Test Bank For LeMone and Burke's Medical-Surgical Nursing: Clinical Reasoning in Patient Care 7th Edition By Paula Gubrud, Margaret Carno , Gerene Bauldoff RN PhD FAAN 9780134868189 All Chapters .

TESTBANK FOR LEMONE & BURKE’S MEDICAL-
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SURGICAL NURSING: CLINICAL REASONING IN
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HOSPITAL CLIENT CARE 7TH EDITION/ALL
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CHAPTERS1-52
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,Chapter1 b




1. Thecaregiver iscaring forfourHospital clientsona medical–surgicalunit. Which
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Hospital client should the caregiver see initially?
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1. AHospital client admitted withhepatitisAwho hashad severe diarrhea for
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thelast 24 hours
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2. AHospital client admittedwithpneumonia who ishassmallamounts
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ofyellow productive sputum
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3. AHospital client admitted with fever ofunknownorigin(FUO) who
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hasbeen without fever for the last 48 hours
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4. A Hospital client admitted with a wound infection whose WBC is 8,500
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bmm3ACCURATE ANSWER:-1
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Reasoning:->>>Thecaregiver must decidewhichHospital client should beseenontheinitial b b b b b b b b b b b b




roundsofthe day. The caregiver must remember thatthe first
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Hospital client to be seenshould be the Hospital client who needs the attentionofthe
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caregiver initially. A Hospital client with hepatitis A does experience diarrhea,but
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diarrhea for the last 24 hours could cause the Hospital client to have a problem with
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dehydration and experience a stateof fluid volume deficit.
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CognitiveLevel:Application b b




Hospital clientNeeds:Safe,EffectiveCareEnvironment
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Nursing Process: Planning
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2. The caregiver is preparing to administer influenza vaccines to a mass drive-throughclinic.
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Whichstatement bya Hospital client would indicate further questioning priortogiving the
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Hospital client the influenza vaccine?
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1. “Iamallergic to horsehair.” b b b b b




2. “I tryto get myvaccine everyyear.” b b b b b b b




3. “Iamnot allergicto anythingexcept eggs.”
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4. “Myhusband hadasevereallergicreactionafterhereceived hisinfluenza b b b b b b b b b b b




vaccine.”
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ACCURATE ANSWER:-3 b




Reasoning:->>>Influenza vaccines are recommended for person at high risk for serious b b b b b b b b b b




sequelae of influenza. The caregiver should be aware that Hospital client with a
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sensitivity to eggs should not receive the vaccine. Vaccines prepared from chickenor
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duck embryos are contraindicated inHospital clients who are allergic to eggs.
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CognitiveLevel:Application b b

,Hospital clientNeeds:Safe,EffectiveCareEnvironment
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Nursing Process: Assessment
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3. The caregiver is caring for four Hospital clients on a medical–surgical unit. The secretary
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gives the caregiver the morning labs. Which of the following labs would require that the
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caregiver call the physician and inform the healthcare provider about the Hospital client’s
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abnormalities?
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1. b WBC14,600 mm3 b b




2. Serumprotein6.9g/dL b b b




3. I&D(incision and drainage) showing no growthforthe last 24hours
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4. Albumin4.2g/dL b b




ACCURATE ANSWER:-1
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Reasoning:->>>When the caregiver is caring for several Hospital clients, all of the labs b b b b b b b b b b b b




should be checked frequently throughout the shift to assess for any abnormalities. TheWBC
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in option 1 is abnormal. (Normal WBC 4,000–10,000 mm3.) All of the other lab results are
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within acceptable range; therefore, the results should not be called in to thephysician.
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Cognitive Level: Application b b




Hospital client Needs:
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Physiologic IntegrityNursing
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Process:
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Assessment


4. The caregiver is orienting a new graduate. The caregiver is reinforcing the
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importance of standard precautions. Which of the following observations bythe
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caregiver wouldrequire further educationregardingstandard precautions?
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1. Thegraduatecaregiver understandstowashhandswhenentering and b b b b b b b b b




exiting the Hospital client’s room.
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2. Thegraduatecaregiver wearsgloveswhenserving breakfasttrays to b b b b b b b b b




various Hospital clients.b b b




3. Thegraduatecaregiver wearsagown,gloves, andgoggleswhensuctioning a b b b b b b b b b b b




Hospital client. b b




4. Thegraduate caregiver leaves allsupplies intheroomofaHospital b b b b b b b b b b b




client who is in contact isolation.
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ACCURATE ANSWER:-2 b




Reasoning:->>>The caregiver must have an understanding of standard precautions. b b b b b b b b




Prevention is the most important measure to prevent nosocomial infections.
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Standard precautionswerepublished in 1996that provideguidelines
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for the handling of blood and other body fluids. These guidelines are used with all
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, Hospital clients, regardless ofwhether theyhave a known infectious disease. Standard
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precautions are used
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by all healthcare workers who have direct contact with Hospital clients or with their
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body fluids. It is not necessary for the caregiver to wear gloves while delivering food
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trays tothe Hospital client, because there is not contact withthe Hospital client.
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CognitiveLevel:Application b b




Hospital clientNeeds:Safe,EffectiveCareEnvironment
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Nursing Process: Evaluation
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5. Theadmitting department alertsthecaregiver onamedical–surgicalunit thata Hospital
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client with active tuberculosis (TB) is being admitted to the unit. Which type of isolation is
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appropriate based onthe Hospital client’s diagnosis?
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1. Standardprecautions b




2. Airborneprecautions b




3. Dropletprecautions b




4. Contact precautions b




ACCURATE ANSWER:-2
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Reasoning:->>>In addition to handwashing and standard precautions, the nature and spread of b b b b b b b b b b b




some infectious diseases require that special techniques be used to protect uninfected Hospital
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clients and workers. The Hospital client with pulmonary tuberculosis will be placed in airborne
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precautions. The Hospital client should be placed in a private room with special ventilationthat
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does not allow air to circulateto generalhealthcenter ventilation;a maskor specialfilter
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respirators will be used for everyone entering the room.
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CognitiveLevel:Application b b




Hospital clientNeeds:Safe,EffectiveCareEnvironment
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Nursing Process: Assessment
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6. A Hospital client is receiving IV vancomycin for the treatment of Clostridium
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difficile.The caregiver understands that the Hospital client who develops flushing,
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tachycardia, and hypotensionduring the infusionof vancomycin indicates:
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1. Ototoxicityeffect. b




2. Superinfection.
3. Redmansyndrome. b b




4. Hives.

ACCURATE ANSWER:-3 b




Reasoning:->>>Vancomycininhibitscellwallsynthesis,and isusedforseriousinfections.It b b b b b b b b b b b




is only effective against gram-positive bacteria, especially Staphylococcus aureus and
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