STROMBERG COMPLETE ELABORATIONS 2023/2024 CHAPTERS 1-49
,Contents
Chapter 01: Caring for Medical-Surgical Patients ................................................................ 4
Chapter 02: Critical Thinking, Clinical Judgment, and the Nursing Process ......................... 15
Chapter 03: Fluids, Electrolytes, Acid-Base Balance, and Intravenous Therapy .................. 28
Chapter 04: Care of Preoperative and Intraoperative Surgical Patients ............................. 40
Chapter 05: Care of Postoperative Surgical Patients.......................................................... 52
Chapter 06: Infection Prevention and Control ................................................................... 63
Chapter 07: Care of Patients With Pain ............................................................................. 74
Chapter 08: Care of Patients With Cancer ......................................................................... 88
Chapter 09: Chronic Illness and Rehabilitation ................................................................ 102
Chapter 10: The Immune and Lymphatic Systems ........................................................... 116
Chapter 11: Care of Patients With Immune and Lymphatic Disorders .............................. 130
Chapter 12: The Respiratory System ............................................................................... 147
Chapter 13: Care of Patients With Disorders of the Upper Respiratory System ................ 165
Chapter 14: Care of Patients With Disorders of the Lower Respiratory System ................ 180
Chapter 15: The Hematologic System ............................................................................. 197
Chapter 16. Care of Patients With Hematologic Disorders ............................................... 211
Chapter 17: The Cardiovascular System .......................................................................... 225
Chapter 18: Care of Patients With Hypertension and Peripheral Vascular Disease ........... 237
Chapter 19: Care of Patients With Cardiac Disorders ....................................................... 253
Chapter 20: Care of Patients With Coronary Artery Disease and Cardiac Surgery ............. 267
Chapter 21: The Neurologic System ................................................................................ 287
Chapter 22: Care of Patients With Head and Spinal Cord Injuries .................................... 301
Chapter 23: Care of Patients With Brain Disorders .......................................................... 317
Chapter 24: Care of Patients With Peripheral Nerve and Degenerative Neurologic Disorders
...................................................................................................................................... 333
Chapter 25: The Sensory System Eye .............................................................................. 347
Chapter 26: The Sensory System Ear ............................................................................... 363
Chapter 27: The Gastrointestinal System ........................................................................ 374
Chapter 28. Care of Patients With Disorders of the Upper Gastrointestinal System ......... 392
Chapter 29. Care of Patients With Disorders of the Lower Gastrointestinal System ......... 407
,Chapter 30. Care of Patients With Disorders of the Gallbladder, Liver, and Pancreas ....... 425
Chapter 31. The Musculoskeletal System ........................................................................ 443
Chapter 32: Care of Patients With Musculoskeletal and Connective Tissue Disorders ...... 459
Chapter 33: The Urinary System ..................................................................................... 481
Chapter 34. Care of Patients With Disorders of the Urinary System................................. 498
Chapter 35: The Endocrine System ................................................................................. 518
Chapter 36: Care of Patients With Pituitary, Thyroid, Parathyroid, and Adrenal Disorders532
Chapter 37: Care of Patients With Diabetes and Hypoglycaemia ..................................... 551
Chapter 38: The Reproductive System ............................................................................ 571
Chapter 39: Care of Women With Reproductive Disorders .............................................. 579
Chapter 40: Care of Men With Reproductive Disorders ................................................... 597
Chapter 41: Care of Patients With Sexually Transmitted Infections ................................. 616
Chapter 42: The Integumentary System .......................................................................... 632
Chapter 43: Care of Patients With Integumentary Disorders and Burns ........................... 651
Chapter 44: Care of Patients in Disasters or Bioterrorism Attacks.................................... 674
Chapter 45: Care of Patients With Emergent Conditions, Trauma, and Shock .................. 692
Chapter 46: Care of Patients With Cognitive Function Disorders ..................................... 709
Chapter 47: Care of Patients With Anxiety, Mood, and Eating Disorders ......................... 728
Chapter 48: Care of Patients With Substance-Related and Addictive Disorders ............... 744
Chapter 49: Care of Patients With Thought and Personality Disorders ............................ 761
,Chapter 01: Caring for Medical-Surgical Patients
MULTIPLE CHOICE
1. Which statement accurately describes the primary purpose of the state nurse practice act
(NPA)?
a. To test and license LPN/LVNs
b. To define the scope of LPN/LVN practice
c. To improve the quality of care provided by the LPN/LVN
d. To limit the LPN/LVN employment placement
ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary
purpose of the NPA of each state defines the scope of nursing practice in that state.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3 TOP: NPA KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the
vocational nurse has not been taught during her educational program. How should the vocational nurse
respond?
a. Ask a more experienced nurse to demonstrate the procedure.
b. Look up the procedure in the procedure manual.
c. Attempt to perform the procedure with supervision.
d. Inform the charge nurse of her lack of training in this procedure.
ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the
vocational nurse should seek further training to gain proficiency. Although the other options might be
helpful, they are not safe.
DIF: Cognitive Level: Application REF: p. 3 OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process
Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
3. Which patient statement indicates a need for further discharge teaching that the vocational
nurse should address?
,a. "I have no idea of how this drug will affect me."
b. "Do you know if my physician is coming back today?"
c. "Will my insurance pay for my stay?"
d. "Am I going to have to go to a nursing home?"
ANS: A
Lack of knowledge at discharge about medication effects and side effects is a concern that should be
addressed by the vocational nurse. The other concerns in the options are the responsibility of other
departments to which the nurse might refer the patient.
DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 TOP: Teaching KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
4. According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care
facility acts in which capacity?
a. Working under direct supervision of an RN on the unit
b. Working with the RN in the building
c. Working under general supervision by the RN available on site or by phone
d. Working as an independent vocational nurse
ANS: C
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general
supervision of an RN available on site or by phone.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 TOP: Charge Nurse/Manager KEY: Nursing
Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. The nurse is educating a patient that is a member of a health maintenance organization (HMO).
Which information should the nurse include?
a. Seek the opinion of an alternate health care provider.
b. Contact the insurance company for coverage details as services may be limited.
c. Provide detailed documentation of all care received for his condition.
, d. Wait at least 6 months to see a specialist.
ANS: B
HMOs are a kind of managed care. This is accomplished by paying providers to care for groups of
patients for a set capitation fee and by limiting services. Patients are not required to seek a second
opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
DIF: Cognitive Level: Application REF: p. 9 OBJ: 9 TOP: Charge Nurse/Manager KEY:
Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
6. The patient complains to the nurse that he is confused about his "deductible" that he owes the
hospital. Which statement accurately explains a deductible?
a. An amount of money put aside for the payment of future medical bills
b. A one-time fee for service
c. An amount of money deducted from the bill by the insurance company
d. An annual amount of money the patient must pay out-of-pocket for medical care
ANS: D
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company
assuming the cost. This practice improves the profit of the insurance company.
DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: 9 TOP: Health Care Financing
KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
7. A patient asks the nurse what Medicare Part A covers. Which response is correct?
a. Medicare Part A covers inpatient hospital costs.
b. Medicare Part A covers reimbursement to the physician.
c. Medicare Part A covers outpatient hospital services.
d. Medicare Part A covers ambulance transportation.
ANS: A
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care.
Medicare Part B pays the physician, ambulance transport, and outpatient services.
DIF: Cognitive Level: Comprehension REF: p. 8, Box 1-4 OBJ: 9 TOP: Government-Sponsored Health
Insurance KEY: Nursing Process Step: Implementation