TESTBANK FOR LEMONE & BURKE’S
MEDICAL- SURGICAL NURSING: CLINICAL
REASONING IN HOSPITAL CLIENT CARE 7TH
EDITION/ALL CHAPTERS 1-52
,Chapter 1 d
1. The caregiver is caring for four Hospital clients on a medical–
d d d d d d d d d d
surgical unit. WhichHospital client should the caregiver see initially?
d d d d d d d d d
1. A Hospital client admitted with hepatitis A who has had severe diarrhea f
d d d d d d d d d d d d
or thelast 24 hours d d d d
2. A Hospital client admitted with pneumonia who is has small amou
d d d d d d d d d d
nts ofyellow productive sputum d d d d
3. A Hospital client admitted with fever of unknown origin (FUO) w
d d d d d d d d d d
ho hasbeen without fever for the last 48 hours
d d d d d d d d d
4. A Hospital client admitted with a wound infection whose WBC is 8,500
d d d d d d d d d d d
mm3ACCURATE ANSWER:-1
d d d
Reasoning:-
>>>The caregiver must decide which Hospital client should be seen on theinitial r
d d d d d d d d d d d d d
ounds of the day. The caregiver must remember that the first
d d d d d d d d d d
Hospital client to be seen should be the Hospital client who needs the attention of t
d d d d d d d d d d d d d d d
he caregiver initially. A Hospital client with hepatitis A does experience diarrhea,
d d d d d d d d d d d d
but diarrhea for the last 24 hours could cause the Hospital client to have a problem
d d d d d d d d d d d d d d d d
withdehydration and experience a state of fluid volume deficit.
d d d d d d d d d
Cognitive Level: Applicationd d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Planning
d d d
2. The caregiver is preparing to administer influenza vaccines to a mass drive-
d d d d d d d d d d d
through clinic. Which statement by a Hospital client would indicate further questioning pr
d d d d d d d d d d d d d
ior togiving the Hospital client the influenza vaccine?
d d d d d d d d
1. ―I am allergic to horse hair.‖
d d d d d
2. ―I try to get my vaccine every year.‖
d d d d d d d
3. ―I am not allergic to anything except eggs.‖
d d d d d d d
4. ―My husband had a severe allergic reaction after he received his influenzava
d d d d d d d d d d d d
ccine.‖
ACCURATE ANSWER:-3 d
Reasoning:-
>>>Influenza vaccines are recommended for person at high risk for serious sequela d d d d d d d d d d d
e of influenza. The caregiver should be aware that Hospital client with asensitivity t
d d d d d d d d d d d d d d
o eggs should not receive the vaccine. Vaccines prepared from chicken or duck emb
d d d d d d d d d d d d d
ryos are contraindicated in Hospital clients who are allergic to eggs.
d d d d d d d d d d
,Cognitive Level: Application d d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Assessment
d d d
3. The caregiver is caring for four Hospital clients on a medical–
d d d d d d d d d d
surgical unit. The secretary gives the caregiver the morning labs. Which of the following la
d d d d d d d d d d d d d d
bs would require that the caregiver call the physician and inform the healthcare provider ab
d d d d d d d d d d d d d d
out the Hospital client‘s abnormalities?
d d d d
1. d WBC 14,600 mm3 d d
2. Serum protein 6.9 g/dL d d d
3. I & D (incision and drainage) showing no growth for the last 24 hours
d d d d d d d d d d d d d
4. Albumin 4.2 g/dL d d d
ACCURATE ANSWER:-1 d
Reasoning:-
>>>When the caregiver is caring for several Hospital clients, all of the labsshould be che
d d d d d d d d d d d d d d d
cked frequently throughout the shift to assess for any abnormalities. TheWBC in option
d d d d d d d d d d d d d d
1 is abnormal. (Normal WBC 4,000–
d d d d d
10,000 mm3.) All of the other labresults are within acceptable range; therefore, the result
d d d d d d d d d d d d d d
s should not be called in to thephysician.
d d d d d d d d
Cognitive Level: Application d d d
Hospital client Needs: Physiod d d
logic Integrity Nursing Proces
d d d
s:
Assessment
4. The caregiver is orienting a new graduate. The caregiver is reinforcing the impo
d d d d d d d d d d d d
rtance of standard precautions. Which of the following observations by the caregiv
d d d d d d d d d d d
er would require further education regardingstandard precautions?
d d d d d d d
1. The graduate caregiver understands to wash hands whenentering a
d d d d d d d d d
nd exiting the Hospital client‘s room.
d d d d d
2. The graduate caregiver wears gloves when serving breakfasttrays to va
d d d d d d d d d d
rious Hospital clients. d d
3. The graduate caregiver wears a gown, gloves, and goggles whensuctioning
d d d d d d d d d d d
a Hospital client. d d
4. The graduate caregiver leaves all supplies in the room of aHospital cl
d d d d d d d d d d d d
ient who is in contact isolation. d d d d d
ACCURATE ANSWER:-2 d
, Reasoning:-
>>>The caregiver must have an understanding of standard precautions. Preventio
d d d d d d d d d
n is the most important measure to prevent nosocomial infections. Standard preca
d d d d d d d d d d d
utions were published in 1996 that provide guidelines d d d d d d d
for the handling of blood and other body fluids. These guidelines are used with all H
d d d d d d d d d d d d d d d
ospital clients, regardless of whether they have a known infectious disease. Standar
d d d d d d d d d d d
dprecautions are used
d d d
by all healthcare workers who have direct contact with Hospital clients or with thei
d d d d d d d d d d d d d
r body fluids. It is not necessary for the caregiver to wear gloves while delivering fo
d d d d d d d d d d d d d d d
od trays to the Hospital client, because there is not contact with the Hospital client.
d d d d d d d d d d d d d d
Cognitive Level: Application d d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Evaluation
d d d
5. The admitting department alerts the caregiver on a medical–
d d d d d d d d
surgical unit thata Hospital client with active tuberculosis (TB) is being admitted to the uni
d d d d d d d d d d d d d d d
t. Which type of isolation is appropriate based on the Hospital client‘s diagnosis?
d d d d d d d d d d d d
1. Standard precautions d
2. Airborne precautions d
3. Droplet precautions d
4. Contact precautions d d
ACCURATE ANSWER:-2 d
Reasoning:-
>>>In addition to handwashing and standard precautions, the nature and spread of some inf
d d d d d d d d d d d d d
ectious diseases require that special techniques be used to protect uninfected Hospital client
d d d d d d d d d d d d
s and workers. The Hospital client with pulmonary tuberculosis will be placed in airborne pr
d d d d d d d d d d d d d d
ecautions. The Hospital client should be placed in a private room with special ventilation th
d d d d d d d d d d d d d d
at does not allow air to circulate to general health center ventilation; a maskor special filter r
d d d d d d d d d d d d d d d d d
espirators will be used for everyone entering the room.
d d d d d d d d
Cognitive Level: Application d d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Assessment
d d d
6. A Hospital client is receiving IV vancomycin for the treatment of Clostridium dif
d d d d d d d d d d d d
ficile.The caregiver understands that the Hospital client who develops flushing, tac
d d d d d d d d d d d
hycardia, and hypotension during the infusion of vancomycin indicates:
d d d d d d d d
1. Ototoxicity effect. d
2. Superinfection.
3. Red man syndrome. d d
MEDICAL- SURGICAL NURSING: CLINICAL
REASONING IN HOSPITAL CLIENT CARE 7TH
EDITION/ALL CHAPTERS 1-52
,Chapter 1 d
1. The caregiver is caring for four Hospital clients on a medical–
d d d d d d d d d d
surgical unit. WhichHospital client should the caregiver see initially?
d d d d d d d d d
1. A Hospital client admitted with hepatitis A who has had severe diarrhea f
d d d d d d d d d d d d
or thelast 24 hours d d d d
2. A Hospital client admitted with pneumonia who is has small amou
d d d d d d d d d d
nts ofyellow productive sputum d d d d
3. A Hospital client admitted with fever of unknown origin (FUO) w
d d d d d d d d d d
ho hasbeen without fever for the last 48 hours
d d d d d d d d d
4. A Hospital client admitted with a wound infection whose WBC is 8,500
d d d d d d d d d d d
mm3ACCURATE ANSWER:-1
d d d
Reasoning:-
>>>The caregiver must decide which Hospital client should be seen on theinitial r
d d d d d d d d d d d d d
ounds of the day. The caregiver must remember that the first
d d d d d d d d d d
Hospital client to be seen should be the Hospital client who needs the attention of t
d d d d d d d d d d d d d d d
he caregiver initially. A Hospital client with hepatitis A does experience diarrhea,
d d d d d d d d d d d d
but diarrhea for the last 24 hours could cause the Hospital client to have a problem
d d d d d d d d d d d d d d d d
withdehydration and experience a state of fluid volume deficit.
d d d d d d d d d
Cognitive Level: Applicationd d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Planning
d d d
2. The caregiver is preparing to administer influenza vaccines to a mass drive-
d d d d d d d d d d d
through clinic. Which statement by a Hospital client would indicate further questioning pr
d d d d d d d d d d d d d
ior togiving the Hospital client the influenza vaccine?
d d d d d d d d
1. ―I am allergic to horse hair.‖
d d d d d
2. ―I try to get my vaccine every year.‖
d d d d d d d
3. ―I am not allergic to anything except eggs.‖
d d d d d d d
4. ―My husband had a severe allergic reaction after he received his influenzava
d d d d d d d d d d d d
ccine.‖
ACCURATE ANSWER:-3 d
Reasoning:-
>>>Influenza vaccines are recommended for person at high risk for serious sequela d d d d d d d d d d d
e of influenza. The caregiver should be aware that Hospital client with asensitivity t
d d d d d d d d d d d d d d
o eggs should not receive the vaccine. Vaccines prepared from chicken or duck emb
d d d d d d d d d d d d d
ryos are contraindicated in Hospital clients who are allergic to eggs.
d d d d d d d d d d
,Cognitive Level: Application d d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Assessment
d d d
3. The caregiver is caring for four Hospital clients on a medical–
d d d d d d d d d d
surgical unit. The secretary gives the caregiver the morning labs. Which of the following la
d d d d d d d d d d d d d d
bs would require that the caregiver call the physician and inform the healthcare provider ab
d d d d d d d d d d d d d d
out the Hospital client‘s abnormalities?
d d d d
1. d WBC 14,600 mm3 d d
2. Serum protein 6.9 g/dL d d d
3. I & D (incision and drainage) showing no growth for the last 24 hours
d d d d d d d d d d d d d
4. Albumin 4.2 g/dL d d d
ACCURATE ANSWER:-1 d
Reasoning:-
>>>When the caregiver is caring for several Hospital clients, all of the labsshould be che
d d d d d d d d d d d d d d d
cked frequently throughout the shift to assess for any abnormalities. TheWBC in option
d d d d d d d d d d d d d d
1 is abnormal. (Normal WBC 4,000–
d d d d d
10,000 mm3.) All of the other labresults are within acceptable range; therefore, the result
d d d d d d d d d d d d d d
s should not be called in to thephysician.
d d d d d d d d
Cognitive Level: Application d d d
Hospital client Needs: Physiod d d
logic Integrity Nursing Proces
d d d
s:
Assessment
4. The caregiver is orienting a new graduate. The caregiver is reinforcing the impo
d d d d d d d d d d d d
rtance of standard precautions. Which of the following observations by the caregiv
d d d d d d d d d d d
er would require further education regardingstandard precautions?
d d d d d d d
1. The graduate caregiver understands to wash hands whenentering a
d d d d d d d d d
nd exiting the Hospital client‘s room.
d d d d d
2. The graduate caregiver wears gloves when serving breakfasttrays to va
d d d d d d d d d d
rious Hospital clients. d d
3. The graduate caregiver wears a gown, gloves, and goggles whensuctioning
d d d d d d d d d d d
a Hospital client. d d
4. The graduate caregiver leaves all supplies in the room of aHospital cl
d d d d d d d d d d d d
ient who is in contact isolation. d d d d d
ACCURATE ANSWER:-2 d
, Reasoning:-
>>>The caregiver must have an understanding of standard precautions. Preventio
d d d d d d d d d
n is the most important measure to prevent nosocomial infections. Standard preca
d d d d d d d d d d d
utions were published in 1996 that provide guidelines d d d d d d d
for the handling of blood and other body fluids. These guidelines are used with all H
d d d d d d d d d d d d d d d
ospital clients, regardless of whether they have a known infectious disease. Standar
d d d d d d d d d d d
dprecautions are used
d d d
by all healthcare workers who have direct contact with Hospital clients or with thei
d d d d d d d d d d d d d
r body fluids. It is not necessary for the caregiver to wear gloves while delivering fo
d d d d d d d d d d d d d d d
od trays to the Hospital client, because there is not contact with the Hospital client.
d d d d d d d d d d d d d d
Cognitive Level: Application d d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Evaluation
d d d
5. The admitting department alerts the caregiver on a medical–
d d d d d d d d
surgical unit thata Hospital client with active tuberculosis (TB) is being admitted to the uni
d d d d d d d d d d d d d d d
t. Which type of isolation is appropriate based on the Hospital client‘s diagnosis?
d d d d d d d d d d d d
1. Standard precautions d
2. Airborne precautions d
3. Droplet precautions d
4. Contact precautions d d
ACCURATE ANSWER:-2 d
Reasoning:-
>>>In addition to handwashing and standard precautions, the nature and spread of some inf
d d d d d d d d d d d d d
ectious diseases require that special techniques be used to protect uninfected Hospital client
d d d d d d d d d d d d
s and workers. The Hospital client with pulmonary tuberculosis will be placed in airborne pr
d d d d d d d d d d d d d d
ecautions. The Hospital client should be placed in a private room with special ventilation th
d d d d d d d d d d d d d d
at does not allow air to circulate to general health center ventilation; a maskor special filter r
d d d d d d d d d d d d d d d d d
espirators will be used for everyone entering the room.
d d d d d d d d
Cognitive Level: Application d d
Hospital client Needs: Safe, Effective Care Environme
d d d d d d
ntNursing Process: Assessment
d d d
6. A Hospital client is receiving IV vancomycin for the treatment of Clostridium dif
d d d d d d d d d d d d
ficile.The caregiver understands that the Hospital client who develops flushing, tac
d d d d d d d d d d d
hycardia, and hypotension during the infusion of vancomycin indicates:
d d d d d d d d
1. Ototoxicity effect. d
2. Superinfection.
3. Red man syndrome. d d
