1
,Table of Content dt dt
Chapter 01: Professional Nursing .............................................................................................................................................4
dt dt dt
Chapter 02: Social Determinants of Health.............................................................................................................................10
dt dt dt dt dt
Chapter 03: Health History and Physical Examination Harding: Lewis’sMedical-SurgicalNursing,12thEdition.....................15
dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 04: Patient and Caregiver Teaching ...........................................................................................................................20
dt dt dt dt dt
Chapter 05: Chronic Illness and Older Adults.........................................................................................................................26
dt dt dt dt dt dt
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ...................................................................................................34
dt dt dt dt d t
Chapter 07: Stress Management .............................................................................................................................................38
dt dt dt
Chapter 08: Sleep and Sleep Disorders ...................................................................................................................................42
dt dt dt dt dt
Chapter 09: Pain .....................................................................................................................................................................47
dt dt
Chapter 10: Palliative and End-of-Life Care ...........................................................................................................................56
dt dt dt dt dt
Chapter 11: Substance Use Disorders in Acute Care ...............................................................................................................61
dt dt dt dt dt dt dt
Chapter 12: Inflammation and Healing ...................................................................................................................................69
dt dt dt dt
Chapter 13: Genetics ..............................................................................................................................................................76
dt dt
Chapter 14: Immune Responses and Transplantation Harding: Lewis’sMedical-SurgicalNursing,12thEdition ......................79
dt dt dt dt dt dt dt dt dt dt dt
Chapter 15: Infection ..............................................................................................................................................................87
dt dt
Chapter 16: Cancer .................................................................................................................................................................97
dt dt
Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ........111
dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 18: Preoperative Care ..............................................................................................................................................124
dt dt dt
Chapter 19: Intraoperative Care ............................................................................................................................................131
dt dt dt
Chapter 20: Postoperative Care.............................................................................................................................................137
dt dt dt
Chapter 21: Emergency and Disaster Nursing ......................................................................................................................145
dt dt dt dt dt
Chapter 22: Assessment and Management: Visual Problems Harding: Lewis’s Medical-
dt dt dt dt dt dt dt dt dt
Surgical Nursing, 12th Edition 153 Chapter 23: Assessment and Management: Auditory Problems Harding: Lewis’s Medica
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
l-Surgical Nursing, 12th Edition
dt dt dt
.............................................................................................................................................................................................166
Chapter 24: Assessment: Integumentary System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ...........................173
dt dt dt dt dt dt dt dt dt dt
Chapter 25: Integumentary Problems ...................................................................................................................................178
dt dt dt
Chapter 26: Burns .................................................................................................................................................................186
dt dt
Chapter 27: Assessment: Respiratory System .......................................................................................................................195
dt dt dt dt
Chapter 28: Supporting Ventilation ......................................................................................................................................203
dt dt dt
Chapter 29: Upper Respiratory Problems..............................................................................................................................214
dt dt dt dt
Chapter 30: Lower Respiratory Problems .............................................................................................................................220
dt dt dt dt
Chapter 31: Obstructive Pulmonary Diseases .......................................................................................................................235
dt dt dt dt
Chapter 32: Acute Respiratory Failure and Acute Respiratory Distress Syndrome Harding: Lewis’s Medical-
dt dt dt dt dt dt dt dt dt dt dt dt
Surgical Nursing, 12th Edition .............................................................................................................................................248
dt dt dt
first? .................................................................................................................................................................................253
Chapter 33: Assessment: Hematologic System .....................................................................................................................257
dt dt dt dt
Chapter 34: Hematologic Problems ......................................................................................................................................262
dt dt dt
Chapter 35: Assessment: Cardiovascular System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ..........................277
dt dt dt dt dt dt dt dt dt dt
Chapter 36: Hypertension .....................................................................................................................................................289
dt dt
Chapter 38: Heart Failure .....................................................................................................................................................311
dt dt dt
Chapter 39: Dysrhythmias ....................................................................................................................................................319
dt dt
2
,Chapter 40: Inflammatory and Structural Heart Disorders Harding: Lewis’s Medical-Surgical Nursing, 12th Edition .........329
dt dt dt dt dt dt dt dt dt dt dt dt
first? ................................................................................................................................................................................. 339
Chapter 41: Vascular Disorders ............................................................................................................................................ 341
dt dt dt
Chapter 43: Assessment: Gastrointestinal System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ......................... 364
dt dt dt dt dt dt dt dt dt dt
Chapter 44: Nutrition Problems ............................................................................................................................................ 369
dt dt dt
Chapter 45: Obesity .............................................................................................................................................................. 377
dt dt
Chapter 46: Upper Gastrointestinal Problems ....................................................................................................................... 383
dt dt dt dt
Chapter 47: Lower Gastrointestinal Problems ...................................................................................................................... 397
dt dt dt dt
first? ................................................................................................................................................................................. 408
Chapter 48: Liver, Biliary Tract, and Pancreas Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ........... 414
dt dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 49: Assessment: Urinary System ............................................................................................................................. 429
dt dt dt dt
Chapter 50: Renal and Urologic Problems ............................................................................................................................ 436
dt dt dt dt dt
Chapter 51: Acute Kidney Injury and Chronic Kidney Disease Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
............................................................................................................................................................................................. 450
Chapter 52: Assessment: Endocrine System ......................................................................................................................... 462
dt dt dt dt
Chapter 53: Diabetes ............................................................................................................................................................ 469
dt dt
Chapter 54: Endocrine Problems .......................................................................................................................................... 484
dt dt dt
first? ................................................................................................................................................................................. 494
Chapter 55: Assessment: Reproductive System .................................................................................................................... 499
dt dt dt dt
first? ................................................................................................................................................................................. 502
Chapter 56: Breast Problems ................................................................................................................................................ 503
dt dt dt
Chapter 57: Sexually Transmitted Infections ........................................................................................................................ 512
dt dt dt dt
Chapter 58: Female Reproductive Problems ......................................................................................................................... 519
dt dt dt dt
Chapter 59: Male Reproductive Problems ............................................................................................................................ 533
dt dt dt dt
Chapter 60: Assessment: Nervous System ............................................................................................................................ 544
dt dt dt dt
Chapter 61: Acute Intracranial Problems .............................................................................................................................. 550
dt dt dt dt
Chapter 62: Stroke ................................................................................................................................................................ 565
dt dt
Chapter 63: Chronic Neurologic Problems ........................................................................................................................... 574
dt dt dt dt
Chapter 64: Dementia and Delirium ..................................................................................................................................... 585
dt dt dt dt
Chapter 65: Spinal Cord and Peripheral Nerve Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ........... 593
dt dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 66: Assessment: Musculoskeletal System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ........................ 603
dt dt dt dt dt dt dt dt dt dt
Chapter 67: Musculoskeletal Trauma and Orthopedic Surgery Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
dt dt dt dt dt dt dt dt dt dt dt dt
............................................................................................................................................................................................. 608
Chapter 68:Musculoskeletal Problems ................................................................................................................................. 622
dt dt
Chapter 69: Arthritis and Connective Tissue Diseases Harding: Lewis’sMedical-SurgicalNursing,12thEdition ................... 629
dt dt dt dt dt dt dt dt dt dt dt dt
3
, Chapter 01: Professional Nursing
dt dt dt
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
dt dt dt dt d t
MULTIPLE CHOICE dt
1. The nurse completes an admission database and explains that the plan of care and discharge g
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
oals will be developed with the patient‘s input. The patient asks, “How is this different from wha
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
t the physician does?” Which response would the nurse provide?
dt dt dt dt dt dt dt dt dt
a. “The role of the nurse is to administer medications and other treatments prescribed by
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
your physician.” dt
b. “In addition to caring for you while you are sick, the nurses will help you plan to mai
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
ntain your health.” dt dt
c. “The nurse‘s job is to collect information and communicate anyproblems that oc
dt dt dt dt dt dt dt dt dt dt dt dt
cur to the physician.” dt dt dt
d. “Nurses perform manyof the same procedures as the physician, but nurses are wit
dt dt dt dt dt dt dt dt dt dt dt dt dt
h the patients for a longer time than the physician.”
dt dt dt dt dt dt dt dt dt
ANS: B dt
The American Nurses Association (ANA) definition of nursing describes the role of nurses in pr
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
omoting health. The other responses describe dependent and collaborative functions of the nur
dt dt dt dt dt dt dt dt dt dt dt dt
sing role but do not accurately describe the nurse‘s unique role in thehealth care system.
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
DIF: Cognitive Level: Analyze (Analysis)
dt dt dt dt
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
dt dt dt dt dt dt dt dt dt dt
2. Which statement bythe nurse accurately describes the use of evidence-based practice (EBP)?
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a. “Patient care is based on clinical judgment, experience, and traditions.”
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b. “Data are analyzed later to show that the patient outcomes are consistentlymet.”
dt dt dt dt dt dt dt dt dt dt dt dt
c. “Research from all published articles are used as a guide for planning patient care.” dt dt dt dt dt dt dt dt dt dt dt dt dt
d. “Recommendations are based on research, clinical expertise, and patient p dt dt dt dt dt dt dt dt dt
references.”
ANS: D dt
Evidence-based practice (EBP) is the use of the best research- dt dt dt dt dt dt dt dt dt
based evidence combined with clinician expertise and consideration of patient preferences. Cli
dt dt dt dt dt dt dt dt dt dt dt
nical judgment based on the nurse‘s clinical experience is part of EBP, but clinical decision ma
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
king should also incorporate current research and research-
dt dt dt dt dt dt dt
based guidelines. Evaluation of patient outcomes is important, but data analysis is not required t
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
o use EBP. All published articles do not provide research evidence; interventions should be bas
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
ed on credible research, preferably randomized controlled studies with a large number of subjec
dt dt dt dt dt dt dt dt dt dt dt dt dt
ts.
DIF: Cognitive Level: Understand (Comprehension) dt dt dt
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
dt dt dt dt dt dt dt dt dt dt
3. Which statement bythe nurse provides a clear explanation of the nursing process?
dt dt dt dt dt dt dt dt dt dt dt dt
a. “The nursing process is a research method of diagnosing the patient‘s health care pro
dt dt dt dt dt dt dt dt dt dt dt dt dt
blems.”
b. “The nursing process is used primarilyto explain nursing interventions to other he
dt dt dt dt dt dt dt dt dt dt dt dt
alth care professionals.” dt dt
c. “The nursing process is a problem-solving tool used to identifyand manage the
dt dt dt dt dt dt dt dt dt dt dt dt
4
,Table of Content dt dt
Chapter 01: Professional Nursing .............................................................................................................................................4
dt dt dt
Chapter 02: Social Determinants of Health.............................................................................................................................10
dt dt dt dt dt
Chapter 03: Health History and Physical Examination Harding: Lewis’sMedical-SurgicalNursing,12thEdition.....................15
dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 04: Patient and Caregiver Teaching ...........................................................................................................................20
dt dt dt dt dt
Chapter 05: Chronic Illness and Older Adults.........................................................................................................................26
dt dt dt dt dt dt
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ...................................................................................................34
dt dt dt dt d t
Chapter 07: Stress Management .............................................................................................................................................38
dt dt dt
Chapter 08: Sleep and Sleep Disorders ...................................................................................................................................42
dt dt dt dt dt
Chapter 09: Pain .....................................................................................................................................................................47
dt dt
Chapter 10: Palliative and End-of-Life Care ...........................................................................................................................56
dt dt dt dt dt
Chapter 11: Substance Use Disorders in Acute Care ...............................................................................................................61
dt dt dt dt dt dt dt
Chapter 12: Inflammation and Healing ...................................................................................................................................69
dt dt dt dt
Chapter 13: Genetics ..............................................................................................................................................................76
dt dt
Chapter 14: Immune Responses and Transplantation Harding: Lewis’sMedical-SurgicalNursing,12thEdition ......................79
dt dt dt dt dt dt dt dt dt dt dt
Chapter 15: Infection ..............................................................................................................................................................87
dt dt
Chapter 16: Cancer .................................................................................................................................................................97
dt dt
Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ........111
dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 18: Preoperative Care ..............................................................................................................................................124
dt dt dt
Chapter 19: Intraoperative Care ............................................................................................................................................131
dt dt dt
Chapter 20: Postoperative Care.............................................................................................................................................137
dt dt dt
Chapter 21: Emergency and Disaster Nursing ......................................................................................................................145
dt dt dt dt dt
Chapter 22: Assessment and Management: Visual Problems Harding: Lewis’s Medical-
dt dt dt dt dt dt dt dt dt
Surgical Nursing, 12th Edition 153 Chapter 23: Assessment and Management: Auditory Problems Harding: Lewis’s Medica
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
l-Surgical Nursing, 12th Edition
dt dt dt
.............................................................................................................................................................................................166
Chapter 24: Assessment: Integumentary System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ...........................173
dt dt dt dt dt dt dt dt dt dt
Chapter 25: Integumentary Problems ...................................................................................................................................178
dt dt dt
Chapter 26: Burns .................................................................................................................................................................186
dt dt
Chapter 27: Assessment: Respiratory System .......................................................................................................................195
dt dt dt dt
Chapter 28: Supporting Ventilation ......................................................................................................................................203
dt dt dt
Chapter 29: Upper Respiratory Problems..............................................................................................................................214
dt dt dt dt
Chapter 30: Lower Respiratory Problems .............................................................................................................................220
dt dt dt dt
Chapter 31: Obstructive Pulmonary Diseases .......................................................................................................................235
dt dt dt dt
Chapter 32: Acute Respiratory Failure and Acute Respiratory Distress Syndrome Harding: Lewis’s Medical-
dt dt dt dt dt dt dt dt dt dt dt dt
Surgical Nursing, 12th Edition .............................................................................................................................................248
dt dt dt
first? .................................................................................................................................................................................253
Chapter 33: Assessment: Hematologic System .....................................................................................................................257
dt dt dt dt
Chapter 34: Hematologic Problems ......................................................................................................................................262
dt dt dt
Chapter 35: Assessment: Cardiovascular System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ..........................277
dt dt dt dt dt dt dt dt dt dt
Chapter 36: Hypertension .....................................................................................................................................................289
dt dt
Chapter 38: Heart Failure .....................................................................................................................................................311
dt dt dt
Chapter 39: Dysrhythmias ....................................................................................................................................................319
dt dt
2
,Chapter 40: Inflammatory and Structural Heart Disorders Harding: Lewis’s Medical-Surgical Nursing, 12th Edition .........329
dt dt dt dt dt dt dt dt dt dt dt dt
first? ................................................................................................................................................................................. 339
Chapter 41: Vascular Disorders ............................................................................................................................................ 341
dt dt dt
Chapter 43: Assessment: Gastrointestinal System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ......................... 364
dt dt dt dt dt dt dt dt dt dt
Chapter 44: Nutrition Problems ............................................................................................................................................ 369
dt dt dt
Chapter 45: Obesity .............................................................................................................................................................. 377
dt dt
Chapter 46: Upper Gastrointestinal Problems ....................................................................................................................... 383
dt dt dt dt
Chapter 47: Lower Gastrointestinal Problems ...................................................................................................................... 397
dt dt dt dt
first? ................................................................................................................................................................................. 408
Chapter 48: Liver, Biliary Tract, and Pancreas Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ........... 414
dt dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 49: Assessment: Urinary System ............................................................................................................................. 429
dt dt dt dt
Chapter 50: Renal and Urologic Problems ............................................................................................................................ 436
dt dt dt dt dt
Chapter 51: Acute Kidney Injury and Chronic Kidney Disease Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
............................................................................................................................................................................................. 450
Chapter 52: Assessment: Endocrine System ......................................................................................................................... 462
dt dt dt dt
Chapter 53: Diabetes ............................................................................................................................................................ 469
dt dt
Chapter 54: Endocrine Problems .......................................................................................................................................... 484
dt dt dt
first? ................................................................................................................................................................................. 494
Chapter 55: Assessment: Reproductive System .................................................................................................................... 499
dt dt dt dt
first? ................................................................................................................................................................................. 502
Chapter 56: Breast Problems ................................................................................................................................................ 503
dt dt dt
Chapter 57: Sexually Transmitted Infections ........................................................................................................................ 512
dt dt dt dt
Chapter 58: Female Reproductive Problems ......................................................................................................................... 519
dt dt dt dt
Chapter 59: Male Reproductive Problems ............................................................................................................................ 533
dt dt dt dt
Chapter 60: Assessment: Nervous System ............................................................................................................................ 544
dt dt dt dt
Chapter 61: Acute Intracranial Problems .............................................................................................................................. 550
dt dt dt dt
Chapter 62: Stroke ................................................................................................................................................................ 565
dt dt
Chapter 63: Chronic Neurologic Problems ........................................................................................................................... 574
dt dt dt dt
Chapter 64: Dementia and Delirium ..................................................................................................................................... 585
dt dt dt dt
Chapter 65: Spinal Cord and Peripheral Nerve Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ........... 593
dt dt dt dt dt dt dt dt dt dt dt dt dt
Chapter 66: Assessment: Musculoskeletal System Harding: Lewis’sMedical-SurgicalNursing,12thEdition ........................ 603
dt dt dt dt dt dt dt dt dt dt
Chapter 67: Musculoskeletal Trauma and Orthopedic Surgery Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
dt dt dt dt dt dt dt dt dt dt dt dt
............................................................................................................................................................................................. 608
Chapter 68:Musculoskeletal Problems ................................................................................................................................. 622
dt dt
Chapter 69: Arthritis and Connective Tissue Diseases Harding: Lewis’sMedical-SurgicalNursing,12thEdition ................... 629
dt dt dt dt dt dt dt dt dt dt dt dt
3
, Chapter 01: Professional Nursing
dt dt dt
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
dt dt dt dt d t
MULTIPLE CHOICE dt
1. The nurse completes an admission database and explains that the plan of care and discharge g
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
oals will be developed with the patient‘s input. The patient asks, “How is this different from wha
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
t the physician does?” Which response would the nurse provide?
dt dt dt dt dt dt dt dt dt
a. “The role of the nurse is to administer medications and other treatments prescribed by
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
your physician.” dt
b. “In addition to caring for you while you are sick, the nurses will help you plan to mai
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
ntain your health.” dt dt
c. “The nurse‘s job is to collect information and communicate anyproblems that oc
dt dt dt dt dt dt dt dt dt dt dt dt
cur to the physician.” dt dt dt
d. “Nurses perform manyof the same procedures as the physician, but nurses are wit
dt dt dt dt dt dt dt dt dt dt dt dt dt
h the patients for a longer time than the physician.”
dt dt dt dt dt dt dt dt dt
ANS: B dt
The American Nurses Association (ANA) definition of nursing describes the role of nurses in pr
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
omoting health. The other responses describe dependent and collaborative functions of the nur
dt dt dt dt dt dt dt dt dt dt dt dt
sing role but do not accurately describe the nurse‘s unique role in thehealth care system.
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
DIF: Cognitive Level: Analyze (Analysis)
dt dt dt dt
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
dt dt dt dt dt dt dt dt dt dt
2. Which statement bythe nurse accurately describes the use of evidence-based practice (EBP)?
dt dt dt dt dt dt dt dt dt dt dt dt
a. “Patient care is based on clinical judgment, experience, and traditions.”
dt dt dt dt dt dt dt dt dt
b. “Data are analyzed later to show that the patient outcomes are consistentlymet.”
dt dt dt dt dt dt dt dt dt dt dt dt
c. “Research from all published articles are used as a guide for planning patient care.” dt dt dt dt dt dt dt dt dt dt dt dt dt
d. “Recommendations are based on research, clinical expertise, and patient p dt dt dt dt dt dt dt dt dt
references.”
ANS: D dt
Evidence-based practice (EBP) is the use of the best research- dt dt dt dt dt dt dt dt dt
based evidence combined with clinician expertise and consideration of patient preferences. Cli
dt dt dt dt dt dt dt dt dt dt dt
nical judgment based on the nurse‘s clinical experience is part of EBP, but clinical decision ma
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
king should also incorporate current research and research-
dt dt dt dt dt dt dt
based guidelines. Evaluation of patient outcomes is important, but data analysis is not required t
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
o use EBP. All published articles do not provide research evidence; interventions should be bas
dt dt dt dt dt dt dt dt dt dt dt dt dt dt
ed on credible research, preferably randomized controlled studies with a large number of subjec
dt dt dt dt dt dt dt dt dt dt dt dt dt
ts.
DIF: Cognitive Level: Understand (Comprehension) dt dt dt
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
dt dt dt dt dt dt dt dt dt dt
3. Which statement bythe nurse provides a clear explanation of the nursing process?
dt dt dt dt dt dt dt dt dt dt dt dt
a. “The nursing process is a research method of diagnosing the patient‘s health care pro
dt dt dt dt dt dt dt dt dt dt dt dt dt
blems.”
b. “The nursing process is used primarilyto explain nursing interventions to other he
dt dt dt dt dt dt dt dt dt dt dt dt
alth care professionals.” dt dt
c. “The nursing process is a problem-solving tool used to identifyand manage the
dt dt dt dt dt dt dt dt dt dt dt dt
4