Nursing textbooks medical-surgical practice questions, set 13
Nursing textbooks · medical-surgical
Nursing textbooks medical-surgical practice questionsset 13
You practice adult health stems across systems, then name the action that changes the outcome. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the Nursing textbooks exam guide or more Nursing textbooks practice questions.
Five medical-surgical questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
You are the nurse planning to teach tracheostomy care to a patient who will be discharged home following a spinal cord injury. When preparing your teaching, which of the following is the most important component of your teaching plan?
A. Citing the evidence that underlies each of your teaching points
B. Alleviating the patients guilt associated with not knowing appropriate self-care
C. Determining the patients readiness to learn new information
D. Including your nursing colleagues in the planning process
Show answer and rationale
Correct answer: C — Determining the patients readiness to learn new information
Assessment in the teaching-learning process is directed toward the systematic collection of data about the person and family's learning needs and readiness to learn. Patient readiness is critical to accepting and integrating new information. Unless the patient is ready to accept new information, patient teaching will be ineffective. Citing the evidence base will not likely enhance learning. Patient guilt cannot be alleviated until the patient understands the intricacies of the condition and his physiologic response to the disease. Inclusion of colleagues can be beneficial, but this does not determine the success or failure of teaching.
Question 2
A patient diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The patient reveals feelings of depression and anger with life. The treatment team suggests the use of a medication. Which type of medication should the nurse expect?
A. Selective serotonin reuptake inhibitor (SSRI)
B. Monoamine oxidase inhibitor (MAOI)
C. Benzodiazepine
D. Antipsychotic
Show answer and rationale
Correct answer: A — Selective serotonin reuptake inhibitor (SSRI)
There is no medication to specifically treat a personality disorder, but SSRI antidepressants or mood stabilizers may be used for relief of symptoms that coexist. SSRIs are used to treat depression. Many patients with borderline personality disorder are fearful of taking something over which they have little control. Because SSRIs have a good side effect profile, the patient is more likely to comply with the medication. Low-dose antipsychotic or anxiolytic medications are not supported by the data given in this scenario. MAOIs require great diligence in adherence to a restricted diet and are rarely used for patients who are impulsive.
Question 3
The nurse is caring for a patient who has begun to awaken after 30 minutes in the postanesthesia care unit (PACU), who is restless and shouting at the nurse. The patient's oxygen saturation is 99%, and recent laboratory results are all normal. Which of the following actions by the nurse is most appropriate?
A. Insert an oral or nasal airway.
B. Notify the anesthesia care provider.
C. Orient the patient to time, place, and person.
D. Be sure that the patient's IV lines are secure.
Show answer and rationale
Correct answer: D — Be sure that the patient's IV lines are secure.
Because the patient's assessment indicates physiological stability, the most likely cause of the patient's agitation is emergence delirium, which will resolve as the patient wakes up more fully. The nurse should ensure patient safety through interventions such as raising the bed rails and securing IV lines. Emergence delirium is common in patients recovering from anaesthesia, so there is no need to notify the anaesthesiologist. Insertion of an airway is not needed because the oxygen saturation is good. Orientation of the patient is needed but is not likely to be effective until the effects of anaesthesia have resolved more completely.
Question 4
Which instruction will the nurse give when teaching the patient to cough effectively after surgery?
A. Breathe through the nose, hold breath, and exhale slowly.
B. Take three deep breaths and cough from the chest.
C. Inhale while contracting the abdominal muscles and exhale while contracting the diaphragm.
D. Take short, frequent panting breaths and cough from the throat to clear accumulated mucus.
Show answer and rationale
Correct answer: B — Take three deep breaths and cough from the chest.
Because lung ventilation is vital, the nurse assists the patient to turn, cough, and breathe deeply every 1 to 2 hours until the chest is clear. Having practiced this combination preoperatively, the patient is usually adequately able to remove trapped mucus and surgical gases. The patient should first take three deep breaths, and cough deeply from the chest. Breathing through the nose, holding the breath and exhaling slowly describes deep breathing, not coughing. Diaphragmatic breathing is not the same as coughing. The patient should breathe deeply and cough from the lungs, not take short, panting breathings or cough from the throat.
Question 5
The nurse is reviewing the concept care map for a client with multiple medical problems. What significance does the concept care map have in relation to the client's plan of care?
A. It provides guidance for health care providers to develop a treatment plan for the client.
B. It is considered the best method of evaluating the client's plan of care.
C. It is a means for nurses to consider all of a client's problems and develop a plan for treatment.
D. It is the student version of a client's nursing care plan.
Show answer and rationale
Correct answer: C — It is a means for nurses to consider all of a client's problems and develop a plan for treatment.
The significance of the concept map is that it is a means for nurses to consider all of the client's problems (nursing and medical) and develop a plan for the treatment of those problems. A concept map may be reviewed by a health care provider, but it does not provide guidance for health care providers to develop a client's treatment plan. A concept map is an alternate to nursing care plans but is not considered the best method for evaluating the plan of care. A concept map is not a student version of a client's nursing care plan. It does assist a student in assessing what is known about a client and what information is still needed.
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Question 6
The nurse is caring for a patient on the first postoperative day who is dizzy when ambulating in the room. In what order will the nurse accomplish the following activities? (All the activities are appropriate.)
A. Take the patient's blood pressure (BP).
B. Place the patient in the supine position.
C. Assist the patient to sit and repeat 5 minutes later.
D. Record the results.
Correct answer:
The first priority for the patient with syncope is to prevent a fall, so the patient should be placed in the supine position. Assessment of the BP will determine whether the dizziness is due to orthostatic hypotension, which occurs because of hypovolemia. After taking BP, the patient is assisted to the sitting position and the BP is rechecked in 1-3 minutes. Because this is a common postoperative problem that is usually resolved through nursing measures such as increasing fluid intake and making position changes more slowly, there is no need to notify the health care provider and the nurse is to record the results of the assessment.
A nurse uses critical-thinking skills to develop the care plan for an older adult with dementia awaiting placement in a long-term care facility. Which statements describe characteristics of the critical thinking used by nurses engaged in clinical reasoning? Select all that apply.
A. Functions independently of nursing standards, ethics, and state practice acts
B. Based on the principles of the nursing process, problem solving, and the scientific method
C. Driven by patient, family, and community needs as well as nurses' needs to give competent, efficient care
D. Avoids designs to compensate for problems created by human nature, such as medication errors
E. Constantly reevaluating, self-correcting, and striving for improvement
Correct answer:
Critical thinking applied to clinical reasoning and clinical judgment is guided by standards, policies and procedures, and ethics. When applying principles of nursing process, problem solving, and the scientific method, clinical reasoning identifies the key problems, issues, and risks. This is driven by patient, family, and community needs as well as nurses' needs to give competent, efficient care. It also calls for strategies that make the most of human potential and compensate for problems created by human nature. It is constantly reevaluating, self-correcting, and striving to improve the quality and safety of health care systems.
A nurse is caring for a patient who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the patient does which of the following in order to prevent common complications associated with a hip fracture?
A. Avoid requesting analgesia unless pain becomes unbearable.
B. Use supplementary oxygen when transferring or mobilizing.
C. Increase fluid intake and perform prescribed foot exercises.
D. Remain on bed rest for 14 days or until instructed by the orthopedic surgeon.
Correct answer:
Deep vein thrombosis (DVT) is among the most common complications related to a hip fracture. To prevent DVT, the nurse encourages intake of fluids and ankle and foot exercises. The patient should not be told to endure pain; a proactive approach to pain control should be adopted. While respiratory complications commonly include atelectasis and pneumonia, the use of deep-breathing exercises, changes in position at least every 2 hours, and the use of incentive spirometry help prevent the respiratory complications more than using supplementary oxygen. Bed rest may be indicated in the short term, but is not normally required for 14 days.
A. The pain, redness, and swelling are part of the inflammatory process, but it is probably too early for an infection.
B. Bee stings frequently cause infection, pain, and swelling, and, with treatment, the infection should begin to subside late today.
C. The infection was probably caused by the stinger, which may still be in the wound.
D. The mothers assessment is accurate and the ED doctor will probably prescribe antibiotics to fix the problem.
Correct answer:
Cells or tissues of the body may be injured or killed by any agent (physical, chemical, infectious). When this happens, an inflammatory response (or inflammation) naturally occurs in the healthy tissues adjacent to the injury site. Inflammation is not the same as infection. An infectious agent is only one of several agents that may trigger an inflammatory response. Although bee stings may cause infection, the signs and symptoms (very painful, looks swollen and red) result from the acute inflammatory response. If the stinger were still in the wound, it would only be creating inflammation, not infection. Antibiotics are not indicated.
A postoperative patient who has a large abdominal incision suddenly calls out for help, shouting, 'Something is falling out of my incision!' The nurse notes the wound is gaping open with tissue bulging outward. Place the nursing interventions in the order they should be performed, arranged from first to last.
A. Notify the health care provider of the situation.
B. Cover exposed tissue with sterile towels moistened with sterile 0.9% sodium chloride solution.
C. Place the patient in the low Fowler position.
D. Document the findings and outcome of interventions.
E. Maintain NPO status for return to the OR for repair.
Correct answer:
The correct order of nursing interventions for this postoperative emergency is to place the patient in the low Fowler position (to prevent further damage or protrusion from increased intraabdominal pressure), cover exposed tissue with sterile towels moistened with sterile 0.9% sodium chloride solution (to protect the wound), and notify the surgical site of the situation (to address the problem issue, likely requiring with surgery). The patient must be kept NPO for prompt surgical repair will be needed. After the patient has received attention, the nurse should document all assessments and interventions performed in a timely manner.
When listening to a patient what action by the nurse demonstrates disinterest and coldness?
A. Tightly crossing her arms
B. Uncrossing her arms
C. Uncrossing her legs
D. Facing the patient
Correct answer:
The way that an individual sits, stands, and moves is called posture. Posture has the potential to convey warmth and acceptance, or distance and disinterest. An open posture is demonstrated with a relaxed stance with uncrossed arms and legs while facing the other individual. A slight shift in body position toward an individual, a smile, and direct eye contact are all consistent with open posturing and convey warmth and caring. Closed posture is a more formal, distant stance, generally with the arms, and possibly the legs, tightly crossed. A person will often interpret closed posture as disinterest, coldness, and even nonacceptance.
How can the nurse demonstrate warmth and acceptance when listening to a patient?
A. Tightly crossing her arms
B. Uncrossing her arms
C. Tightly crossing her legs
D. Facing away from the patient
Correct answer:
The way that an individual sits, stands, and moves is called posture. Posture has the potential to convey warmth and acceptance, or distance and disinterest. An open posture is demonstrated with a relaxed stance with uncrossed arms and legs while facing the other individual. A slight shift in body position toward an individual, a smile, and direct eye contact are all consistent with open posturing and convey warmth and caring. Closed posture is a more formal, distant stance, generally with the arms, and possibly the legs, tightly crossed. A person will often interpret closed posture as disinterest, coldness, and even nonacceptance.
After teaching a group of nursing students about the cell cycle and how it relates to antineoplastic drugs, the instructor determines that the teaching was successful when the students identify which phase of the cell cycle as being affected by antimetabolites?
A. S phase
B. M phase
C. G2 phase
D. G1 phase
Correct answer:
Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division. This interferes with the synthesis of RNA and DNA, making it impossible for the cancerous cell to divide into two daughter cells. The vinca alkaloids interfere with amino acid production in the S phase and formation of microtubules in the M phase. Taxanes also interfere in the M phase with microtubules. Cells are stopped during the S and G2 phases by the podophyllotoxins and thus are unable to divide. DNA synthesis during the S phase is inhibited by camptothecin analog drugs such as topotecan (Hycamtin).
A student nurse is learning about the health care needs of lesbian, gay, bisexual, transgender, and queerquestioning (LGBTQ) clients. Which terms are correctly defined? (Select all that apply.)
A. Gender dysphoria: Distress caused by incongruence between natal sex and gender identity
B. Gender queer: A label used when gender identity does not conform to male or female
C. Natal sex: The sex one is born with or is assigned at birth
D. Transition: The process of changing one's gender presentation to align with gender identity
E. Gender fluid: A gender identity that can change over time
Correct answer:
Gender dysphoria is emotional distress caused by the incongruence between natal sex (sex assigned at birth) and gender identity. Gender queer is a label sometimes used by people whose gender identity does not fit within the binary of male or female. Natal sex refers to the sex assigned at birth. The term 'transition' in the provided options is incorrect as it refers to the process of changing one's gender presentation or physical characteristics to align with gender identity, not establishing a sexual identity. Gender fluid is a valid term for a gender identity that can shift over time, but it was not part of the original options.
What does the nurse understand is the focus of healthcare when a client receives services from a health maintenance organization (HMO)?
A. Avoiding coverage for needed services
B. Health promotion and maintenance
C. To offer discounted services to all patients
D. High-quality service and contain cost
Correct answer:
If the HMO does not require much high-cost care, providers make money; if members use many high-cost resources, providers lose money. This method of financing provides the strongest incentives for limiting use of expensive services and focusing healthcare on health maintenance and promotion. If services such as diagnostic testing are required, the HMO will cover this and not avoid payment. Services are not discounted for patients that are nonmembers or members. The goals of a physician hospital organization (PHO) are to maintain high-quality service and contain costs while fostering group contracts, collaboration, and capitation.
About these Nursing textbooks medical-surgical questions
Nursing textbooks medical-surgical practice questions, set 13 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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