Test Bank for Understanding Medical-Surgical
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
Chapter 1
1. The nurse* is*caring* for* four* clients* on* a* medical–surgical*unit.* Which* client*
should*the* nurse* see* initially?
1. A*client* admitted*with*hepatitis*A*who* has*had* severe* diarrhea* for*the*
last* 24* hours
2. A*client* admitted* with*pneumonia* who* is* has*small* amounts* of*
yellow* productive* sputum
3. A*client* admitted*with* fever* of*unknown*origin* (FUO)* who* has*
been* without* fever* for* the* last* 48* hours
4. A*client* admitted* with* a* wound* infection* whose* WBC* is* 8,500* mm3
Answer:* 1
Rationale:* The* nurse* must* decide* which* client* should* be* seen*on* the* initial* rounds* of*
the* day. * The* nurse* must* remember* that* the* first* client* to* be* seen* should* be* the*
client* who* needs* the* attention* of* the* nurse* initially. * A* client* with* hepatitis* A*
does* experience* diarrhea,* but* diarrhea* for* the* last* 24* hours* could* cause* the*
client* to* have* a* problem* with* dehydration* and* experience* a* state* of* fluid*
volume* deficit.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Planning
2. The* nurse* is*preparing*to* administer* influenza* vaccines* to* a*mass* drive-through*
clinic.* Which* statement* by* a* client* would* indicate* further* questioning* prior* to* giving*
the* client* the* influenza* vaccine?
1. “I* am*allergic* to* horse* hair.”
2. “I* try*to* get* my* vaccine* every* year.”
3. “I* am*not* allergic* to* anything* except* eggs.”
4. “My*husband* had* a*severe* allergic* reaction* after* he*received* his*
influenza* vaccine.”
Answer:* 3
Rationale:* Influenza* vaccines* are* recommended* for* person* at* high* risk* for* serious*
sequelae* of* influenza.* The* nurse* should* be*aware* that* client* with* a* sensitivity*to*
eggs* should* not* receive* the* vaccine.* Vaccines* prepared* from* chicken* or* duck*
embryos* are* contraindicated* in* clients* who* are* allergic* to* eggs.
Cognitive* Level:* Application
download full file at http://testbankinstant.com
, Test Bank for Understanding Medical-Surgical
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Assessment
3. The* nurse* is* caring* for* four* clients* on* a* medical–surgical* unit.* The* secretary* gives*
the* nurse* the* morning* labs.* Which* of* the* following* labs* would* require* that* the* nurse*
call* the* physician* and* inform* the* healthcare* provider* about* the* client’s* abnormalities?
1. WBC* 14,600* mm3
2. Serum* protein* 6.9* g/dL
3. I* &* D* (incision* and* drainage) * showing* no* growth* for*the* last* 24* hours
4. Albumin* 4.2* g/dL
Answer:* 1
Rationale:* When* the*nurse* is* caring* for* several*clients,* all*of*the* labs* should* be*checked*
frequently* throughout* the* shift* to* assess* for* any* abnormalities.* The* WBC* in* option* 1* is*
abnormal. * (Normal* WBC* 4,000–10,000* mm3.)* All* of* the* other* lab* results* are* within*
acceptable* range;* therefore,* the* results* should* not* be* called* in* to* the* physician.
Cognitive* Level:* Application*
Client*Needs:*Physiologic*
Integrity* Nursing* Process:*
Assessment
4. The* nurse* is* orienting* a* new* graduate.* The* nurse* is* reinforcing* the* importance*
of* standard* precautions.* Which*of*the* following* observations* by*the* nurse* would*
require* further* education* regarding* standard* precautions?
1. The* graduate*nurse*understands* to* wash* hands* when*entering* and*
exiting* the* client’s* room.
2. The* graduate*nurse*wears*gloves* when* serving* breakfast* trays* to*
various* clients.
3. The* graduate* nurse* wears* a* gown,* gloves,* and* goggles* when* suctioning*
a* client.
4. The* graduate*nurse* leaves* all* supplies* in* the* room* of*a* client* who* is*
in* contact* isolation.
Answer:* 2
Rationale:* The* nurse* must* have* an* understanding* of* standard* precautions.* Prevention*
is* the* most* important* measure* to* prevent* nosocomial* infections.* Standard*
precautions* were* published* in* 1996* that* provide* guidelines* for* the* handling* of*
blood* and* other* body*fluids.* These* guidelines* are* used* with*all* clients,*
regardless* of* whether* they* have* a* known* infectious* disease.* Standard*
precautions* are* used
download full file at http://testbankinstant.com
, Test Bank for Understanding Medical-Surgical
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
by* all* healthcare* workers* who* have* direct* contact* with* clients* or* with* their*
body* fluids.* It* is* not* necessary* for* the* nurse* to* wear* gloves* while* delivering *
food*trays* to* the* client,* because* there* is* not* contact* with* the* client.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Evaluation
5. The*admitting* department* alerts*the* nurse* on*a* medical–surgical*unit * that* a*client*
with* active* tuberculosis* (TB)* is* being* admitted* to* the* unit.* Which* type* of* isolation* is*
appropriate* based* on* the* client’s* diagnosis?
1. Standard* precautions
2. Airborne* precautions
3. Droplet* precautions
4. Contact* precautions
Answer:* 2
In* addition* to* handwashing* and* standard* precautions,* the* nature* and* spread* of* some*
infectious* diseases* require* that* special* techniques* be* used* to* protect* uninfected* clients*
and* workers.* The* client* with* pulmonary* tuberculosis* will* be* placed* in* airborne*
precautions. * The* client* should* be*placed* in* a* private* room*with* special* ventilation* that*
does* not* allow* air* to* circulate* to* general* hospital* ventilation;* a* mask* or* special* filter *
respirators* will* be* used* for* everyone* entering* the* room.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Assessment
6. A*client* is* receiving* IV* vancomycin* for* the* treatment* of* Clostridium* difficile.*
The* nurse*understands*that*the* client* who* develops* flushing,* tachycardia,* and*
hypotension* during* the* infusion* of* vancomycin* indicates:
1. Ototoxicity*effect.
2. Superinfection.
3. Red* man* syndrome.
4. Hives.
Answer:* 3
Rationale:*Vancomycin* inhibits*cell*wall*synthesis, * and* is*used* for* serious* infections.* It*
is* only* effective* against* gram-positive* bacteria,* especially* Staphylococcus* aureus* and
download full file at http://testbankinstant.com
, Test Bank for Understanding Medical-Surgical
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
Staphylococcus* epidermidis.* The* nurse* should* infuse* this* medication* slowly* over* 60*
minutes* or* more* to* avoid* “red* man”* syndrome.* The* syndrome* is* characterized* by*
erythematous*rash,* flushing,* tachycardia,* and* hypotension.* Clients* can*become* dizzy*
and* agitated.
Cognitive* Level:* Application
Client*Needs:*Physiological*Integrity*
Nursing* Process:* Evaluation
7. The* physician* has* ordered* for*the* client* to* receive* a* trough* blood* level* to* evaluate*
the* therapeutic* effect* of* an* antibiotic.* The* nurse* understands* that* the* trough* should*
be* ordered:
1. A*few* minutes* before* the* next* scheduled* dose*of* medication.
2. 1–2* hours* after* the* oral* administration* of*the* medication.
3. 30* minutes* after* the* IV*administration.
4. During* the* infusion* of*the* antibiotic.
Answer:* 1
Rationale:* Antibiotic* peak* and* trough* levels* monitor* therapeutic* blood* levels* of* the*
prescribed* medication.* The* therapeutic* range—the* minimum* and* maximum* blood*
levels* at* which* the* drug* is* effective—is* known* for* a* given* drug.* By* measuring* blood*
levels* at* the* predicted* peak* (1–2* hours* after* oral* administration,* 1* hour* after*
intramuscular* administration,* and* 30* minutes* after* IV*administration)* and*trough*
(usually*a* few* minutes* before* the* next* scheduled* dose),* it* is* also* possible* to* determine*
whether* the* drug* is* reaching* a* toxic* or* harmful* level* during* therapy, * increasing* the*
likelihood* of* adverse* effects.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Assessment
8. The* nurse* needs*to* change* a*dressing* on*the* client’s* abdomen.* Which*of*the*
following* techniques* should* be* implemented?
1. Contact* precautions
2. Standard* precautions
3. Droplet* precautions
4. Airborne* precautions
Answer:* 2
download full file at http://testbankinstant.com
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
Chapter 1
1. The nurse* is*caring* for* four* clients* on* a* medical–surgical*unit.* Which* client*
should*the* nurse* see* initially?
1. A*client* admitted*with*hepatitis*A*who* has*had* severe* diarrhea* for*the*
last* 24* hours
2. A*client* admitted* with*pneumonia* who* is* has*small* amounts* of*
yellow* productive* sputum
3. A*client* admitted*with* fever* of*unknown*origin* (FUO)* who* has*
been* without* fever* for* the* last* 48* hours
4. A*client* admitted* with* a* wound* infection* whose* WBC* is* 8,500* mm3
Answer:* 1
Rationale:* The* nurse* must* decide* which* client* should* be* seen*on* the* initial* rounds* of*
the* day. * The* nurse* must* remember* that* the* first* client* to* be* seen* should* be* the*
client* who* needs* the* attention* of* the* nurse* initially. * A* client* with* hepatitis* A*
does* experience* diarrhea,* but* diarrhea* for* the* last* 24* hours* could* cause* the*
client* to* have* a* problem* with* dehydration* and* experience* a* state* of* fluid*
volume* deficit.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Planning
2. The* nurse* is*preparing*to* administer* influenza* vaccines* to* a*mass* drive-through*
clinic.* Which* statement* by* a* client* would* indicate* further* questioning* prior* to* giving*
the* client* the* influenza* vaccine?
1. “I* am*allergic* to* horse* hair.”
2. “I* try*to* get* my* vaccine* every* year.”
3. “I* am*not* allergic* to* anything* except* eggs.”
4. “My*husband* had* a*severe* allergic* reaction* after* he*received* his*
influenza* vaccine.”
Answer:* 3
Rationale:* Influenza* vaccines* are* recommended* for* person* at* high* risk* for* serious*
sequelae* of* influenza.* The* nurse* should* be*aware* that* client* with* a* sensitivity*to*
eggs* should* not* receive* the* vaccine.* Vaccines* prepared* from* chicken* or* duck*
embryos* are* contraindicated* in* clients* who* are* allergic* to* eggs.
Cognitive* Level:* Application
download full file at http://testbankinstant.com
, Test Bank for Understanding Medical-Surgical
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Assessment
3. The* nurse* is* caring* for* four* clients* on* a* medical–surgical* unit.* The* secretary* gives*
the* nurse* the* morning* labs.* Which* of* the* following* labs* would* require* that* the* nurse*
call* the* physician* and* inform* the* healthcare* provider* about* the* client’s* abnormalities?
1. WBC* 14,600* mm3
2. Serum* protein* 6.9* g/dL
3. I* &* D* (incision* and* drainage) * showing* no* growth* for*the* last* 24* hours
4. Albumin* 4.2* g/dL
Answer:* 1
Rationale:* When* the*nurse* is* caring* for* several*clients,* all*of*the* labs* should* be*checked*
frequently* throughout* the* shift* to* assess* for* any* abnormalities.* The* WBC* in* option* 1* is*
abnormal. * (Normal* WBC* 4,000–10,000* mm3.)* All* of* the* other* lab* results* are* within*
acceptable* range;* therefore,* the* results* should* not* be* called* in* to* the* physician.
Cognitive* Level:* Application*
Client*Needs:*Physiologic*
Integrity* Nursing* Process:*
Assessment
4. The* nurse* is* orienting* a* new* graduate.* The* nurse* is* reinforcing* the* importance*
of* standard* precautions.* Which*of*the* following* observations* by*the* nurse* would*
require* further* education* regarding* standard* precautions?
1. The* graduate*nurse*understands* to* wash* hands* when*entering* and*
exiting* the* client’s* room.
2. The* graduate*nurse*wears*gloves* when* serving* breakfast* trays* to*
various* clients.
3. The* graduate* nurse* wears* a* gown,* gloves,* and* goggles* when* suctioning*
a* client.
4. The* graduate*nurse* leaves* all* supplies* in* the* room* of*a* client* who* is*
in* contact* isolation.
Answer:* 2
Rationale:* The* nurse* must* have* an* understanding* of* standard* precautions.* Prevention*
is* the* most* important* measure* to* prevent* nosocomial* infections.* Standard*
precautions* were* published* in* 1996* that* provide* guidelines* for* the* handling* of*
blood* and* other* body*fluids.* These* guidelines* are* used* with*all* clients,*
regardless* of* whether* they* have* a* known* infectious* disease.* Standard*
precautions* are* used
download full file at http://testbankinstant.com
, Test Bank for Understanding Medical-Surgical
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
by* all* healthcare* workers* who* have* direct* contact* with* clients* or* with* their*
body* fluids.* It* is* not* necessary* for* the* nurse* to* wear* gloves* while* delivering *
food*trays* to* the* client,* because* there* is* not* contact* with* the* client.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Evaluation
5. The*admitting* department* alerts*the* nurse* on*a* medical–surgical*unit * that* a*client*
with* active* tuberculosis* (TB)* is* being* admitted* to* the* unit.* Which* type* of* isolation* is*
appropriate* based* on* the* client’s* diagnosis?
1. Standard* precautions
2. Airborne* precautions
3. Droplet* precautions
4. Contact* precautions
Answer:* 2
In* addition* to* handwashing* and* standard* precautions,* the* nature* and* spread* of* some*
infectious* diseases* require* that* special* techniques* be* used* to* protect* uninfected* clients*
and* workers.* The* client* with* pulmonary* tuberculosis* will* be* placed* in* airborne*
precautions. * The* client* should* be*placed* in* a* private* room*with* special* ventilation* that*
does* not* allow* air* to* circulate* to* general* hospital* ventilation;* a* mask* or* special* filter *
respirators* will* be* used* for* everyone* entering* the* room.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Assessment
6. A*client* is* receiving* IV* vancomycin* for* the* treatment* of* Clostridium* difficile.*
The* nurse*understands*that*the* client* who* develops* flushing,* tachycardia,* and*
hypotension* during* the* infusion* of* vancomycin* indicates:
1. Ototoxicity*effect.
2. Superinfection.
3. Red* man* syndrome.
4. Hives.
Answer:* 3
Rationale:*Vancomycin* inhibits*cell*wall*synthesis, * and* is*used* for* serious* infections.* It*
is* only* effective* against* gram-positive* bacteria,* especially* Staphylococcus* aureus* and
download full file at http://testbankinstant.com
, Test Bank for Understanding Medical-Surgical
Nursing 6th Edition Linda S. Williams Paula D.
Hopper
Staphylococcus* epidermidis.* The* nurse* should* infuse* this* medication* slowly* over* 60*
minutes* or* more* to* avoid* “red* man”* syndrome.* The* syndrome* is* characterized* by*
erythematous*rash,* flushing,* tachycardia,* and* hypotension.* Clients* can*become* dizzy*
and* agitated.
Cognitive* Level:* Application
Client*Needs:*Physiological*Integrity*
Nursing* Process:* Evaluation
7. The* physician* has* ordered* for*the* client* to* receive* a* trough* blood* level* to* evaluate*
the* therapeutic* effect* of* an* antibiotic.* The* nurse* understands* that* the* trough* should*
be* ordered:
1. A*few* minutes* before* the* next* scheduled* dose*of* medication.
2. 1–2* hours* after* the* oral* administration* of*the* medication.
3. 30* minutes* after* the* IV*administration.
4. During* the* infusion* of*the* antibiotic.
Answer:* 1
Rationale:* Antibiotic* peak* and* trough* levels* monitor* therapeutic* blood* levels* of* the*
prescribed* medication.* The* therapeutic* range—the* minimum* and* maximum* blood*
levels* at* which* the* drug* is* effective—is* known* for* a* given* drug.* By* measuring* blood*
levels* at* the* predicted* peak* (1–2* hours* after* oral* administration,* 1* hour* after*
intramuscular* administration,* and* 30* minutes* after* IV*administration)* and*trough*
(usually*a* few* minutes* before* the* next* scheduled* dose),* it* is* also* possible* to* determine*
whether* the* drug* is* reaching* a* toxic* or* harmful* level* during* therapy, * increasing* the*
likelihood* of* adverse* effects.
Cognitive* Level:* Application
Client* Needs:*Safe,*Effective*Care*Environment*
Nursing* Process:* Assessment
8. The* nurse* needs*to* change* a*dressing* on*the* client’s* abdomen.* Which*of*the*
following* techniques* should* be* implemented?
1. Contact* precautions
2. Standard* precautions
3. Droplet* precautions
4. Airborne* precautions
Answer:* 2
download full file at http://testbankinstant.com
