
Cognitive Level: Application
Client Needs: Safe, Effective Care Environment Nursing Process: Planning
2. The nurse is preparing to administer influenza vaccines to a mass drive-through clinic. Which statement by a
client would indicate further questioning prior to giving the client the influenza vaccine?
1. ―I am allergic to horse hair.‖
2. ―I try to get my vaccine every year.‖
3. ―I am not allergic to anything except eggs.‖
4. ―My husband had a severe allergic reaction after he received his influenza vaccine.‖
Answer: 3
Fr
Rationale: Influenza vaccines are recommended for person at high risk for serious sequelae of influenza. The nurse
should be aware that client with a sensitivity to eggs should not receive the vaccine. Vaccines prepared from chicken
an
or duck embryos are contraindicated in clients who are allergic to eggs.
Cognitive Level: Application
kl
yn
Client Needs: Safe, Effective Care Environment Nursing Process: Assessment
e
A
pl
us
P
Page | 2
as
s
, Franklyn A Plus Pass
3. The nurse is caring for four clients on a medical–surgical unit. The secretary gives the nurse the morning labs.
Which of the following labs would require that the nurse call the physician and inform the healthcare provider about
the client‘s abnormalities?
1. WBC 14,600 mm3
2. Serum protein 6.9 g/dL
3. I & D (incision and drainage) showing no growth for the last 24 hours
4. Albumin 4.2 g/dL
Answer: 1
Rationale: When the nurse is caring for several clients, all of the labs should be checked frequently throughout the
shift to assess for any abnormalities. The WBC in option 1 is abnormal. (Normal WBC 4,000–10,000 mm3.) All of
the other lab results are within acceptable range; therefore, the results should not be called in to the physician.
Cognitive Level: Application Client Needs: Physiologic Integrity Nursing Process: Assessment
4. The nurse is orienting a new graduate. The nurse is reinforcing the importance of standard precautions. Which of
the following observations by the nurse would require further education regarding standard precautions?
1. The graduate nurse understands to wash hands when entering and exiting the client‘s room.
2. The graduate nurse wears gloves when serving breakfast trays to various clients.
3. The graduate nurse wears a gown, gloves, and goggles when suctioning a client.
4. The graduate nurse leaves all supplies in the room of a client who is in contact isolation.
Answer: 2
Rationale: The nurse must have an understanding of standard precautions. Prevention is the most important measure
to prevent nosocomial infections. Standard precautions were published in 1996 that provide guidelines for the
handling of blood and other body fluids. These guidelines are used with all clients, regardless of whether they have a
Fr
known infectious disease. Standard precautions are used by all healthcare workers who have direct contact with
clients or with their body fluids. It is not necessary for the nurse to wear gloves while delivering food trays to the
an
client, because there is not contact with the client.
kl
Cognitive Level: Application
yn
Client Needs: Safe, Effective Care Environment Nursing Process: Evaluation
e
A
5. The admitting department alerts the nurse on a medical–surgical unit that a client with active tuberculosis (TB) is
being admitted to the unit. Which type of isolation is appropriate based on the client‘s diagnosis?
pl
1. Standard precautions
us
2. Airborne precautions
P
Page | 3
as
s
, Franklyn A Plus Pass
3. Droplet precautions
4. Contact precautions
Answer: 2
In addition to handwashing and standard precautions, the nature and spread of some infectious diseases require that
special techniques be used to protect uninfected clients and workers. The client with pulmonary tuberculosis will be
placed in airborne precautions. The client should be placed in a private room with special ventilation that does not
allow air to circulate to general hospital ventilation; a mask or special filter respirators will be used for everyone
entering the room.
Cognitive Level: Application
Client Needs: Safe, Effective Care Environment Nursing Process: Assessment
6. A client is receiving IV vancomycin for the treatment of Clostridium difficile. The nurse understands that the
client who develops flushing, tachycardia, and hypotension during the infusion of vancomycin indicates:
1. Ototoxicity effect.
2. Superinfection.
3. Red man syndrome.
4. Hives.
Answer: 3
Rationale: Vancomycin inhibits cell wall synthesis, and is used for serious infections. It is only effective against
gram-positive bacteria, especially Staphylococcus aureus and Staphylococcus epidermidis. The nurse should infuse
this medication slowly over 60 minutes or more to avoid ―red man‖ syndrome. The syndrome is characterized by
erythematous rash, flushing, tachycardia, and hypotension. Clients can become dizzy and agitated.
Cognitive Level: Application
Fr
Client Needs: Physiological Integrity Nursing Process: Evaluation
an
7. The physician has ordered for the client to receive a trough blood level to evaluate the therapeutic effect of an
kl
antibiotic. The nurse understands that the trough should be ordered:
yn
1. A few minutes before the next scheduled dose of medication.
e
2. 1–2 hours after the oral administration of the medication.
A
3. 30 minutes after the IV administration.
pl
4. During the infusion of the antibiotic.
us
Answer: 1
P
Page | 4
as
s
