LEWIS MEDICAL SURGICAL NURSING, 10TH EDITION:TEST BANK - LEWIS MEDICAL SURGICAL NURSING, 10TH EDITION CHAPTER 1-68 EXAM WITH VERIFIED QUESTIONS AND COMPLETE 100%CORRECT ANSWERS WITH VERIFIED AND WELL EXPLAINED RATIONALES ALREADY GRADED A+ BY EXPERTS|LATE

LEWIS MEDICAL SURGICAL NURSING, 10TH EDITION:TEST BANK - LEWIS MEDICAL SURGICAL NURSING, 10TH EDITION CHAPTER 1-68 EXAM WITH VERIFIED QUESTIONS AND COMPLETE 100%CORRECT ANSWERS WITH VERIFIED AND WELL EXPLAINED RATIONALES ALREADY GRADED A+ BY EXPERTS|LATEST VERSION 2024 WITH GUARANTEED SUCCESS AFTER DOWNLOAD ALREADY !!!!!!! (PROVEN ITS ALL YOU NEED TO EXCEL IN YOUR EXAMS When one parent has an autosomal recessive disorder and the other parent has no genes for the autosomal recessive disorder, the children will be carriers of the autosomal recessive disorder. The children will not have the disorder or display characteristics of the disorder, regardless of gender. DIF: Cognitive Level: Apply (application) REF: 181 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity A patient with a family history of cystic fibrosis (CF) asks for information about genetic testing. Which response by the nurse is most appropriate? Refer the patient to a qualified genetic counselor. Ask the patient why genetic testing seems necessary. Remind the patient that genetic testing has many social implications. Tell the patient that cystic fibrosis is an autosomal recessive disorder. ANS: A A genetic counselor is best qualified to address the multiple issues involved in genetic testing for a patient who is considering having children. Although genetic testing does have social implications, the patient will be better served by a genetic counselor, who will have more expertise in this area. CF is an autosomal recessive disorder, but the patient might not understand the implications of this statement. Asking why the patient feels genetic testing is important may imply to the patient that the nurse is questioning her value system. DIF: Cognitive Level: Analyze (analysis) REF: 185 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity A male patient with hemophilia asks the nurse if his children will be hemophiliacs. Which response by the nurse is accurate? “All of your children will be at risk for hemophilia.” “Hemophilia is a multifactorial inherited condition.” “Only your male children are at risk for hemophilia.” “Your female children will be carriers for hemophilia.” ANS: D Because hemophilia is caused by a mutation of the X chromosome, all female children of a man with hemophilia are carriers of the disorder and can transmit the mutated gene to their offspring. Sons of a man with hemophilia will not have the disorder. Hemophilia is caused by a single genetic mutation and is not a multifactorial inherited condition. DIF: Cognitive Level: Apply (application) REF: 181 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance When caring for a young adult patient who has abnormalities in the cytochrome P450 (CYP 450) gene, which action will the nurse include in the patient’s plan of care? a. Teach that some medications may not work effectively. Teach about genetic risk for cystic fibrosis in any children. Encourage scheduling screening mammograms starting at age 30. Encourage the patient to watch for early symptoms of heart disease. ANS: A The CYP 450 gene affects the metabolism of many medications, and they may not work as effectively or may have unexpected toxic effects. The CYP 450 gene does not affect risk for breast cancer, cystic fibrosis, or coronary artery disease. DIF: Cognitive Level: Apply (application) REF: 186 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance A patient tells the nurse, “I would like to use a home genetic test to see if I will develop breast cancer.” Which is the nurse’s best initial response? a. “Home genetic testing is very expensive.” “Are you prepared to cope with a positive result?” “Are you concerned about developing breast cancer?” “Genetic testing only determines if you are at higher risk for breast cancer.” ANS: C Asking about the concern uses the communication technique of clarifying for further assessment. The other options accurately indicate information about genetic testing, but the initial response by the nurse should be focused on assessment. DIF: Cognitive Level: Analyze (analysis) REF: 185 OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance The nurse in the outpatient clinic has obtained health histories for these new patients. Which patient may need referral for genetic testing? A 20-yr-old patient whose maternal grandparents died after strokes at ages 80 and 82 A 20-yr-old patient with a positive pregnancy test whose first child has cerebral palsy A 30-yr-old patient who has a sibling with newly diagnosed polycystic kidney disease A 30-yr-old patient with a history of cigarette smoking who is complaining of dyspnea ANS: C The adult form of polycystic kidney disease is an autosomal dominant disorder and frequently it is asymptomatic until the patient is older. Presymptomatic testing will give the patient information that will be useful in guiding lifestyle and childbearing choices. The other patients do not have any indication of genetic disorders or need for genetic testing. DIF: Cognitive Level: Apply (application) REF: 182 OBJ: Special Questions: Multiple Patients TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance Chapter 13: Altered Immune Responses and Transplantation Lewis: Medical-Surgical Nursing, 10th Edition MULTIPLE CHOICE The nurse provides discharge instructions to a patient who has an immune deficiency involving the T lymphocytes. Which health screening should the nurse include in the teaching plan for this patient? Screening for allergies Screening for malignancies Screening for antibody deficiencies Screening for autoimmune disorders ANS: B Cell-mediated immunity is responsible for the recognition and destruction of cancer cells. Allergic reactions, autoimmune disorders, and antibody deficiencies are mediated primarily by B lymphocytes and humoral immunity. DIF: Cognitive Level: Apply (application) REF: 196 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance Which example should the nurse use to explain an infant’s “passive immunity” to a new mother? a. Vaccinations Breastfeeding Stem cells in peripheral blood Exposure to communicable diseases ANS: B Colostrum in breast milk provides passive immunity through antibodies from the mother. These antibodies protect the infant for a few months. However, memory cells are not retained, so the protection is not permanent. Active immunity is acquired by being immunized with vaccinations or having an infection. Stem cells are unspecialized cells used to repopulate a person's bone marrow after high-dose chemotherapy. DIF: Cognitive Level: Apply (application) REF: 192 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity A patient is being evaluated for possible atopic dermatitis. The nurse expects elevation of which laboratory value? IgE c. Basophils IgA d. Neutrophils ANS: A Serum IgE is elevated in an allergic response (type 1 hypersensitivity disorders). The eosinophil level will be elevated rather than neutrophil or basophil counts. IgA is located in body secretions and would not be tested when evaluating a patient who has symptoms of atopic dermatitis. DIF: Cognitive Level: Apply (application) REF: 194 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity An older adult patient who is having an annual check-up tells the nurse, “I feel fine, and I don’t want to pay for all these unnecessary cancer screening tests!” Which information should the nurse plan to teach this patient? Consequences of aging on cell-mediated immunity Decrease in antibody production associated with aging Impact of poor nutrition on immune function in older people Incidence of cancer-associated infections in older individuals ANS: A The primary impact of aging on immune function is on T cells, which are important for immune surveillance and tumor immunity. Antibody function is not affected as much by aging. Poor nutrition can also contribute to decreased immunity, but there is no evidence that it is a contributing factor for this patient. Although some types of cancer are associated with specific infections, this patient does not have an active infection. DIF: Cognitive Level: Apply (application) REF: 196 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity A patient who collects honey to earn supplemental income has developed a hypersensitivity to bee stings. Which statement, if made by the patient, would indicate a need for additional teaching? “I need to find a different way to earn extra money.” “I will take oral antihistamines before going to work.” “I will get a prescription for epinephrine and learn to self-inject it.” “I should wear a Medic-Alert bracelet indicating my allergy to bee stings.” ANS: B Because the patient is at risk for bee stings and the severity of allergic reactions tends to increase with added exposure to allergen, taking oral antihistamines will not adequately control the patient’s hypersensitivity reaction. The other patient statements indicate a good understanding of management of the problem. DIF: Cognitive Level: Apply (application) REF: 197 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity Which information about intradermal skin testing should the nurse teach to a patient with possible allergies? “Do not eat anything for about 6 hours before the testing.” “Take an oral antihistamine about an hour before the testing.” “Plan to wait in the clinic for 20 to 30 minutes after the testing.” “Reaction to the testing will take about 48 to 72 hours to occur.” ANS: C Allergic reactions usually occur within minutes after injection of an allergen, and the patient will be monitored for at least 20 minutes for anaphylactic reactions after the testing. Medications that might modify the response, such as antihistamines, should be avoided before allergy testing. There is no reason to be NPO for skin testing. Results with intradermal testing occur within minutes. DIF: Cognitive Level: Apply (application) REF: 200 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity