FULL TEST BANK FOR MEDICAL SURGICAL NURSING CONCEPTS FOR INTERPROFESSIONAL COLLABORATIVE
CARE 10TH EDITION ALL CHAPTERS (1-69)
|A+ ULTIMATE GUIDE 2021
,CONTENTS
CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR MEDICAL-SURGICAL NURSING5
CHAPTER 02: CLINICAL JUDGMENT AND SYSTEMS THINKING.......................................................... 13
CHAPTER 03: OVERVIEW OF HEALTH CONCEPTS FOR MEDICAL-SURGICAL NURSING........................ 20
CHAPTER 04: COMMON HEALTH PROBLEMS OF OLDER ADULTS ..................................................... 28
CHAPTER 05: ASSESSMENT AND CARE OF PATIENTS WITH PAIN ..................................................... 39
CHAPTER 06: CONCEPTS OF GENETICS AND GENOMICS .................................................................. 55
CHAPTER 07: CONCEPTS OF REHABILITATION FOR CHRONIC AND DISABLING HEALTH PROBLEMS ... 63
CHAPTER 08: CONCEPTS OF CARE FOR PATIENTS AT END OF LIFE.................................................... 73
CHAPTER 09: CONCEPTS OF CARE FOR PERIOPERATIVE PATIENTS ................................................... 83
CHAPTER 10: CONCEPTS OF EMERGENCY AND TRAUMA NURSING ............................................... 100
CHAPTER 11: CONCEPTS OF CARE FOR PATIENTS WITH COMMON ENVIRONMENTAL EMERGENCIES111
CHAPTER 12: CONCEPTS OF DISASTER PREPAREDNESS ................................................................. 125
CHAPTER 13: CONCEPTS OF FLUID AND ELECTROLYTE BALANCE ................................................... 135
CHAPTER 14: CONCEPTS OF ACID–BASE BALANCE ........................................................................ 148
CHAPTER 15: CONCEPTS OF INFUSION THERAPY .......................................................................... 159
CHAPTER 16: CONCEPTS OF INFLAMMATION AND IMMUNITY...................................................... 172
CHAPTER 17: CONCEPTS OF CARE FOR PATIENTS WITH HIV DISEASE............................................. 183
CHAPTER 18: CONCEPTS OF CARE FOR PATIENTS WITH HYPERSENSITIVITY (ALLERGY) AND ........... 197
AUTOIMMUNITY ........................................................................................................................ 197
CHAPTER 19: CONCEPTS OF CANCER DEVELOPMENT .................................................................... 203
CHAPTER 20: CONCEPTS OF CARE FOR PATIENTS WITH CANCER ................................................... 210
CHAPTER 21: CONCEPTS OF CARE FOR PATIENTS WITH INFECTION ............................................... 227
CHAPTER 22: ASSESSMENT OF THE SKIN, HAIR, AND NAILS........................................................... 238
CHAPTER 23: CONCEPTS OF CARE FOR PATIENTS WITH SKIN PROBLEMS ....................................... 246
CHAPTER 24: ASSESSMENT OF THE RESPIRATORY SYSTEM ........................................................... 252
CHAPTER 25: CONCEPTS OF CARE FOR PATIENTS REQUIRING OXYGEN THERAPY OR TRACHEOSTOMY273
CHAPTER 26: CONCEPTS OF CARE FOR PATIENTS WITH NONINFECTIOUS UPPER RESPIRATORY PROBLEMS
.................................................................................................................................................. 279
CHAPTER 27: CONCEPTS OF CARE FOR PATIENTS WITH NON-INFECTIOUS LOWER RESPIRATORY
PROBLEMS ................................................................................................................................. 293
CHAPTER 28: CONCEPTS OF CARE FOR PATIENTS WITH INFECTIOUS RESPIRATORY PROBLEMS ...... 312
,CHAPTER 29: CRITICAL CARE OF PATIENTS WITH RESPIRATORY EMERGENCIES.............................. 326
CHAPTER 30: ASSESSMENT OF THE CARDIOVASCULAR SYSTEM .................................................... 342
CHAPTER 31: CONCEPTS OF CARE FOR PATIENTS WITH DYSRHYTHMIAS ....................................... 355
CHAPTER 32: CONCEPTS OF CARE FOR PATIENTS WITH CARDIAC PROBLEMS ................................ 370
CHAPTER 33: CONCEPTS OF CARE FOR PATIENTS WITH VASCULAR PROBLEMS .............................. 387
CHAPTER 34: CRITICAL CARE OF PATIENTS WITH SHOCK ............................................................... 407
CHAPTER 35: CRITICAL CARE OF PATIENTS WITH ACUTE CORONARY SYNDROMES ........................ 418
CHAPTER 36: ASSESSMENT OF THE HEMATOLOGIC SYSTEM ......................................................... 434
CHAPTER 37: CONCEPTS OF CARE FOR PATIENTS WITH HEMATOLOGIC PROBLEMS ....................... 440
CHAPTER 38: ASSESSMENT OF THE NERVOUS SYSTEM ................................................................. 459
CHAPTER 39: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE CENTRAL NERVOUS SYSTEM:
THE BRAIN
.................................................................................................................................................. 470
CHAPTER 40: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE CENTRAL NERVOUS ..... 487
SYSTEM: THE SPINAL CORD ......................................................................................................... 487
CHAPTER 41: CRITICAL CARE OF PATIENTS WITH NEUROLOGIC EMERGENCIES .............................. 502
CHAPTER 42: ASSESSMENT AND CARE OF PATIENTS WITH EYE AND VISION PROBLEMS................. 518
CHAPTER 43: ASSESSMENT AND CARE OF PATIENTS WITH EAR AND HEARING PROBLEMS............. 529
CHAPTER 44: ASSESSMENT OF THE MUSCULOSKELETAL SYSTEM .................................................. 539
CHAPTER 45: CONCEPTS OF CARE FOR PATIENTS WITH MUSCULOSKELETAL PROBLEMS ................ 546
CHAPTER 46: CONCEPTS OF CARE FOR PATIENTS WITH ARTHRITIS AND TOTAL JOINT ARTHROPLASTY556
CHAPTER 47: CONCEPTS OF CARE FOR PATIENTS WITH MUSCULOSKELETAL TRAUMA ................... 571
CHAPTER 48: ASSESSMENT OF THE GASTROINTESTINAL SYSTEM .................................................. 588
CHAPTER 49: CONCEPTS OF CARE FOR PATIENTS WITH ORAL CAVITY AND ESOPHAGEAL PROBLEMS595
CHAPTER 50: CONCEPTS OF CARE FOR OF PATIENTS WITH STOMACH DISORDERS ......................... 603
CHAPTER 51: CONCEPTS OF CARE FOR PATIENTS WITH NONINFLAMMATORY INTESTINAL DISORDERS612
CHAPTER 52: CONCEPTS OF CARE FOR PATIENTS WITH INFLAMMATORY INTESTINAL DISORDERS . 626
CHAPTER 53: CONCEPTS OF CARE FOR PATIENTS WITH LIVER PROBLEMS ..................................... 639
CHAPTER 54: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE BILIARY SYSTEM AND
PANCREAS .................................................................................................................................. 651
CHAPTER 55: CONCEPTS OF CARE FOR PATIENTS WITH MALNUTRITION: UNDERNUTRITION AND OBESITY
.................................................................................................................................................. 660
CHAPTER 56: ASSESSMENT OF THE ENDOCRINE SYSTEM .............................................................. 670
CHAPTER 57: CONCEPTS OF CARE FOR PATIENTS WITH PITUITARY AND ADRENAL GLAND PROBLEMS677
,CHAPTER 58: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE THYROID AND ............. 686
PARATHYROID GLANDS .............................................................................................................. 686
CHAPTER 59: CONCEPTS OF CARE FOR PATIENTS WITH DIABETES MELLITUS ................................. 693
CHAPTER 60: ASSESSMENT OF THE RENAL/URINARY SYSTEM ....................................................... 716
CHAPTER 61: CONCEPTS OF CARE FOR PATIENTS WITH URINARY PROBLEMS ................................ 724
CHAPTER 62: CONCEPTS OF CARE FOR PATIENTS WITH KIDNEY DISORDERS .................................. 737
CHAPTER 63: CONCEPTS OF CARE FOR PATIENTS WITH ACUTE KIDNEY INJURY AND CHRONIC ....... 746
KIDNEY DISEASE ......................................................................................................................... 746
CHAPTER 64: ASSESSMENT OF THE REPRODUCTIVE SYSTEM......................................................... 761
CHAPTER 65: CONCEPTS OF CARE FOR PATIENTS WITH BREAST DISORDERS .................................. 767
CHAPTER 66: CONCEPTS OF CARE FOR PATIENTS WITH GYNAECOLOGIC PROBLEMS ...................... 776
CHAPTER 67: CONCEPTS OF CARE FOR CLIENTS WITH MALE REPRODUCTIVE PROBLEMS ............... 785
CHAPTER 68: CONCEPTS OF CARE FOR TRANSGENDER PATIENTS .................................................. 794
CHAPTER 69: CONCEPTS OF CARE FOR PATIENTS WITH SEXUALLY TRANSMITTED INFECTIONS....... 800
,CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR MEDICAL-SURGICAL
NURSING
MULTIPLE CHOICE
1. A NEW NURSE IS WORKING WITH A PRECEPTOR ON A MEDICAL-SURGICAL UNIT. THE PRECEPTOR
ADVISES THE NEW NURSE 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. HEALTH CARE ERRORS HAVE BEEN WIDELY REPORTED FOR 25 YEARS, MANY OF
WHICH RESULT IN CLIENT INJURY, DEATH, AND INCREASED HEALTH CARE COSTS. THERE ARE SEVERAL
NATIONAL AND INTERNATIONAL ORGANIZATIONS THAT HAVE EITHER RECOMMENDED OR MANDATED
SAFETY INITIATIVES.
EVERY NURSE HAS THE RESPONSIBILITY TO GUARD THE CLIENT’S SAFETY. THE OTHER ACTIONS ARE
IMPORTANT FOR QUALITY NURSING, BUT THEY ARE NOT AS VITAL AS PROVIDING SAFETY. NOT MAKING
MEDICATION ERRORS DOES PROVIDE SAFETY, BUT IS TOO NARROW IN SCOPE TO BE THE BEST ANSWER.
DIF: UNDERSTANDING TOP: INTEGRATED PROCESS: NURSING PROCESS:
INTERVENTION KEY: CLIENT SAFETY
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
2. A NURSE IS ORIENTING A NEW CLIENT AND FAMILY TO THE MEDICAL-SURGICAL UNIT. WHAT
INFORMATION DOES THE NURSE PROVIDE TO BEST 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 SAFETY 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 TOP: INTEGRATED PROCESS:
TEACHING/LEARNING KEY: CLIENT SAFETY
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
3. A NURSE IS CARING FOR A POSTOPERATIVE CLIENT ON THE SURGICAL UNIT. THE CLIENT’S BLOOD
PRESSURE WAS
142/76 MM HG 30 MINUTES AGO, AND NOW IS 88/50 MM HG. WHAT ACTION WOULD THE NURSE TAKE
FIRST?
a. CALL THE RAPID RESPONSE TEAM.
b. DOCUMENT AND CONTINUE TO MONITOR.
c. NOTIFY THE PRIMARY HEALTH CARE PROVIDER.
d. REPEAT THE BLOOD PRESSURE 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 WOULD CALL THE RRT. CHANGES IN BLOOD
PRESSURE, MENTAL STATUS, HEART RATE, TEMPERATURE, OXYGEN SATURATION, AND LAST 2 HOURS’
URINE OUTPUT ARE PARTICULARLY SIGNIFICANT AND ARE PART OF THE MODIFIED EARLY WARNING
SYSTEM GUIDE. DOCUMENTATION IS VITAL, BUT THE NURSE MUST DO MORE THAN DOCUMENT. THE
PRIMARY HEALTH CARE PROVIDER WOULD BE NOTIFIED, BUT THIS IS NOT MORE IMPORTANT THAN
CALLING THE RRT. THE CLIENT’S BLOOD PRESSURE WOULD BE REASSESSED FREQUENTLY, BUT THE
PRIORITY IS GETTING THE RAPID CARE TO THE CLIENT.
DIF: APPLYING TOP: INTEGRATED PROCESS: COMMUNICATION AND
DOCUMENTATION KEY: RAPID RESPONSE TEAM (RRT), CLINICAL JUDGMENT
MSC: CLIENT NEEDS CATEGORY: PHYSIOLOGICAL INTEGRITY: PHYSIOLOGICAL ADAPTATION
4. 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 CLIENT’S 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
SHOWING RESPECT FOR THE CLIENT AND FAMILY’S PREFERENCES AND NEEDS IS ESSENTIAL TO ENSURE
A HOLISTIC OR “WHOLE-PERSON” APPROACH TO CARE. BY ASSESSING THE EFFECT OF THE CLIENT’S
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 TOP: INTEGRATED PROCESS: CULTURE AND SPIRITUALITY
KEY: CLIENT-CENTERED CARE, CULTURE MSC: CLIENT NEEDS CATEGORY: PSYCHOSOCIAL INTEGRITY
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 PROVIDER’S PHONE NUMBER BY THE TELEPHONE.
c. MAKE SURE THAT ALL PROVIDERS WASH HANDS BEFORE ENTERING THE ROOM.
d. WRITE DOWN THE NAME OF EACH CAREGIVER WHO COMES IN THE ROOM.
ANS:A
MEDICATION RECONCILIATION IS A FORMAL PROCESS IN WHICH THE CLIENT’S ACTUAL CURRENT
MEDICATIONS ARE COMPARED TO THE PRESCRIBED MEDICATIONS AT THE TIME OF ADMISSION,
TRANSFER, OR DISCHARGE. THIS NATIONAL CLIENT SAFETY GOAL IS IMPORTANT TO REDUCE
MEDICATION ERRORS. THE CLIENT WOULD NOT HAVE TO BE RESPONSIBLE FOR PROVIDERS WASHING
THEIR HANDS, AND EVEN IF THE CLIENT DOES SO, THIS IS TOO NARROW TO BE THE MOST
IMPORTANT ACTION TO PREVENT ERRORS. KEEPING THE PROVIDER’S PHONE NUMBER NEARBY AND
DOCUMENTING
EVERYONE WHO ENTERS THE ROOM ALSO DO NOT GUARANTEE SAFETY.
DIF: APPLYING TOP: INTEGRATED PROCESS:
TEACHING/LEARNING KEY: CLIENT SAFETY, INFORMATICS
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
, 6. WHICH ACTION BY THE NURSE WORKING WITH A CLIENT BEST DEMONSTRATES RESPECT FOR
AUTONOMY?
a. ASKS IF THE CLIENT HAS QUESTIONS BEFORE SIGNING A CONSENT.
b. GIVES THE CLIENT ACCURATE INFORMATION WHEN QUESTIONED.
c. KEEPS THE PROMISES MADE TO THE CLIENT AND FAMILY.
d. TREATS THE CLIENT FAIRLY COMPARED TO OTHER CLIENTS.
ANS:A
AUTONOMY IS SELF-DETERMINATION. THE CLIENT WOULD MAKE DECISIONS REGARDING CARE. WHEN
THE NURSE OBTAINS A SIGNATURE ON THE CONSENT FORM, ASSESSING IF THE CLIENT STILL HAS
QUESTIONS IS VITAL, BECAUSE WITHOUT FULL INFORMATION THE CLIENT CANNOT PRACTICE
AUTONOMY. GIVING ACCURATE INFORMATION IS PRACTICING WITH VERACITY. KEEPING PROMISES IS
UPHOLDING FIDELITY. TREATING THE CLIENT FAIRLY IS PROVIDING SOCIAL JUSTICE.
DIF: APPLYING TOP: INTEGRATED PROCESS: CARING KEY: ETHICS, AUTONOMY
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: MANAGEMENT OF
CARE
7. A NURSE ASKS A MORE SEASONED COLLEAGUE TO EXPLAIN BEST PRACTICES WHEN
COMMUNICATING WITH A PERSON FROM THE LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND
QUESTIONING/QUEER (LGBTQ) COMMUNITY. WHAT ANSWER BY THE FACULTY IS MOST ACCURATE?
A. AVOID EMBARRASSING THE CLIENT BY ASKING QUESTIONS.
b. DON’T MAKE ASSUMPTIONS ABOUT HIS OR HER HEALTH NEEDS.
c. MOST LGBTQ PEOPLE DO NOT WANT TO SHARE INFORMATION.
d. NO DIFFERENCES EXIST IN COMMUNICATING WITH THIS POPULATION.
ANS:B
MANY MEMBERS OF THE LGBTQ COMMUNITY HAVE FACED DISCRIMINATION FROM HEALTH CARE
PROVIDERS AND MAY BE RELUCTANT TO SEEK HEALTH CARE. THE NURSE WOULD NEVER MAKE
ASSUMPTIONS ABOUT THE NEEDS OF MEMBERS OF THIS POPULATION. RATHER, RESPECTFUL
QUESTIONS ARE APPROPRIATE. IF APPROACHED WITH SENSITIVITY, THE CLIENT WITH ANY HEALTH CARE
NEED IS MORE LIKELY TO ANSWER HONESTLY.
DIF: UNDERSTANDING TOP: INTEGRATED PROCESS: TEACHING/LEARNING
KEY: HEALTH CARE DISPARITIES, LGBTQ MSC: CLIENT NEEDS CATEGORY: PSYCHOSOCIAL INTEGRITY
8. A NURSE IS CALLING THE ON-CALL HEALTH CARE PROVIDER ABOUT A CLIENT WHO HAD A
, HYSTERECTOMY 2 DAYS AGO AND HAS PAIN THAT IS UNRELIEVED BY THE PRESCRIBED OPIOID PAIN
MEDICATION. WHICH STATEMENT
CARE 10TH EDITION ALL CHAPTERS (1-69)
|A+ ULTIMATE GUIDE 2021
,CONTENTS
CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR MEDICAL-SURGICAL NURSING5
CHAPTER 02: CLINICAL JUDGMENT AND SYSTEMS THINKING.......................................................... 13
CHAPTER 03: OVERVIEW OF HEALTH CONCEPTS FOR MEDICAL-SURGICAL NURSING........................ 20
CHAPTER 04: COMMON HEALTH PROBLEMS OF OLDER ADULTS ..................................................... 28
CHAPTER 05: ASSESSMENT AND CARE OF PATIENTS WITH PAIN ..................................................... 39
CHAPTER 06: CONCEPTS OF GENETICS AND GENOMICS .................................................................. 55
CHAPTER 07: CONCEPTS OF REHABILITATION FOR CHRONIC AND DISABLING HEALTH PROBLEMS ... 63
CHAPTER 08: CONCEPTS OF CARE FOR PATIENTS AT END OF LIFE.................................................... 73
CHAPTER 09: CONCEPTS OF CARE FOR PERIOPERATIVE PATIENTS ................................................... 83
CHAPTER 10: CONCEPTS OF EMERGENCY AND TRAUMA NURSING ............................................... 100
CHAPTER 11: CONCEPTS OF CARE FOR PATIENTS WITH COMMON ENVIRONMENTAL EMERGENCIES111
CHAPTER 12: CONCEPTS OF DISASTER PREPAREDNESS ................................................................. 125
CHAPTER 13: CONCEPTS OF FLUID AND ELECTROLYTE BALANCE ................................................... 135
CHAPTER 14: CONCEPTS OF ACID–BASE BALANCE ........................................................................ 148
CHAPTER 15: CONCEPTS OF INFUSION THERAPY .......................................................................... 159
CHAPTER 16: CONCEPTS OF INFLAMMATION AND IMMUNITY...................................................... 172
CHAPTER 17: CONCEPTS OF CARE FOR PATIENTS WITH HIV DISEASE............................................. 183
CHAPTER 18: CONCEPTS OF CARE FOR PATIENTS WITH HYPERSENSITIVITY (ALLERGY) AND ........... 197
AUTOIMMUNITY ........................................................................................................................ 197
CHAPTER 19: CONCEPTS OF CANCER DEVELOPMENT .................................................................... 203
CHAPTER 20: CONCEPTS OF CARE FOR PATIENTS WITH CANCER ................................................... 210
CHAPTER 21: CONCEPTS OF CARE FOR PATIENTS WITH INFECTION ............................................... 227
CHAPTER 22: ASSESSMENT OF THE SKIN, HAIR, AND NAILS........................................................... 238
CHAPTER 23: CONCEPTS OF CARE FOR PATIENTS WITH SKIN PROBLEMS ....................................... 246
CHAPTER 24: ASSESSMENT OF THE RESPIRATORY SYSTEM ........................................................... 252
CHAPTER 25: CONCEPTS OF CARE FOR PATIENTS REQUIRING OXYGEN THERAPY OR TRACHEOSTOMY273
CHAPTER 26: CONCEPTS OF CARE FOR PATIENTS WITH NONINFECTIOUS UPPER RESPIRATORY PROBLEMS
.................................................................................................................................................. 279
CHAPTER 27: CONCEPTS OF CARE FOR PATIENTS WITH NON-INFECTIOUS LOWER RESPIRATORY
PROBLEMS ................................................................................................................................. 293
CHAPTER 28: CONCEPTS OF CARE FOR PATIENTS WITH INFECTIOUS RESPIRATORY PROBLEMS ...... 312
,CHAPTER 29: CRITICAL CARE OF PATIENTS WITH RESPIRATORY EMERGENCIES.............................. 326
CHAPTER 30: ASSESSMENT OF THE CARDIOVASCULAR SYSTEM .................................................... 342
CHAPTER 31: CONCEPTS OF CARE FOR PATIENTS WITH DYSRHYTHMIAS ....................................... 355
CHAPTER 32: CONCEPTS OF CARE FOR PATIENTS WITH CARDIAC PROBLEMS ................................ 370
CHAPTER 33: CONCEPTS OF CARE FOR PATIENTS WITH VASCULAR PROBLEMS .............................. 387
CHAPTER 34: CRITICAL CARE OF PATIENTS WITH SHOCK ............................................................... 407
CHAPTER 35: CRITICAL CARE OF PATIENTS WITH ACUTE CORONARY SYNDROMES ........................ 418
CHAPTER 36: ASSESSMENT OF THE HEMATOLOGIC SYSTEM ......................................................... 434
CHAPTER 37: CONCEPTS OF CARE FOR PATIENTS WITH HEMATOLOGIC PROBLEMS ....................... 440
CHAPTER 38: ASSESSMENT OF THE NERVOUS SYSTEM ................................................................. 459
CHAPTER 39: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE CENTRAL NERVOUS SYSTEM:
THE BRAIN
.................................................................................................................................................. 470
CHAPTER 40: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE CENTRAL NERVOUS ..... 487
SYSTEM: THE SPINAL CORD ......................................................................................................... 487
CHAPTER 41: CRITICAL CARE OF PATIENTS WITH NEUROLOGIC EMERGENCIES .............................. 502
CHAPTER 42: ASSESSMENT AND CARE OF PATIENTS WITH EYE AND VISION PROBLEMS................. 518
CHAPTER 43: ASSESSMENT AND CARE OF PATIENTS WITH EAR AND HEARING PROBLEMS............. 529
CHAPTER 44: ASSESSMENT OF THE MUSCULOSKELETAL SYSTEM .................................................. 539
CHAPTER 45: CONCEPTS OF CARE FOR PATIENTS WITH MUSCULOSKELETAL PROBLEMS ................ 546
CHAPTER 46: CONCEPTS OF CARE FOR PATIENTS WITH ARTHRITIS AND TOTAL JOINT ARTHROPLASTY556
CHAPTER 47: CONCEPTS OF CARE FOR PATIENTS WITH MUSCULOSKELETAL TRAUMA ................... 571
CHAPTER 48: ASSESSMENT OF THE GASTROINTESTINAL SYSTEM .................................................. 588
CHAPTER 49: CONCEPTS OF CARE FOR PATIENTS WITH ORAL CAVITY AND ESOPHAGEAL PROBLEMS595
CHAPTER 50: CONCEPTS OF CARE FOR OF PATIENTS WITH STOMACH DISORDERS ......................... 603
CHAPTER 51: CONCEPTS OF CARE FOR PATIENTS WITH NONINFLAMMATORY INTESTINAL DISORDERS612
CHAPTER 52: CONCEPTS OF CARE FOR PATIENTS WITH INFLAMMATORY INTESTINAL DISORDERS . 626
CHAPTER 53: CONCEPTS OF CARE FOR PATIENTS WITH LIVER PROBLEMS ..................................... 639
CHAPTER 54: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE BILIARY SYSTEM AND
PANCREAS .................................................................................................................................. 651
CHAPTER 55: CONCEPTS OF CARE FOR PATIENTS WITH MALNUTRITION: UNDERNUTRITION AND OBESITY
.................................................................................................................................................. 660
CHAPTER 56: ASSESSMENT OF THE ENDOCRINE SYSTEM .............................................................. 670
CHAPTER 57: CONCEPTS OF CARE FOR PATIENTS WITH PITUITARY AND ADRENAL GLAND PROBLEMS677
,CHAPTER 58: CONCEPTS OF CARE FOR PATIENTS WITH PROBLEMS OF THE THYROID AND ............. 686
PARATHYROID GLANDS .............................................................................................................. 686
CHAPTER 59: CONCEPTS OF CARE FOR PATIENTS WITH DIABETES MELLITUS ................................. 693
CHAPTER 60: ASSESSMENT OF THE RENAL/URINARY SYSTEM ....................................................... 716
CHAPTER 61: CONCEPTS OF CARE FOR PATIENTS WITH URINARY PROBLEMS ................................ 724
CHAPTER 62: CONCEPTS OF CARE FOR PATIENTS WITH KIDNEY DISORDERS .................................. 737
CHAPTER 63: CONCEPTS OF CARE FOR PATIENTS WITH ACUTE KIDNEY INJURY AND CHRONIC ....... 746
KIDNEY DISEASE ......................................................................................................................... 746
CHAPTER 64: ASSESSMENT OF THE REPRODUCTIVE SYSTEM......................................................... 761
CHAPTER 65: CONCEPTS OF CARE FOR PATIENTS WITH BREAST DISORDERS .................................. 767
CHAPTER 66: CONCEPTS OF CARE FOR PATIENTS WITH GYNAECOLOGIC PROBLEMS ...................... 776
CHAPTER 67: CONCEPTS OF CARE FOR CLIENTS WITH MALE REPRODUCTIVE PROBLEMS ............... 785
CHAPTER 68: CONCEPTS OF CARE FOR TRANSGENDER PATIENTS .................................................. 794
CHAPTER 69: CONCEPTS OF CARE FOR PATIENTS WITH SEXUALLY TRANSMITTED INFECTIONS....... 800
,CHAPTER 01: OVERVIEW OF PROFESSIONAL NURSING CONCEPTS FOR MEDICAL-SURGICAL
NURSING
MULTIPLE CHOICE
1. A NEW NURSE IS WORKING WITH A PRECEPTOR ON A MEDICAL-SURGICAL UNIT. THE PRECEPTOR
ADVISES THE NEW NURSE 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. HEALTH CARE ERRORS HAVE BEEN WIDELY REPORTED FOR 25 YEARS, MANY OF
WHICH RESULT IN CLIENT INJURY, DEATH, AND INCREASED HEALTH CARE COSTS. THERE ARE SEVERAL
NATIONAL AND INTERNATIONAL ORGANIZATIONS THAT HAVE EITHER RECOMMENDED OR MANDATED
SAFETY INITIATIVES.
EVERY NURSE HAS THE RESPONSIBILITY TO GUARD THE CLIENT’S SAFETY. THE OTHER ACTIONS ARE
IMPORTANT FOR QUALITY NURSING, BUT THEY ARE NOT AS VITAL AS PROVIDING SAFETY. NOT MAKING
MEDICATION ERRORS DOES PROVIDE SAFETY, BUT IS TOO NARROW IN SCOPE TO BE THE BEST ANSWER.
DIF: UNDERSTANDING TOP: INTEGRATED PROCESS: NURSING PROCESS:
INTERVENTION KEY: CLIENT SAFETY
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
2. A NURSE IS ORIENTING A NEW CLIENT AND FAMILY TO THE MEDICAL-SURGICAL UNIT. WHAT
INFORMATION DOES THE NURSE PROVIDE TO BEST 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 SAFETY 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 TOP: INTEGRATED PROCESS:
TEACHING/LEARNING KEY: CLIENT SAFETY
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
3. A NURSE IS CARING FOR A POSTOPERATIVE CLIENT ON THE SURGICAL UNIT. THE CLIENT’S BLOOD
PRESSURE WAS
142/76 MM HG 30 MINUTES AGO, AND NOW IS 88/50 MM HG. WHAT ACTION WOULD THE NURSE TAKE
FIRST?
a. CALL THE RAPID RESPONSE TEAM.
b. DOCUMENT AND CONTINUE TO MONITOR.
c. NOTIFY THE PRIMARY HEALTH CARE PROVIDER.
d. REPEAT THE BLOOD PRESSURE 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 WOULD CALL THE RRT. CHANGES IN BLOOD
PRESSURE, MENTAL STATUS, HEART RATE, TEMPERATURE, OXYGEN SATURATION, AND LAST 2 HOURS’
URINE OUTPUT ARE PARTICULARLY SIGNIFICANT AND ARE PART OF THE MODIFIED EARLY WARNING
SYSTEM GUIDE. DOCUMENTATION IS VITAL, BUT THE NURSE MUST DO MORE THAN DOCUMENT. THE
PRIMARY HEALTH CARE PROVIDER WOULD BE NOTIFIED, BUT THIS IS NOT MORE IMPORTANT THAN
CALLING THE RRT. THE CLIENT’S BLOOD PRESSURE WOULD BE REASSESSED FREQUENTLY, BUT THE
PRIORITY IS GETTING THE RAPID CARE TO THE CLIENT.
DIF: APPLYING TOP: INTEGRATED PROCESS: COMMUNICATION AND
DOCUMENTATION KEY: RAPID RESPONSE TEAM (RRT), CLINICAL JUDGMENT
MSC: CLIENT NEEDS CATEGORY: PHYSIOLOGICAL INTEGRITY: PHYSIOLOGICAL ADAPTATION
4. 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 CLIENT’S 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
SHOWING RESPECT FOR THE CLIENT AND FAMILY’S PREFERENCES AND NEEDS IS ESSENTIAL TO ENSURE
A HOLISTIC OR “WHOLE-PERSON” APPROACH TO CARE. BY ASSESSING THE EFFECT OF THE CLIENT’S
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 TOP: INTEGRATED PROCESS: CULTURE AND SPIRITUALITY
KEY: CLIENT-CENTERED CARE, CULTURE MSC: CLIENT NEEDS CATEGORY: PSYCHOSOCIAL INTEGRITY
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 PROVIDER’S PHONE NUMBER BY THE TELEPHONE.
c. MAKE SURE THAT ALL PROVIDERS WASH HANDS BEFORE ENTERING THE ROOM.
d. WRITE DOWN THE NAME OF EACH CAREGIVER WHO COMES IN THE ROOM.
ANS:A
MEDICATION RECONCILIATION IS A FORMAL PROCESS IN WHICH THE CLIENT’S ACTUAL CURRENT
MEDICATIONS ARE COMPARED TO THE PRESCRIBED MEDICATIONS AT THE TIME OF ADMISSION,
TRANSFER, OR DISCHARGE. THIS NATIONAL CLIENT SAFETY GOAL IS IMPORTANT TO REDUCE
MEDICATION ERRORS. THE CLIENT WOULD NOT HAVE TO BE RESPONSIBLE FOR PROVIDERS WASHING
THEIR HANDS, AND EVEN IF THE CLIENT DOES SO, THIS IS TOO NARROW TO BE THE MOST
IMPORTANT ACTION TO PREVENT ERRORS. KEEPING THE PROVIDER’S PHONE NUMBER NEARBY AND
DOCUMENTING
EVERYONE WHO ENTERS THE ROOM ALSO DO NOT GUARANTEE SAFETY.
DIF: APPLYING TOP: INTEGRATED PROCESS:
TEACHING/LEARNING KEY: CLIENT SAFETY, INFORMATICS
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: SAFETY AND INFECTION
CONTROL
, 6. WHICH ACTION BY THE NURSE WORKING WITH A CLIENT BEST DEMONSTRATES RESPECT FOR
AUTONOMY?
a. ASKS IF THE CLIENT HAS QUESTIONS BEFORE SIGNING A CONSENT.
b. GIVES THE CLIENT ACCURATE INFORMATION WHEN QUESTIONED.
c. KEEPS THE PROMISES MADE TO THE CLIENT AND FAMILY.
d. TREATS THE CLIENT FAIRLY COMPARED TO OTHER CLIENTS.
ANS:A
AUTONOMY IS SELF-DETERMINATION. THE CLIENT WOULD MAKE DECISIONS REGARDING CARE. WHEN
THE NURSE OBTAINS A SIGNATURE ON THE CONSENT FORM, ASSESSING IF THE CLIENT STILL HAS
QUESTIONS IS VITAL, BECAUSE WITHOUT FULL INFORMATION THE CLIENT CANNOT PRACTICE
AUTONOMY. GIVING ACCURATE INFORMATION IS PRACTICING WITH VERACITY. KEEPING PROMISES IS
UPHOLDING FIDELITY. TREATING THE CLIENT FAIRLY IS PROVIDING SOCIAL JUSTICE.
DIF: APPLYING TOP: INTEGRATED PROCESS: CARING KEY: ETHICS, AUTONOMY
MSC: CLIENT NEEDS CATEGORY: SAFE AND EFFECTIVE CARE ENVIRONMENT: MANAGEMENT OF
CARE
7. A NURSE ASKS A MORE SEASONED COLLEAGUE TO EXPLAIN BEST PRACTICES WHEN
COMMUNICATING WITH A PERSON FROM THE LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND
QUESTIONING/QUEER (LGBTQ) COMMUNITY. WHAT ANSWER BY THE FACULTY IS MOST ACCURATE?
A. AVOID EMBARRASSING THE CLIENT BY ASKING QUESTIONS.
b. DON’T MAKE ASSUMPTIONS ABOUT HIS OR HER HEALTH NEEDS.
c. MOST LGBTQ PEOPLE DO NOT WANT TO SHARE INFORMATION.
d. NO DIFFERENCES EXIST IN COMMUNICATING WITH THIS POPULATION.
ANS:B
MANY MEMBERS OF THE LGBTQ COMMUNITY HAVE FACED DISCRIMINATION FROM HEALTH CARE
PROVIDERS AND MAY BE RELUCTANT TO SEEK HEALTH CARE. THE NURSE WOULD NEVER MAKE
ASSUMPTIONS ABOUT THE NEEDS OF MEMBERS OF THIS POPULATION. RATHER, RESPECTFUL
QUESTIONS ARE APPROPRIATE. IF APPROACHED WITH SENSITIVITY, THE CLIENT WITH ANY HEALTH CARE
NEED IS MORE LIKELY TO ANSWER HONESTLY.
DIF: UNDERSTANDING TOP: INTEGRATED PROCESS: TEACHING/LEARNING
KEY: HEALTH CARE DISPARITIES, LGBTQ MSC: CLIENT NEEDS CATEGORY: PSYCHOSOCIAL INTEGRITY
8. A NURSE IS CALLING THE ON-CALL HEALTH CARE PROVIDER ABOUT A CLIENT WHO HAD A
, HYSTERECTOMY 2 DAYS AGO AND HAS PAIN THAT IS UNRELIEVED BY THE PRESCRIBED OPIOID PAIN
MEDICATION. WHICH STATEMENT
