TEST BANK FOR MEDICAL-SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMON
Test Bank for Medical-Surgical Nursing Critical
Thinking in Client Care, 4th Edition Priscilla LeMon
,TEST BANK FOR MEDICAL-SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMON
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
Correct 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
,TEST BANK FOR MEDICAL-SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMON
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.”
Correct 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.
, TEST BANK FOR MEDICAL-SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMON
Cognitive Level: Application
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
Correct 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.
CARE, 4TH EDITION PRISCILLA LEMON
Test Bank for Medical-Surgical Nursing Critical
Thinking in Client Care, 4th Edition Priscilla LeMon
,TEST BANK FOR MEDICAL-SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMON
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
Correct 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
,TEST BANK FOR MEDICAL-SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMON
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.”
Correct 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.
, TEST BANK FOR MEDICAL-SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMON
Cognitive Level: Application
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
Correct 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.
