MEDICAL-SURGICAL 09/27/2026
NURSING
TEST BANK 4 FOR BRUNNER & SUDDARTH’S
MEDICAL-SURGICAL NURSING 15TH EDITION |
ALL 68 CHAPTERS WITH ANSWER KEYS AT
END OF EACH CHAPTER
A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an ulcer on the
heel of the left foot that has not healed with wound care. The nurse observes that the entire
left foot is darker in color than the right foot. Which additional symptom should the nurse
JOYCEWWALES 1
, MEDICAL-SURGICAL 09/27/2026
NURSING
expect to find?
A.
Pedal pulses will be weak or absent in the left foot.
B.
The client will state that the left foot is usually warm.
C.
Flexion and extension of the left foot will be limited.
D.
Capillary refill of the client's left toes will be brisk.
A
Rationale: Symptoms associated with decreased blood supply are weak or absent pedal and
tibial pulses. The client with diabetes experiences vascular scarring as a result of
atherosclerotic changes in the peripheral vessels. This results in compromised perfusion to
the dependent extremities, which further delays wound healing in the affected foot. Although
flexion and extension may be limited, depending on the degree of damage, this is not always
the case. Options B and D are signs of adequate perfusion of the foot, which would not be
expected in this client.
The nurse is assessing a male client with acute pancreatitis. Which finding requires the most
immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
While the nurse is taking the client's blood pressure, he has a carpal spasm.
C.
On a 1 to 10 scale, the client tells the nurse that his epigastric pain is at 7.
D.
The client states that he will continue to drink alcohol after going home.
JOYCEWWALES 2
, MEDICAL-SURGICAL 09/27/2026
NURSING
B
Rationale: A positive Trousseau sign indicates hypocalcemia and always requires further
assessment and intervention, regardless of the cause (40% to 75% of those with acute
pancreatitis experience hypocalcemia, which can have serious, systemic effects). A key
diagnostic finding of pancreatitis is serum amylase and lipase levels that are two to five times
higher than the normal value. Severe boring pain is an expected symptom for this diagnosis,
but dealing with the hypocalcemia is a priority over administering an analgesic. Long-term
planning and teaching do not have the same immediate importance as a positive Trousseau
sign.
Which nursing action is necessary for the client with a flail chest?
A.
Withhold prescribed analgesic medications.
B.
Percuss the fractured rib area with light taps.
C.
Avoid implementing pulmonary suctioning.
D.
Encourage coughing and deep breathing.
D
Rationale: Treatment of flail chest is focused on preventing atelectasis and related
complications of compromised ventilation by encouraging coughing and deep breathing. This
condition is typically diagnosed in clients with three or more rib fractures, resulting in
paradoxic movement of a segment of the chest wall. Option C should not be avoided
because suctioning is necessary to maintain pulmonary toilet in clients who require
mechanical ventilation. Option A should not be withheld. Option B should not be applied
because the fractures are clearly visible on the chest radiograph.
JOYCEWWALES 3
, MEDICAL-SURGICAL 09/27/2026
NURSING
A female client who received a nephrotoxic drug is admitted with acute renal failure and asks
the nurse if she will need dialysis for the rest of her life. Which pathophysiologic consequence
should the nurse explain that supports the need for temporary dialysis until acute tubular
necrosis subsides?
A.
Azotemia
B.
Oliguria
C.
Hyperkalemia
D.
Nephron obstruction
D
Rationale: CKD is characterized by progressive and irreversible destruction of nephrons,
frequently caused by hypertension and diabetes mellitus. Nephrotoxins cause acute tubular
necrosis, a reversible acute renal failure, which creates renal tubular obstruction from
endothelial cells that are sloughed or become edematous. The obstruction of urine flow will
resolve with the return of an adequate glomerular filtration rate, and when it does, dialysis will
no longer be needed. Options A, B, and C are manifestations seen in the acute and chronic
forms of kidney disease.
Which content about self-care should the nurse include in the teaching plan of a female client
who has genital herpes? (Select all that apply.)
A.
Encourage annual physical and Pap smear.
B.
Take antiviral medication as prescribed.
C.
JOYCEWWALES 4
NURSING
TEST BANK 4 FOR BRUNNER & SUDDARTH’S
MEDICAL-SURGICAL NURSING 15TH EDITION |
ALL 68 CHAPTERS WITH ANSWER KEYS AT
END OF EACH CHAPTER
A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an ulcer on the
heel of the left foot that has not healed with wound care. The nurse observes that the entire
left foot is darker in color than the right foot. Which additional symptom should the nurse
JOYCEWWALES 1
, MEDICAL-SURGICAL 09/27/2026
NURSING
expect to find?
A.
Pedal pulses will be weak or absent in the left foot.
B.
The client will state that the left foot is usually warm.
C.
Flexion and extension of the left foot will be limited.
D.
Capillary refill of the client's left toes will be brisk.
A
Rationale: Symptoms associated with decreased blood supply are weak or absent pedal and
tibial pulses. The client with diabetes experiences vascular scarring as a result of
atherosclerotic changes in the peripheral vessels. This results in compromised perfusion to
the dependent extremities, which further delays wound healing in the affected foot. Although
flexion and extension may be limited, depending on the degree of damage, this is not always
the case. Options B and D are signs of adequate perfusion of the foot, which would not be
expected in this client.
The nurse is assessing a male client with acute pancreatitis. Which finding requires the most
immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
While the nurse is taking the client's blood pressure, he has a carpal spasm.
C.
On a 1 to 10 scale, the client tells the nurse that his epigastric pain is at 7.
D.
The client states that he will continue to drink alcohol after going home.
JOYCEWWALES 2
, MEDICAL-SURGICAL 09/27/2026
NURSING
B
Rationale: A positive Trousseau sign indicates hypocalcemia and always requires further
assessment and intervention, regardless of the cause (40% to 75% of those with acute
pancreatitis experience hypocalcemia, which can have serious, systemic effects). A key
diagnostic finding of pancreatitis is serum amylase and lipase levels that are two to five times
higher than the normal value. Severe boring pain is an expected symptom for this diagnosis,
but dealing with the hypocalcemia is a priority over administering an analgesic. Long-term
planning and teaching do not have the same immediate importance as a positive Trousseau
sign.
Which nursing action is necessary for the client with a flail chest?
A.
Withhold prescribed analgesic medications.
B.
Percuss the fractured rib area with light taps.
C.
Avoid implementing pulmonary suctioning.
D.
Encourage coughing and deep breathing.
D
Rationale: Treatment of flail chest is focused on preventing atelectasis and related
complications of compromised ventilation by encouraging coughing and deep breathing. This
condition is typically diagnosed in clients with three or more rib fractures, resulting in
paradoxic movement of a segment of the chest wall. Option C should not be avoided
because suctioning is necessary to maintain pulmonary toilet in clients who require
mechanical ventilation. Option A should not be withheld. Option B should not be applied
because the fractures are clearly visible on the chest radiograph.
JOYCEWWALES 3
, MEDICAL-SURGICAL 09/27/2026
NURSING
A female client who received a nephrotoxic drug is admitted with acute renal failure and asks
the nurse if she will need dialysis for the rest of her life. Which pathophysiologic consequence
should the nurse explain that supports the need for temporary dialysis until acute tubular
necrosis subsides?
A.
Azotemia
B.
Oliguria
C.
Hyperkalemia
D.
Nephron obstruction
D
Rationale: CKD is characterized by progressive and irreversible destruction of nephrons,
frequently caused by hypertension and diabetes mellitus. Nephrotoxins cause acute tubular
necrosis, a reversible acute renal failure, which creates renal tubular obstruction from
endothelial cells that are sloughed or become edematous. The obstruction of urine flow will
resolve with the return of an adequate glomerular filtration rate, and when it does, dialysis will
no longer be needed. Options A, B, and C are manifestations seen in the acute and chronic
forms of kidney disease.
Which content about self-care should the nurse include in the teaching plan of a female client
who has genital herpes? (Select all that apply.)
A.
Encourage annual physical and Pap smear.
B.
Take antiviral medication as prescribed.
C.
JOYCEWWALES 4
