MEDICAL-SURGICAL 09/27/2026
NURSING
TEST BANK 1 FOR BRUNNER & SUDDARTH’S
MEDICAL-SURGICAL NURSING 15TH EDITION |
ALL 68 CHAPTERS WITH ANSWER KEYS AT
END OF EACH CHAPTER
A client in the emergency department is bleeding profusely from a gunshot wound to the
abdomen. What action should the nurse immediately?
A.Place the client in a 45-degree Trendelenburg position to promote cerebral blood flow.
JOYCEWWALES 1
, MEDICAL-SURGICAL 09/27/2026
NURSING
B.Turn the client prone to place pressure on the abdominal wound to help staunch the
bleeding.
C.Maintain the client in a supine position to reduce diaphragmatic pressure and visualize the
wound.
D.Put the client on the right side to apply pressure to the liver and spleen to stop
hemorrhaging. –
Correct Answer :Correct Answer: C
Rationale:Placing the client in a supine position reduces diaphragmatic pressure, thereby
enhancing oxygenation, and allows for visualization of the abdominal wound. Option A
compromises diaphragmatic expansion and inhibits pressoreceptor activity. Option B places
the client at risk of evisceration of the abdominal wound and increased bleeding. Option D will
not stop internal bleeding in the liver and spleen caused by the gunshot wound.
Client census is often used to determine staffing needs. Which method of obtaining census
determination for a particular unit provides the best formula for determining long-range
staffing patterns?
A.Midnight census
B.Oncoming shift census
C.Average daily census
D.Hourly census –
Correct Answer :Correct Answer: C
Rationale:An average daily census is determined by trend data and takes into account
seasonal and daily fluctuations, so it is the best method for determining staffing needs.
Options A and B provide data at a certain point in time, and that data could change quickly. It
is unrealistic to expect to obtain an hourly census, and such data would only provide
information about a certain point in time
JOYCEWWALES 2
, MEDICAL-SURGICAL 09/27/2026
NURSING
Which abnormal laboratory finding indicates that a client with diabetes needs further
evaluation for diabetic nephropathy?
A.Hypokalemia
B.Microalbuminuria
C.Elevated serum lipid levels
D.Ketonuria –
Correct Answer :Correct Answer: B
Rationale:Microalbuminuria is the earliest sign of diabetic nephropathy and indicates the need
for follow-up evaluation. Hyperkalemia, not option A, is associated with end-stage renal
disease caused by diabetic nephropathy. Option C may be elevated in end-stage renal
disease. Option D may signal the onset of diabetic ketoacidosis (DKA).
The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very
restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock
is in place. Which action should the nurse take first?
A.Measure the urine specific gravity.
B.Obtain IV fluids for infusion per protocol.
C.Prepare for insertion of a central venous catheter.
D.Auscultate the client's breath sounds
. - Correct Answer :Correct Answer: B
Rationale:The client is at risk for hypovolemic shock because of the postoperative status and
is exhibiting early signs of shock. A priority intervention is the initiation of IV fluids to restore
JOYCEWWALES 3
, MEDICAL-SURGICAL 09/27/2026
NURSING
tissue perfusion. Options A, C, and D are all important interventions but are of lower priority
than option B.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a nasogastric tube
draining bright red blood. The nurse notes that the client's serum hemoglobin and hematocrit
levels are decreased. Which additional change in laboratory data should the nurse expect?
A.Increased serum albumin level
B.Decreased serum creatinine
C.Decreased serum ammonia level
D.Increased liver function test results –
Correct Answer :Correct Answer: C
Rationale:The breakdown of glutamine in the intestine and the increased activity of colonic
bacteria from the digestion of proteins increase ammonia levels in clients with advanced liver
disease, so removal of blood, a protein source, from the intestine results in a reduced level of
ammonia. Options A, B, and D will not be significantly affected by the removal of blood.
The nurse is preparing a teaching plan for a group of healthy adults. Which individual is most
likely to maintain optimum health?
A.A teacher whose blood glucose levels average 126 mg/dL daily with oral antidiabetic drugs
B.An accountant whose blood pressure averages 140/96 mm Hg and who says he does not
have time to exercise
C.A stock broker whose total serum cholesterol level dropped to 290 mg/dL with diet
modifications
D.A recovering IV heroin user who contracted hepatitis more than 10 years ago –
JOYCEWWALES 4
NURSING
TEST BANK 1 FOR BRUNNER & SUDDARTH’S
MEDICAL-SURGICAL NURSING 15TH EDITION |
ALL 68 CHAPTERS WITH ANSWER KEYS AT
END OF EACH CHAPTER
A client in the emergency department is bleeding profusely from a gunshot wound to the
abdomen. What action should the nurse immediately?
A.Place the client in a 45-degree Trendelenburg position to promote cerebral blood flow.
JOYCEWWALES 1
, MEDICAL-SURGICAL 09/27/2026
NURSING
B.Turn the client prone to place pressure on the abdominal wound to help staunch the
bleeding.
C.Maintain the client in a supine position to reduce diaphragmatic pressure and visualize the
wound.
D.Put the client on the right side to apply pressure to the liver and spleen to stop
hemorrhaging. –
Correct Answer :Correct Answer: C
Rationale:Placing the client in a supine position reduces diaphragmatic pressure, thereby
enhancing oxygenation, and allows for visualization of the abdominal wound. Option A
compromises diaphragmatic expansion and inhibits pressoreceptor activity. Option B places
the client at risk of evisceration of the abdominal wound and increased bleeding. Option D will
not stop internal bleeding in the liver and spleen caused by the gunshot wound.
Client census is often used to determine staffing needs. Which method of obtaining census
determination for a particular unit provides the best formula for determining long-range
staffing patterns?
A.Midnight census
B.Oncoming shift census
C.Average daily census
D.Hourly census –
Correct Answer :Correct Answer: C
Rationale:An average daily census is determined by trend data and takes into account
seasonal and daily fluctuations, so it is the best method for determining staffing needs.
Options A and B provide data at a certain point in time, and that data could change quickly. It
is unrealistic to expect to obtain an hourly census, and such data would only provide
information about a certain point in time
JOYCEWWALES 2
, MEDICAL-SURGICAL 09/27/2026
NURSING
Which abnormal laboratory finding indicates that a client with diabetes needs further
evaluation for diabetic nephropathy?
A.Hypokalemia
B.Microalbuminuria
C.Elevated serum lipid levels
D.Ketonuria –
Correct Answer :Correct Answer: B
Rationale:Microalbuminuria is the earliest sign of diabetic nephropathy and indicates the need
for follow-up evaluation. Hyperkalemia, not option A, is associated with end-stage renal
disease caused by diabetic nephropathy. Option C may be elevated in end-stage renal
disease. Option D may signal the onset of diabetic ketoacidosis (DKA).
The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very
restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock
is in place. Which action should the nurse take first?
A.Measure the urine specific gravity.
B.Obtain IV fluids for infusion per protocol.
C.Prepare for insertion of a central venous catheter.
D.Auscultate the client's breath sounds
. - Correct Answer :Correct Answer: B
Rationale:The client is at risk for hypovolemic shock because of the postoperative status and
is exhibiting early signs of shock. A priority intervention is the initiation of IV fluids to restore
JOYCEWWALES 3
, MEDICAL-SURGICAL 09/27/2026
NURSING
tissue perfusion. Options A, C, and D are all important interventions but are of lower priority
than option B.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a nasogastric tube
draining bright red blood. The nurse notes that the client's serum hemoglobin and hematocrit
levels are decreased. Which additional change in laboratory data should the nurse expect?
A.Increased serum albumin level
B.Decreased serum creatinine
C.Decreased serum ammonia level
D.Increased liver function test results –
Correct Answer :Correct Answer: C
Rationale:The breakdown of glutamine in the intestine and the increased activity of colonic
bacteria from the digestion of proteins increase ammonia levels in clients with advanced liver
disease, so removal of blood, a protein source, from the intestine results in a reduced level of
ammonia. Options A, B, and D will not be significantly affected by the removal of blood.
The nurse is preparing a teaching plan for a group of healthy adults. Which individual is most
likely to maintain optimum health?
A.A teacher whose blood glucose levels average 126 mg/dL daily with oral antidiabetic drugs
B.An accountant whose blood pressure averages 140/96 mm Hg and who says he does not
have time to exercise
C.A stock broker whose total serum cholesterol level dropped to 290 mg/dL with diet
modifications
D.A recovering IV heroin user who contracted hepatitis more than 10 years ago –
JOYCEWWALES 4
