1
,Table of Content zl zl
Chapter 01: Professional Nursing .............................................................................................................................................4
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Chapter 02: Social Determinants of Health .............................................................................................................................10
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Chapter 03: Health History and Physical Examination Harding:Lewis’sMedical-SurgicalNursing,12thEdition .....................15
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Chapter 04: Patient and Caregiver Teaching ...........................................................................................................................20
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Chapter 05: Chronic Illness and Older Adults .........................................................................................................................26
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Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ...................................................................................................34
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Chapter 07: Stress Management .............................................................................................................................................38
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Chapter 08: Sleep and Sleep Disorders ...................................................................................................................................42
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Chapter 09: Pain .....................................................................................................................................................................47
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Chapter 10: Palliative and End-of-Life Care ...........................................................................................................................56
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Chapter 11: Substance Use Disorders in Acute Care ...............................................................................................................61
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Chapter 12: Inflammation and Healing ...................................................................................................................................69
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Chapter 13: Genetics ..............................................................................................................................................................76
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Chapter 14: Immune Responses and Transplantation Harding:Lewis’sMedical-SurgicalNursing,12thEdition .......................79
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Chapter 15: Infection ..............................................................................................................................................................87
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Chapter 16: Cancer .................................................................................................................................................................97
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Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances Harding: Lewis’s Medical-Surgical Nursing, 12th Edition .........111
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Chapter 18: Preoperative Care ..............................................................................................................................................124
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Chapter 19: Intraoperative Care ............................................................................................................................................131
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Chapter 20: Postoperative Care .............................................................................................................................................137
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Chapter 21: Emergency and Disaster Nursing.......................................................................................................................145
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Chapter 22: Assessment and Management: Visual Problems Harding: Lewis’s Medical-
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Surgical Nursing, 12th Edition 153 Chapter 23: Assessment and Management: Auditory Problems Harding: Lewis’s Medical
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-Surgical Nursing, 12th Edition
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.............................................................................................................................................................................................166
Chapter 24: Assessment: Integumentary System Harding:Lewis’sMedical-SurgicalNursing,12thEdition............................173
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Chapter 25: Integumentary Problems....................................................................................................................................178
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Chapter 26: Burns .................................................................................................................................................................186
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Chapter 27: Assessment: Respiratory System .......................................................................................................................195
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Chapter 28: Supporting Ventilation ......................................................................................................................................203
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Chapter 29: Upper Respiratory Problems ..............................................................................................................................214
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Chapter 30: Lower Respiratory Problems .............................................................................................................................220
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Chapter 31: Obstructive Pulmonary Diseases .......................................................................................................................235
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Chapter 32: Acute Respiratory Failure and Acute Respiratory Distress Syndrome Harding: Lewis’s Medical-
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Surgical Nursing, 12th Edition .............................................................................................................................................248
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first? .................................................................................................................................................................................253
Chapter 33: Assessment: Hematologic System .....................................................................................................................257
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Chapter 34: Hematologic Problems ......................................................................................................................................262
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Chapter 35: Assessment: Cardiovascular System Harding:Lewis’sMedical-SurgicalNursing,12thEdition ...........................277
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Chapter 36: Hypertension .....................................................................................................................................................289
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Chapter 38: Heart Failure......................................................................................................................................................311
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Chapter 39: Dysrhythmias ....................................................................................................................................................319
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2
,Chapter 40: Inflammatory and Structural Heart Disorders Harding: Lewis’s Medical-Surgical Nursing, 12th Edition..........329
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first? ................................................................................................................................................................................. 339
Chapter 41: Vascular Disorders ............................................................................................................................................ 341
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Chapter 43: Assessment: Gastrointestinal System Harding:Lewis’sMedical-SurgicalNursing,12thEdition .......................... 364
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Chapter 44: Nutrition Problems ............................................................................................................................................ 369
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Chapter 45: Obesity .............................................................................................................................................................. 377
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Chapter 46: Upper Gastrointestinal Problems ....................................................................................................................... 383
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Chapter 47: Lower Gastrointestinal Problems ....................................................................................................................... 397
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first? ................................................................................................................................................................................. 408
Chapter 48: Liver, Biliary Tract, and Pancreas Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition............ 414
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Chapter 49: Assessment: Urinary System ............................................................................................................................. 429
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Chapter 50: Renal and Urologic Problems ............................................................................................................................ 436
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Chapter 51: Acute Kidney Injury and Chronic Kidney Disease Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
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............................................................................................................................................................................................. 450
Chapter 52: Assessment: Endocrine System ......................................................................................................................... 462
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Chapter 53: Diabetes ............................................................................................................................................................ 469
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Chapter 54: Endocrine Problems .......................................................................................................................................... 484
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first? ................................................................................................................................................................................. 494
Chapter 55: Assessment: Reproductive System .................................................................................................................... 499
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first? ................................................................................................................................................................................. 502
Chapter 56: Breast Problems ................................................................................................................................................ 503
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Chapter 57: Sexually Transmitted Infections ........................................................................................................................ 512
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Chapter 58: Female Reproductive Problems ......................................................................................................................... 519
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Chapter 59: Male Reproductive Problems ............................................................................................................................ 533
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Chapter 60: Assessment: Nervous System ............................................................................................................................ 544
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Chapter 61: Acute Intracranial Problems .............................................................................................................................. 550
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Chapter 62: Stroke ................................................................................................................................................................ 565
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Chapter 63: Chronic Neurologic Problems ........................................................................................................................... 574
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Chapter 64: Dementia and Delirium ..................................................................................................................................... 585
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Chapter 65: Spinal Cord and Peripheral Nerve Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition............ 593
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Chapter 66: Assessment: Musculoskeletal System Harding:Lewis’sMedical-SurgicalNursing,12thEdition ......................... 603
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Chapter 67: Musculoskeletal Trauma and Orthopedic Surgery Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
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............................................................................................................................................................................................. 608
Chapter 68:Musculoskeletal Problems ................................................................................................................................. 622
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Chapter 69: Arthritis and Connective Tissue Diseases Harding:Lewis’sMedical-SurgicalNursing,12thEdition.................... 629
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3
, Chapter 01: Professional Nursing
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Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
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MULTIPLE CHOICE zl
1. The nurse completes an admission database and explains that the plan of care and discharge go
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als will be developed with the patient‘s input. The patient asks, “How is this different from what t
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he physician does?” Which response would the nurse provide?
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a. “The role of the nurseis to administer medications and other treatments prescribed by
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your physician.” zl
b. “In addition to caringfor you while you aresick, the nurses will help you plan to mai
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ntain your health.” zl zl
c. “Thenurse‘s job is to collect information and communicate anyproblems that occ
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ur to the physician.” zl zl zl
d. “Nurses perform manyof the same procedures as the physician, but nurses are wit
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h the patients for a longer time than the physician.”
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ANS: B zl
The American Nurses Association (ANA) definition of nursing describes the role of nurses in pr
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omoting health. The other responses describe dependent and collaborative functions of the nurs
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ing role but do not accurately describe the nurse‘s unique role in thehealth care system.
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DIF: Cognitive Level: Analyze (Analysis)
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TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
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2. Which statement bythe nurse accuratelydescribes the use of evidence-based practice (EBP)?
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a. “Patient care is based on clinical judgment, experience, and traditions.” zl zl zl zl zl zl zl zl zl
b. “Data are analyzed later to show that the patient outcomes are consistentlymet.”
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c. “Research from all published articles are used as a guide for planning patient care.” zl zl zl zl zl zl zl zl zl zl zl zl zl
d. “Recommendations arebased on research, clinical expertise, and patient pr zl zl zl zl zl zl zl zl zl
eferences.”
ANS: D zl
Evidence-based practice (EBP) is the use of the best research- zl zl zl zl zl zl zl zl zl
based evidence combined with clinician expertise and consideration of patient preferences. Cli
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nical judgment based on the nurse‘s clinical experience is part of EBP, but clinical decision mak
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ing should also incorporate current research and research-
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based guidelines. Evaluation of patient outcomes is important, but data analysis is not required t
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o use EBP. All published articles do not provide research evidence; interventions should be base
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d on credible research, preferably randomized controlled studies with a large number of subjects
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.
DIF: Cognitive Level: Understand (Comprehension) zl zl zl
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
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3. Which statement bythe nurse provides a clear explanation of the nursing process?
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a. “Thenursing process is a research method ofdiagnosing the patient‘s health care pro
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blems.”
b. “Thenursing process is used primarilyto explain nursinginterventions to other hea
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lth care professionals.” zl zl
c. “Thenursing process is a problem-solving tool used to identifyand manage the
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4
,Table of Content zl zl
Chapter 01: Professional Nursing .............................................................................................................................................4
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Chapter 02: Social Determinants of Health .............................................................................................................................10
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Chapter 03: Health History and Physical Examination Harding:Lewis’sMedical-SurgicalNursing,12thEdition .....................15
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Chapter 04: Patient and Caregiver Teaching ...........................................................................................................................20
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Chapter 05: Chronic Illness and Older Adults .........................................................................................................................26
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Harding: Lewis’s Medical-Surgical Nursing, 12th Edition ...................................................................................................34
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Chapter 07: Stress Management .............................................................................................................................................38
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Chapter 08: Sleep and Sleep Disorders ...................................................................................................................................42
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Chapter 09: Pain .....................................................................................................................................................................47
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Chapter 10: Palliative and End-of-Life Care ...........................................................................................................................56
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Chapter 11: Substance Use Disorders in Acute Care ...............................................................................................................61
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Chapter 12: Inflammation and Healing ...................................................................................................................................69
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Chapter 13: Genetics ..............................................................................................................................................................76
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Chapter 14: Immune Responses and Transplantation Harding:Lewis’sMedical-SurgicalNursing,12thEdition .......................79
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Chapter 15: Infection ..............................................................................................................................................................87
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Chapter 16: Cancer .................................................................................................................................................................97
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Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances Harding: Lewis’s Medical-Surgical Nursing, 12th Edition .........111
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Chapter 18: Preoperative Care ..............................................................................................................................................124
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Chapter 19: Intraoperative Care ............................................................................................................................................131
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Chapter 20: Postoperative Care .............................................................................................................................................137
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Chapter 21: Emergency and Disaster Nursing.......................................................................................................................145
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Chapter 22: Assessment and Management: Visual Problems Harding: Lewis’s Medical-
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Surgical Nursing, 12th Edition 153 Chapter 23: Assessment and Management: Auditory Problems Harding: Lewis’s Medical
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-Surgical Nursing, 12th Edition
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.............................................................................................................................................................................................166
Chapter 24: Assessment: Integumentary System Harding:Lewis’sMedical-SurgicalNursing,12thEdition............................173
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Chapter 25: Integumentary Problems....................................................................................................................................178
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Chapter 26: Burns .................................................................................................................................................................186
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Chapter 27: Assessment: Respiratory System .......................................................................................................................195
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Chapter 28: Supporting Ventilation ......................................................................................................................................203
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Chapter 29: Upper Respiratory Problems ..............................................................................................................................214
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Chapter 30: Lower Respiratory Problems .............................................................................................................................220
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Chapter 31: Obstructive Pulmonary Diseases .......................................................................................................................235
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Chapter 32: Acute Respiratory Failure and Acute Respiratory Distress Syndrome Harding: Lewis’s Medical-
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Surgical Nursing, 12th Edition .............................................................................................................................................248
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first? .................................................................................................................................................................................253
Chapter 33: Assessment: Hematologic System .....................................................................................................................257
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Chapter 34: Hematologic Problems ......................................................................................................................................262
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Chapter 35: Assessment: Cardiovascular System Harding:Lewis’sMedical-SurgicalNursing,12thEdition ...........................277
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Chapter 36: Hypertension .....................................................................................................................................................289
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Chapter 38: Heart Failure......................................................................................................................................................311
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Chapter 39: Dysrhythmias ....................................................................................................................................................319
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2
,Chapter 40: Inflammatory and Structural Heart Disorders Harding: Lewis’s Medical-Surgical Nursing, 12th Edition..........329
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first? ................................................................................................................................................................................. 339
Chapter 41: Vascular Disorders ............................................................................................................................................ 341
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Chapter 43: Assessment: Gastrointestinal System Harding:Lewis’sMedical-SurgicalNursing,12thEdition .......................... 364
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Chapter 44: Nutrition Problems ............................................................................................................................................ 369
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Chapter 45: Obesity .............................................................................................................................................................. 377
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Chapter 46: Upper Gastrointestinal Problems ....................................................................................................................... 383
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Chapter 47: Lower Gastrointestinal Problems ....................................................................................................................... 397
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first? ................................................................................................................................................................................. 408
Chapter 48: Liver, Biliary Tract, and Pancreas Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition............ 414
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Chapter 49: Assessment: Urinary System ............................................................................................................................. 429
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Chapter 50: Renal and Urologic Problems ............................................................................................................................ 436
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Chapter 51: Acute Kidney Injury and Chronic Kidney Disease Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
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............................................................................................................................................................................................. 450
Chapter 52: Assessment: Endocrine System ......................................................................................................................... 462
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Chapter 53: Diabetes ............................................................................................................................................................ 469
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Chapter 54: Endocrine Problems .......................................................................................................................................... 484
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first? ................................................................................................................................................................................. 494
Chapter 55: Assessment: Reproductive System .................................................................................................................... 499
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first? ................................................................................................................................................................................. 502
Chapter 56: Breast Problems ................................................................................................................................................ 503
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Chapter 57: Sexually Transmitted Infections ........................................................................................................................ 512
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Chapter 58: Female Reproductive Problems ......................................................................................................................... 519
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Chapter 59: Male Reproductive Problems ............................................................................................................................ 533
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Chapter 60: Assessment: Nervous System ............................................................................................................................ 544
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Chapter 61: Acute Intracranial Problems .............................................................................................................................. 550
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Chapter 62: Stroke ................................................................................................................................................................ 565
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Chapter 63: Chronic Neurologic Problems ........................................................................................................................... 574
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Chapter 64: Dementia and Delirium ..................................................................................................................................... 585
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Chapter 65: Spinal Cord and Peripheral Nerve Problems Harding: Lewis’s Medical-Surgical Nursing, 12th Edition............ 593
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Chapter 66: Assessment: Musculoskeletal System Harding:Lewis’sMedical-SurgicalNursing,12thEdition ......................... 603
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Chapter 67: Musculoskeletal Trauma and Orthopedic Surgery Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
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............................................................................................................................................................................................. 608
Chapter 68:Musculoskeletal Problems ................................................................................................................................. 622
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Chapter 69: Arthritis and Connective Tissue Diseases Harding:Lewis’sMedical-SurgicalNursing,12thEdition.................... 629
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3
, Chapter 01: Professional Nursing
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Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
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MULTIPLE CHOICE zl
1. The nurse completes an admission database and explains that the plan of care and discharge go
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als will be developed with the patient‘s input. The patient asks, “How is this different from what t
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he physician does?” Which response would the nurse provide?
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a. “The role of the nurseis to administer medications and other treatments prescribed by
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your physician.” zl
b. “In addition to caringfor you while you aresick, the nurses will help you plan to mai
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ntain your health.” zl zl
c. “Thenurse‘s job is to collect information and communicate anyproblems that occ
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ur to the physician.” zl zl zl
d. “Nurses perform manyof the same procedures as the physician, but nurses are wit
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h the patients for a longer time than the physician.”
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ANS: B zl
The American Nurses Association (ANA) definition of nursing describes the role of nurses in pr
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omoting health. The other responses describe dependent and collaborative functions of the nurs
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ing role but do not accurately describe the nurse‘s unique role in thehealth care system.
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DIF: Cognitive Level: Analyze (Analysis)
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TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
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2. Which statement bythe nurse accuratelydescribes the use of evidence-based practice (EBP)?
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a. “Patient care is based on clinical judgment, experience, and traditions.” zl zl zl zl zl zl zl zl zl
b. “Data are analyzed later to show that the patient outcomes are consistentlymet.”
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c. “Research from all published articles are used as a guide for planning patient care.” zl zl zl zl zl zl zl zl zl zl zl zl zl
d. “Recommendations arebased on research, clinical expertise, and patient pr zl zl zl zl zl zl zl zl zl
eferences.”
ANS: D zl
Evidence-based practice (EBP) is the use of the best research- zl zl zl zl zl zl zl zl zl
based evidence combined with clinician expertise and consideration of patient preferences. Cli
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nical judgment based on the nurse‘s clinical experience is part of EBP, but clinical decision mak
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ing should also incorporate current research and research-
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based guidelines. Evaluation of patient outcomes is important, but data analysis is not required t
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o use EBP. All published articles do not provide research evidence; interventions should be base
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d on credible research, preferably randomized controlled studies with a large number of subjects
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.
DIF: Cognitive Level: Understand (Comprehension) zl zl zl
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
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3. Which statement bythe nurse provides a clear explanation of the nursing process?
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a. “Thenursing process is a research method ofdiagnosing the patient‘s health care pro
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blems.”
b. “Thenursing process is used primarilyto explain nursinginterventions to other hea
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lth care professionals.” zl zl
c. “Thenursing process is a problem-solving tool used to identifyand manage the
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4
