FULL TEST BANK
MEDICAL SURGICAL NURSING 9TH EDITION
IGNATAVICIUS .
COMPLETE CHAPTERS 1-74& ANSWERZS
,TABLE OF CONTENTS
CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR MEDICAL- SURGICAL NURSING .... 5
CHAPTER 02: OVERVIEW OF HEALTH CONCEPTS FOR MEDICAL-SURGICAL NURSING............................... 15
CHAPTER 03: COMMON HEALTH PROBLEMS OF OLDER ADULTS .............................................................. 25
CHAPTER 04: ASSESSMENT AND CARE OF PATIENTS WITH PAIN ............................................................... 39
CHAPTER 05: GENETIC CONCEPTS FOR MEDICAL-SURGICAL NURSING ..................................................... 64
CHAPTER 06: REHABILITATION CONCEPTS FOR CHRONIC AND DISABLING HEALTH PROBLEMS .............. 77
CHAPTER 07: END-OF-LIFE CARE ................................................................................................................. 90
CHAPTER 08: CONCEPTS OF EMERGENCY AND TRAUMA NURSING......................................................... 102
CHAPTER 09: CARE OF PATIENTS WITH COMMON ENVIRONMENTAL EMERGENCIES ............................ 114
CHAPTER 10: CONCEPTS OF EMERGENCY AND DISASTER PREPAREDNESS .............................................. 127
CHAPTER 11: ASSESSMENT AND CARE OF PATIENTS WITH FLUID AND ELECTROLYTE IMBALANCES ...... 140
CHAPTER 12: ASSESSMENT AND CARE OF PATIENTS WITH ACID-BASE IMBALANCES ............................. 157
CHAPTER 13: INFUSION THERAPY ............................................................................................................. 171
CHAPTER 14: CARE OF PREOPERATIVE PATIENTS ..................................................................................... 191
CHAPTER 15: CARE OF INTRAOPERATIVE PATIENTS ................................................................................. 210
CHAPTER 16: CARE OF POSTOPERATIVE PATIENTS .................................................................................. 223
CHAPTER 17: INFLAMMATION AND IMMUNITY ....................................................................................... 238
CHAPTER 18: CARE OF PATIENTS WITH ARTHRITIS AND OTHER CONNECTIVE TISSUE DISEASES ............ 250
CHAPTER 19: CARE OF PATIENTS WITH HIV DISEASE ............................................................................... 284
CHAPTER 20: CARE OF PATIENTS WITH HYPERSENSITIVITY (ALLERGY) AND AUTOIMMUNITY................ 303
CHAPTER 21: CANCER DEVELOPMENT...................................................................................................... 314
CHAPTER 22: CARE OF PATIENTS WITH CANCER ...................................................................................... 324
CHAPTER 23: CARE OF PATIENTS WITH INFECTION .................................................................................. 346
CHAPTER 24: ASSESSMENT OF THE SKIN, HAIR, AND NAILS..................................................................... 361
CHAPTER 25: CARE OF PATIENTS WITH SKIN PROBLEMS ......................................................................... 371
CHAPTER 26: CARE OF PATIENTS WITH BURNS ........................................................................................ 403
CHAPTER 27: ASSESSMENT OF THE RESPIRATORY SYSTEM...................................................................... 436
CHAPTER 28: CARE OF PATIENTS REQUIRING OXYGEN THERAPY OR TRACHEOSTOMY .......................... 450
CHAPTER 29: CARE OF PATIENTS WITH NONINFECTIOUS UPPER RESPIRATORY PROBLEMS................... 463
CHAPTER 30: CARE OF PATIENTS WITH NONINFECTIOUS LOWER RESPIRATORY PROBLEMS ................. 477
,CHAPTER 31: CARE OF PATIENTS WITH INFECTIOUS RESPIRATORY PROBLEMS ...................................... 502
CHAPTER 32: CARE OF CRITICALLY ILL PATIENTS WITH RESPIRATORY PROBLEMS .................................. 522
CHAPTER 33: ASSESSMENT OF THE CARDIOVASCULAR SYSTEM .............................................................. 547
CHAPTER 34: CARE OF PATIENTS WITH DYSRHYTHMIAS.......................................................................... 565
CHAPTER 35: CARE OF PATIENTS WITH CARDIAC PROBLEMS .................................................................. 584
CHAPTER 36: CARE OF PATIENTS WITH VASCULAR PROBLEMS ............................................................... 607
CHAPTER 37: CARE OF PATIENTS WITH SHOCK ........................................................................................ 632
CHAPTER 38: CARE OF PATIENTS WITH ACUTE CORONARY SYNDROMES ............................................... 647
CHAPTER 39: ASSESSMENT OF THE HEMATOLOGIC SYSTEM ................................................................... 668
CHAPTER 40: CARE OF PATIENTS WITH HEMATOLOGIC PROBLEMS ........................................................ 676
CHAPTER 41: ASSESSMENT OF THE NERVOUS SYSTEM ............................................................................ 702
CHAPTER 42: CARE OF PATIENTS WITH PROBLEMS OF THE CNS: THE BRAIN .......................................... 723
CHAPTER 43: CARE OF PATIENTS WITH PROBLEMS OF THE CNS: THE SPINAL CORD .............................. 746
CHAPTER 44: CARE OF PATIENTS WITH PROBLEMS OF THE PERIPHERAL NERVOUS SYSTEM ................. 767
CHAPTER 45: CARE OF CRITICALLY ILL PATIENTS WITH NEUROLOGIC PROBLEMS................................... 780
CHAPTER 46: ASSESSMENT OF THE EYE AND VISION ............................................................................... 810
CHAPTER 47: CARE OF PATIENTS WITH EYE AND VISION PROBLEMS ...................................................... 816
CHAPTER 48: ASSESSMENT AND CARE OF PATIENTS WITH EAR AND HEARING PROBLEMS ................... 829
CHAPTER 49: ASSESSMENT OF THE MUSCULOSKELETAL SYSTEM ........................................................... 844
CHAPTER 50: CARE OF PATIENTS WITH MUSCULOSKELETAL PROBLEMS ................................................ 855
CHAPTER 51: CARE OF PATIENTS WITH MUSCULOSKELETAL TRAUMA.................................................... 874
CHAPTER 52: ASSESSMENT OF THE GASTROINTESTINAL SYSTEM ........................................................... 897
CHAPTER 53: CARE OF PATIENTS WITH ORAL CAVITY PROBLEMS ........................................................... 909
CHAPTER 54: CARE OF PATIENTS WITH ESOPHAGEAL PROBLEMS ........................................................... 918
CHAPTER 55: CARE OF PATIENTS WITH STOMACH DISORDERS ............................................................... 934
CHAPTER 56: CARE OF PATIENTS WITH NONINFLAMMATORY INTESTINAL DISORDERS ......................... 949
CHAPTER 57: CARE OF PATIENTS WITH INFLAMMATORY INTESTINAL DISORDERS ................................. 971
CHAPTER 58: CARE OF PATIENTS WITH LIVER PROBLEMS ....................................................................... 992
CHAPTER 59: CARE OF PATIENTS WITH PROBLEMS OF THE BILIARY SYSTEM AND PANCREAS ............. 1009
CHAPTER 60: CARE OF PATIENTS WITH MALNUTRITION: UNDERNUTRITION AND OBESITY ................. 1025
CHAPTER 61: ASSESSMENT OF THE ENDOCRINE SYSTEM ...................................................................... 1044
CHAPTER 62: CARE OF PATIENTS WITH PITUITARY AND ADRENAL GLAND PROBLEMS ......................... 1057
CHAPTER 63: CARE OF PATIENTS WITH PROBLEMS OF THE THYROID AND PARATHYROID GLANDS .... 1074
,CHAPTER 64: CARE OF PATIENTS WITH DIABETES MELLITUS ................................................................. 1089
CHAPTER 65: ASSESSMENT OF THE RENAL/URINARY SYSTEM ............................................................... 1129
CHAPTER 66: CARE OF PATIENTS WITH URINARY PROBLEMS ................................................................ 1146
CHAPTER 67: CARE OF PATIENTS WITH KIDNEY DISORDERS .................................................................. 1169
CHAPTER 68: CARE OF PATIENTS WITH ACUTE KIDNEY INJURY AND CHRONIC KIDNEY DISEASE .......... 1183
CHAPTER 69: ASSESSMENT OF THE REPRODUCTIVE SYSTEM ................................................................ 1208
CHAPTER 70: CARE OF PATIENTS WITH BREAST DISORDERS.................................................................. 1217
CHAPTER 71: CARE OF PATIENTS WITH GYNECOLOGIC PROBLEMS ....................................................... 1231
CHAPTER 72: CARE OF PATIENTS WITH MALE REPRODUCTIVE PROBLEMS ........................................... 1246
CHAPTER 73: CARE OF TRANSGENDER PATIENTS ................................................................................... 1263
CHAPTER 74: CARE OF PATIENTS WITH SEXUALLY TRANSMITTED DISEASES ......................................... 1271
,CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR
MEDICAL- SURGICAL NURSING
MULTIPLE CHOICE
1. A NURSE WISHES TO PROVIDE CLIENT-CENTERED CARE IN ALL INTERACTIONS. WHICH ACTION
BY THE NURSE BEST DEMONSTRATES THIS CONCEPT?
A. ASSESSES FOR CULTURAL INFLUENCES AFFECTING HEALTH CARE
B. ENSURES THAT ALL THE CLIENTS BASIC NEEDS ARE MET
C. TELLS THE CLIENT AND FAMILY ABOUT ALL UPCOMING TESTS
D. THOROUGHLY ORIENTS THE CLIENT AND FAMILY TO THE ROOM
ANS:A
COMPETENCY IN CLIENT-FOCUSED CARE IS DEMONSTRATED WHEN THE NURSE FOCUSES ON
COMMUNICATION, CULTURE, RESPECT COMPASSION, CLIENT EDUCATION, AND EMPOWERMENT. BY
ASSESSING THE EFFECT OF THE CLIENTS CULTURE ON HEALTH CARE, THIS NURSE IS PRACTICING CLIENT-
FOCUSED CARE. PROVIDING FOR BASIC NEEDS DOES NOT DEMONSTRATE THIS COMPETENCE. SIMPLY
TELLING THE CLIENT ABOUT ALL UPCOMING TESTS IS NOT PROVIDING EMPOWERING EDUCATION.
ORIENTING THE CLIENT AND FAMILY TO THE ROOM IS AN IMPORTANT SAFETY MEASURE, BUT NOT
DIRECTLY RELATED TO DEMONSTRATING CLIENT-CENTERED CARE.
DIF: UNDERSTANDING/COMPREHENSION REF: 3
KEY: PATIENT-CENTERED CARE| CULTURE MSC: INTEGRATED PROCESS: CARING NOT: CLIENT NEEDS
CATEGORY: PSYCHOSOCIAL INTEGRITY
2. A NURSE IS CARING FOR A POSTOPERATIVE CLIENT ON THE SURGICAL UNIT. THE CLIENTS BLOOD
PRESSURE WAS 142/76 MM HG 30 MINUTES AGO, AND NOW IS 88/50 MM HG. WHAT ACTION BY THE
NURSE IS BEST?
A. CALL THE RAPID RESPONSE TEAM.
B. DOCUMENT AND CONTINUE TO MONITOR.
C. NOTIFY THE PRIMARY CARE PROVIDER.
D. REPEAT BLOOD PRESSURE MEASUREMENT IN 15 MINUTES.
,ANS:A
THE PURPOSE OF THE RAPID RESPONSE TEAM (RRT) IS TO INTERVENE WHEN CLIENTS ARE
DETERIORATING BEFORE THEY SUFFER EITHER RESPIRATORY OR CARDIAC ARREST. SINCE THE CLIENT
HAS MANIFESTED A SIGNIFICANT CHANGE, THE NURSE SHOULD CALL THE RRT. CHANGES IN BLOOD
PRESSURE, MENTAL STATUS, HEART RATE, AND PAIN ARE PARTICULARLY SIGNIFICANT.
DOCUMENTATION IS VITAL, BUT THE NURSE MUST DO MORE THAN DOCUMENT. THE PRIMARY CARE
PROVIDER SHOULD BE NOTIFIED, BUT THIS IS NOT THE PRIORITY OVER CALLING THE RRT. THE CLIENTS
BLOOD PRESSURE SHOULD BE REASSESSED FREQUENTLY, BUT THE PRIORITY IS GETTING THE RAPID
CARE TO THE CLIENT.
DIF: APPLYING/APPLICATION REF: 3
KEY: RAPID RESPONSE TEAM (RRT)| MEDICAL EMERGENCIES MSC: INTEGRATED PROCESS:
COMMUNICATION AND DOCUMENTATION
NOT: CLIENT NEEDS CATEGORY: PHYSIOLOGICAL INTEGRITY: PHYSIOLOGICAL ADAPTATION
3. A NURSE IS ORIENTING A NEW CLIENT AND FAMILY TO THE INPATIENT UNIT. WHAT
INFORMATION DOES THE NURSE PROVIDE TO HELP THE CLIENT PROMOTE HIS OR HER OWN SAFETY?
A. ENCOURAGE THE CLIENT AND FAMILY TO BE ACTIVE PARTNERS.
B. HAVE THE CLIENT MONITOR HAND HYGIENE IN CAREGIVERS.
C. OFFER THE FAMILY THE OPPORTUNITY TO STAY WITH THE CLIENT.
D. TELL THE CLIENT TO ALWAYS WEAR HIS OR HER ARMBAND.
ANS:A
EACH ACTION COULD BE IMPORTANT FOR THE CLIENT OR FAMILY TO PERFORM. HOWEVER,
ENCOURAGING THE CLIENT TO BE ACTIVE IN HIS OR HER HEALTH CARE AS A PARTNER IS THE MOST
CRITICAL. THE OTHER ACTIONS ARE VERY LIMITED IN SCOPE AND DO NOT PROVIDE THE BROAD
PROTECTION THAT BEING ACTIVE AND INVOLVED DOES.
DIF: UNDERSTANDING/COMPREHENSION REF: 3 KEY: PATIENT SAFETY
, MSC: INTEGRATED PROCESS: TEACHING/LEARNING
NOT: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
4. A NEW NURSE IS WORKING WITH A PRECEPTOR ON AN INPATIENT MEDICAL-SURGICAL UNIT.
THE PRECEPTOR ADVISES THE STUDENT THAT WHICH IS THE PRIORITY WHEN WORKING AS A
PROFESSIONAL NURSE?
A. ATTENDING TO HOLISTIC CLIENT NEEDS
B. ENSURING CLIENT SAFETY
C. NOT MAKING MEDICATION ERRORS
D. PROVIDING CLIENT-FOCUSED CARE
ANS:B
ALL ACTIONS ARE APPROPRIATE FOR THE PROFESSIONAL NURSE. HOWEVER, ENSURING CLIENT SAFETY
IS THE PRIORITY. UP TO 98,000 DEATHS RESULT EACH YEAR FROM ERRORS IN HOSPITAL CARE,
ACCORDING TO THE 2000 INSTITUTE OF MEDICINE REPORT. MANY MORE CLIENTS HAVE SUFFERED
INJURIES AND LESS SERIOUS OUTCOMES. EVERY NURSE HAS THE RESPONSIBILITY TO GUARD THE
CLIENTS SAFETY.
DIF: UNDERSTANDING/COMPREHENSION REF: 2 KEY: PATIENT SAFETY
MSC: INTEGRATED PROCESS: NURSING PROCESS: INTERVENTION
NOT: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
5. A CLIENT IS GOING TO BE ADMITTED FOR A SCHEDULED SURGICAL PROCEDURE. WHICH ACTION
DOES THE NURSE EXPLAIN IS THE MOST IMPORTANT THING THE CLIENT CAN DO TO PROTECT AGAINST
ERRORS?
A. BRING A LIST OF ALL MEDICATIONS AND WHAT THEY ARE FOR.
B. KEEP THE DOCTORS PHONE NUMBER BY THE TELEPHONE.
C. MAKE SURE ALL PROVIDERS WASH HANDS BEFORE ENTERING THE ROOM.
D. WRITE DOWN THE NAME OF EACH CAREGIVER WHO COMES IN THE ROOM.
MEDICAL SURGICAL NURSING 9TH EDITION
IGNATAVICIUS .
COMPLETE CHAPTERS 1-74& ANSWERZS
,TABLE OF CONTENTS
CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR MEDICAL- SURGICAL NURSING .... 5
CHAPTER 02: OVERVIEW OF HEALTH CONCEPTS FOR MEDICAL-SURGICAL NURSING............................... 15
CHAPTER 03: COMMON HEALTH PROBLEMS OF OLDER ADULTS .............................................................. 25
CHAPTER 04: ASSESSMENT AND CARE OF PATIENTS WITH PAIN ............................................................... 39
CHAPTER 05: GENETIC CONCEPTS FOR MEDICAL-SURGICAL NURSING ..................................................... 64
CHAPTER 06: REHABILITATION CONCEPTS FOR CHRONIC AND DISABLING HEALTH PROBLEMS .............. 77
CHAPTER 07: END-OF-LIFE CARE ................................................................................................................. 90
CHAPTER 08: CONCEPTS OF EMERGENCY AND TRAUMA NURSING......................................................... 102
CHAPTER 09: CARE OF PATIENTS WITH COMMON ENVIRONMENTAL EMERGENCIES ............................ 114
CHAPTER 10: CONCEPTS OF EMERGENCY AND DISASTER PREPAREDNESS .............................................. 127
CHAPTER 11: ASSESSMENT AND CARE OF PATIENTS WITH FLUID AND ELECTROLYTE IMBALANCES ...... 140
CHAPTER 12: ASSESSMENT AND CARE OF PATIENTS WITH ACID-BASE IMBALANCES ............................. 157
CHAPTER 13: INFUSION THERAPY ............................................................................................................. 171
CHAPTER 14: CARE OF PREOPERATIVE PATIENTS ..................................................................................... 191
CHAPTER 15: CARE OF INTRAOPERATIVE PATIENTS ................................................................................. 210
CHAPTER 16: CARE OF POSTOPERATIVE PATIENTS .................................................................................. 223
CHAPTER 17: INFLAMMATION AND IMMUNITY ....................................................................................... 238
CHAPTER 18: CARE OF PATIENTS WITH ARTHRITIS AND OTHER CONNECTIVE TISSUE DISEASES ............ 250
CHAPTER 19: CARE OF PATIENTS WITH HIV DISEASE ............................................................................... 284
CHAPTER 20: CARE OF PATIENTS WITH HYPERSENSITIVITY (ALLERGY) AND AUTOIMMUNITY................ 303
CHAPTER 21: CANCER DEVELOPMENT...................................................................................................... 314
CHAPTER 22: CARE OF PATIENTS WITH CANCER ...................................................................................... 324
CHAPTER 23: CARE OF PATIENTS WITH INFECTION .................................................................................. 346
CHAPTER 24: ASSESSMENT OF THE SKIN, HAIR, AND NAILS..................................................................... 361
CHAPTER 25: CARE OF PATIENTS WITH SKIN PROBLEMS ......................................................................... 371
CHAPTER 26: CARE OF PATIENTS WITH BURNS ........................................................................................ 403
CHAPTER 27: ASSESSMENT OF THE RESPIRATORY SYSTEM...................................................................... 436
CHAPTER 28: CARE OF PATIENTS REQUIRING OXYGEN THERAPY OR TRACHEOSTOMY .......................... 450
CHAPTER 29: CARE OF PATIENTS WITH NONINFECTIOUS UPPER RESPIRATORY PROBLEMS................... 463
CHAPTER 30: CARE OF PATIENTS WITH NONINFECTIOUS LOWER RESPIRATORY PROBLEMS ................. 477
,CHAPTER 31: CARE OF PATIENTS WITH INFECTIOUS RESPIRATORY PROBLEMS ...................................... 502
CHAPTER 32: CARE OF CRITICALLY ILL PATIENTS WITH RESPIRATORY PROBLEMS .................................. 522
CHAPTER 33: ASSESSMENT OF THE CARDIOVASCULAR SYSTEM .............................................................. 547
CHAPTER 34: CARE OF PATIENTS WITH DYSRHYTHMIAS.......................................................................... 565
CHAPTER 35: CARE OF PATIENTS WITH CARDIAC PROBLEMS .................................................................. 584
CHAPTER 36: CARE OF PATIENTS WITH VASCULAR PROBLEMS ............................................................... 607
CHAPTER 37: CARE OF PATIENTS WITH SHOCK ........................................................................................ 632
CHAPTER 38: CARE OF PATIENTS WITH ACUTE CORONARY SYNDROMES ............................................... 647
CHAPTER 39: ASSESSMENT OF THE HEMATOLOGIC SYSTEM ................................................................... 668
CHAPTER 40: CARE OF PATIENTS WITH HEMATOLOGIC PROBLEMS ........................................................ 676
CHAPTER 41: ASSESSMENT OF THE NERVOUS SYSTEM ............................................................................ 702
CHAPTER 42: CARE OF PATIENTS WITH PROBLEMS OF THE CNS: THE BRAIN .......................................... 723
CHAPTER 43: CARE OF PATIENTS WITH PROBLEMS OF THE CNS: THE SPINAL CORD .............................. 746
CHAPTER 44: CARE OF PATIENTS WITH PROBLEMS OF THE PERIPHERAL NERVOUS SYSTEM ................. 767
CHAPTER 45: CARE OF CRITICALLY ILL PATIENTS WITH NEUROLOGIC PROBLEMS................................... 780
CHAPTER 46: ASSESSMENT OF THE EYE AND VISION ............................................................................... 810
CHAPTER 47: CARE OF PATIENTS WITH EYE AND VISION PROBLEMS ...................................................... 816
CHAPTER 48: ASSESSMENT AND CARE OF PATIENTS WITH EAR AND HEARING PROBLEMS ................... 829
CHAPTER 49: ASSESSMENT OF THE MUSCULOSKELETAL SYSTEM ........................................................... 844
CHAPTER 50: CARE OF PATIENTS WITH MUSCULOSKELETAL PROBLEMS ................................................ 855
CHAPTER 51: CARE OF PATIENTS WITH MUSCULOSKELETAL TRAUMA.................................................... 874
CHAPTER 52: ASSESSMENT OF THE GASTROINTESTINAL SYSTEM ........................................................... 897
CHAPTER 53: CARE OF PATIENTS WITH ORAL CAVITY PROBLEMS ........................................................... 909
CHAPTER 54: CARE OF PATIENTS WITH ESOPHAGEAL PROBLEMS ........................................................... 918
CHAPTER 55: CARE OF PATIENTS WITH STOMACH DISORDERS ............................................................... 934
CHAPTER 56: CARE OF PATIENTS WITH NONINFLAMMATORY INTESTINAL DISORDERS ......................... 949
CHAPTER 57: CARE OF PATIENTS WITH INFLAMMATORY INTESTINAL DISORDERS ................................. 971
CHAPTER 58: CARE OF PATIENTS WITH LIVER PROBLEMS ....................................................................... 992
CHAPTER 59: CARE OF PATIENTS WITH PROBLEMS OF THE BILIARY SYSTEM AND PANCREAS ............. 1009
CHAPTER 60: CARE OF PATIENTS WITH MALNUTRITION: UNDERNUTRITION AND OBESITY ................. 1025
CHAPTER 61: ASSESSMENT OF THE ENDOCRINE SYSTEM ...................................................................... 1044
CHAPTER 62: CARE OF PATIENTS WITH PITUITARY AND ADRENAL GLAND PROBLEMS ......................... 1057
CHAPTER 63: CARE OF PATIENTS WITH PROBLEMS OF THE THYROID AND PARATHYROID GLANDS .... 1074
,CHAPTER 64: CARE OF PATIENTS WITH DIABETES MELLITUS ................................................................. 1089
CHAPTER 65: ASSESSMENT OF THE RENAL/URINARY SYSTEM ............................................................... 1129
CHAPTER 66: CARE OF PATIENTS WITH URINARY PROBLEMS ................................................................ 1146
CHAPTER 67: CARE OF PATIENTS WITH KIDNEY DISORDERS .................................................................. 1169
CHAPTER 68: CARE OF PATIENTS WITH ACUTE KIDNEY INJURY AND CHRONIC KIDNEY DISEASE .......... 1183
CHAPTER 69: ASSESSMENT OF THE REPRODUCTIVE SYSTEM ................................................................ 1208
CHAPTER 70: CARE OF PATIENTS WITH BREAST DISORDERS.................................................................. 1217
CHAPTER 71: CARE OF PATIENTS WITH GYNECOLOGIC PROBLEMS ....................................................... 1231
CHAPTER 72: CARE OF PATIENTS WITH MALE REPRODUCTIVE PROBLEMS ........................................... 1246
CHAPTER 73: CARE OF TRANSGENDER PATIENTS ................................................................................... 1263
CHAPTER 74: CARE OF PATIENTS WITH SEXUALLY TRANSMITTED DISEASES ......................................... 1271
,CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR
MEDICAL- SURGICAL NURSING
MULTIPLE CHOICE
1. A NURSE WISHES TO PROVIDE CLIENT-CENTERED CARE IN ALL INTERACTIONS. WHICH ACTION
BY THE NURSE BEST DEMONSTRATES THIS CONCEPT?
A. ASSESSES FOR CULTURAL INFLUENCES AFFECTING HEALTH CARE
B. ENSURES THAT ALL THE CLIENTS BASIC NEEDS ARE MET
C. TELLS THE CLIENT AND FAMILY ABOUT ALL UPCOMING TESTS
D. THOROUGHLY ORIENTS THE CLIENT AND FAMILY TO THE ROOM
ANS:A
COMPETENCY IN CLIENT-FOCUSED CARE IS DEMONSTRATED WHEN THE NURSE FOCUSES ON
COMMUNICATION, CULTURE, RESPECT COMPASSION, CLIENT EDUCATION, AND EMPOWERMENT. BY
ASSESSING THE EFFECT OF THE CLIENTS CULTURE ON HEALTH CARE, THIS NURSE IS PRACTICING CLIENT-
FOCUSED CARE. PROVIDING FOR BASIC NEEDS DOES NOT DEMONSTRATE THIS COMPETENCE. SIMPLY
TELLING THE CLIENT ABOUT ALL UPCOMING TESTS IS NOT PROVIDING EMPOWERING EDUCATION.
ORIENTING THE CLIENT AND FAMILY TO THE ROOM IS AN IMPORTANT SAFETY MEASURE, BUT NOT
DIRECTLY RELATED TO DEMONSTRATING CLIENT-CENTERED CARE.
DIF: UNDERSTANDING/COMPREHENSION REF: 3
KEY: PATIENT-CENTERED CARE| CULTURE MSC: INTEGRATED PROCESS: CARING NOT: CLIENT NEEDS
CATEGORY: PSYCHOSOCIAL INTEGRITY
2. A NURSE IS CARING FOR A POSTOPERATIVE CLIENT ON THE SURGICAL UNIT. THE CLIENTS BLOOD
PRESSURE WAS 142/76 MM HG 30 MINUTES AGO, AND NOW IS 88/50 MM HG. WHAT ACTION BY THE
NURSE IS BEST?
A. CALL THE RAPID RESPONSE TEAM.
B. DOCUMENT AND CONTINUE TO MONITOR.
C. NOTIFY THE PRIMARY CARE PROVIDER.
D. REPEAT BLOOD PRESSURE MEASUREMENT IN 15 MINUTES.
,ANS:A
THE PURPOSE OF THE RAPID RESPONSE TEAM (RRT) IS TO INTERVENE WHEN CLIENTS ARE
DETERIORATING BEFORE THEY SUFFER EITHER RESPIRATORY OR CARDIAC ARREST. SINCE THE CLIENT
HAS MANIFESTED A SIGNIFICANT CHANGE, THE NURSE SHOULD CALL THE RRT. CHANGES IN BLOOD
PRESSURE, MENTAL STATUS, HEART RATE, AND PAIN ARE PARTICULARLY SIGNIFICANT.
DOCUMENTATION IS VITAL, BUT THE NURSE MUST DO MORE THAN DOCUMENT. THE PRIMARY CARE
PROVIDER SHOULD BE NOTIFIED, BUT THIS IS NOT THE PRIORITY OVER CALLING THE RRT. THE CLIENTS
BLOOD PRESSURE SHOULD BE REASSESSED FREQUENTLY, BUT THE PRIORITY IS GETTING THE RAPID
CARE TO THE CLIENT.
DIF: APPLYING/APPLICATION REF: 3
KEY: RAPID RESPONSE TEAM (RRT)| MEDICAL EMERGENCIES MSC: INTEGRATED PROCESS:
COMMUNICATION AND DOCUMENTATION
NOT: CLIENT NEEDS CATEGORY: PHYSIOLOGICAL INTEGRITY: PHYSIOLOGICAL ADAPTATION
3. A NURSE IS ORIENTING A NEW CLIENT AND FAMILY TO THE INPATIENT UNIT. WHAT
INFORMATION DOES THE NURSE PROVIDE TO HELP THE CLIENT PROMOTE HIS OR HER OWN SAFETY?
A. ENCOURAGE THE CLIENT AND FAMILY TO BE ACTIVE PARTNERS.
B. HAVE THE CLIENT MONITOR HAND HYGIENE IN CAREGIVERS.
C. OFFER THE FAMILY THE OPPORTUNITY TO STAY WITH THE CLIENT.
D. TELL THE CLIENT TO ALWAYS WEAR HIS OR HER ARMBAND.
ANS:A
EACH ACTION COULD BE IMPORTANT FOR THE CLIENT OR FAMILY TO PERFORM. HOWEVER,
ENCOURAGING THE CLIENT TO BE ACTIVE IN HIS OR HER HEALTH CARE AS A PARTNER IS THE MOST
CRITICAL. THE OTHER ACTIONS ARE VERY LIMITED IN SCOPE AND DO NOT PROVIDE THE BROAD
PROTECTION THAT BEING ACTIVE AND INVOLVED DOES.
DIF: UNDERSTANDING/COMPREHENSION REF: 3 KEY: PATIENT SAFETY
, MSC: INTEGRATED PROCESS: TEACHING/LEARNING
NOT: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
4. A NEW NURSE IS WORKING WITH A PRECEPTOR ON AN INPATIENT MEDICAL-SURGICAL UNIT.
THE PRECEPTOR ADVISES THE STUDENT THAT WHICH IS THE PRIORITY WHEN WORKING AS A
PROFESSIONAL NURSE?
A. ATTENDING TO HOLISTIC CLIENT NEEDS
B. ENSURING CLIENT SAFETY
C. NOT MAKING MEDICATION ERRORS
D. PROVIDING CLIENT-FOCUSED CARE
ANS:B
ALL ACTIONS ARE APPROPRIATE FOR THE PROFESSIONAL NURSE. HOWEVER, ENSURING CLIENT SAFETY
IS THE PRIORITY. UP TO 98,000 DEATHS RESULT EACH YEAR FROM ERRORS IN HOSPITAL CARE,
ACCORDING TO THE 2000 INSTITUTE OF MEDICINE REPORT. MANY MORE CLIENTS HAVE SUFFERED
INJURIES AND LESS SERIOUS OUTCOMES. EVERY NURSE HAS THE RESPONSIBILITY TO GUARD THE
CLIENTS SAFETY.
DIF: UNDERSTANDING/COMPREHENSION REF: 2 KEY: PATIENT SAFETY
MSC: INTEGRATED PROCESS: NURSING PROCESS: INTERVENTION
NOT: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
5. A CLIENT IS GOING TO BE ADMITTED FOR A SCHEDULED SURGICAL PROCEDURE. WHICH ACTION
DOES THE NURSE EXPLAIN IS THE MOST IMPORTANT THING THE CLIENT CAN DO TO PROTECT AGAINST
ERRORS?
A. BRING A LIST OF ALL MEDICATIONS AND WHAT THEY ARE FOR.
B. KEEP THE DOCTORS PHONE NUMBER BY THE TELEPHONE.
C. MAKE SURE ALL PROVIDERS WASH HANDS BEFORE ENTERING THE ROOM.
D. WRITE DOWN THE NAME OF EACH CAREGIVER WHO COMES IN THE ROOM.
