moral questions. These issues include:#### 2.1 **Patient Autonomy and Informed Consent**One of the fundamental
ethical principles in healthcare is respect for patient autonomy—the right of patients to make decisions about their own
bodies and medical treatments. This principle is enshrined in the legal concept of informed consent. Informed consent
requires healthcare providers to disclose all relevant information about the risks, benefits, and alternatives to a medical
treatment or procedure, allowing patients to make informed decisions.However, challenges arise when patients are not
fully capable of making informed decisions (e.g., due to age, mental illness, or language barriers). In such cases, ethical
dilemmas can arise regarding whether a third party (e.g., a parent or guardian) should make the
RN Adult Medical Surgical Nursing
REVIEW MODULE EDITION 11.0
Contributors Consultants
Honey C. Holman, MSN, RN Greta Lucinda Baldwin Mason, MSN, RN
Debborah Williams, MSN, RN Christi Blair, DNP, RN
Sheryl Sommer, PhD, RN, CNE Tracey Bousquet, BSN, RN
Janean Johnson, MSN, RN, CNE Valerie S. Eschiti, PhD, RN,
AHN-BC, CHTP, CTN-A
Brenda S. Ball, MEd, BSN, RN
Penny Fauber, PhD, MS, BSN, RN
LaKeisha Wheless, MSN, RN
Sara Hoffmann, MSN, RN
Peggy Leehy, MSN, RN
Tomekia Luckett, PhD, RN
Terri Lemon, DNP, MSN, RN
Donna Russo, RN, MSN, CCRN, CNE
Melanie P. Schrader, PhD, RN
, INTELLECTUAL PROPERTY NOTICE
ATI Nursing is a division of Assessment Technologies Institute®, LLC.
Copyright © 2019 Assessment Technologies Institute, LLC. All rights reserved.
The reproduction of this work in any electronic, mechanical or other means, now known or hereafter
invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the
content in this publication, including, for example, the cover, all of the page headers, images, illustrations,
graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual
property rights or licenses held by Assessment Technologies Institute, LLC, one of its affiliates, or by
third parties who have licensed their materials to Assessment Technologies Institute, LLC.
REPRINTED APRIL 2021
Director of content review: Kristen Lawler
Director of development: Derek Prater
Project management: Tiflany Pavlik, Shannon Tierney
Coordination of content review: Honey C. Holman, Debborah Williams
Copy editing: Kelly Von Lunen, Bethany Phillips, Kya Rodgers
Layout: Spring Lenox, Maureen Bradshaw, Bethany Phillips
Illustrations: Randi Hardy, Marley Starcev
Online media: Brant Stacy, Ron Hanson, Britney Fuller, Barry Wilson
Cover design: Jason Buck
Interior book design: Spring Lenox
IMPORTANT NOTICE TO THE READER
Assessment Technologies Institute, LLC, is the publisher of this publication. The content of this publication is for
iVformatioVal aVd eduCatioVal purposes oVly aVd may be modified or updated by the publisher at aVy time. This
publication is not providing medical advice and is not intended to be a substitute for professional medical advice,
diagnosis, or treatment. The publisher has designed this publication to provide accurate information regarding the
subject matter covered; however, the publisher is not responsible for errors, omissions, or for any outcomes related to
the use of the contents of this book and makes no guarantee and assumes no responsibility or liability for the use of the
produCts aVd proCedures desCribed or the CorreCtVess, suffiCieVCy, or CompleteVess of stated iVformatioV, opiVioVs, or
reCommeVdatioVs. The publisher does Vot reCommeVd or eVdorse aVy speCifiC tests, providers, produCts, proCedures,
proCesses, opiVioVs, or other iVformatioV that may be meVtioVed iV this publiCatioV. TreatmeVts aVd side effeCts desCribed
iV this book may Vot be appliCable to all people; likewise, some people may require a dose or experieVCe a side effeCt
that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by
II
,the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice,
aVd goverVmeVt regulatioVs ofteV ChaVge the aCCepted staVdard iV this field. WheV CoVsideratioV is beiVg giveV to use
of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the
drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations
on dose, precautions, and contraindications and determining the appropriate usage for the product. Any references
in this book to procedures to be employed when rendering emergency care to the sick and injured are provided solely
as a general guide. Other or additional safety measures may be required under particular circumstances. This book
is not intended as a statement of the standards of care required in any particular situation, because circumstances
and a patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this book
shall in any way advise personnel concerning legal authority to perform the activities or procedures discussed. Such
speCifiC determiVatioV should be made oVly with the aid of legal CouVsel. Some images iV this book feature models.
These models do not necessarily endorse, represent, or participate in the activities represented in the images. THE
PUBLISHER MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, WITH
RESPECT TO THE CONTENT HEREIN. THIS PUBLICATION IS PROVIDED AS-IS, AND THE PUBLISHER AND ITS AFFILIATES
SHALL NOT BE LIABLE FOR ANY ACTUAL, INCIDENTAL, SPECIAL, CONSEQUENTIAL, PUNITIVE, OR EXEMPLARY
DAMAGES RESULTING, IN WHOLE OR IN PART, FROM THE READER’S USE OF, OR RELIANCE UPON, SUCH CONTENT.
, User’s Guide
Welcome to the Assessment Technologies Institute® RN ACTIVE LEARNING SCENARIOS
Adult Medical Surgical Nursing Review Module Edition AND APPLICATION EXERCISES
11.0. The mission of ATI’s Content Mastery Series ® Review
Each chapter includes opportunities for you to test your
Modules is to provide user-friendly compendiums of
knowledge and to practice applying that knowledge. Active
nursing knowledge that will:
Learning Scenario exercises pose a nursing scenario
● Help you locate important information quickly.
● Assist iV your learViVg efforts.
and then direct you to use an ATI Active Learning
Template (included at the back of this book) to record
● Provide exercises for applying your nursing knowledge.
the important knowledge a nurse should apply to the
● Facilitate your entry into the nursing profession as a
scenario. An example is then provided to which you can
newly licensed nurse.
compare your completed Active Learning Template. The
This newest edition of the Review Modules has been Application Exercises include NCLEX-style questions, such
redesigned to optimize your learning experience. We’ve as multiple-choice and multiple-select items, providing
fit more CoVteVt iVto less spaCe aVd have doVe so iV a you with opportunities to practice answering the kinds of
way that will make it eveV easier for you to fiVd aVd questions you might expect to see on ATI assessments or
understand the information you need. the NCLEX. After the Application Exercises, an answer key
is provided, along with rationales.
ORGANIZATION
This Review Module is organized into units covering the
NCLEX® CONNECTIONS
foundations of nursing care (Unit 1), body systems and To prepare for the NCLEX-RN, it is important to
physiological processes (Units 2 to 13), and perioperative understand how the content in this Review Module
nursing care (Unit 14). Chapters within these units is connected to the NCLEX-RN test plaV. You CaV fiVd
conform to one of three organizing principles for information on the detailed test plan at the National
presenting the content. Council of State Boards of Nursing’s website, www.ncsbn.
● Nursing concepts org. When reviewing content in this Review Module,
● Procedures regularly ask yourself, “How does this CoVteVt fit iVto
● System disorders the test plan, and what types of questions related to this
content should I expect?”
Nursing concepts chapters begin with an overview
describing the central concept and its relevance to nursing. To help you in this process, we’ve included NCLEX
Subordinate themes are covered in outline form to Connections at the beginning of each unit and with each
demonstrate relationships and present the information in question in the Application Exercises Answer Keys. The
a clear, succinct manner. NCLEX Connections at the beginning of each unit point
out areas of the detailed test plan that relate to the content
Procedures chapters include an overview describing
within that unit. The NCLEX Connections attached to the
the procedure(s) covered in the chapter. These
Application Exercises Answer Keys demonstrate how each
chapters provide nursing knowledge relevant to each
exerCise fits withiV the detailed CoVteVt outliVe.
procedure, including indications, nursing considerations,
These NCLEX Connections will help you understand how
iVterpretatioV of fiVdiVgs, aVd Complications.
the detailed content outline is organized, starting with
System disorders chapters include an overview describing major client needs categories and subcategories and
the disorder(s) and/or disease process. These chapters followed by related content areas and tasks. The major
address assessments, including risk factors, expected client needs categories are:
fiVdiVgs, laboratory tests, aVd diagVostiC proCedures. ● Safe aVd EffeCtive Care EVviroVmeVt
Next, you will focus on patient-centered care, including ◯ Management of Care
nursing care, medications, therapeutic procedures, ◯ Safety and Infection Control
interprofessional care, and client education. Finally, you ● Health Promotion and Maintenance
will fiVd CompliCatioVs related to the disorder, aloVg with ● Psychosocial Integrity
nursing actions in response to those complications. ● Physiological Integrity
◯ Basic Care and Comfort
◯ Pharmacological and Parenteral Therapies
◯ Reduction of Risk Potential
◯ Physiological Adaptation
An NCLEX Connection might, for example, alert you that
content within a unit is related to:
● Reduction of Risk Potential
◯ Diagnostic Tests
■ Monitor the results of diagnostic testing and
intervene as needed.
ethical principles in healthcare is respect for patient autonomy—the right of patients to make decisions about their own
bodies and medical treatments. This principle is enshrined in the legal concept of informed consent. Informed consent
requires healthcare providers to disclose all relevant information about the risks, benefits, and alternatives to a medical
treatment or procedure, allowing patients to make informed decisions.However, challenges arise when patients are not
fully capable of making informed decisions (e.g., due to age, mental illness, or language barriers). In such cases, ethical
dilemmas can arise regarding whether a third party (e.g., a parent or guardian) should make the
RN Adult Medical Surgical Nursing
REVIEW MODULE EDITION 11.0
Contributors Consultants
Honey C. Holman, MSN, RN Greta Lucinda Baldwin Mason, MSN, RN
Debborah Williams, MSN, RN Christi Blair, DNP, RN
Sheryl Sommer, PhD, RN, CNE Tracey Bousquet, BSN, RN
Janean Johnson, MSN, RN, CNE Valerie S. Eschiti, PhD, RN,
AHN-BC, CHTP, CTN-A
Brenda S. Ball, MEd, BSN, RN
Penny Fauber, PhD, MS, BSN, RN
LaKeisha Wheless, MSN, RN
Sara Hoffmann, MSN, RN
Peggy Leehy, MSN, RN
Tomekia Luckett, PhD, RN
Terri Lemon, DNP, MSN, RN
Donna Russo, RN, MSN, CCRN, CNE
Melanie P. Schrader, PhD, RN
, INTELLECTUAL PROPERTY NOTICE
ATI Nursing is a division of Assessment Technologies Institute®, LLC.
Copyright © 2019 Assessment Technologies Institute, LLC. All rights reserved.
The reproduction of this work in any electronic, mechanical or other means, now known or hereafter
invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the
content in this publication, including, for example, the cover, all of the page headers, images, illustrations,
graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual
property rights or licenses held by Assessment Technologies Institute, LLC, one of its affiliates, or by
third parties who have licensed their materials to Assessment Technologies Institute, LLC.
REPRINTED APRIL 2021
Director of content review: Kristen Lawler
Director of development: Derek Prater
Project management: Tiflany Pavlik, Shannon Tierney
Coordination of content review: Honey C. Holman, Debborah Williams
Copy editing: Kelly Von Lunen, Bethany Phillips, Kya Rodgers
Layout: Spring Lenox, Maureen Bradshaw, Bethany Phillips
Illustrations: Randi Hardy, Marley Starcev
Online media: Brant Stacy, Ron Hanson, Britney Fuller, Barry Wilson
Cover design: Jason Buck
Interior book design: Spring Lenox
IMPORTANT NOTICE TO THE READER
Assessment Technologies Institute, LLC, is the publisher of this publication. The content of this publication is for
iVformatioVal aVd eduCatioVal purposes oVly aVd may be modified or updated by the publisher at aVy time. This
publication is not providing medical advice and is not intended to be a substitute for professional medical advice,
diagnosis, or treatment. The publisher has designed this publication to provide accurate information regarding the
subject matter covered; however, the publisher is not responsible for errors, omissions, or for any outcomes related to
the use of the contents of this book and makes no guarantee and assumes no responsibility or liability for the use of the
produCts aVd proCedures desCribed or the CorreCtVess, suffiCieVCy, or CompleteVess of stated iVformatioV, opiVioVs, or
reCommeVdatioVs. The publisher does Vot reCommeVd or eVdorse aVy speCifiC tests, providers, produCts, proCedures,
proCesses, opiVioVs, or other iVformatioV that may be meVtioVed iV this publiCatioV. TreatmeVts aVd side effeCts desCribed
iV this book may Vot be appliCable to all people; likewise, some people may require a dose or experieVCe a side effeCt
that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by
II
,the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice,
aVd goverVmeVt regulatioVs ofteV ChaVge the aCCepted staVdard iV this field. WheV CoVsideratioV is beiVg giveV to use
of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the
drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations
on dose, precautions, and contraindications and determining the appropriate usage for the product. Any references
in this book to procedures to be employed when rendering emergency care to the sick and injured are provided solely
as a general guide. Other or additional safety measures may be required under particular circumstances. This book
is not intended as a statement of the standards of care required in any particular situation, because circumstances
and a patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this book
shall in any way advise personnel concerning legal authority to perform the activities or procedures discussed. Such
speCifiC determiVatioV should be made oVly with the aid of legal CouVsel. Some images iV this book feature models.
These models do not necessarily endorse, represent, or participate in the activities represented in the images. THE
PUBLISHER MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, WITH
RESPECT TO THE CONTENT HEREIN. THIS PUBLICATION IS PROVIDED AS-IS, AND THE PUBLISHER AND ITS AFFILIATES
SHALL NOT BE LIABLE FOR ANY ACTUAL, INCIDENTAL, SPECIAL, CONSEQUENTIAL, PUNITIVE, OR EXEMPLARY
DAMAGES RESULTING, IN WHOLE OR IN PART, FROM THE READER’S USE OF, OR RELIANCE UPON, SUCH CONTENT.
, User’s Guide
Welcome to the Assessment Technologies Institute® RN ACTIVE LEARNING SCENARIOS
Adult Medical Surgical Nursing Review Module Edition AND APPLICATION EXERCISES
11.0. The mission of ATI’s Content Mastery Series ® Review
Each chapter includes opportunities for you to test your
Modules is to provide user-friendly compendiums of
knowledge and to practice applying that knowledge. Active
nursing knowledge that will:
Learning Scenario exercises pose a nursing scenario
● Help you locate important information quickly.
● Assist iV your learViVg efforts.
and then direct you to use an ATI Active Learning
Template (included at the back of this book) to record
● Provide exercises for applying your nursing knowledge.
the important knowledge a nurse should apply to the
● Facilitate your entry into the nursing profession as a
scenario. An example is then provided to which you can
newly licensed nurse.
compare your completed Active Learning Template. The
This newest edition of the Review Modules has been Application Exercises include NCLEX-style questions, such
redesigned to optimize your learning experience. We’ve as multiple-choice and multiple-select items, providing
fit more CoVteVt iVto less spaCe aVd have doVe so iV a you with opportunities to practice answering the kinds of
way that will make it eveV easier for you to fiVd aVd questions you might expect to see on ATI assessments or
understand the information you need. the NCLEX. After the Application Exercises, an answer key
is provided, along with rationales.
ORGANIZATION
This Review Module is organized into units covering the
NCLEX® CONNECTIONS
foundations of nursing care (Unit 1), body systems and To prepare for the NCLEX-RN, it is important to
physiological processes (Units 2 to 13), and perioperative understand how the content in this Review Module
nursing care (Unit 14). Chapters within these units is connected to the NCLEX-RN test plaV. You CaV fiVd
conform to one of three organizing principles for information on the detailed test plan at the National
presenting the content. Council of State Boards of Nursing’s website, www.ncsbn.
● Nursing concepts org. When reviewing content in this Review Module,
● Procedures regularly ask yourself, “How does this CoVteVt fit iVto
● System disorders the test plan, and what types of questions related to this
content should I expect?”
Nursing concepts chapters begin with an overview
describing the central concept and its relevance to nursing. To help you in this process, we’ve included NCLEX
Subordinate themes are covered in outline form to Connections at the beginning of each unit and with each
demonstrate relationships and present the information in question in the Application Exercises Answer Keys. The
a clear, succinct manner. NCLEX Connections at the beginning of each unit point
out areas of the detailed test plan that relate to the content
Procedures chapters include an overview describing
within that unit. The NCLEX Connections attached to the
the procedure(s) covered in the chapter. These
Application Exercises Answer Keys demonstrate how each
chapters provide nursing knowledge relevant to each
exerCise fits withiV the detailed CoVteVt outliVe.
procedure, including indications, nursing considerations,
These NCLEX Connections will help you understand how
iVterpretatioV of fiVdiVgs, aVd Complications.
the detailed content outline is organized, starting with
System disorders chapters include an overview describing major client needs categories and subcategories and
the disorder(s) and/or disease process. These chapters followed by related content areas and tasks. The major
address assessments, including risk factors, expected client needs categories are:
fiVdiVgs, laboratory tests, aVd diagVostiC proCedures. ● Safe aVd EffeCtive Care EVviroVmeVt
Next, you will focus on patient-centered care, including ◯ Management of Care
nursing care, medications, therapeutic procedures, ◯ Safety and Infection Control
interprofessional care, and client education. Finally, you ● Health Promotion and Maintenance
will fiVd CompliCatioVs related to the disorder, aloVg with ● Psychosocial Integrity
nursing actions in response to those complications. ● Physiological Integrity
◯ Basic Care and Comfort
◯ Pharmacological and Parenteral Therapies
◯ Reduction of Risk Potential
◯ Physiological Adaptation
An NCLEX Connection might, for example, alert you that
content within a unit is related to:
● Reduction of Risk Potential
◯ Diagnostic Tests
■ Monitor the results of diagnostic testing and
intervene as needed.
