FOCUS ON ADULT HEALTH: MEDICAL-SURGICAL
NURSING
2nd Edition — Enhanced Study Guide
Original exam-oriented companion guide based on the publicly visible topic structure of Linda Honan’s text. It does not
reproduce the Stuvia test bank, textbook exercises, answer key, or locked material.
How to Use This Guide
Use each system in three passes: recognize the condition, prioritize nursing assessment/interventions, then justify the
priority using physiology and safety. On exams, ask: What is the immediate threat? What finding is unexpected? What action
prevents deterioration? What teaching is most important?
1. Foundations, Health Promotion, Chronic Illness & End-of-Life Care
• Adult-health nursing emphasizes assessment, clinical judgment, prevention of complications, patient education,
coordination of care, and safe delegation.
• Health promotion includes risk-factor modification, screening, vaccination, nutrition, activity, sleep, medication adherence,
and self-management.
• Chronic illness care is long-term and partnership-based. Assess functional status, coping, health literacy, caregiver
resources, adherence barriers, and goals.
• End-of-life priorities shift toward comfort, dignity, symptom control, communication, advance care planning, and support for
patient/family preferences.
Exam Focus
• What is the priority when a stable chronic-care patient develops a new acute change? Treat the new change as potentially
urgent; reassess ABCs, vital signs, mental status, and relevant focused findings before routine teaching.
• Exam trap: Do not confuse patient choice with family preference. When the patient has decision-making capacity, the
patient's informed choices guide care.
2. Fluids, Electrolytes & Acid–Base Balance
• Sodium strongly influences extracellular fluid balance and neurologic function. Potassium is critical for neuromuscular and
cardiac conduction. Calcium affects neuromuscular activity and cardiac function. Magnesium affects neuromuscular stability
and rhythm.
• Volume deficit may present with thirst, dry mucosa, tachycardia, orthostatic changes, reduced urine output, and
concentrated urine. Excess volume can produce edema, weight gain, hypertension, crackles, and dyspnea.
• Acid–base interpretation: first identify pH direction, then CO2 and bicarbonate. Respiratory problems primarily alter CO2;
metabolic problems primarily alter bicarbonate. Determine whether compensation is occurring.
Exam Focus
• High-yield rule: potassium abnormalities can become rhythm emergencies. Review ECG changes, renal function,
medication causes, and replacement safety rather than treating a laboratory number in isolation.
• Mnemonic: ROME — Respiratory Opposite (pH vs CO2), Metabolic Equal (pH vs HCO3).
3. Perioperative Nursing
Original educational study guide — not a reproduction of the Stuvia test bank. Page 1
, • Preoperative priorities include informed consent verification, medication/allergy review, baseline assessment, infection
prevention, fasting requirements, patient teaching, and risk assessment.
• Postoperative priorities include airway and breathing, circulation, pain, neurologic status, wound/drain assessment,
mobility, urinary output, bowel function, and prevention of thromboembolism and pulmonary complications.
• Red flags include sudden respiratory compromise, uncontrolled bleeding, new confusion, rapidly worsening pain with
abnormal findings, low urine output, or signs of infection/sepsis.
Exam Focus
• Exam trap: The nurse should not obtain informed consent on behalf of the provider. The nurse verifies that consent is
present and that the patient understands enough to ask questions, then escalates unanswered questions appropriately.
4. Cancer Care & Pain Management
• Cancer nursing spans prevention, screening, diagnosis, treatment, symptom management, psychosocial care, survivorship,
and palliative care. Common treatment effects include fatigue, nausea, mucosal injury, myelosuppression, alopecia,
neuropathy, and infection risk.
• Pain assessment should include location, quality, intensity, timing, aggravating/relieving factors, functional impact, previous
response, and patient goals. Reassessment determines whether the intervention worked.
• Nonpharmacologic measures can complement analgesics: positioning, relaxation, heat/cold when appropriate, distraction,
guided imagery, massage, and environmental modification.
Exam Focus
• Priority with severe new pain plus instability: assess for an acute complication rather than automatically assuming the
symptom is expected.
• Exam trap: Pain is subjective. A patient's report is the primary source for pain intensity when the patient can communicate.
5. Respiratory Assessment & Disorders
• Assess respiratory rate/pattern, work of breathing, oxygenation, breath sounds, cough/sputum, chest movement, mental
status, and relevant history.
• Upper-airway disorders may threaten airway patency. Lower-airway and parenchymal disease may impair ventilation,
diffusion, or oxygenation.
• COPD care commonly emphasizes smoking cessation, prescribed inhalers, breathing strategies, energy conservation,
vaccination, nutrition, and recognition of exacerbation symptoms. Asthma care emphasizes trigger control, controller therapy
when prescribed, rescue therapy, and an action plan.
• Acute respiratory deterioration is an ABC priority. Increasing work of breathing, altered mental status, cyanosis, silent chest,
or falling oxygenation requires rapid escalation.
Exam Focus
• Mnemonic: OPEN AIRWAY → OXYGENATION → VENTILATION → CAUSE. Stabilize first, then investigate the cause.
6. Cardiovascular & Circulatory Disorders
• Assess chest discomfort, dyspnea, edema, pulses, capillary refill, blood pressure, rhythm, heart sounds, activity tolerance,
and signs of poor perfusion.
• Hypertension is often asymptomatic; sustained elevation damages target organs. Teaching centers on adherence, lifestyle
changes, monitoring, and follow-up.
Original educational study guide — not a reproduction of the Stuvia test bank. Page 2
NURSING
2nd Edition — Enhanced Study Guide
Original exam-oriented companion guide based on the publicly visible topic structure of Linda Honan’s text. It does not
reproduce the Stuvia test bank, textbook exercises, answer key, or locked material.
How to Use This Guide
Use each system in three passes: recognize the condition, prioritize nursing assessment/interventions, then justify the
priority using physiology and safety. On exams, ask: What is the immediate threat? What finding is unexpected? What action
prevents deterioration? What teaching is most important?
1. Foundations, Health Promotion, Chronic Illness & End-of-Life Care
• Adult-health nursing emphasizes assessment, clinical judgment, prevention of complications, patient education,
coordination of care, and safe delegation.
• Health promotion includes risk-factor modification, screening, vaccination, nutrition, activity, sleep, medication adherence,
and self-management.
• Chronic illness care is long-term and partnership-based. Assess functional status, coping, health literacy, caregiver
resources, adherence barriers, and goals.
• End-of-life priorities shift toward comfort, dignity, symptom control, communication, advance care planning, and support for
patient/family preferences.
Exam Focus
• What is the priority when a stable chronic-care patient develops a new acute change? Treat the new change as potentially
urgent; reassess ABCs, vital signs, mental status, and relevant focused findings before routine teaching.
• Exam trap: Do not confuse patient choice with family preference. When the patient has decision-making capacity, the
patient's informed choices guide care.
2. Fluids, Electrolytes & Acid–Base Balance
• Sodium strongly influences extracellular fluid balance and neurologic function. Potassium is critical for neuromuscular and
cardiac conduction. Calcium affects neuromuscular activity and cardiac function. Magnesium affects neuromuscular stability
and rhythm.
• Volume deficit may present with thirst, dry mucosa, tachycardia, orthostatic changes, reduced urine output, and
concentrated urine. Excess volume can produce edema, weight gain, hypertension, crackles, and dyspnea.
• Acid–base interpretation: first identify pH direction, then CO2 and bicarbonate. Respiratory problems primarily alter CO2;
metabolic problems primarily alter bicarbonate. Determine whether compensation is occurring.
Exam Focus
• High-yield rule: potassium abnormalities can become rhythm emergencies. Review ECG changes, renal function,
medication causes, and replacement safety rather than treating a laboratory number in isolation.
• Mnemonic: ROME — Respiratory Opposite (pH vs CO2), Metabolic Equal (pH vs HCO3).
3. Perioperative Nursing
Original educational study guide — not a reproduction of the Stuvia test bank. Page 1
, • Preoperative priorities include informed consent verification, medication/allergy review, baseline assessment, infection
prevention, fasting requirements, patient teaching, and risk assessment.
• Postoperative priorities include airway and breathing, circulation, pain, neurologic status, wound/drain assessment,
mobility, urinary output, bowel function, and prevention of thromboembolism and pulmonary complications.
• Red flags include sudden respiratory compromise, uncontrolled bleeding, new confusion, rapidly worsening pain with
abnormal findings, low urine output, or signs of infection/sepsis.
Exam Focus
• Exam trap: The nurse should not obtain informed consent on behalf of the provider. The nurse verifies that consent is
present and that the patient understands enough to ask questions, then escalates unanswered questions appropriately.
4. Cancer Care & Pain Management
• Cancer nursing spans prevention, screening, diagnosis, treatment, symptom management, psychosocial care, survivorship,
and palliative care. Common treatment effects include fatigue, nausea, mucosal injury, myelosuppression, alopecia,
neuropathy, and infection risk.
• Pain assessment should include location, quality, intensity, timing, aggravating/relieving factors, functional impact, previous
response, and patient goals. Reassessment determines whether the intervention worked.
• Nonpharmacologic measures can complement analgesics: positioning, relaxation, heat/cold when appropriate, distraction,
guided imagery, massage, and environmental modification.
Exam Focus
• Priority with severe new pain plus instability: assess for an acute complication rather than automatically assuming the
symptom is expected.
• Exam trap: Pain is subjective. A patient's report is the primary source for pain intensity when the patient can communicate.
5. Respiratory Assessment & Disorders
• Assess respiratory rate/pattern, work of breathing, oxygenation, breath sounds, cough/sputum, chest movement, mental
status, and relevant history.
• Upper-airway disorders may threaten airway patency. Lower-airway and parenchymal disease may impair ventilation,
diffusion, or oxygenation.
• COPD care commonly emphasizes smoking cessation, prescribed inhalers, breathing strategies, energy conservation,
vaccination, nutrition, and recognition of exacerbation symptoms. Asthma care emphasizes trigger control, controller therapy
when prescribed, rescue therapy, and an action plan.
• Acute respiratory deterioration is an ABC priority. Increasing work of breathing, altered mental status, cyanosis, silent chest,
or falling oxygenation requires rapid escalation.
Exam Focus
• Mnemonic: OPEN AIRWAY → OXYGENATION → VENTILATION → CAUSE. Stabilize first, then investigate the cause.
6. Cardiovascular & Circulatory Disorders
• Assess chest discomfort, dyspnea, edema, pulses, capillary refill, blood pressure, rhythm, heart sounds, activity tolerance,
and signs of poor perfusion.
• Hypertension is often asymptomatic; sustained elevation damages target organs. Teaching centers on adherence, lifestyle
changes, monitoring, and follow-up.
Original educational study guide — not a reproduction of the Stuvia test bank. Page 2
