Answers
CHAPTER 1 6. caring and compassion
7. Nursing care must be culturally competent, appro
priate, and sensitive to cultural differences.
SECTION I: ASSESSING YOUR
8. Evidence-based practice is a best practice derived
UNDERSTANDING from valid and reliable research studies that also
Activity A considers the health care setting, patient prefer-
1. knowledge, skills, and attitudes (KSA) ences and values, and clinical judgment.
2. cardiovascular disease, cancers, diabetes, and chronic 9. When a nurse is faced with two conflicting alter-
lung diseases natives, it is the nurse’s moral responsibility to
3. interview, observation, and examination choose the lesser of the two evils. These situation
4. veracity, fidelity, benevolence, wisdom, and moral often result in feelings of moral distress in the nurs
courage who is obliged to make a choice.
10. Substance use disorders (SUDs), posttraumatic
Activity B
stress disorder (PTSD), traumatic brain injury
1. the capacity to perform to the best of one’s abil- (TBI), suicide, depression, hazardous substance
ity, the ability to adjust and adapt to varying exposure, and amputations
situations, a reported feeling of well-being, and a 11. artificial intelligence, blockchain, cloud tech-
feeling that everything is harmonious nology, disease management technology, and
2. Shifting population demographics; changing improved operability of electronic health records
patterns of disease and wellness; advances in (EHRs)
technology and genetics; emphasis on health care 12. clinical guidelines, algorithms, care mapping,
quality, costs, reform efforts, and interprofessional multidisciplinary action plans (MAPs), and clinica
collaborative practices pathways
3. Human responses requiring nursing intervention 13. communication and relationships, educational
should include self-image changes, impaired ven- level, knowledge and ability to use critical think-
tilation, and anxiety and fear. Answer may also ing, familiarity with the environment and the
include pain and discomfort, grief, and impaired context of care, experience and exposure to a
functioning in areas such as rest and sleep. variety of situations
4. assessment, diagnosis, planning, implementation,
and evaluation SECTION II: APPLYING YOUR KNOWLEDGE
5. In Maslow hierarchy of needs, needs are ranked as
follows. Refer to Figure 1-1 in the textbook. Activity C
1. c 2. a, b, c, d 3. b
Need Example
Physiologic Food and water SECTION III: PRACTICING FOR NCLEX
Safety and security Financial security Activity D
Belongingness and affection Companionship 1. d 2. a 3. d 4. b 5. a
Esteem and self-respect Recognition by society 6. d 7. a 8. b 9. d 10. c
Self-actualization Achieved potential in an
11. a
area
Self-fulfillment Creativity (painting)
Knowledge and under- Information and explana-
standing tion
Aesthetics Attractive environment
37
,372 ANSWERS
CHAPTER 2 SECTION III: PRACTICING FOR NCLEX
SECTION I: ASSESSING YOUR Activity D
UNDERSTANDING 1. b 2. c 3. a, c, d 4. b, c, d 5. a
6. b 7. c
Activity A
1. Transitional care
2. cost, health care quality CHAPTER 3
3. ADLs and IADLs
4. cost-effectiveness, accountability, and quality care SECTION I: ASSESSING YOUR
5. Functional Independence Measure (FIM™) UNDERSTANDING
6. Footdrop
Activity A
7. Safety
1. Significant factors include the availability of
Activity B
health care outside the hospital setting, the
1. breakdowns in care transitions including during employment of diverse health care providers
the discharge planning processes, as evidenced to accomplish care management goals, and the
by patients’ inability to manage their own care; increased use of alternative strategies other than
and, as a result of poor communication between the traditional approaches to care.
the hospital and the next level of care (e.g., home 2. People with a chronic illness need as much health
health facility, primary care office) regarding care information as possible to actively participate
patients’ needs and resources in and assume responsibility for the management
2. helping the patient and the patient’s family tran- of their own care. Health education can help the
sition through different levels of care patient adapt to illness and cooperate with a treat-
3. adaptive devices and assistive devices ment regimen. The goal of health education is to
4. returning patients to optimal functionality teach people to maximize their health potential.
through a holistic approach to care that is based 3. Answer may include five of the following: medi
on scientific evidence cation adherence; maintaining a healthy diet;
5. Call the patient to obtain permission for a visit, increasing daily exercise; self-monitoring for signs
schedule the visit, and verify the address. of illness; practicing good overall hygiene; seeking
6. During the initial home visit, the patient is evalu- health screenings and evaluations; and performing
ated, and a plan of care is established. therapeutic, preventive measures.
7. Refer to Table 2-1, Therapeutic Exercises, in the 4. Adherence implies that a patient makes one or more
textbook. lifestyle changes to carry out specific activities to
8. reduction in reimbursement for costs associated promote and maintain health.
with these readmissions 5. Factors influencing adherence include d emographic
9. Medical-surgical nursing is a specialty area of variables such as age, gender, and education; illness
practice that provides nursing services to patients variables such as the severity of illness and the
from adolescence through the end of life in a effects of therapy; psychosocial variables such as
variety of inpatient and outpatient clinical set- intelligence and attitudes toward illness; financial
tings. Critical-care nursing is a specialty area of variables; and therapeutic regimen variables.
practice that provides nursing services to critically 6. Choice, establishment of agreed-upon goals, and
ill patients across the lifespan, traditionally deliv- the quality of the patient–provider relationship
ered in acute care settings such as the hospital 7. Refer to the “Transtheoretical Model of Change”
intensive care unit (ICU). adapted from Miller (2015) and DiClemente
10. The development of a comprehensive discharge (2007). Refer to Table 3-2, Stages in the
plan requires collaboration between professionals Transtheoretical Model of Change, in the textbook.
at the referring facility and the home care facility, 8. The teaching–learning process requires the active
as well as other community agencies that provide involvement of teacher and learner, in an effort to
specific resources upon discharge. reach the desired outcome: a change in behavior.
The teacher serves as a facilitator of learning.
SECTION II: APPLYING YOUR KNOWLEDGE 9. Answer may include six of the following: The
Activity C older adult patient may have difficulty adhering
to a therapeutic regimen because of increased sen-
CASE STUDY: Assessing the Need for a sitivity to medications, difficulty in adjusting to
Home Visit change and stress, financial constraints, forgetful-
1. Refer to section “Home Health Visits” and Chart 2-3, ness, inadequate support systems, lifetime habits
Assessing the Home Environment, in the textbook of self-medication, visual impairments, hearing
to complete the case study. deficits, and mobility limitations.
Copyright © 2022 by Wolters Kluwer. Study Guide for Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 15th Edition.
, ANSWERS 37
10. The desired outcomes and the critical time periods 2. Using a learning contract or agreement can be a
serve as a basis for evaluating the effectiveness of motivator for learning; positive reinforcement is
the teaching strategies. provided as the person moves from one goal to th
11. The effects of a learning situation are influenced next.
by a person’s physical, emotional, and experien-
tial readiness to learn. Physical readiness implies SECTION III: PRACTICING FOR NCLEX
the physical ability of a person to attend to a
Activity D
learning situation. Basic physiologic needs are
met so that higher-level needs can be addressed. 1. b 2. a, b, e 3. a, b, e 4. b 5. a
Emotional readiness involves the patient’s motiva- 6. a 7. a 8. a 9. b 10. a
tion to learn and can be encouraged by providing 11. a 12. c
realistic goals that can be easily achieved so that
self-esteem needs can be met. A person needs to
be ready to accept the emotional changes (anxi- CHAPTER 4
ety, stress) that accompany behavior modification
resulting from the learning process. Experiential SECTION I: ASSESSING YOUR
readiness refers to a person’s past experiences that UNDERSTANDING
influence their approach to the learning process.
Previous positive feedback and improved self-image Activity A
reinforce experiential readiness. 1. obtaining a patient health history, performing a
12. Lecture method, group teaching, demonstrations, physical examination
use of teaching aids, reinforcement, and follow-up 2. Answer may include the following: patterns of
13. Refer to Chart 3-2. sleep, exercise, nutrition, recreation, and personal
14. self-responsibility, nutritional awareness, stress habits such as smoking, the use of illicit drugs,
reduction and management, and physical fitness alcohol, and caffeine.
15. Improves the function of the circulatory system 3. heart disease, cancer, stroke
and the lungs; decreases cholesterol and low- 4. iron, folate, calcium
density lipoprotein levels; decreases body weight Activity B
by increasing calorie expenditure; delays degener-
1. The nurse needs to establish rapport, put the patient
ative changes such as osteoporosis; and improves
at ease, encourage honest communication, make eye
flexibility and overall muscle strength and endur-
contact, and listen carefully.
ance
2. When an atmosphere of mutual trust and confi-
Activity B dence exists between an interviewer and a patient
1. Health education is an independent function of the patient becomes more open and honest, and i
nursing practice that is a primary responsibility of more likely to share personal concerns and problem
the nursing profession. 3. Shared by members of the same cultural group.
2. Although diseases in children and those of an Includes an internal sense and external perception
infectious nature are of utmost concern, the largest of distinctiveness. Influenced by specific condition
groups of people today who need health education related to environmental and technical factors and
are those with chronic illnesses and disabilities. to the availability of resources. Dynamic and ever
3. Patients are encouraged to adhere to their thera- changing.
peutic regimen. Adherence connotes active, vol- 4. Answer may include six of the following: cancer,
untary, and collaborative patient efforts, whereas hypertension, heart disease, diabetes, epilepsy,
adherence is a more passive role. mental illness, tuberculosis, kidney disease, arthri-
4. Evaluation should be continuous throughout the tis, allergies, asthma, alcoholism, and obesity.
teaching process so that the information gathered 5. United States, Great Britain, and Canada
can be used to improve teaching activities. 6. The Mini-Nutritional Assessment (MNA)
5. The older adults usually experience significant 7. Refer to Table 4-3, Factors Associated with Potenti
gains from health promotion activities. Nutritional Deficits, in the textbook.
6. About 80% of those older than 65 years of age Activity C
have one or more chronic illnesses.
PART I
SECTION II: APPLYING YOUR KNOWLEDGE a. Inspection
b. Inspection
Activity C c. Palpation
1. The variables of choice, establishment of mutual d. Palpation
goals, and quality of the patient–provider relation- e. Percussion
ship directly influence the behavioral changes that f. Auscultation
can result from patient education. These factors are g. Auscultation
directly linked to motivation for learning. h. Palpation
Copyright © 2022 by Wolters Kluwer. Study Guide for Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 15th Edition.
, 374 ANSWERS
PART II 2. Hyperpnea is the body’s development of rapid
Refer to Table 4-2, Physical Indicators of Nutritional breathing after intense exercise in response to an
Status, in the textbook. accumulation of lactic acid in muscle tissue and a
1. h 2. c 3. d 4. e 5. g deficit of oxygen.
6. b 3. Examples of acute, time-limited stressors may
include taking an examination, giving a speech,
or driving in a snowstorm. Examples of chronic,
SECTION II: APPLYING YOUR KNOWLEDGE
enduring stressors may include poverty, a handicap
Activity D or disability, or living with an alcoholic.
CASE STUDY: Estimate Ideal Body Weight 4. a. E xamples of day-to-day stressors may include
traffic jam, sick child, missed appointment, car
1. b, medium frame (her height-to-waist circumference
would not start, or train is late.
ratio is 10:4)
b. E xamples of major events affecting large groups
2. 125 lb, lose, 50 lb (refer to Table 4-1, How Is BMI
of people could include earthquakes, wars, ter-
Calculated?, in the textbook)
rorism, or events of history.
3. 29, overweight
c. Examples of infrequent, significant events in
CASE STUDY: Cultural and Nutritional a person’s life would include marriage, birth,
Assessment death, or retirement.
1. Greet the patient using the last or complete name. 5. Adolph Meyer, in the 1930s, first showed a cor-
Avoid being too casual or familiar. Point to yourself relation between illness and critical life events.
and say your name. Smile. Proceed in an unhurried A Recent Life Changes Questionnaire (RLCQ)
manner. Pay attention to any effort by the patient was developed by Holmes and Rahe (1967) that
or family to communicate. Speak in a low, moder- assigned numerical values to life events requiring
ate voice. Avoid talking loudly. Repeat and summa- a change in a person’s life pattern. A correlation
rize frequently. Use audiovisual aids when feasible. was seen between illness and the number of
2. A patient who is Muslim does not eat pork or pork stressful events; the higher the numerical value,
products. the greater the chance for becoming ill.
6. Internal cognitive appraisal refers to the evalua-
SECTION III: PRACTICING FOR NCLEX tion of an event relative to what is at stake and
what coping resources are available. External
Activity E resources consist of money to purchase services
1. b, d, e 2. a, c, d 3. d 4. b 5. b and materials and social support systems that
6. c 7. b, c, d 8. a, b, c 9. b 10. a provide emotional and esteem support.
11. d 12. a 13. a 14. a 15. a 7. Hans Selye stated that “stress is essentially the
16. d rate of wear and tear on the body.” He also
defined stress as being a “nonspecific response” of
the body regardless of the stimulus producing the
response.
CHAPTER 5 8. Answer should include six of the following:
hypertension, diseases of the heart and blood ves-
SECTION I: ASSESSING YOUR sels, kidney diseases, rheumatic and rheumatoid
UNDERSTANDING arthritides, inflammation of the skin and eyes,
Activity A infections, allergic and hypersensitivity diseases,
nervous and mental diseases, sexual dysfunction,
1. challenging, damaging, threatening
digestive diseases, metabolic diseases, and cancer.
2. dead, diseased, injured
9. Answer can include anxiety, ineffective coping
3. hypothalamus
patterns, impaired thought processes, disrupted
4. synthesize enzymes, transform energy, grow and
relationships, impaired adjustment, ineffective
reproduce
coping, social isolation, risk for spiritual distress,
5. level of education
and decisional conflict.
6. constancy, homeostasis, stress, and adaptation
10. People with positive energy and a healthy outlook
7. blood pressure, acid–base balance, blood glucose
on life typically perceive stressors as interesting,
levels, body temperature, fluid and electrolyte
challenging, meaningful, and opportunities for
balance
change and growth.
8. redness, heat, swelling, pain, loss of function
11. Physical stressors include cold, heat, and chemi-
Activity B cal agents; physiologic stressors include pain and
1. When the body suffers an injury, the response fatigue. An example of a psychosocial stressor is
is maladaptive if the defense mechanisms have a fear (e.g., fear of failing an examination, losing a
negative effect on health. job, waiting for a diagnostic test result).
Copyright © 2022 by Wolters Kluwer. Study Guide for Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 15th Edition.
CHAPTER 1 6. caring and compassion
7. Nursing care must be culturally competent, appro
priate, and sensitive to cultural differences.
SECTION I: ASSESSING YOUR
8. Evidence-based practice is a best practice derived
UNDERSTANDING from valid and reliable research studies that also
Activity A considers the health care setting, patient prefer-
1. knowledge, skills, and attitudes (KSA) ences and values, and clinical judgment.
2. cardiovascular disease, cancers, diabetes, and chronic 9. When a nurse is faced with two conflicting alter-
lung diseases natives, it is the nurse’s moral responsibility to
3. interview, observation, and examination choose the lesser of the two evils. These situation
4. veracity, fidelity, benevolence, wisdom, and moral often result in feelings of moral distress in the nurs
courage who is obliged to make a choice.
10. Substance use disorders (SUDs), posttraumatic
Activity B
stress disorder (PTSD), traumatic brain injury
1. the capacity to perform to the best of one’s abil- (TBI), suicide, depression, hazardous substance
ity, the ability to adjust and adapt to varying exposure, and amputations
situations, a reported feeling of well-being, and a 11. artificial intelligence, blockchain, cloud tech-
feeling that everything is harmonious nology, disease management technology, and
2. Shifting population demographics; changing improved operability of electronic health records
patterns of disease and wellness; advances in (EHRs)
technology and genetics; emphasis on health care 12. clinical guidelines, algorithms, care mapping,
quality, costs, reform efforts, and interprofessional multidisciplinary action plans (MAPs), and clinica
collaborative practices pathways
3. Human responses requiring nursing intervention 13. communication and relationships, educational
should include self-image changes, impaired ven- level, knowledge and ability to use critical think-
tilation, and anxiety and fear. Answer may also ing, familiarity with the environment and the
include pain and discomfort, grief, and impaired context of care, experience and exposure to a
functioning in areas such as rest and sleep. variety of situations
4. assessment, diagnosis, planning, implementation,
and evaluation SECTION II: APPLYING YOUR KNOWLEDGE
5. In Maslow hierarchy of needs, needs are ranked as
follows. Refer to Figure 1-1 in the textbook. Activity C
1. c 2. a, b, c, d 3. b
Need Example
Physiologic Food and water SECTION III: PRACTICING FOR NCLEX
Safety and security Financial security Activity D
Belongingness and affection Companionship 1. d 2. a 3. d 4. b 5. a
Esteem and self-respect Recognition by society 6. d 7. a 8. b 9. d 10. c
Self-actualization Achieved potential in an
11. a
area
Self-fulfillment Creativity (painting)
Knowledge and under- Information and explana-
standing tion
Aesthetics Attractive environment
37
,372 ANSWERS
CHAPTER 2 SECTION III: PRACTICING FOR NCLEX
SECTION I: ASSESSING YOUR Activity D
UNDERSTANDING 1. b 2. c 3. a, c, d 4. b, c, d 5. a
6. b 7. c
Activity A
1. Transitional care
2. cost, health care quality CHAPTER 3
3. ADLs and IADLs
4. cost-effectiveness, accountability, and quality care SECTION I: ASSESSING YOUR
5. Functional Independence Measure (FIM™) UNDERSTANDING
6. Footdrop
Activity A
7. Safety
1. Significant factors include the availability of
Activity B
health care outside the hospital setting, the
1. breakdowns in care transitions including during employment of diverse health care providers
the discharge planning processes, as evidenced to accomplish care management goals, and the
by patients’ inability to manage their own care; increased use of alternative strategies other than
and, as a result of poor communication between the traditional approaches to care.
the hospital and the next level of care (e.g., home 2. People with a chronic illness need as much health
health facility, primary care office) regarding care information as possible to actively participate
patients’ needs and resources in and assume responsibility for the management
2. helping the patient and the patient’s family tran- of their own care. Health education can help the
sition through different levels of care patient adapt to illness and cooperate with a treat-
3. adaptive devices and assistive devices ment regimen. The goal of health education is to
4. returning patients to optimal functionality teach people to maximize their health potential.
through a holistic approach to care that is based 3. Answer may include five of the following: medi
on scientific evidence cation adherence; maintaining a healthy diet;
5. Call the patient to obtain permission for a visit, increasing daily exercise; self-monitoring for signs
schedule the visit, and verify the address. of illness; practicing good overall hygiene; seeking
6. During the initial home visit, the patient is evalu- health screenings and evaluations; and performing
ated, and a plan of care is established. therapeutic, preventive measures.
7. Refer to Table 2-1, Therapeutic Exercises, in the 4. Adherence implies that a patient makes one or more
textbook. lifestyle changes to carry out specific activities to
8. reduction in reimbursement for costs associated promote and maintain health.
with these readmissions 5. Factors influencing adherence include d emographic
9. Medical-surgical nursing is a specialty area of variables such as age, gender, and education; illness
practice that provides nursing services to patients variables such as the severity of illness and the
from adolescence through the end of life in a effects of therapy; psychosocial variables such as
variety of inpatient and outpatient clinical set- intelligence and attitudes toward illness; financial
tings. Critical-care nursing is a specialty area of variables; and therapeutic regimen variables.
practice that provides nursing services to critically 6. Choice, establishment of agreed-upon goals, and
ill patients across the lifespan, traditionally deliv- the quality of the patient–provider relationship
ered in acute care settings such as the hospital 7. Refer to the “Transtheoretical Model of Change”
intensive care unit (ICU). adapted from Miller (2015) and DiClemente
10. The development of a comprehensive discharge (2007). Refer to Table 3-2, Stages in the
plan requires collaboration between professionals Transtheoretical Model of Change, in the textbook.
at the referring facility and the home care facility, 8. The teaching–learning process requires the active
as well as other community agencies that provide involvement of teacher and learner, in an effort to
specific resources upon discharge. reach the desired outcome: a change in behavior.
The teacher serves as a facilitator of learning.
SECTION II: APPLYING YOUR KNOWLEDGE 9. Answer may include six of the following: The
Activity C older adult patient may have difficulty adhering
to a therapeutic regimen because of increased sen-
CASE STUDY: Assessing the Need for a sitivity to medications, difficulty in adjusting to
Home Visit change and stress, financial constraints, forgetful-
1. Refer to section “Home Health Visits” and Chart 2-3, ness, inadequate support systems, lifetime habits
Assessing the Home Environment, in the textbook of self-medication, visual impairments, hearing
to complete the case study. deficits, and mobility limitations.
Copyright © 2022 by Wolters Kluwer. Study Guide for Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 15th Edition.
, ANSWERS 37
10. The desired outcomes and the critical time periods 2. Using a learning contract or agreement can be a
serve as a basis for evaluating the effectiveness of motivator for learning; positive reinforcement is
the teaching strategies. provided as the person moves from one goal to th
11. The effects of a learning situation are influenced next.
by a person’s physical, emotional, and experien-
tial readiness to learn. Physical readiness implies SECTION III: PRACTICING FOR NCLEX
the physical ability of a person to attend to a
Activity D
learning situation. Basic physiologic needs are
met so that higher-level needs can be addressed. 1. b 2. a, b, e 3. a, b, e 4. b 5. a
Emotional readiness involves the patient’s motiva- 6. a 7. a 8. a 9. b 10. a
tion to learn and can be encouraged by providing 11. a 12. c
realistic goals that can be easily achieved so that
self-esteem needs can be met. A person needs to
be ready to accept the emotional changes (anxi- CHAPTER 4
ety, stress) that accompany behavior modification
resulting from the learning process. Experiential SECTION I: ASSESSING YOUR
readiness refers to a person’s past experiences that UNDERSTANDING
influence their approach to the learning process.
Previous positive feedback and improved self-image Activity A
reinforce experiential readiness. 1. obtaining a patient health history, performing a
12. Lecture method, group teaching, demonstrations, physical examination
use of teaching aids, reinforcement, and follow-up 2. Answer may include the following: patterns of
13. Refer to Chart 3-2. sleep, exercise, nutrition, recreation, and personal
14. self-responsibility, nutritional awareness, stress habits such as smoking, the use of illicit drugs,
reduction and management, and physical fitness alcohol, and caffeine.
15. Improves the function of the circulatory system 3. heart disease, cancer, stroke
and the lungs; decreases cholesterol and low- 4. iron, folate, calcium
density lipoprotein levels; decreases body weight Activity B
by increasing calorie expenditure; delays degener-
1. The nurse needs to establish rapport, put the patient
ative changes such as osteoporosis; and improves
at ease, encourage honest communication, make eye
flexibility and overall muscle strength and endur-
contact, and listen carefully.
ance
2. When an atmosphere of mutual trust and confi-
Activity B dence exists between an interviewer and a patient
1. Health education is an independent function of the patient becomes more open and honest, and i
nursing practice that is a primary responsibility of more likely to share personal concerns and problem
the nursing profession. 3. Shared by members of the same cultural group.
2. Although diseases in children and those of an Includes an internal sense and external perception
infectious nature are of utmost concern, the largest of distinctiveness. Influenced by specific condition
groups of people today who need health education related to environmental and technical factors and
are those with chronic illnesses and disabilities. to the availability of resources. Dynamic and ever
3. Patients are encouraged to adhere to their thera- changing.
peutic regimen. Adherence connotes active, vol- 4. Answer may include six of the following: cancer,
untary, and collaborative patient efforts, whereas hypertension, heart disease, diabetes, epilepsy,
adherence is a more passive role. mental illness, tuberculosis, kidney disease, arthri-
4. Evaluation should be continuous throughout the tis, allergies, asthma, alcoholism, and obesity.
teaching process so that the information gathered 5. United States, Great Britain, and Canada
can be used to improve teaching activities. 6. The Mini-Nutritional Assessment (MNA)
5. The older adults usually experience significant 7. Refer to Table 4-3, Factors Associated with Potenti
gains from health promotion activities. Nutritional Deficits, in the textbook.
6. About 80% of those older than 65 years of age Activity C
have one or more chronic illnesses.
PART I
SECTION II: APPLYING YOUR KNOWLEDGE a. Inspection
b. Inspection
Activity C c. Palpation
1. The variables of choice, establishment of mutual d. Palpation
goals, and quality of the patient–provider relation- e. Percussion
ship directly influence the behavioral changes that f. Auscultation
can result from patient education. These factors are g. Auscultation
directly linked to motivation for learning. h. Palpation
Copyright © 2022 by Wolters Kluwer. Study Guide for Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 15th Edition.
, 374 ANSWERS
PART II 2. Hyperpnea is the body’s development of rapid
Refer to Table 4-2, Physical Indicators of Nutritional breathing after intense exercise in response to an
Status, in the textbook. accumulation of lactic acid in muscle tissue and a
1. h 2. c 3. d 4. e 5. g deficit of oxygen.
6. b 3. Examples of acute, time-limited stressors may
include taking an examination, giving a speech,
or driving in a snowstorm. Examples of chronic,
SECTION II: APPLYING YOUR KNOWLEDGE
enduring stressors may include poverty, a handicap
Activity D or disability, or living with an alcoholic.
CASE STUDY: Estimate Ideal Body Weight 4. a. E xamples of day-to-day stressors may include
traffic jam, sick child, missed appointment, car
1. b, medium frame (her height-to-waist circumference
would not start, or train is late.
ratio is 10:4)
b. E xamples of major events affecting large groups
2. 125 lb, lose, 50 lb (refer to Table 4-1, How Is BMI
of people could include earthquakes, wars, ter-
Calculated?, in the textbook)
rorism, or events of history.
3. 29, overweight
c. Examples of infrequent, significant events in
CASE STUDY: Cultural and Nutritional a person’s life would include marriage, birth,
Assessment death, or retirement.
1. Greet the patient using the last or complete name. 5. Adolph Meyer, in the 1930s, first showed a cor-
Avoid being too casual or familiar. Point to yourself relation between illness and critical life events.
and say your name. Smile. Proceed in an unhurried A Recent Life Changes Questionnaire (RLCQ)
manner. Pay attention to any effort by the patient was developed by Holmes and Rahe (1967) that
or family to communicate. Speak in a low, moder- assigned numerical values to life events requiring
ate voice. Avoid talking loudly. Repeat and summa- a change in a person’s life pattern. A correlation
rize frequently. Use audiovisual aids when feasible. was seen between illness and the number of
2. A patient who is Muslim does not eat pork or pork stressful events; the higher the numerical value,
products. the greater the chance for becoming ill.
6. Internal cognitive appraisal refers to the evalua-
SECTION III: PRACTICING FOR NCLEX tion of an event relative to what is at stake and
what coping resources are available. External
Activity E resources consist of money to purchase services
1. b, d, e 2. a, c, d 3. d 4. b 5. b and materials and social support systems that
6. c 7. b, c, d 8. a, b, c 9. b 10. a provide emotional and esteem support.
11. d 12. a 13. a 14. a 15. a 7. Hans Selye stated that “stress is essentially the
16. d rate of wear and tear on the body.” He also
defined stress as being a “nonspecific response” of
the body regardless of the stimulus producing the
response.
CHAPTER 5 8. Answer should include six of the following:
hypertension, diseases of the heart and blood ves-
SECTION I: ASSESSING YOUR sels, kidney diseases, rheumatic and rheumatoid
UNDERSTANDING arthritides, inflammation of the skin and eyes,
Activity A infections, allergic and hypersensitivity diseases,
nervous and mental diseases, sexual dysfunction,
1. challenging, damaging, threatening
digestive diseases, metabolic diseases, and cancer.
2. dead, diseased, injured
9. Answer can include anxiety, ineffective coping
3. hypothalamus
patterns, impaired thought processes, disrupted
4. synthesize enzymes, transform energy, grow and
relationships, impaired adjustment, ineffective
reproduce
coping, social isolation, risk for spiritual distress,
5. level of education
and decisional conflict.
6. constancy, homeostasis, stress, and adaptation
10. People with positive energy and a healthy outlook
7. blood pressure, acid–base balance, blood glucose
on life typically perceive stressors as interesting,
levels, body temperature, fluid and electrolyte
challenging, meaningful, and opportunities for
balance
change and growth.
8. redness, heat, swelling, pain, loss of function
11. Physical stressors include cold, heat, and chemi-
Activity B cal agents; physiologic stressors include pain and
1. When the body suffers an injury, the response fatigue. An example of a psychosocial stressor is
is maladaptive if the defense mechanisms have a fear (e.g., fear of failing an examination, losing a
negative effect on health. job, waiting for a diagnostic test result).
Copyright © 2022 by Wolters Kluwer. Study Guide for Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 15th Edition.
