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Test Bank For Lewis Medical Surgical Nursing 12Th Edition By Mariann M. Harding, Jeffrey Kwong, Debra Hagler All Chapters Covered (Chapters 1 To 69) Examwith Actual Questions And Complete 100%Correct Answers With Verified And Well Explained Rationales Alr

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TEST BANK FOR LEWIS MEDICAL SURGICAL NURSING 12TH EDITION BY MARIANN M. HARDING, JEFFREY KWONG, DEBRA HAGLER ALL CHAPTERS COVERED (CHAPTERS 1 TO 69) EXAMWITH ACTUAL QUESTIONS AND COMPLETE 100%CORRECT ANSWERS WITH VERIFIED AND WELL EXPLAINED RATIONALES ALREADY GRADED A+ BY EXPERTS |LATEST VERSION 2024 WITH GUARANTEED SUCCESS AFTER DOWNLOAD ALREADY PASSED!!!!!!! (PROVEN ITS ALL YOU NEED TO EXCEL IN YOUR EXAMS A 19-yr-old woman admitted with anorexia nervosa is 5 ft, 6 in (163 cm) tall and weighs 88 lb (41 kg). Laboratory tests reveal hypokalemia and iron-deficiency anemia. Which patient problem has the highest priority? a. Difficulty coping Negative self-image Electrolyte imbalance Nutritionally compromised ANS: C The patient‘s hypokalemia may lead to life-threatening cardiac dysrhythmias. The other diagnoses may also be appropriate for this patient but are not associated with immediate risk for fatal complications. DIF:CognitiveLevel: Analyze (Analysis) TOP: NursingProcess: Planning MSC:NCLEX: PhysiologicalIntegrity The nurse is planning care for a patient who is chronically malnourished. Which action would the nurse to delegate to assistive personnel (AP)? Assist the patient to choose high-nutrition items from the menu. Monitor the patient for skin breakdown over the bony prominences. Offer the patient the prescribed nutritional supplement between meals. Assess the patient‘s strength while ambulating the patient in the room. ANS: C Feeding the patient and assisting with oral intake are included in AP education and scope of practice. Assessing the patient and assisting the patient in choosing high-nutrition foods require licensed practical/vocational nurse (LPN/VN)—or registered nurse (RN)—level education and scope of practice. DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Planning MSC:NCLEX: Safe and Effective Care Environment A severely malnourished patient reports that he is Jewish. Which initial action would the nurse take to meet his nutritional needs? a. Have family members bring in food. Ask the patient about food preferences. Teach the patient about nutritious Kosher foods. Order supplements that are manufactured Kosher. ANS: B The nurse‘s first action would be further assessment of whether the patient follows any specific religious guidelines that impact nutrition. The other actions may also be appropriate, based on the information obtained during the assessment. DIF:CognitiveLevel: Analyze (Analysis) TOP: NursingProcess: Assessment MSC:NCLEX: Psychosocial Integrity MULTIPLE RESPONSE 1. Which patients would the nurse refer to the dietitian for a complete nutritional assessment? (Select all that apply.) A 35-yr-old patient who reports intermittent nausea for the past 2 days A 48-yr-old patient with rheumatoid arthritis who takes prednisone daily A 23-yr-old patient who has a history of fluctuating weight gains and losses A 64-yr-old patient who is admitted for debridement of an infected surgical wound A 52-yr-old patient admitted with chest pain and possible myocardial infarction (MI) ANS: B, C, D Weight fluctuations, use of corticosteroids, and draining or infected wounds all suggest that the patient may be at risk for malnutrition. Patients with chest pain or MI are not usually poorly nourished. Although vomiting that lasts 5 days places a patient at risk, nausea that has persisted for 2 days does not always indicate poor nutritional status or risk for health problems caused by poor nutrition. DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Implementation MSC:NCLEX: PhysiologicalIntegrity Chapter 45: Obesity Harding: Lewis’s Medical-Surgical Nursing, 12th Edition MULTIPLE CHOICE Which statement by the nurse is most likely to help a 22-yr-old patient with extreme obesity in losing weight on a 1000-calorie diet? “It will be necessary to change lifestyle habits permanently to maintain weight loss.” “You are likely to notice changes in how you feel after a few weeks of diet and exercise.” “You will decrease your risk for future health problems such as diabetes by losing weight now.” “Most of the weight that you lose during the first weeks of dieting is water weight rather than fat.” ANS: B Motivation is a key factor in successful weight loss and a short-term outcome provides a higher motivation. Future health problems are unlikely to motivate a 22-yr-old patient. Telling a patient that the initial weight loss is water would be discouraging, although this may be correct. Changing lifestyle habits permanently is recommended, but this process occurs over time, and discussing this is not likely to motivate the patient. DIF:CognitiveLevel: Analyze (Analysis) TOP: NursingProcess: Implementation MSC:NCLEX: Psychosocial Integrity After the nurse teaches about the recommended amounts of foods from animal and plant sources, which menu selections indicate that the patient understands the diet instructions? a. 3 oz of lean beef, 2 oz of low-fat cheese, and a sliced tomato 3 oz of roasted pork, a cup of broccoli, and a cup of carrot sticks Cup of tossed salad and nonfat dressing topped with a chicken breast Half cup of tuna mixed with nonfat mayonnaise and a half cup of celery ANS: B This selection is most consistent with the recommendations to limit foods from animal sources and increase plant source foods. The other choices all have higher ratios of animal origin foods to plant source foods than would be recommended. DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Evaluation MSC:NCLEX: Health Promotion and Maintenance Which action would the nurse take when coaching adults who are obese in a behavior therapy program? Having the adults write down the caloric intake of each meal Asking the adults about situations that tend to increase appetite Suggesting that the adults plan rewards such as sugarless candy for achieving their goals Encouraging the adults to eat small amounts frequently rather than having scheduled meals ANS: B Behavior therapy programs focus on how and when the person eats and de-emphasize aspects such as calorie counting. Nonfood rewards are recommended for achievement of weight-loss goals. Patients are often taught to restrict eating to designated meals when using behavior therapy. DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Implementation MSC:NCLEX: Health Promotion and Maintenance The nurse is coaching a community group for persons who are overweight. Which participant behavior is an example of the best exercise plan for weight loss? a. Walking for 40 minutes 6 or 7 days/week Playing soccer for an hour on the weekend Running for 10 to 15 minutes 3 times/week Lifting weights for 2 hours with friends 1 time/week ANS: A Exercise should be at least 150 minutes of moderate-intensity aerobic activity (i.e., brisk walking) every week. Muscle-strengthening activities on 2 or more days a week is recommended. Exercising in highly aerobic activities for short bursts or only once a week is not helpful and may be dangerous in an individual who has not been exercising. Running may be appropriate, but patients should start with an exercise that is less stressful and can be done for a longer period. DIF:CognitiveLevel: Analyze (Analysis) TOP: NursingProcess

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TEST BANK FOR LEWIS MEDICAL
SURGICAL NURSING 12TH EDITION
BY MARIANN M. HARDING,
JEFFREY KWONG, DEBRA HAGLER
ALL CHAPTERS COVERED
(CHAPTERS 1 TO 69) EXAMWITH
ACTUAL QUESTIONS AND
COMPLETE 100%CORRECT
ANSWERS WITH VERIFIED AND
WELL EXPLAINED RATIONALES
ALREADY GRADED A+ BY EXPERTS
|LATEST VERSION 2024 WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD ALREADY
PASSED!!!!!!! (PROVEN ITS ALL YOU
NEED TO EXCEL IN YOUR EXAMS




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The nurse is admitting a patient with possible rheumatic fever. Which question on the
admission health history will be most pertinent to ask?
a. "Do you use any illegal IV drugs?"
b. "Have you had a recent sore throat?"
c. "Have you injured your chest in the last few weeks?"
d. "Do you have a family history of congenital heart disease?" ANS: B
Rheumatic fever occurs as a result of an abnormal immune response to a streptococcal
infection. Although illicit IV drug use should be discussed with the patient before discharge, it
is not a risk factor for rheumatic fever, and would not be as pertinent when admitting the
patient. Family history is not a risk factor for rheumatic fever. Chest injury would cause
musculoskeletal chest pain rather than rheumatic fever.

A patient with rheumatic fever has subcutaneous nodules, erythema marginatum, and
polyarthritis. Based on these findings, which nursing diagnosis would be most appropriate?
a. Pain related to permanent joint fixation
b. Activity intolerance related to arthralgia
c. Risk for infection related to open skin lesions
d. Risk for impaired skin integrity related to pruritus ANS: B

The patient's joint pain will lead to difficulty with activity. The skin lesions seen in rheumatic
fever are not open or pruritic. Although acute joint pain will be a problem for this patient, joint
inflammation is a temporary clinical manifestation of rheumatic fever and is not associated
with permanent joint changes.

The nurse establishes the nursing diagnosis of ineffective health maintenance related to lack of
knowledge regarding long-term management of rheumatic fever when a 30-year-old recovering
from rheumatic fever without carditis says which of the following?
a. "I will need prophylactic antibiotic therapy for 5 years."
b. "I will need to take aspirin or ibuprofen (Motrin) to relieve my joint pain."
c. "I will call the doctor if I develop excessive fatigue or difficulty breathing."
d. "I will be immune to further episodes of rheumatic fever after this infection." ANS: D

Patients with a history of rheumatic fever are more susceptible to a second episode. Patients
with rheumatic fever without carditis require prophylaxis until age 20 and for a minimum of 5
years. The other patient statements are correct and would not support the nursing diagnosis of
ineffective health maintenance.

When developing a community health program to decrease the incidence of rheumatic fever,
which action would be most important for the community health nurse to include?
a. Vaccinate high-risk groups in the community with streptococcal vaccine.
b. Teach community members to seek treatment for streptococcal pharyngitis.
c. Teach about the importance of monitoring temperature when sore throats occur.
d. Teach about prophylactic antibiotics to those with a family history of rheumatic fever.
ANS: B

The incidence of rheumatic fever is decreased by treatment of streptococcal infections with
antibiotics. Family history is not a risk factor for rheumatic fever. There is no immunization




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that is effective in decreasing the incidence of rheumatic fever. Teaching about monitoring
temperature will not decrease the incidence of rheumatic fever.
When caring for a patient with mitral valve stenosis, it is most important that the nurse assess
for:

a. diastolic murmur.
b. peripheral edema.
c. right upper quadrant tenderness.
d. complaints of shortness of breath. ANS: d

The pressure gradient changes in mitral stenosis lead to fluid backup into the lungs, resulting in
hypoxemia and dyspnea. The other findings also may be associated with mitral valve disease
but are not indicators of possible hypoxemia.
After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria with no residual
effects, the nurse anticipates teaching the patient about
a. cerebral aneurysm clipping.
b. heparin intravenous infusion.
c. oral low-dose aspirin therapy.
d. tissue plasminogen activator (tPA). ANS: C

The patient's symptoms are consistent with transient ischemic attack (TIA), and drugs that
inhibit platelet aggregation are prescribed after a TIA to prevent a stroke. Continuous heparin
infusion is not routinely used after TIA or with acute ischemic stroke. The patient's symptoms
are not consistent with a cerebral aneurysm. tPA is used only for acute ischemic stroke, not for
TIA.

A patient is being admitted with a possible stroke. Which information from the assessment
indicates that the nurse should consult with the health care provider before giving the
prescribed aspirin?

a. The patient has dysphasia.

b. The patient has atrial fibrillation.

c. The patient reports that symptoms began with a severe headache.

d. The patient has a history of brief episodes of right-sided hemiplegia. ANS: C

A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin is
contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack are not
contraindications to aspirin use.
A patient with a stroke experiences facial drooping on the right side and right-sided arm and
leg paralysis. When admitting the patient, which clinical manifestation will the nurse expect to
find?

a. Impulsive behavior
b. Right-sided neglect
c. Hyperactive left-sided tendon reflexes




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