Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition (Hinkle, 2022), All Chapters

During an orientation class, the medical unit's nursing educator is presenting education on transcultural nursing to a group of newly licensed nurses. What should the staff educator identify as the underlying focus of transcultural nursing? A. To enhance the cultural environment of institutions B. To promote the health of communities C. To provide culture-specific and culture-universal care D. To promote the well-being of discrete, marginalized groups ANS: C Rationale: The underlying focus of transcultural nursing is to provide culture-specific and culture-universal care that promotes the well-being or health of individuals, families, groups, communities, and institutions. It includes, but is not limited to, institutions, communities, or marginalized groups. PTS: 1 REF: p. 72 ______________________________________________________________________________________________ ______________________________________________________________________________________________ Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15e (Hinkle, 2022) 56 | P a g e NAT: Client Needs: Safe, Effective Care Environment: Management of Care | Client Needs: Physiological Integrity: Basic Care and Comfort TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Understand NOT: Multiple Choice 35. The future of transcultural nursing care lies in finding ways to promote cultural competence in nursing students. How can this goal be best accomplished? A. By offering multicultural health studies in nursing curricula B. By enhancing the content of community nursing classes C. By requiring students to care primarily for clients from other ethnic groups D. By screening applicants according to their cultural competence ANS: A Rationale: Nursing programs are exploring creative ways to promote cultural competence and humanistic care in nursing students, including offering multicultural health studies in their curricula. Enhancing the content of community nursing classes would not necessarily achieve this goal. Matching students to clients from other cultures is often impractical, and applicants are not screened by their cultural competence. PTS: 1 REF: p. 73 NAT: Client Needs: Psychosocial Integrity | Client Needs: Physiological Integrity: Basic Care and Comfort TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice 36. Computed tomography of a 72-year-old client reveals lung cancer with metastasis to the liver. The client's adult child has been adamant that any "bad news" be withheld from the client to protect the client from stress, stating that this is a priority in their family’s culture. How should the nurse and the other members of the care team best respond? A. Explain to the adult child the team's ethical obligation to inform the client. B. Refer the family to social work. C. Have a nurse or health care provider from the client's culture make contact with the client and adult child. D. Speak with the child to explore the rationale and attempt to reach a consensus. ANS: D Rationale: Nurses must promote open dialogue and work with clients, families, health care providers, and other health care providers to reach the culturally appropriate solution for the individual client. A referral to social work is not a sufficient response, and enlisting a caregiver from the same culture may not be ethical or effective. Although the nurse may need to explain to the client’s child the team’s ethical obligation to inform the client at some point, the best response is to speak further with the adult child to explore the rationale and attempt to reach a consensus. PTS: 1 REF: p. 93 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice MULTIPLE RESPONSE ______________________________________________________________________________________________ ______________________________________________________________________________________________ Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15e (Hinkle, 2022) 57 | P a g e 37. The nurse is completing a family history for a client who is admitted for exacerbation of chronic obstructive pulmonary disease (COPD). The nurse should include questions that address which health problem? Select all that apply. A. Allergies B. Alcohol use disorder C. Fractures D. Hypervitaminosis E. Obesity ANS: A, B, E Rationale: In general, the following conditions are included in a family history: cancer, hypertension, heart disease, diabetes, epilepsy, mental illness, tuberculosis, kidney disease, arthritis, allergies, asthma, alcohol use disorder, and obesity. Fractures and hypervitaminosis do not have genetic etiologies. PTS: 1 REF: p. 75 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Response 38. The nurse is performing a cultural nursing assessment of a newly admitted client. What should the nurse include in the assessment? Select all that apply. A. Family structure B. Subgroups C. Cultural beliefs D. Health practices E. Values ANS: A, C, D, E Rationale: Cultural nursing assessment refers to a systematic appraisal or examination of individuals, families, groups, and communities in terms of their cultural beliefs, values, and practices. Subgroups are not a specific focus of this assessment. PTS: 1 REF: p. 91 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Remember NOT: Multiple Response ______________________________________________________________________________________________ ______________________________________________________________________________________________ Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15e (Hinkle, 2022) 58 | P a g e Chapter 5: Stress and Inflammatory Responses Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition MULTIPLE CHOICE 1. A nurse is counseling a client with an opioid addiction who is now ready for discharge. What factors would the nurse emphasize to build resilience and prevent relapse? A. Finding a fulfilling job that they enjoy and setting new goals B. Having a supportive relationship with family members and role model exposure C. Taking an inexpensive, short vacation to unwind and reevaluate problems D. Promoting a strenuous exercise program that emphasizes weight loss ANS: B Rationale: Factors that play a role in building a client’s resilience are having strong, supportive relationships with family members and other individuals as well as being exposed to positive role models. Finding a job, taking a vacation, and starting an exercise program are steps that are individualized goals and don’t, in themselves, build resilience. Resilience is defined as the ability of a person to function well in a stressful situation. PTS: 1 REF: p. 100 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 5: Stress and Inflammatory Responses KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 2. The nurse is caring for an adult client who has just received a diagnosis of prostate cancer. The client states, “I will never be able to cope with this situation.” How should the nurse best understand the concept of stress when attempting to meet this client's needs? A. It is a physiologic measurement used to deal with change, and the client will physically adapt. B. It is a physiologic or psychological process that the client implements to adapt to change. C. It is an external event or situation that produces change that does not contribute to growth. D. It is a disruptive condition produced by a change that influences the client’s dynamic balance. ANS: D Rationale: Stress is a disruptive condition produced by a change in the environment that is perceived as challenging, threatening, or damaging to a person’s dynamic balance or equilibrium. Stressors can be described as psychological, physiologic, or psychosocial. Stress can be an internal or external event and contributes to growth. PTS: 1 REF: p. 98 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 5: Stress and Inflammatory Responses KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice 3. The nurse is with a client who has learned that they have glioblastoma multiforme, a brain tumor associated with an exceptionally poor prognosis. The client’s heart rate increases, eyes dilate, and blood pressure increases. The nurse recognizes these changes as being attributable to what response? A. Part of the limbic system response B. Sympathetic nervous response C. Hypothalamic–pituitary response D. Local adaptation syndrome ______________________________________________________________________________________________ ______________________________________________________________________________________________ Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15e (Hinkle, 2022) 59 | P a g e ANS: B Rationale: The sympathetic nervous system responds rapidly to stress; norepinephrine is released at nerve endings, causing the organs to respond (i.e., heart rate increases, eyes dilate, and blood pressure increases). The limbic system is a mediator of emotions and behavior that are critical to survival during times of stress. The hypothalamic–pituitary response regulates the cortisol-induced metabolic effect that results in elevated blood sugars during stressful situations. Local adaptation syndrome is a tissue-specific inflammatory reaction. PTS: 1 REF: p. 101 NAT: Client Needs: Physiological Integrity: Physiological Adaptation TOP: Chapter 5: Stress and Inflammatory Responses KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 4. A hospitalized client tells the nurse about feeling anxious about "being in this place.” The client's blood pressure and heart rate are elevated but return to normal after 10 minutes. The client asks the nurse whether there is a concern for hypertension. What statement will guide the nurse's response? A. The client should not worry because the increased blood pressure was stress-related and the client's regular blood pressure is good. B. The first blood pressure reading was part of a stress response; the long-term blood pressure is controlled by negative feedback systems. C. Blood pressure is the only measure of hypertension; the client needs to recheck it regularly. D. A respiratory infection is probably the cause of the elevated blood pressure and will return to normal after treatment. ANS: B Rationale: A stress response will temporarily elevate blood pressure and heart rate. Long-term blood pressure response is controlled by negative feedback systems. The nurse would be incorrect in assuming the client's blood pressure is good based on only two blood pressure readings. The stress of a respiratory infection could account for the elevated blood pressure, but assuring the client that the blood pressure will return to normal with treatment may not be true. PTS: 1 REF: p. 103 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 5: Stress and Inflammatory Responses KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 5. A client presents to the health center and is diagnosed with an enlarged thyroid. The health care provider believes the thyroid cells may be undergoing hyperplasia. How should the nurse explain this condition to the client? A. Hyperplasia is the abnormal decrease in cell and organ size and is a precursor to cancer. B. Hyperplasia is an abnormal increase in new cells and is reversible with the stimulus for cell growth removed. C. Hyperplasia is the change in appearance of the thyroid due to a chronic irritation and will reverse with the stimulus removed. D. Hyperplasia is a cancerous growth and will be removed surgically. ANS: B Rationale: Hyperplasia is an increase in the number of new cells in an organ or tissue. This is due to increased mitotic stimulation from the additional cell division, and this, in turn, enlarges the tissue. Hyperplasia is reversible when the stimulus for cell growth is removed. Hyperplasia is the increase in the number of new cells, not a change in size or appearance. Hyperplasia is the increase in the number of new cells, which may or may not be cancerous growth.