TIMBY’S INTRODUCTORY MEDICAL-SURGICAL
NURSING 13TH EDITION STUDY GUIDE 2026 –
COMPLETE CHAPTER REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
Chapter 1: Foundations of Nursing Practice
Question 1: A nurse is caring for a patient who recently had a stroke and requires extensive
assistance with activities of daily living (ADLs). The nurse assists the patient with bathing,
dressing, and transferring. According to Henderson's Nursing Theory, which fundamental human
need is the nurse primarily addressing?
A. The need to worship according to one's faith
B. The need for normal elimination
C. The need to work and feel accomplished
D. The need to move and maintain desirable postures
Correct Answer: D. The need to move and maintain desirable postures
Explanation:
• D is correct. Virginia Henderson's "Definition of Nursing" identifies 14 fundamental
human needs. Assisting a post-stroke patient with bathing, dressing, and transferring
directly addresses the need "to move and maintain desirable postures."
• A is incorrect. While spiritual needs are important, the scenario describes physical
assistance, not spiritual support.
• B is incorrect. The need for normal elimination is a separate fundamental need, but the
scenario does not mention assistance with toileting.
• C is incorrect. The need to work is another of Henderson's needs, but the described care
focuses on basic mobility and self-care, not vocational fulfillment.
Chapter 5: Fluid, Electrolyte, and Acid-Base Balance
Question 2: A patient with congestive heart failure is receiving furosemide (Lasix). The nurse
identifies a serum potassium level of 3.2 mEq/L. Which of the following clinical manifestations
should the nurse anticipate assessing in this patient?
,A. Deep tendon hyporeflexia and muscle weakness
B. Tall, peaked T-waves on the ECG
C. Bradycardia and abdominal cramps
D. Polyuria and flushed, dry skin
Correct Answer: A. Deep tendon hyporeflexia and muscle weakness
Explanation:
• A is correct. Furosemide is a potassium-wasting diuretic. A serum potassium of 3.2
mEq/L indicates hypokalemia. Key signs include muscle weakness, fatigue, leg cramps,
and decreased reflexes (hyporeflexia).
• B is incorrect. Tall, peaked T-waves are a classic sign of hyperkalemia (high potassium),
not hypokalemia.
• C is incorrect. Bradycardia is not typical of hypokalemia, which more commonly causes
dysrhythmias like premature ventricular contractions. Abdominal cramps can occur, but
bradycardia is not a primary feature.
• D is incorrect. Polyuria may be related to the diuretic itself, but flushed, dry skin is not a
specific manifestation of hypokalemia.
Chapter 10: Pain Management
Question 3: The nurse is preparing to administer pain medication to a postoperative patient.
Which statement by the patient best indicates an understanding of patient-controlled analgesia
(PCA)?
A. "My family can push the button for me if I'm sleeping and look like I'm in pain."
B. "I should push the button as soon as I start to feel the pain coming back."
C. "I need to wait until the pain is severe before I use the pump, so I don't get addicted."
D. "The pump won't let me have too much medication, even if I push the button many times."
Correct Answer: B. "I should push the button as soon as I start to feel the pain coming
back."
Explanation:
• B is correct. A key principle of PCA is prevention of severe pain. Patients should be
taught to self-administer before pain becomes intense, leading to better pain control
with less total medication.
, • A is incorrect. Only the patient should activate the PCA pump. Family members
activating it can lead to over-sedation and respiratory depression, as they cannot assess
the patient's level of consciousness.
• C is incorrect. This reflects the common misconception about addiction in acute pain
management. Waiting for severe pain leads to ineffective pain control and is not a
strategy to prevent addiction, which is rare in postoperative settings.
• D is incorrect. While PCA pumps have a lockout interval to prevent overdose, they are
not foolproof. Excessive, frequent attempts can still lead to over-medication, especially if
the pump is malfunctioning or programmed incorrectly. Safety relies on correct
programming and patient/family education.
Chapter 15: Perioperative Nursing
Question 4: During the immediate postoperative period in the PACU, which nursing assessment
takes the highest priority?
A. Assessing the surgical incision for drainage
B. Monitoring the patient's level of pain
C. Evaluating the patency of the airway and respiratory status
D. Checking the pedal pulses in the lower extremities
Correct Answer: C. Evaluating the patency of the airway and respiratory status
Explanation:
• C is correct. According to the ABC (Airway, Breathing, Circulation) priority framework,
airway and breathing are always the highest priority. Residual anesthesia and opioids
can depress respiratory drive, making this assessment critical in the PACU.
• A is incorrect. While important, assessing the incision is not the immediate priority over
airway and breathing.
• B is incorrect. Pain management is a key component of post-op care, but a patient must
have a patent airway and adequate respirations first.
• D is incorrect. Assessing circulation (e.g., pulses) is part of the "C" in ABC and is vital, but
it follows establishing a patent airway and adequate breathing.
Chapter 25: Nursing Management: Patients with Shock
NURSING 13TH EDITION STUDY GUIDE 2026 –
COMPLETE CHAPTER REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
Chapter 1: Foundations of Nursing Practice
Question 1: A nurse is caring for a patient who recently had a stroke and requires extensive
assistance with activities of daily living (ADLs). The nurse assists the patient with bathing,
dressing, and transferring. According to Henderson's Nursing Theory, which fundamental human
need is the nurse primarily addressing?
A. The need to worship according to one's faith
B. The need for normal elimination
C. The need to work and feel accomplished
D. The need to move and maintain desirable postures
Correct Answer: D. The need to move and maintain desirable postures
Explanation:
• D is correct. Virginia Henderson's "Definition of Nursing" identifies 14 fundamental
human needs. Assisting a post-stroke patient with bathing, dressing, and transferring
directly addresses the need "to move and maintain desirable postures."
• A is incorrect. While spiritual needs are important, the scenario describes physical
assistance, not spiritual support.
• B is incorrect. The need for normal elimination is a separate fundamental need, but the
scenario does not mention assistance with toileting.
• C is incorrect. The need to work is another of Henderson's needs, but the described care
focuses on basic mobility and self-care, not vocational fulfillment.
Chapter 5: Fluid, Electrolyte, and Acid-Base Balance
Question 2: A patient with congestive heart failure is receiving furosemide (Lasix). The nurse
identifies a serum potassium level of 3.2 mEq/L. Which of the following clinical manifestations
should the nurse anticipate assessing in this patient?
,A. Deep tendon hyporeflexia and muscle weakness
B. Tall, peaked T-waves on the ECG
C. Bradycardia and abdominal cramps
D. Polyuria and flushed, dry skin
Correct Answer: A. Deep tendon hyporeflexia and muscle weakness
Explanation:
• A is correct. Furosemide is a potassium-wasting diuretic. A serum potassium of 3.2
mEq/L indicates hypokalemia. Key signs include muscle weakness, fatigue, leg cramps,
and decreased reflexes (hyporeflexia).
• B is incorrect. Tall, peaked T-waves are a classic sign of hyperkalemia (high potassium),
not hypokalemia.
• C is incorrect. Bradycardia is not typical of hypokalemia, which more commonly causes
dysrhythmias like premature ventricular contractions. Abdominal cramps can occur, but
bradycardia is not a primary feature.
• D is incorrect. Polyuria may be related to the diuretic itself, but flushed, dry skin is not a
specific manifestation of hypokalemia.
Chapter 10: Pain Management
Question 3: The nurse is preparing to administer pain medication to a postoperative patient.
Which statement by the patient best indicates an understanding of patient-controlled analgesia
(PCA)?
A. "My family can push the button for me if I'm sleeping and look like I'm in pain."
B. "I should push the button as soon as I start to feel the pain coming back."
C. "I need to wait until the pain is severe before I use the pump, so I don't get addicted."
D. "The pump won't let me have too much medication, even if I push the button many times."
Correct Answer: B. "I should push the button as soon as I start to feel the pain coming
back."
Explanation:
• B is correct. A key principle of PCA is prevention of severe pain. Patients should be
taught to self-administer before pain becomes intense, leading to better pain control
with less total medication.
, • A is incorrect. Only the patient should activate the PCA pump. Family members
activating it can lead to over-sedation and respiratory depression, as they cannot assess
the patient's level of consciousness.
• C is incorrect. This reflects the common misconception about addiction in acute pain
management. Waiting for severe pain leads to ineffective pain control and is not a
strategy to prevent addiction, which is rare in postoperative settings.
• D is incorrect. While PCA pumps have a lockout interval to prevent overdose, they are
not foolproof. Excessive, frequent attempts can still lead to over-medication, especially if
the pump is malfunctioning or programmed incorrectly. Safety relies on correct
programming and patient/family education.
Chapter 15: Perioperative Nursing
Question 4: During the immediate postoperative period in the PACU, which nursing assessment
takes the highest priority?
A. Assessing the surgical incision for drainage
B. Monitoring the patient's level of pain
C. Evaluating the patency of the airway and respiratory status
D. Checking the pedal pulses in the lower extremities
Correct Answer: C. Evaluating the patency of the airway and respiratory status
Explanation:
• C is correct. According to the ABC (Airway, Breathing, Circulation) priority framework,
airway and breathing are always the highest priority. Residual anesthesia and opioids
can depress respiratory drive, making this assessment critical in the PACU.
• A is incorrect. While important, assessing the incision is not the immediate priority over
airway and breathing.
• B is incorrect. Pain management is a key component of post-op care, but a patient must
have a patent airway and adequate respirations first.
• D is incorrect. Assessing circulation (e.g., pulses) is part of the "C" in ABC and is vital, but
it follows establishing a patent airway and adequate breathing.
Chapter 25: Nursing Management: Patients with Shock
