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DEWITT’S MEDICAL-SURGICAL NURSING: CONCEPTS
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AND PRACTICE, 4TH EDITION by Holly K. Stromberg.
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,TABLE OF CONTENT
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Chapter 01: Caring for Medical-Surgical Patients ...................................................................................... 4
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Chapter 02: Critical Thinking and the Nursing Process ......................................................................... 14
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Chapter 03: Fluid, Electrolytes, Acid-Base Balance, and Intravenous Therapy .................................... 24
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Chapter 04: Care of Preoperative and Intraoperative Surgical Patients ................................................. 34
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Chapter 05: Care of Postoperative Patients............................................................................................... 44
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Chapter 06: Infection Prevention and Control .......................................................................................... 54
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Chapter 07: Care of Patients with Pain .................................................................................................... 64
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Chapter 08: Care of Patients with Cancer ................................................................................................ 74
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Chapter 09: Chronic Illness and Rehabilitation ........................................................................................ 84
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Chapter 10: The Immune and Lymphatic System.................................................................................... 95
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Chapter 11: Care of Patients with Immune and Lymphatic Disorders (with HIV and AIDS) .............105
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Chapter 12: The Respiratory System ........................................................................................................116
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Chapter 13: Care of Patients with Disorders of the Upper Respiratory System ................................126
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Chapter 14: Care of Patients with Disorders of the Lower Respiratory System ...............................136
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Chapter 15: The Hematologic System ......................................................................................................147
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Chapter 16: Care of Patients with Hematologic Disorders ....................................................................157
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Chapter 17: The Cardiovascular System ...................................................................................................167
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Chapter 18: Care of Patients with Hypertension and Peripheral Vascular Disease ............................177
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Chapter 19: Care of Patients with Cardiac Disorders ............................................................................187
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Chapter 20: Care of Patients with Coronary Artery Disease and Cardiac Surgery ............................197
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Chapter 21: The Neurologic System .........................................................................................................208
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Chapter 22: Care of Patients with Head and Spinal Cord Injuries .....................................................218
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Chapter 23: Care of Patients with Disorders of the Brain ...................................................................228
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Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases ...............................238
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Chapter 25: The Sensory System: Eye and Ear .....................................................................................248
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Chapter 26: Care of Patients with Disorders of the Eyes and Ears ....................................................258
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Chapter 27: The Gastrointestinal System .................................................................................................269
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Chapter 28: Care of Patients with Disorders of the Upper Gastrointestinal System .........................280
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Chapter 29: Care of Patients with Disorders of the Lower Gastrointestinal System .........................291
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Chapter 30: Care of Patients with Disorders of the Liver, Gallbladder, and Pancreas ............................302
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Chapter 31: The Musculoskeletal System.................................................................................................313
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Chapter 32: Care of Patients with Musculoskeletal and Connective Tissue Disorders ......................323
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Chapter 33: The Urinary System ..............................................................................................................334
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Chapter 34: Care of Patients with Disorders of the Urinary System ..................................................346
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Chapter 35: The Endocrine System ..........................................................................................................358
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Chapter 36: Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders....................368
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Chapter 37: Care of Patients with Diabetes and Hypoglycemia ...........................................................380
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Chapter 38: Care of Women with Reproductive Disorders ...................................................................392
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Chapter 39: Care of Men with Reproductive Disorders ........................................................................404
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,Chapter 40: Care of Patients with Sexually Transmitted Infections .....................................................416
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Chapter 41: The Integumentary System....................................................................................................426
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Chapter 42: Care of Patents with Integumentary Disorders and Burns ...............................................436
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Chapter 43: Care of Patients in Disasters or Bioterrorism Attack .......................................................447
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Chapter 44: Care of Patients with Emergencies, Trauma, and Shock .................................................457
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Chapter 45: Care of Patients with Anxiety, Mood, and Eating Disorders ..........................................469
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Chapter 46: Care of Patients with Substance Abuse Disorders ............................................................479
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Chapter 47: Care of Patients with Cognitive Disorders .........................................................................490
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Chapter 48: Care of Patients with Thought and Personality Disorders ...............................................500
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, Chapter 01: Caring for Medical-Surgical Patients
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deWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition
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MULTIPLE CHOICE mk
1. Which statement accurately describes the primary purpose of the state nurse
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practice act (NPA)?
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a. To test and license LPN/LVNs.
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b. To define the scope of LPN/LVN practice.
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c. To improve the quality of care provided by the LPN/LVN.
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d. To limit the LPN/LVN employment placement.
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ANS: m k B
While improving quality of care provided by the LPN/LVN may be a result of the NPA,
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the primary purpose of the NPA of each state defines the scope of nursing practice in
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that state.
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PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
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OBJ: 3 TOP: NPA
m k KEY: Nursing Process Step: m k mk mk mk
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
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Care
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2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill
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that the vocational nurse has not been taught during her educational program. How
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should the vocational nurse respond?
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a. Ask a more experienced nurse to demonstrate the procedure.
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b. Look up the procedure in the procedure manual.
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c. Attempt to perform the procedure with supervision.
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d. Inform the charge nurse of her lack of training in this procedure.
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ANS: m k D
The charge nurse should be informed of the lack of training to perform the procedure,
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and the vocational nurse should seek further training to gain proficiency. Although
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the other options might be helpful, they are not safe.
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PTS: 1 DIF: Cognitive Level: Application REF: 3 mk mk mk
OBJ: 1 TOP: m k Providing Safe Care KEY: Nursing Process Step: m k mk mk mk mk mk
N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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3. Which patient statement indicates a need for further discharge teaching that the
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vocational nurse should address?
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a. ―I have no idea of how this drug will affect me.‖
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b. ―Do you know if my physician is coming back today?‖
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c. ―Will my insurance pay for mystay?‖
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d. ―Am I going to have to go to a nursing home?‖
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ANS: m k A
Lack of knowledge at discharge about medication effects and side effects is a concern
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that should be addressed by the vocational nurse. The other concerns in the options
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are the responsibility of other departments to which the nurse might refer the
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patient.
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PTS: m k m k 1 DIF: Cognitive Level: Application REF: 2 mk mk mk
OBJ: m k m k 1 TOP: Teaching KEY: Nursing Process Step: Implementation
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DEWITT’S MEDICAL-SURGICAL NURSING: CONCEPTS
mk mk mk
AND PRACTICE, 4TH EDITION by Holly K. Stromberg.
mk mk mk mk mk mk mk
,TABLE OF CONTENT
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Chapter 01: Caring for Medical-Surgical Patients ...................................................................................... 4
mk mk mk mk mk
Chapter 02: Critical Thinking and the Nursing Process ......................................................................... 14
mk mk mk mk mk mk mk
Chapter 03: Fluid, Electrolytes, Acid-Base Balance, and Intravenous Therapy .................................... 24
mk mk mk mk mk mk mk mk
Chapter 04: Care of Preoperative and Intraoperative Surgical Patients ................................................. 34
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Chapter 05: Care of Postoperative Patients............................................................................................... 44
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Chapter 06: Infection Prevention and Control .......................................................................................... 54
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Chapter 07: Care of Patients with Pain .................................................................................................... 64
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Chapter 08: Care of Patients with Cancer ................................................................................................ 74
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Chapter 09: Chronic Illness and Rehabilitation ........................................................................................ 84
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Chapter 10: The Immune and Lymphatic System.................................................................................... 95
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Chapter 11: Care of Patients with Immune and Lymphatic Disorders (with HIV and AIDS) .............105
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Chapter 12: The Respiratory System ........................................................................................................116
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Chapter 13: Care of Patients with Disorders of the Upper Respiratory System ................................126
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Chapter 14: Care of Patients with Disorders of the Lower Respiratory System ...............................136
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Chapter 15: The Hematologic System ......................................................................................................147
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Chapter 16: Care of Patients with Hematologic Disorders ....................................................................157
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Chapter 17: The Cardiovascular System ...................................................................................................167
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Chapter 18: Care of Patients with Hypertension and Peripheral Vascular Disease ............................177
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Chapter 19: Care of Patients with Cardiac Disorders ............................................................................187
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Chapter 20: Care of Patients with Coronary Artery Disease and Cardiac Surgery ............................197
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Chapter 21: The Neurologic System .........................................................................................................208
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Chapter 22: Care of Patients with Head and Spinal Cord Injuries .....................................................218
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Chapter 23: Care of Patients with Disorders of the Brain ...................................................................228
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Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases ...............................238
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Chapter 25: The Sensory System: Eye and Ear .....................................................................................248
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Chapter 26: Care of Patients with Disorders of the Eyes and Ears ....................................................258
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Chapter 27: The Gastrointestinal System .................................................................................................269
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Chapter 28: Care of Patients with Disorders of the Upper Gastrointestinal System .........................280
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Chapter 29: Care of Patients with Disorders of the Lower Gastrointestinal System .........................291
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Chapter 30: Care of Patients with Disorders of the Liver, Gallbladder, and Pancreas ............................302
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Chapter 31: The Musculoskeletal System.................................................................................................313
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Chapter 32: Care of Patients with Musculoskeletal and Connective Tissue Disorders ......................323
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Chapter 33: The Urinary System ..............................................................................................................334
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Chapter 34: Care of Patients with Disorders of the Urinary System ..................................................346
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Chapter 35: The Endocrine System ..........................................................................................................358
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Chapter 36: Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders....................368
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Chapter 37: Care of Patients with Diabetes and Hypoglycemia ...........................................................380
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Chapter 38: Care of Women with Reproductive Disorders ...................................................................392
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Chapter 39: Care of Men with Reproductive Disorders ........................................................................404
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,Chapter 40: Care of Patients with Sexually Transmitted Infections .....................................................416
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Chapter 41: The Integumentary System....................................................................................................426
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Chapter 42: Care of Patents with Integumentary Disorders and Burns ...............................................436
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Chapter 43: Care of Patients in Disasters or Bioterrorism Attack .......................................................447
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Chapter 44: Care of Patients with Emergencies, Trauma, and Shock .................................................457
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Chapter 45: Care of Patients with Anxiety, Mood, and Eating Disorders ..........................................469
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Chapter 46: Care of Patients with Substance Abuse Disorders ............................................................479
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Chapter 47: Care of Patients with Cognitive Disorders .........................................................................490
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Chapter 48: Care of Patients with Thought and Personality Disorders ...............................................500
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, Chapter 01: Caring for Medical-Surgical Patients
mk mk mk mk mk
deWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition
mk mk mk mk mk mk mk
MULTIPLE CHOICE mk
1. Which statement accurately describes the primary purpose of the state nurse
mk mk mk mk mk mk mk mk mk mk
practice act (NPA)?
mk mk mk
a. To test and license LPN/LVNs.
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b. To define the scope of LPN/LVN practice.
mk mk mk mk mk mk
c. To improve the quality of care provided by the LPN/LVN.
mk mk mk mk mk mk mk mk mk
d. To limit the LPN/LVN employment placement.
mk mk mk mk mk
ANS: m k B
While improving quality of care provided by the LPN/LVN may be a result of the NPA,
mk mk mk mk mk mk mk mk mk mk mk mk mk mk mk
the primary purpose of the NPA of each state defines the scope of nursing practice in
mk mk mk mk mk mk mk mk mk mk mk mk mk mk mk mk
that state.
mk mk
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2
m k m k mk mk mk
OBJ: 3 TOP: NPA
m k KEY: Nursing Process Step: m k mk mk mk
Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated
mk mk mk mk mk mk mk mk
Care
mk
2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill
mk mk mk mk mk mk mk mk mk mk mk mk mk mk
that the vocational nurse has not been taught during her educational program. How
mk mk mk mk mk mk mk mk mk mk mk mk mk
should the vocational nurse respond?
mk mk mk mk mk
a. Ask a more experienced nurse to demonstrate the procedure.
mk mk mk mk mk mk mk mk
b. Look up the procedure in the procedure manual.
mk mk mk mk mk mk mk
c. Attempt to perform the procedure with supervision.
mk mk mk mk mk mk
d. Inform the charge nurse of her lack of training in this procedure.
mk mk mk mk mk mk mk mk mk mk mk
ANS: m k D
The charge nurse should be informed of the lack of training to perform the procedure,
mk mk mk mk mk mk mk mk mk mk mk mk mk mk
and the vocational nurse should seek further training to gain proficiency. Although
mk mk mk mk mk mk mk mk mk mk mk mk
the other options might be helpful, they are not safe.
mk mk mk mk mk mk mk mk mk mk
PTS: 1 DIF: Cognitive Level: Application REF: 3 mk mk mk
OBJ: 1 TOP: m k Providing Safe Care KEY: Nursing Process Step: m k mk mk mk mk mk
N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
mk mk mk mk mk mk mk mk mk
3. Which patient statement indicates a need for further discharge teaching that the
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vocational nurse should address?
mk mk mk mk
a. ―I have no idea of how this drug will affect me.‖
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b. ―Do you know if my physician is coming back today?‖
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c. ―Will my insurance pay for mystay?‖
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d. ―Am I going to have to go to a nursing home?‖
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ANS: m k A
Lack of knowledge at discharge about medication effects and side effects is a concern
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that should be addressed by the vocational nurse. The other concerns in the options
mk mk mk mk mk mk mk mk mk mk mk mk mk mk
are the responsibility of other departments to which the nurse might refer the
mk mk mk mk mk mk mk mk mk mk mk mk mk
patient.
mk
PTS: m k m k 1 DIF: Cognitive Level: Application REF: 2 mk mk mk
OBJ: m k m k 1 TOP: Teaching KEY: Nursing Process Step: Implementation
m k mk mk mk mk
