1
,Table of Content
r r
Chapterr01:rProfessionalrNursing..............................................................................................................................................4
Chapterr02:rSocialrDeterminantsrofrHealth..............................................................................................................................10
Chapterr03:rHealthrHistoryrandrPhysicalrExaminationrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition .....................15
Chapterr04:rPatientrandrCaregiverrTeaching ............................................................................................................................20
Chapterr05:rChronicrIllnessrandrOlderrAdults..........................................................................................................................26
Harding:rLewis’srMedical-SurgicalrNursing,r12thr Edition .....................................................................................................34
Chapterr07:rStressrManagement ..............................................................................................................................................38
Chapterr08:rSleeprandrSleeprDisorders ....................................................................................................................................42
Chapterr09:rPain......................................................................................................................................................................47
Chapterr10:rPalliativerandrEnd-of-LiferCare ............................................................................................................................56
Chapterr11:rSubstancerUserDisordersrinrAcuterCare ................................................................................................................61
Chapterr12:rInflammationrandrHealing....................................................................................................................................69
Chapterr13:rGenetics ...............................................................................................................................................................76
Chapterr14:rImmunerResponsesrandrTransplantationrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition.......................79
Chapterr15:rInfection ..............................................................................................................................................................87
Chapterr16:rCancer .................................................................................................................................................................97
Chapterr17:rFluid,rElectrolyte,randrAcid-BaserImbalancesrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ..........111
Chapterr18:rPreoperativerCare...............................................................................................................................................124
Chapterr19:rIntraoperativerCare ............................................................................................................................................131
Chapterr20:rPostoperativerCare .............................................................................................................................................137
Chapterr21:rEmergencyrandrDisasterrNursing .......................................................................................................................145
Chapterr22:rAssessmentrandrManagement:rVisualrProblemsrHarding:rLewis’srMedical-
SurgicalrNursing,r12thrEditionr153rChapterr23:rAssessmentrandrManagement:rAuditoryrProblemsrHarding:rLewis’srMedical-
SurgicalrNursing,r12thrEdition
.............................................................................................................................................................................................166
Chapterr24:rAssessment:rIntegumentaryrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ...........................173
Chapterr25:rIntegumentaryrProblems ....................................................................................................................................178
Chapterr26:rBurns .................................................................................................................................................................186
Chapterr27:rAssessment:rRespiratoryrSystem .......................................................................................................................195
Chapterr28:rSupportingrVentilation.......................................................................................................................................203
Chapterr29:rUpperrRespiratoryrProblems ..............................................................................................................................214
Chapterr30:rLowerrRespiratoryrProblems..............................................................................................................................220
Chapterr31:rObstructiverPulmonaryrDiseases ........................................................................................................................235
Chapterr32:rAcuterRespiratoryrFailurerandrAcuterRespiratoryrDistressrSyndromerHarding:rLewis’srMedical-
SurgicalrNursing,r12thrEdition ..............................................................................................................................................248
first? .................................................................................................................................................................................253
Chapterr33:rAssessment:rHematologicrSystem .....................................................................................................................257
Chapterr34:rHematologicrProblems.......................................................................................................................................262
Chapterr35:rAssessment:rCardiovascularrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ..........................277
Chapterr36:rHypertension .....................................................................................................................................................289
Chapterr38:rHeartrFailure ......................................................................................................................................................311
Chapterr39:rDysrhythmias ....................................................................................................................................................319
2
,Chapterr40:rInflammatoryrandrStructuralrHeartrDisordersrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ...........329
first? ................................................................................................................................................................................. 339
Chapterr41:rVascularrDisorders............................................................................................................................................. 341
Chapterr43:rAssessment:rGastrointestinalrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ......................... 364
Chapterr44:rNutritionrProblems............................................................................................................................................. 369
Chapterr45:rObesity .............................................................................................................................................................. 377
Chapterr46:rUpperrGastrointestinalrProblems ....................................................................................................................... 383
Chapterr47:rLowerrGastrointestinalrProblems ....................................................................................................................... 397
first? ................................................................................................................................................................................. 408
Chapterr48:rLiver,rBiliaryrTract,randrPancreasrProblemsrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ............. 414
Chapterr49:rAssessment:rUrinaryrSystem.............................................................................................................................. 429
Chapterr50:rRenalrandrUrologicrProblems ............................................................................................................................. 436
Chapterr51:rAcuterKidneyrInjuryrandrChronicrKidneyrDiseaserHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition
............................................................................................................................................................................................. 450
Chapterr52:rAssessment:rEndocrinerSystem.......................................................................................................................... 462
Chapterr53:rDiabetes ............................................................................................................................................................. 469
Chapterr54:rEndocrinerProblems ........................................................................................................................................... 484
first? ................................................................................................................................................................................. 494
Chapterr55:rAssessment:rReproductiverSystem..................................................................................................................... 499
first? ................................................................................................................................................................................. 502
Chapterr56:rBreastrProblems ................................................................................................................................................. 503
Chapterr57:rSexuallyrTransmittedrInfections......................................................................................................................... 512
Chapterr58:rFemalerReproductiverProblems ......................................................................................................................... 519
Chapterr59:rMalerReproductiverProblems ............................................................................................................................. 533
Chapterr60:rAssessment:rNervousrSystem ............................................................................................................................ 544
Chapterr61:rAcuterIntracranialrProblems ............................................................................................................................... 550
Chapterr62:rStroke ................................................................................................................................................................ 565
Chapterr63:rChronicrNeurologicrProblems ............................................................................................................................ 574
Chapterr64:rDementiarandrDelirium ...................................................................................................................................... 585
Chapterr65:rSpinalrCordrandrPeripheralrNerverProblemsrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ............. 593
Chapterr66:rAssessment:rMusculoskeletalrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ........................ 603
Chapterr67:rMusculoskeletalrTraumarandrOrthopedicrSurgeryrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition
............................................................................................................................................................................................. 608
Chapterr68:MusculoskeletalrProblems.................................................................................................................................. 622
Chapterr69:rArthritisrandrConnectiverTissuerDiseasesrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ................... 629
3
, Chapter 01: Professional Nursing
r r r
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
r r r r r
MULTIPLErCHOICE
1. Thernursercompletesranradmissionrdatabaserandrexplainsrthatrtherplanrofrcarerandrdischargergoal
srwillrberdevelopedrwithrtherpatient‘srinput.rTherpatientrasks,r“Howrisrthisrdifferentrfromrwhatrthe
rphysicianrdoes?”rWhichrresponserwouldrthernurserprovide?
a. “Therrolerofrthernurserisrtoradministerrmedicationsrandrotherrtreatmentsrprescribedrbyr
yourrphysician.”
b. “Inradditionrtorcaringrforryourwhileryourarersick,rthernursesrwillrhelpryourplanrtormai
ntainryourrhealth.”
c. “Thernurse‘srjobrisrtorcollectrinformationrandrcommunicateranyrproblemsrthatroc
currtortherphysician.”
d. “Nursesrperformrmanyrofrthersamerproceduresrasrtherphysician,rbutrnursesrarerwi
thrtherpatientsrforrarlongerrtimerthanrtherphysician.”
ANS:rB
TherAmericanrNursesrAssociationr(ANA)rdefinitionrofrnursingrdescribesrtherrolerofrnursesrinrpro
motingrhealth.rTherotherrresponsesrdescriberdependentrandrcollaborativerfunctionsrofrthernursin
grrolerbutrdornotraccuratelyrdescriberthernurse‘sruniquerrolerinrthehealthrcarersystem.
DIF:rCognitiverLevel:rAnalyzer(Analysis)
TOP:rNursingrProcess:rImplementationrMSC:rNCLEX:rSaferandrEffectiverCarerEnvironment
2. Whichrstatementrbyrthernurseraccuratelyrdescribesr theruserofrevidence-basedrpracticer(EBP)?
a. “Patientrcarerisrbasedronrclinicalrjudgment,rexperience,randrtraditions.”
b. “Datarareranalyzedrlaterrtorshowrthatrtherpatientroutcomesrarerconsistentlyrmet.”
c. “Researchrfromrallrpublishedrarticlesrarerusedrasrarguiderforrplanningrpatientrcare.”
d. “Recommendationsrarerbasedronrresearch,rclinicalrexpertise,randrpatientrpr
eferences.”
ANS:rD
Evidence-basedrpracticer(EBP)risrtheruserofrtherbestrresearch-
basedrevidencercombinedrwithrclinicianrexpertiserandrconsiderationrofrpatientrpreferences.rClini
calrjudgmentrbasedronrthernurse‘srclinicalrexperiencerisrpartrofrEBP,rbutrclinicalrdecisionrmakingr
shouldralsorincorporatercurrentrresearchrandrresearch-
basedrguidelines.rEvaluationrofrpatientroutcomesrisrimportant,rbutrdataranalysisrisrnotrrequiredrtor
userEBP.rAllrpublishedrarticlesrdornotrproviderresearchrevidence;rinterventionsrshouldrberbasedro
nrcrediblerresearch,rpreferablyrrandomizedrcontrolledrstudiesrwithrarlargernumberrofrsubjects.
DIF: CognitiverLevel:rUnderstandr(Comprehension)
TOP:rNursingrProcess:rPlanningrMSC:rNCLEX:rSaferandrEffectiverCarerEnvironment
3. Whichrstatementrbyrthernurserprovidesrarclearrexplanationrofrthernursingrprocess?
a. “Thernursingrprocessrisrarresearchrmethodrofrdiagnosingrtherpatient‘srhealthrcarerpro
blems.”
b. “Thernursingrprocessrisrusedrprimarilyrtorexplainrnursingrinterventionsrtorotherrhe
althrcarerprofessionals.”
c. “Thernursingrprocessrisrarproblem-solvingrtoolrusedrtoridentifyrandrmanagerthe
4
,Table of Content
r r
Chapterr01:rProfessionalrNursing..............................................................................................................................................4
Chapterr02:rSocialrDeterminantsrofrHealth..............................................................................................................................10
Chapterr03:rHealthrHistoryrandrPhysicalrExaminationrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition .....................15
Chapterr04:rPatientrandrCaregiverrTeaching ............................................................................................................................20
Chapterr05:rChronicrIllnessrandrOlderrAdults..........................................................................................................................26
Harding:rLewis’srMedical-SurgicalrNursing,r12thr Edition .....................................................................................................34
Chapterr07:rStressrManagement ..............................................................................................................................................38
Chapterr08:rSleeprandrSleeprDisorders ....................................................................................................................................42
Chapterr09:rPain......................................................................................................................................................................47
Chapterr10:rPalliativerandrEnd-of-LiferCare ............................................................................................................................56
Chapterr11:rSubstancerUserDisordersrinrAcuterCare ................................................................................................................61
Chapterr12:rInflammationrandrHealing....................................................................................................................................69
Chapterr13:rGenetics ...............................................................................................................................................................76
Chapterr14:rImmunerResponsesrandrTransplantationrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition.......................79
Chapterr15:rInfection ..............................................................................................................................................................87
Chapterr16:rCancer .................................................................................................................................................................97
Chapterr17:rFluid,rElectrolyte,randrAcid-BaserImbalancesrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ..........111
Chapterr18:rPreoperativerCare...............................................................................................................................................124
Chapterr19:rIntraoperativerCare ............................................................................................................................................131
Chapterr20:rPostoperativerCare .............................................................................................................................................137
Chapterr21:rEmergencyrandrDisasterrNursing .......................................................................................................................145
Chapterr22:rAssessmentrandrManagement:rVisualrProblemsrHarding:rLewis’srMedical-
SurgicalrNursing,r12thrEditionr153rChapterr23:rAssessmentrandrManagement:rAuditoryrProblemsrHarding:rLewis’srMedical-
SurgicalrNursing,r12thrEdition
.............................................................................................................................................................................................166
Chapterr24:rAssessment:rIntegumentaryrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ...........................173
Chapterr25:rIntegumentaryrProblems ....................................................................................................................................178
Chapterr26:rBurns .................................................................................................................................................................186
Chapterr27:rAssessment:rRespiratoryrSystem .......................................................................................................................195
Chapterr28:rSupportingrVentilation.......................................................................................................................................203
Chapterr29:rUpperrRespiratoryrProblems ..............................................................................................................................214
Chapterr30:rLowerrRespiratoryrProblems..............................................................................................................................220
Chapterr31:rObstructiverPulmonaryrDiseases ........................................................................................................................235
Chapterr32:rAcuterRespiratoryrFailurerandrAcuterRespiratoryrDistressrSyndromerHarding:rLewis’srMedical-
SurgicalrNursing,r12thrEdition ..............................................................................................................................................248
first? .................................................................................................................................................................................253
Chapterr33:rAssessment:rHematologicrSystem .....................................................................................................................257
Chapterr34:rHematologicrProblems.......................................................................................................................................262
Chapterr35:rAssessment:rCardiovascularrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ..........................277
Chapterr36:rHypertension .....................................................................................................................................................289
Chapterr38:rHeartrFailure ......................................................................................................................................................311
Chapterr39:rDysrhythmias ....................................................................................................................................................319
2
,Chapterr40:rInflammatoryrandrStructuralrHeartrDisordersrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ...........329
first? ................................................................................................................................................................................. 339
Chapterr41:rVascularrDisorders............................................................................................................................................. 341
Chapterr43:rAssessment:rGastrointestinalrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ......................... 364
Chapterr44:rNutritionrProblems............................................................................................................................................. 369
Chapterr45:rObesity .............................................................................................................................................................. 377
Chapterr46:rUpperrGastrointestinalrProblems ....................................................................................................................... 383
Chapterr47:rLowerrGastrointestinalrProblems ....................................................................................................................... 397
first? ................................................................................................................................................................................. 408
Chapterr48:rLiver,rBiliaryrTract,randrPancreasrProblemsrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ............. 414
Chapterr49:rAssessment:rUrinaryrSystem.............................................................................................................................. 429
Chapterr50:rRenalrandrUrologicrProblems ............................................................................................................................. 436
Chapterr51:rAcuterKidneyrInjuryrandrChronicrKidneyrDiseaserHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition
............................................................................................................................................................................................. 450
Chapterr52:rAssessment:rEndocrinerSystem.......................................................................................................................... 462
Chapterr53:rDiabetes ............................................................................................................................................................. 469
Chapterr54:rEndocrinerProblems ........................................................................................................................................... 484
first? ................................................................................................................................................................................. 494
Chapterr55:rAssessment:rReproductiverSystem..................................................................................................................... 499
first? ................................................................................................................................................................................. 502
Chapterr56:rBreastrProblems ................................................................................................................................................. 503
Chapterr57:rSexuallyrTransmittedrInfections......................................................................................................................... 512
Chapterr58:rFemalerReproductiverProblems ......................................................................................................................... 519
Chapterr59:rMalerReproductiverProblems ............................................................................................................................. 533
Chapterr60:rAssessment:rNervousrSystem ............................................................................................................................ 544
Chapterr61:rAcuterIntracranialrProblems ............................................................................................................................... 550
Chapterr62:rStroke ................................................................................................................................................................ 565
Chapterr63:rChronicrNeurologicrProblems ............................................................................................................................ 574
Chapterr64:rDementiarandrDelirium ...................................................................................................................................... 585
Chapterr65:rSpinalrCordrandrPeripheralrNerverProblemsrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ............. 593
Chapterr66:rAssessment:rMusculoskeletalrSystemrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ........................ 603
Chapterr67:rMusculoskeletalrTraumarandrOrthopedicrSurgeryrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition
............................................................................................................................................................................................. 608
Chapterr68:MusculoskeletalrProblems.................................................................................................................................. 622
Chapterr69:rArthritisrandrConnectiverTissuerDiseasesrHarding:rLewis’srMedical-SurgicalrNursing,r12thrEdition ................... 629
3
, Chapter 01: Professional Nursing
r r r
Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
r r r r r
MULTIPLErCHOICE
1. Thernursercompletesranradmissionrdatabaserandrexplainsrthatrtherplanrofrcarerandrdischargergoal
srwillrberdevelopedrwithrtherpatient‘srinput.rTherpatientrasks,r“Howrisrthisrdifferentrfromrwhatrthe
rphysicianrdoes?”rWhichrresponserwouldrthernurserprovide?
a. “Therrolerofrthernurserisrtoradministerrmedicationsrandrotherrtreatmentsrprescribedrbyr
yourrphysician.”
b. “Inradditionrtorcaringrforryourwhileryourarersick,rthernursesrwillrhelpryourplanrtormai
ntainryourrhealth.”
c. “Thernurse‘srjobrisrtorcollectrinformationrandrcommunicateranyrproblemsrthatroc
currtortherphysician.”
d. “Nursesrperformrmanyrofrthersamerproceduresrasrtherphysician,rbutrnursesrarerwi
thrtherpatientsrforrarlongerrtimerthanrtherphysician.”
ANS:rB
TherAmericanrNursesrAssociationr(ANA)rdefinitionrofrnursingrdescribesrtherrolerofrnursesrinrpro
motingrhealth.rTherotherrresponsesrdescriberdependentrandrcollaborativerfunctionsrofrthernursin
grrolerbutrdornotraccuratelyrdescriberthernurse‘sruniquerrolerinrthehealthrcarersystem.
DIF:rCognitiverLevel:rAnalyzer(Analysis)
TOP:rNursingrProcess:rImplementationrMSC:rNCLEX:rSaferandrEffectiverCarerEnvironment
2. Whichrstatementrbyrthernurseraccuratelyrdescribesr theruserofrevidence-basedrpracticer(EBP)?
a. “Patientrcarerisrbasedronrclinicalrjudgment,rexperience,randrtraditions.”
b. “Datarareranalyzedrlaterrtorshowrthatrtherpatientroutcomesrarerconsistentlyrmet.”
c. “Researchrfromrallrpublishedrarticlesrarerusedrasrarguiderforrplanningrpatientrcare.”
d. “Recommendationsrarerbasedronrresearch,rclinicalrexpertise,randrpatientrpr
eferences.”
ANS:rD
Evidence-basedrpracticer(EBP)risrtheruserofrtherbestrresearch-
basedrevidencercombinedrwithrclinicianrexpertiserandrconsiderationrofrpatientrpreferences.rClini
calrjudgmentrbasedronrthernurse‘srclinicalrexperiencerisrpartrofrEBP,rbutrclinicalrdecisionrmakingr
shouldralsorincorporatercurrentrresearchrandrresearch-
basedrguidelines.rEvaluationrofrpatientroutcomesrisrimportant,rbutrdataranalysisrisrnotrrequiredrtor
userEBP.rAllrpublishedrarticlesrdornotrproviderresearchrevidence;rinterventionsrshouldrberbasedro
nrcrediblerresearch,rpreferablyrrandomizedrcontrolledrstudiesrwithrarlargernumberrofrsubjects.
DIF: CognitiverLevel:rUnderstandr(Comprehension)
TOP:rNursingrProcess:rPlanningrMSC:rNCLEX:rSaferandrEffectiverCarerEnvironment
3. Whichrstatementrbyrthernurserprovidesrarclearrexplanationrofrthernursingrprocess?
a. “Thernursingrprocessrisrarresearchrmethodrofrdiagnosingrtherpatient‘srhealthrcarerpro
blems.”
b. “Thernursingrprocessrisrusedrprimarilyrtorexplainrnursingrinterventionsrtorotherrhe
althrcarerprofessionals.”
c. “Thernursingrprocessrisrarproblem-solvingrtoolrusedrtoridentifyrandrmanagerthe
4