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TestBank-Lewis-Medical-Surgical-Nursing-11th-2020 questions and answers

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1. The nurse teaches a student nurse about how to apply the nursing process when providing patient care. Which statement, if made by the student nurse, indicates that teaching was successful? a. The nursing process is a scientific-based method of diagnosing the patients health care problems. b. The nursing process is a problem-solving tool used to identify and treat patients health care needs. c. The nursing process is based on nursing theory that incorporates the biopsychosocial nature of humans. d. The nursing process is used primarily to explain nursing interventions to other health care professionals. ANS: B The nursing process is a problem-solving approach to the identification and treatment of patients problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing process is in patient care, not to establish nursing theory or explain nursing interventions to other health care professionals. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 2. The nurse describes to a student nurse how to use evidence-based practice guidelines when caring for patients. Which statement, if made by the nurse, would be the most accurate? a. Inferences from clinical research studies are used as a guide. b. Patient care is based on clinical judgment, experience, and traditions. c. Data are evaluated to show that the patient outcomes are consistently met. d. Recommendations are based on research, clinical expertise, and patient preferences. ANS: D Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician expertise. Clinical judgment based on the nurses clinical experience is part of EBP, but clinical decision making should also incorporate current research and research-based guidelines. Evaluation of patient outcomes is important, but interventions should be based on research from randomized control studies with a large number of subjects. DIF: Cognitive Level: Remember (knowledge) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 3 3. The nurse completes an admission database and explains that the plan of care and discharge goals will be developed with the patients input. The patient states, How is this different from what the doctor does? Which response would be most appropriate for the nurse to make? a. The role of the nurse is to administer medications and other treatments prescribed by your doctor. b. The nurses job is to help the doctor by collecting information and communicating any problems that occur. c. Nurses perform many of the same procedures as the doctor, but nurses are with the patients for a longer time than the doctor. d. In addition to caring for you while you are sick, the nurses will assist you to develop an individualized plan to maintain your health. ANS: D This response is consistent with the American Nurses Association (ANA) definition of nursing, which describes the role of nurses in promoting health. The other responses describe some of the dependent and collaborative functions of the nursing role but do not accurately describe the nurses role in the health care system. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 4. A patient who is paralyzed on the left side of the body after a stroke develops a pressure ulcer on the left hip. Which nursing diagnosis is most appropriate? a. Impaired physical mobility related to left-sided paralysis b. Risk for impaired tissue integrity related to left-sided weakness c. Impaired skin integrity related to altered circulation and pressure d. Ineffective tissue perfusion related to inability to move independently ANS: C The patients major problem is the impaired skin integrity as demonstrated by the presence of a pressure ulcer. The nurse is able to treat the cause of altered circulation and pressure by frequently repositioning the patient. Although left-sided weakness is a problem for the patient, the nurse cannot treat the weakness. The risk for diagnosis is not appropriate for this patient, who already has impaired tissue integrity. The patient does have ineffective tissue perfusion, but the impaired skin integrity diagnosis indicates more clearly what the health problem is. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity 5. A patient has been admitted to the hospital for surgery and tells the nurse, I do not feel comfortable leaving my children with my parents. Which action should the nurse take next? Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 4 a. Reassure the patient that these feelings are common for parents. b. Have the patient call the children to ensure that they are doing well. c. Gather more data about the patients feelings about the child-care arrangements. d. Call the patients parents to determine whether adequate child care is being provided. ANS: C Since a complete assessment is necessary in order to identify a problem and choose an appropriate intervention, the nurses first action should be to obtain more information. The other actions may be appropriate, but more assessment is needed before the best intervention can be chosen. DIF: Cognitive Level: Apply (application) OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 6. A patient with a bacterial infection has a nursing diagnosis of deficient fluid volume related to excessive diaphoresis. Which outcome would the nurse recognize as most appropriate for this patient? a. Patient has a balanced intake and output. b. Patients bedding is changed when it becomes damp. c. Patient understands the need for increased fluid intake. d. Patients skin remains cool and dry throughout hospitalization. ANS: A This statement gives measurable data showing resolution of the problem of deficient fluid volume that was identified in the nursing diagnosis statement. The other statements would not indicate that the problem of deficient fluid volume was resolved. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity 7. A nurse asks the patient if pain was relieved after receiving medication. What is the purpose of the evaluation phase of the nursing process? a. To determine if interventions have been effective in meeting patient outcomes b. To document the nursing care plan in the progress notes of the medical record c. To decide whether the patients health problems have been completely resolved Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 5 d. To establish if the patient agrees that the nursing care provided was satisfactory ANS: A Evaluation consists of determining whether the desired patient outcomes have been met and whether the nursing interventions were appropriate. The other responses do not describe the evaluation phase. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Environment 8. The nurse interviews a patient while completing the health history and physical examination. What is the purpose of the assessment phase of the nursing process? a. To teach interventions that relieve health problems b. To use patient data to evaluate patient care outcomes c. To obtain data with which to diagnose patient problems d. To help the patient identify realistic outcomes for health problems ANS: C During the assessment phase, the nurse gathers information about the patient to diagnose patient problems. The other responses are examples of the planning, intervention, and evaluation phases of the nursing process. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment

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Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 1



Table of Contents
nursing
Table of Contents 1
Chapter 01: Professional Nursing 3
Chapter 02: Health Equity and Culturally Competent Care 13
Chapter 03: Health History and Physical Examination 21
Chapter 04: Patient and Caregiver Teaching 28
Chapter 05: Chronic Illness and Older Adults 38
Chapter 06: Stress Management 48
Chapter 07: Sleep and Sleep Disorders 54
Chapter 08: Pain 59
Chapter 09: Palliative and End of Life Care 71
Chapter 10: Substance Use Disorders 79
Chapter 11: Inflammation and Healing 91
Chapter 12: Genetics 101
Chapter 13: Immune Responses and Transplantation 105
Chapter 14: Infection 117
Chapter 15: Cancer 129
Chapter 16: Fluid, Electrolyte, and Acid-Base Imbalances 148
Chapter 17: Preoperative Care 165
Chapter 18: Intraoperative Care 175
Chapter 19: Postoperative Care 184
Chapter 20: Assessment and Management: Visual Problems 196
Chapter 21: Assessment and Management: Auditory Problems 216
Chapter 22: Assessment: Integumentary System 227
Chapter 23: Integumentary Problems 233
Chapter 24: Burns 245
Chapter 25: Assessment: Respiratory System 259
Chapter 26: Upper Respiratory Problems 270
Chapter 27: Lower Respiratory Problems 282
Chapter 28: Obstructive Pulmonary Diseases 305
Chapter 29: Assessment: Hematologic System 325
Chapter 30: Hematologic Problems 332
Chapter 31: Assessment: Cardiovascular System 353
Chapter 32: Hypertension 364
Chapter 33: Coronary Artery Disease and Acute Coronary Syndrome 375
Chapter 34: Heart Failure 394
Chapter 35: Dysrhythmias 406
Chapter 36: Inflammatory and Structural Heart Disorders 420
Chapter 37: Vascular Disorders 435
Chapter 38: Assessment: Gastrointestinal System 450
Chapter 39: Nutritional Problems 458
Chapter 40: Obesity 469
Chapter 41: Upper Gastrointestinal Problems 478
Chapter 42: Lower Gastrointestinal Problems 499
Chapter 43: Liver, Biliary Tract, and Pancreas Problems 523
Chapter 44: Assessment: Urinary System 543
Chapter 45: Renal and Urologic Problems 553
Chapter 46: Acute Kidney Injury and Chronic Kidney Disease 573
Chapter 47: Assessment: Endocrine System 590
Chapter 48: Diabetes Mellitus 600
Chapter 49: Endocrine Problems 622
Chapter 50: Assessment: Reproductive System 642

,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 2



Chapter 51: Breast Disorders 650
Chapter 52: Sexually Transmitted Infections 662
Chapter 53: Female Reproductive Problems 671
Chapter 54: Male Reproductive Problems 693
Chapter 55: Assessment: Nervous System 708
Chapter 56: Acute Intracranial Problems 717
Chapter 57: Stroke 734
Chapter 58: Chronic Neurologic Problems 747
Chapter 59: Dementia and Delirium 763
Chapter 60: Spinal Cord and Peripheral Nerve Problems 772
Chapter 61: Assessment: Musculoskeletal System 787
Chapter 62: Musculoskeletal Trauma and Orthopedic Surgery 794
Chapter 63: Musculoskeletal Problems 814
Chapter 64: Arthritis and Connective Tissue Diseases 825
Chapter 65: Critical Care 845
Chapter 66: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome 864
Chapter 67: Acute Respiratory Failure and Acute Respiratory Distress Syndrome 877
Chapter 68: Emergency and Disaster Nursing 889

,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 3



Chapter 01: Professional Nursing
Test Bank

MULTIPLE CHOICE

1. The nurse teaches a student nurse about how to apply the nursing process when providing patient care.
Which statement, if made by the student nurse, indicates that teaching was successful?

a. The nursing process is a scientific-based method of diagnosing the patients health care problems.


b. The nursing process is a problem-solving tool used to identify and treat patients health care needs.


c. The nursing process is based on nursing theory that incorporates the biopsychosocial nature of
humans.


d. The nursing process is used primarily to explain nursing interventions to other health care
professionals.


ANS: B

The nursing process is a problem-solving approach to the identification and treatment of patients problems.
Diagnosis is only one phase of the nursing process. The primary use of the nursing process is in patient care,
not to establish nursing theory or explain nursing interventions to other health care professionals.

DIF: Cognitive Level: Understand (comprehension)

TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment

2. The nurse describes to a student nurse how to use evidence-based practice guidelines when caring for
patients. Which statement, if made by the nurse, would be the most accurate?

a. Inferences from clinical research studies are used as a guide.


b. Patient care is based on clinical judgment, experience, and traditions.


c. Data are evaluated to show that the patient outcomes are consistently met.


d. Recommendations are based on research, clinical expertise, and patient preferences.


ANS: D

Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician
expertise. Clinical judgment based on the nurses clinical experience is part of EBP, but clinical decision
making should also incorporate current research and research-based guidelines. Evaluation of patient outcomes
is important, but interventions should be based on research from randomized control studies with a large
number of subjects.

DIF: Cognitive Level: Remember (knowledge)

TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment

, Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 4


3. The nurse completes an admission database and explains that the plan of care and discharge goals will be
developed with the patients input. The patient states, How is this different from what the doctor does? Which
response would be most appropriate for the nurse to make?

a. The role of the nurse is to administer medications and other treatments prescribed by your doctor.


b. The nurses job is to help the doctor by collecting information and communicating any problems
that occur.


c. Nurses perform many of the same procedures as the doctor, but nurses are with the patients for a
longer time than the doctor.


d. In addition to caring for you while you are sick, the nurses will assist you to develop an
individualized plan to maintain your health.


ANS: D

This response is consistent with the American Nurses Association (ANA) definition of nursing, which
describes the role of nurses in promoting health. The other responses describe some of the dependent and
collaborative functions of the nursing role but do not accurately describe the nurses role in the health care
system.

DIF: Cognitive Level: Understand (comprehension)

TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment

4. A patient who is paralyzed on the left side of the body after a stroke develops a pressure ulcer on the left hip.
Which nursing diagnosis is most appropriate?

a. Impaired physical mobility related to left-sided paralysis


b. Risk for impaired tissue integrity related to left-sided weakness


c. Impaired skin integrity related to altered circulation and pressure


d. Ineffective tissue perfusion related to inability to move independently


ANS: C

The patients major problem is the impaired skin integrity as demonstrated by the presence of a pressure ulcer.
The nurse is able to treat the cause of altered circulation and pressure by frequently repositioning the patient.
Although left-sided weakness is a problem for the patient, the nurse cannot treat the weakness. The risk for
diagnosis is not appropriate for this patient, who already has impaired tissue integrity. The patient does have
ineffective tissue perfusion, but the impaired skin integrity diagnosis indicates more clearly what the health
problem is.

DIF: Cognitive Level: Apply (application)

TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity

5. A patient has been admitted to the hospital for surgery and tells the nurse, I do not feel comfortable leaving
my children with my parents. Which action should the nurse take next?

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