2
,OpenStax Medical-Surgical Nursing
Instructor Answer Guide
Chapter 1: Professional Medical-Surgical Nursing..........................................................................3
Chapter 2: Culturally Competent Care ......................................................................................... 13
Chapter 3: Health Promotion and Patient Education...................................................................19
Chapter 4: Clinical Judgment in the Nursing Process ................................................................... 31
Chapter 5: Ethical Decision Making..............................................................................................37
Chapter 6: Comprehensive Health Assessment and Physical Examination..................................44
Chapter 7: Pain Assessment and Management............................................................................49
Chapter 8: Stress and Stress-Related Disorders ........................................................................... 53
Chapter 9: Management of Chronic Illness..................................................................................62
Chapter 10: Fluid, Electrolyte, and Acid-Base Imbalances ........................................................... 67
Chapter 11: Gas Exchange, Airway Management and Respiratory System Disorders ................. 72
Chapter 12: Cardiovascular System..............................................................................................82
Chapter 13: Musculoskeletal System ........................................................................................... 90
Chapter 14: Integumentary System..............................................................................................96
Chapter 15: Cerebrovascular System ......................................................................................... 102
Chapter 16: Hematopoietic Disorders and Regulation...............................................................106
Chapter 17: Nervous System and Chronic Diseases of the Nervous System..............................114
Chapter 18: Sensory Organs.......................................................................................................120
Chapter 19: Gastrointestinal System and Gastrointestinal Disorders........................................125
Chapter 20: Genitourinary and Reproductive Systems..............................................................134
Chapter 21: Endocrine System and Endocrine System Disorders...............................................142
Chapter 22: Infection and Infectious Diseases ........................................................................... 147
Chapter 23: Shock and Sepsis.....................................................................................................154
Chapter 24: Management of Patients with Allergic Disorders...................................................162
Chapter 25: Preoperative Care...................................................................................................168
Chapter 26: Intraoperative Care.................................................................................................172
Chapter 27: Postoperative Care ................................................................................................. 179
Chapter 28: Inflammation and Healing ...................................................................................... 184
Chapter 29: Immune Response .................................................................................................. 192
3
,Chapter 30: Genetics..................................................................................................................198
Chapter 31: Cancer.....................................................................................................................203
Chapter 32: Palliative Care.........................................................................................................206
Chapter 33: Emergency Care......................................................................................................212
Chapter 34: Disaster and Recovery ............................................................................................ 220
Chapter 35: Critical Care.............................................................................................................224
Chapter 36: Home Health Nursing and Rehabilitation...............................................................231
Chapter 37: Trends in Healthcare Technology ........................................................................... 233
Chapter 38: Unfolding Case Study and NCLEX Prep ................................................................... 239
Chapter 1: Professional Medical-Surgical Nursing
Review Questions
1. Which action reflects The Joint Commission’s contribution to a health care organizations’
improvement initiatives?
a. setting standards for quality care, QI, and patient safety
b. excluding nurses from safety and improvement initiatives
c. focusing on emergency management and infection prevention
d. eluding the National Patient Safety Goals
[Answer: A]
2. Which component reflects a key element of PCC?
a. excluding the patient's family from the care setting
b. ignoring the patient's emotional well-being
c. customize care based on the patient's values and perspectives
d. respecting the patient's physical comfort
[Answer: C]
3. Ms. Hutto is complaining of pain (8 out of 10) in her lower back and abdomen. As the
patient’s nurse, you determine her abdomen is soft but distended, with positive bowel
sounds in all four quadrants. Interventions such as ambulation, position changes, warm
compresses, and warm prune juice have provided no relief. This scenario highlights which
component of the ISBAR communication tool?
a. situation
b. background
c. assessment
d. recommendation or request
[Answer: C]
4. What is the primary goal of an intercollaborative care team in the context of patient-
centered care?
a. achieving financial targets
4
, b. streamlining administrative processes
c. improving patient outcomes through personalized care
d. minimizing the workload for health care providers
[Answer: C]
5. A nurse is caring for a 72-year-old woman with a diagnosis of atrial fibrillation. When
making his shift change report, the nurse realizes that 4 hours ago, he administered 0.5 mg
of the patient’s antiarrhythmic medication instead of 5.0 mg. When the nurse realizes the
error and calls the physician to report the incident, which ethical principal is described in
this situation?
a. nonmaleficence
b. justice
c. autonomy
d. beneficence
[Answer: A]
6. Mr. Johnson is scheduled for an endoscopy. Despite the excruciating abdominal pain he is
experiencing, Mr. Johnson refuses to have the procedure. Which ethical principal is
described in this scenario?
a. beneficence
b. justice
c. autonomy
d. nonmaleficence
[Answer: C]
7. Which option is a social determinant of health?
a. medical history
b. promotion of healthy choices
c. homelessness
d. life expectancy
[Answer: C]
8. As a nurse practicing EBP, which process related to improving patient satisfaction will be
most effective?
a. checking on each patient’s pain level every 4 hours
b. administering medications as close as possible to the administration times
c. making rounds on each patient hourly
d. offering a bath daily to each patient
[Answer: C]
9. Joann, a nurse in the medical-surgical unit, would like to implement a project to improve
the cleanliness of patient rooms. Aside from the nurses, which group of key stakeholders
should be included in the planning?
a. hospital maintenance staff
b. physical therapists and technicians
c. housekeeping staff and unlicensed assistive personnel
d. occupational therapy team
[Answer: C]
5
,OpenStax Medical-Surgical Nursing
Instructor Answer Guide
Chapter 1: Professional Medical-Surgical Nursing..........................................................................3
Chapter 2: Culturally Competent Care ......................................................................................... 13
Chapter 3: Health Promotion and Patient Education...................................................................19
Chapter 4: Clinical Judgment in the Nursing Process ................................................................... 31
Chapter 5: Ethical Decision Making..............................................................................................37
Chapter 6: Comprehensive Health Assessment and Physical Examination..................................44
Chapter 7: Pain Assessment and Management............................................................................49
Chapter 8: Stress and Stress-Related Disorders ........................................................................... 53
Chapter 9: Management of Chronic Illness..................................................................................62
Chapter 10: Fluid, Electrolyte, and Acid-Base Imbalances ........................................................... 67
Chapter 11: Gas Exchange, Airway Management and Respiratory System Disorders ................. 72
Chapter 12: Cardiovascular System..............................................................................................82
Chapter 13: Musculoskeletal System ........................................................................................... 90
Chapter 14: Integumentary System..............................................................................................96
Chapter 15: Cerebrovascular System ......................................................................................... 102
Chapter 16: Hematopoietic Disorders and Regulation...............................................................106
Chapter 17: Nervous System and Chronic Diseases of the Nervous System..............................114
Chapter 18: Sensory Organs.......................................................................................................120
Chapter 19: Gastrointestinal System and Gastrointestinal Disorders........................................125
Chapter 20: Genitourinary and Reproductive Systems..............................................................134
Chapter 21: Endocrine System and Endocrine System Disorders...............................................142
Chapter 22: Infection and Infectious Diseases ........................................................................... 147
Chapter 23: Shock and Sepsis.....................................................................................................154
Chapter 24: Management of Patients with Allergic Disorders...................................................162
Chapter 25: Preoperative Care...................................................................................................168
Chapter 26: Intraoperative Care.................................................................................................172
Chapter 27: Postoperative Care ................................................................................................. 179
Chapter 28: Inflammation and Healing ...................................................................................... 184
Chapter 29: Immune Response .................................................................................................. 192
3
,Chapter 30: Genetics..................................................................................................................198
Chapter 31: Cancer.....................................................................................................................203
Chapter 32: Palliative Care.........................................................................................................206
Chapter 33: Emergency Care......................................................................................................212
Chapter 34: Disaster and Recovery ............................................................................................ 220
Chapter 35: Critical Care.............................................................................................................224
Chapter 36: Home Health Nursing and Rehabilitation...............................................................231
Chapter 37: Trends in Healthcare Technology ........................................................................... 233
Chapter 38: Unfolding Case Study and NCLEX Prep ................................................................... 239
Chapter 1: Professional Medical-Surgical Nursing
Review Questions
1. Which action reflects The Joint Commission’s contribution to a health care organizations’
improvement initiatives?
a. setting standards for quality care, QI, and patient safety
b. excluding nurses from safety and improvement initiatives
c. focusing on emergency management and infection prevention
d. eluding the National Patient Safety Goals
[Answer: A]
2. Which component reflects a key element of PCC?
a. excluding the patient's family from the care setting
b. ignoring the patient's emotional well-being
c. customize care based on the patient's values and perspectives
d. respecting the patient's physical comfort
[Answer: C]
3. Ms. Hutto is complaining of pain (8 out of 10) in her lower back and abdomen. As the
patient’s nurse, you determine her abdomen is soft but distended, with positive bowel
sounds in all four quadrants. Interventions such as ambulation, position changes, warm
compresses, and warm prune juice have provided no relief. This scenario highlights which
component of the ISBAR communication tool?
a. situation
b. background
c. assessment
d. recommendation or request
[Answer: C]
4. What is the primary goal of an intercollaborative care team in the context of patient-
centered care?
a. achieving financial targets
4
, b. streamlining administrative processes
c. improving patient outcomes through personalized care
d. minimizing the workload for health care providers
[Answer: C]
5. A nurse is caring for a 72-year-old woman with a diagnosis of atrial fibrillation. When
making his shift change report, the nurse realizes that 4 hours ago, he administered 0.5 mg
of the patient’s antiarrhythmic medication instead of 5.0 mg. When the nurse realizes the
error and calls the physician to report the incident, which ethical principal is described in
this situation?
a. nonmaleficence
b. justice
c. autonomy
d. beneficence
[Answer: A]
6. Mr. Johnson is scheduled for an endoscopy. Despite the excruciating abdominal pain he is
experiencing, Mr. Johnson refuses to have the procedure. Which ethical principal is
described in this scenario?
a. beneficence
b. justice
c. autonomy
d. nonmaleficence
[Answer: C]
7. Which option is a social determinant of health?
a. medical history
b. promotion of healthy choices
c. homelessness
d. life expectancy
[Answer: C]
8. As a nurse practicing EBP, which process related to improving patient satisfaction will be
most effective?
a. checking on each patient’s pain level every 4 hours
b. administering medications as close as possible to the administration times
c. making rounds on each patient hourly
d. offering a bath daily to each patient
[Answer: C]
9. Joann, a nurse in the medical-surgical unit, would like to implement a project to improve
the cleanliness of patient rooms. Aside from the nurses, which group of key stakeholders
should be included in the planning?
a. hospital maintenance staff
b. physical therapists and technicians
c. housekeeping staff and unlicensed assistive personnel
d. occupational therapy team
[Answer: C]
5
