Download Lewis’s Medical-Surgical Nursing, 11th Edition Chapters 1-4, 5, 8-10 Testbank (Units 1&2) and more Exams Nursing in PDF only on Docsity!
Lewis’s Medical-Surgical Nursing, 11th
Edition Chapters 1-4, 5, 8-10 Testbank
(Units 1&2) Questions With Correct
Answers.
100% ACCURATE
- The nurse completes an admission database and explains that the plan of care and discharge goals will be developed with the patient's input. The patient asks, "How is this different from what the doctor does?" Which response would be most appropriate for the nurse to make?
a. "The role of the nurse is to administer medications and other treatments prescribed by your doctor."
b. "In addition to caring for you while you are sick, the nurses will help you plan to maintain your health."
c. "The nurse's job is to help the doctor by collecting information and communicating any problems that occur."
d. "Nurses perform many of the same procedures as the doctor, but nurses are with the patients for a longer time than the doctor."
b
- The nurse describes to a student nurse how to use evidence-based practice (EBP) when caring for patients. Which statement by the nurse accurately describes the use of EBP?
a. "Inferences from all published articles are used as a guide."
b. "Patient care is based on clinical judgment, experience, and traditions."
c. "Data are analyzed later to show that the patient outcomes are consistently met."
d. "Recommendations are based on research, clinical expertise, and patient preferences."
d
- The nurse teaches a student nurse about how to apply the nursing process when providing patient care. Which statement by the student nurse indicates that teaching was successful?
a. "The nursing process is a research method of diagnosing the patient's health care problems."
b. "The nursing process is used primarily to explain nursing interventions to other health care professionals."
c. "The nursing process is a problem-solving tool used to identify and treat the patients' health care needs."
d. "The nursing process is based on nursing theory that incorporates the biopsychosocial nature of humans."
c
- A patient admitted to the hospital for surgery tells the nurse, "I do not feel comfortable leaving my children with my parents." Which action should the nurse take next?
a. Reassure the patient that these feelings are common for parents.
b. Have the patient call the children to ensure that they are doing well.
c. Gather information on the patient's concerns about the child care arrangements.
d. Call the patient's parents to determine whether adequate child care is being provided
c
- A patient with a bacterial infection is hypovolemic due to a fever and excessive diaphoresis. Which expected outcome would the nurse recognize as appropriate for this patient?
a. Patient has a balanced intake and output.
b. The problem, its causes, and the signs and symptoms of the problem
c. The problem with the possible etiology and the planned interventions
d. The problem, the pathophysiology of the problem, and the expected outcome
b
- Which patient care task is appropriate for the nurse to delegate to experienced unlicensed assistive personnel (UAP)?
a. Instruct the patient about the need to alternate activity and rest.
b. Monitor level of shortness of breath or fatigue after ambulation.
c. Obtain the patient's blood pressure and pulse rate after ambulation.
d. Determine whether the patient is ready to increase the activity level
c
- A nurse is caring for a group of patients on the medical-surgical unit with the help of one float registered nurse (RN), one unlicensed assistive personnel (UAP), and one licensed practical/vocational nurse (LPN/VN). Which assignment, if delegated by the nurse, would be inappropriate?
a. Check for the presence of bowel sounds by UAP
b. Administration of oral medications by LPN/VN
c. Insulin administration by float RN from the pediatric unit
d. Measurement of a patient's urinary catheter output by UAP
a
- Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/VN)?
a. Complete the initial admission assessment and plan of care.
b. Measure bedside blood glucose before administering insulin.
c. Document teaching completed before a diagnostic procedure.
d. Instruct a patient about low-fat, reduced sodium dietary restrictions.
b
- A nurse is assigned as a case manager for a hospitalized patient with a spinal cord injury. Which activity can the patient expect the nurse in this role to perform?
a. Care for the patient during hospitalization for the injuries.
b. Assist the patient with home care activities during recovery.
c. Coordinate the services the patient receives in the hospital and at home.
d. Determine what medical care the patient needs for optimal rehabilitation
c
- The nurse is caring for an older adult patient who needs continued nursing care and physical therapy to improve mobility after surgery to repair a fractured hip. The nurse would help to arrange for transfer of the patient to which facility?
a. A skilled care facility
b. A transitional care facility
c. A residential care facility
d. An intermediate care facility
c. Quality improvement
d. Informatics and technology
d
- Which information will the nurse consider when deciding what nursing actions to delegate to a licensed practical/vocational nurse (LPN/VN) who is working on a medical-surgical unit? (Select all that apply.)
a. Institutional policies
b. Stability of the patients
c. State nurse practice act
d. LPN/VN teaching abilities
e. Experience of the LPN/VN
a, b, c, e
- Which actions by the nurse administering medications are consistent with promoting safe delivery of patient care? (Select all that apply)
a. Discards a medication that unlabeled.
b. Uses a hand sanitizer before preparing a medication.
c. Identifies the patient by the room number on the door.
d. Checks laboratory test results before administering a diuretic.
e. Gives the patient a list of current medications upon discharge.
a, b, d, e
- The nurse uses the Situation-Background-Assessment-Recommendation (SBAR) format to communicate a change in patient status to a health care provider. In which order should the nurse make the following statements? (Put a comma and a space between each answer choice [A, B, C, D].)
a. "The patient needs to be evaluated immediately and may need intubation and mechanical ventilation."
b. "The patient was admitted yesterday with heart failure and has been receiving furosemide (Lasix) for diuresis, but urine output has been low."
c. "The patient has crackles audible throughout the posterior chest, and the most recent oxygen saturation is 89%. Her condition is very unstable."
d. "This is the nurse on the surgical unit. After assessing the patient, I am very concerned about increased shortness of breath over the past hour."
D, B, C, A
- The nurse is obtaining a health history from a new patient. Which data will be the focus of patient teaching? a. Family history b. Age and genders c. Dietary fat intake d. Race and ethnicity
c
- The nurse works in a clinic located in a community where many of the residents are Hispanic. Which strategy, if implemented by the nurse, would decrease health care disparities and promote health equity for this community?
a. Improve public transportation to the clinic.
b. Update equipment and supplies at the clinic.
c. Teach clinic staff about cultural health beliefs.
d. Obtain low-cost medications for clinic patients
c
- A female staff nurse is assessing a male patient of Arab descent who is admitted with complaints of severe headaches. It is important for the charge nurse to intervene if the nurse takes which action? a. The nurse explains the 0 to 10 intensity pain scale. b. The nurse asks the patient when the headaches started. c. The nurse approaches the bedside and closes the privacy curtain. d. The nurse calls for a male nurse to bring a hospital gown to the room
c
- The nurse is caring for a patient who speaks a different language. If an interpreter is not available, which action by the nurse is appropriate? a. Talk slowly so that each word is clearly heard. b. Use gestures or pictures to demonstrate meaning. c. Speak loudly in close proximity to the patient's ears. d. Repeat important words so that the patient recognizes their significance.
b
- Which action should the nurse include in the plan of care for a hospitalized patient who uses culturally based treatments? a. Encourage the use of additional diagnostic procedures. b. Teach the patient that folk remedies will interfere with prescribed orders. c. Ask the patient to discontinue the cultural treatments during hospitalization. d. Coordinate the use of requested treatments with prescribed medical therapies
d
- The nurse is caring for a newly admitted patient. Which intervention is considered appropriate across most cultures?? a. Insist family members provide most of the patient's personal care. b. Maintain a personal space of at least 2 ft when assessing the patient. c. Ask permission before touching a patient during the physical assessment. d. Consider the patient's ethnicity as the most important factor in planning care.
c
- A staff nurse expresses frustration that a Native American patient always has several family members at the bedside. Which action by the charge nurse is appropriate? a. Request that family members leave until a different nurse can be assigned. b. Ask about the nurse's beliefs regarding family support during hospitalization. c. Have the nurse explain to the family that too many visitors will tire the patient. d. Suggest that the nurse ask family members to leave the room during patient care.
b
- An older Asian American patient tells the nurse that she has lived in the United States for 50 years. The patient speaks English and lives in a predominantly Asian neighborhood. Which initial action by the nurse is appropriate? a. Include a shaman when planning the patient's care. b. Avoid direct eye contact with the patient during care. c. Ask the patient about any special cultural beliefs or practices. d. Involve the patient's oldest son to assist with health care decisions
c
- The nurse plans health care for a community with a large number of recent immigrants from Vietnam. Which intervention is the most important for the nurse to implement? a. Hepatitis testing b. Tuberculosis screening c. Contraceptive teaching d. Colonoscopy information
b
- During an admission assessment, the nurse notices that the patient pauses before answering questions about the health history. Which action by the nurse is appropriate? a. Wait for the patient to answer the questions. b. Give the patient an assessment form and a pen. c. Interview a family member instead of the patient. d. Remind the patient that other patients also need care
a
- The nurse is performing an admission assessment for a patient from China who does not speak English. Which actions could the nurse take to enhance communication? (Select all that apply.) a. Ask the patient's young child to interpret. b. Use a telephone-based medical interpreter. c. Wait until an agency interpreter is available. d. Use exaggerated gestures to convey information. e. Use an electronic translation software application
b, c, e
- A patient who is actively bleeding is admitted to the emergency department. Which approach should the nurse use to obtain an accurate health history? a. Briefly interview the patient while obtaining vital signs. b. Obtain subjective data about the patient from family members. c. Omit subjective data collection and obtain the physical examination. d. Use the health care provider's medical history to obtain subjective dat
a
- Immediate surgery is planned for a patient with acute abdominal pain. Which question by the nurse will elicit direct information about the patient's coping-stress tolerance pattern? a. "Can you rate your pain on a 0 to 10 scale?" b. "What do you think caused this abdominal pain?" c. "Are there other problems or concerns right now?" d. "How do you feel about yourself and being hospitalized?"
c
- During the health history interview, a patient tells the nurse about periodic fainting spells. Which question should the nurse ask to elicit any associated clinical manifestations? a. "How frequently do you have the fainting spells?" b. "Do the spells occur at any particular time of day?" c. "Where are you when you have the fainting spells?" d. "Do you have other symptoms along with the spells?"
d
- The nurse records the following general survey: "The patient is a 50-year-old Asian female accompanied by her husband and two daughters. Alert and oriented. Does not make eye contact with the nurse and responds slowly, but appropriately, to questions. No apparent disabilities or distinguishing features." What additional information should the nurse add to this general survey? a. Nutritional status b. Intake and output c. Reasons for contact with the health care system d. Comments of family members about the condition
a
- A nurse performs a health history and physical examination with a patient who has a right leg fracture. Which assessment would be a pertinent negative finding? a. Patient has several bruised and swollen areas on the right leg. b. Patient states that there have been no other recent health problems. c. Patient refuses to bend the right knee because of the associated pain. d. Patient denies having pain when the area over the fracture is palpated.
d
- The nurse asks an older adult patient with rectal bleeding, "Have you ever had a colonoscopy?" The nurse is performing what type of assessment? a. Focused assessment b. Emergency assessment c. Detailed health assessment d. Comprehensive assessment
a
- The nurse is preparing to perform a focused assessment for a patient reporting shortness of breath. Which equipment will be needed? a. Flashlight b. Stethoscope c. Tongue blades d. Percussion hammer
b
- Which adaptations to the physical examination technique should the nurse include for an alert older adult patient? a. Avoid the use of touch as much as possible. b. Use slightly more pressure for palpation
- Which physical assessment action should the nurse take after inspecting a patient's abdomen? a. Feel for any masses. b. Palpate the abdomen. c. Listen for bowel sounds. d. Percuss the liver borders
c
- When admitting a patient who has just arrived on the unit with a severe headache, what should the nurse do? a. Complete only basic demographic data before addressing the patient's pain. b. Take vital signs and then address the headache before completing the health history. c. Medicate the patient for the headache before doing the health history and examination. d. Inform the patient that the headache can be treated as soon as the health history is completed
b
- In what order will the nurse perform these physical assessment actions for a patient admitted with abdominal pain? (Put a comma and a space between each answer choice [A, B, C, D].) a. Percuss the abdomen to locate any areas of dullness. b. Palpate the abdomen to check for tenderness or masses. c. Inspect the abdomen for distention or other abnormalities. d. Auscultate the abdomen for the presence of bowel sounds.
C, D, A, B
- The nurse has assessed that a patient with newly diagnosed colon cancer does not have basic knowledge about colon cancer. The nurse should initially focus on which learning goal for this patient? a. The patient will state ways of preventing the recurrence of the cancer. b. The patient will explore and select an appropriate colon cancer therapy. c. The patient will demonstrate coping skills needed to manage the disease. d. The patient will choose methods to minimize adverse effects of treatment
b
- After the nurse provides diet instructions for a patient with diabetes, the patient can restate the information but does not make the recommended diet changes. How would the nurse evaluate this outcome? a. Learning did not occur because the patient's behavior did not change. b. Choosing not to follow the diet is the behavior that resulted from learning. c. The nurse's responsibility for helping the patient make diet changes has been fulfilled. d. The teaching methods were ineffective in helping the patient learn about the necessary diet changes.
b
- A patient is diagnosed with heart failure after being admitted to the hospital for shortness of breath and fatigue. Which teaching strategy, if implemented by the nurse, is most likely to be effective? a. Assure the patient that the nurse is an expert on management of heart failure. b. Delay teaching until the patient is seen by a home health nurse after discharge. c. Discuss the importance of medication control to avoid long-term complications. d. Explain to the patient at each meal about the amounts of sodium in various foods
d
- A patient who was admitted to the hospital with hyperglycemia and newly diagnosed diabetes is scheduled for discharge the second day after admission. When implementing patient teaching, what is the priority action for the nurse? a. Provide detailed information about dietary control of glucose. b. Teach glucose self-monitoring and medication administration. c. Give information about the effects of exercise on glucose control. d. Instruct about the risk for cardiovascular disease with hyperglycemia
b
- A patient states, "I told my husband I will go the grocery store to buy fresh fruit, vegetables, and whole grains instead of prepared food snacks." When using the Transtheoretical Model of Health Behavior Change, the nurse identifies that this patient is in which stage of change? a. Preparation b. Termination c. Maintenance d. Contemplation
a
nurse will instruct the patient on appropriate foot care before discharge. d. The patient will understand the rationale for proper foot care after instruction.
b
- A patient needs to learn how to instill eyedrops. Which teaching strategy, if implemented by the nurse, would be most effective? a. Peer teaching b. Lecture-discussion c. Printed instructions d. Return demonstration
d
- The nurse and the patient who is diagnosed with hypertension develop this goal: "The patient will select a 2-g sodium diet from the hospital menu for 3 days." Which evaluation method will the nurse use to determine whether teaching was effective? a. Have the patient list substitutes for favorite foods that are high in sodium. b. Check the sodium content of the patient's menu choices over the next 3 days. c. Compare the patient's sodium intake before and after the teaching was implemented. d. Ask the patient to identify which foods on the hospital menus are high in sodium for 3 days in a row
b
- The nurse prepares written handouts to be used as part of the standardized teaching plan for patients who have been recently diagnosed with diabetes. What statement is written at a level appropriate to include in the handouts? a. Polyphagia, polydipsia, and polyuria are common symptoms of diabetes. b. Eating the right foods can help in keeping blood glucose at a near-normal level. c. Some patients with diabetes control blood glucose with oral medications, injections, or dietary interventions. d. Diabetes is characterized by chronic hyperglycemia and the associated symptoms than can lead to long-term complications
b
- The hospital nurse implements a teaching plan to assist an older patient who lives alone to independently accomplish daily activities. How would the nurse best evaluate the patient's long-term response to the teaching? a. Make a referral to the home health nursing agency for home visits. b. Have the patient demonstrate the learned skills at the end of the teaching session. c. Arrange a physical therapy visit before the patient is discharged from the hospital. d. Check the patient's ability to bathe and get dressed without assistance the next day.
a
- A patient who smokes a pack of cigarettes per day tells the nurse, "I enjoy smoking and have no plans to quit." When using the Transtheoretical Model of Health Behavior Change, the nurse identifies that this patient is in which stage of change? a. Precontemplation b. Contemplation c. Maintenance d. Termination
a
- An older Asian patient seen at the health clinic is diagnosed with protein malnutrition. What action should the nurse plan to implement first? a. Suggest the use of liquid supplements as a way to increase protein intake. b. Encourage the patient to increase the dietary intake of meat, cheese, and milk. c. Ask the patient to record the intake of all foods and beverages for a 3-day period. d. Focus on the use of combinations of beans and rice to improve daily protein intake
c
- A middle-aged patient who has diabetes tells the nurse, "I want to know how to give my own insulin so I don't have to bother my wife all the time." What action should the nurse complete first? a. Demonstrate how to draw up and administer insulin. b. Discuss the use of exercise to decrease insulin needs. c. Teach about differences between the various types of insulin. d. Provide handouts about therapeutic and adverse effects of insulin
a
