Nursing textbooks medical-surgical practice questions, set 34
Nursing textbooks · medical-surgical
Nursing textbooks medical-surgical practice questionsset 34
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
The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient?
A. Show a video about anticoagulation therapy.
B. Present all the information in one session just before discharge.
C. Give the patient pamphlets about the medications to read at home.
D. Develop large-print handouts that reflect the verbal information presented.
Show answer and rationale
Correct answer: D — Develop large-print handouts that reflect the verbal information presented.
Developing large-print handouts addresses altered perception in two ways. First, by using visual aids to reinforce verbal instructions, one addresses the possibility of decreased ability to hear high-frequency sounds. By developing the handouts in large print, one addresses the possibility of decreased visual acuity. Showing a video does not allow discussion of the information; furthermore, the text and print may be small and difficult to read and understand. Presenting all the information in one session before discharge also does not allow for discussion, and the patient may not be able to hear or see the information sufficiently. Because of the possibility of decreased short-term memory and slowed cognitive function, simply giving pamphlets to read without other teaching strategies may not be appropriate.
Question 2
During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?
A. A family member of the patient
B. A close family friend of the patient
C. A translator who does not know the patient
D. Prewritten note cards with both English and the patient's language
Show answer and rationale
Correct answer: C — A translator who does not know the patient
The nurse should communicate with the patient in the patient's native language if at all possible. If the nurse is not able to speak the patient's native language, a translator should be made available so as to prevent communication problems, minimize errors, and help boost the patient's level of trust and understanding of the nurse. In practice, this translator may be another nurse or health care professional, a nonprofessional member of the health care team, or a layperson, family member, adult friend, or religious leader or associate. However, it is best to avoid family members as translators, if possible, because of issues with bias, misinterpretation, and potential confidentiality issues.
Question 3
A patient is considering using herbal supplements and asks the nurse about them. Which response by the nurse would be most appropriate?
A. Herbal supplements are safe to use because they are regulated closely.
B. Herbal supplements can affect the way other medications will act.
C. Taking more than the recommended amount usually is not harmful because they are natural.
D. The risk of the supplement interacting with any prescription medications is extremely low.
Show answer and rationale
Correct answer: B — Herbal supplements can affect the way other medications will act.
The nurse needs to explain to the patient that just because an herbal supplement is labeled 'natural' does not mean the supplement is safe or without harmful effects. Herbal supplements can act the same way as drugs and can cause medical problems if not used correctly or if taken in large amounts. Herbal supplements are not regulated by the FDA, so products lack standardization in relation to purity and potency. In addition, the patient should be warned not to take more than the recommended dose of any herbal health product or supplement. The problems that these products can cause are much more likely to occur if the patient takes too much or takes them for too long.
Question 4
The nurses behavior is an example of what?
A. Acculturation
B. Cultural blindness
C. Cultural imposition
D. Cultural taboos
Show answer and rationale
Correct answer: C — Cultural imposition
The nurses behavior is an example of cultural imposition, defined as the tendency to impose ones cultural beliefs, values, and patterns of behavior on a person from a different culture. Acculturation is the process by which members of a cultural group adapt to or learn how to take on the behaviors of another group. Cultural blindness is the inability of people to recognize their own values, beliefs, and practices and those of others because of strong ethnocentric tendencies. Cultural taboos are activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group.
Question 5
A recent nursing graduate has been surprised at the sharp contrast between some patients lifestyles in their homes and the nurses own practices and beliefs. To work therapeutically with the patient, what must the nurse do?
A. Request another assignment if there is dissonance with the patients lifestyle.
B. Ask the patient to come to the agency to receive treatment, if possible.
C. Resolve to convey respect for the patients beliefs and choices.
D. Try to adapt the patients home to the norms of a hospital environment.
Show answer and rationale
Correct answer: C — Resolve to convey respect for the patients beliefs and choices.
To work successfully with patients in any setting, the nurse must be nonjudgmental and convey respect for patients beliefs, even if they differ sharply from the nurses. This can be difficult when a patients lifestyle involves activities that a nurse considers harmful or unacceptable, such as smoking, use of alcohol, drug abuse, or overeating. The nurse should not request another assignment because of a difference in beliefs, nor do nurses ask for the patient to come to the agency to receive treatment. It is also inappropriate to convert the patients home to a hospital-like environment.
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Question 6
Based on her cancer diagnosis and her yin/yang beliefs, which meal will the patient most likely order for lunch?
A. Chicken noodle soup with crackers, fruit crisp, and hot tea
B. Turkey sandwich, small tossed salad, and iced tea
C. Chefs salad, bread, and water
D. Fruit smoothie and granola bar
Correct answer:
Foods are classified as cold (yin) and hot (yang) in the naturalistic or holistic perspective. In this theory, foods are transformed into yin and yang energy when metabolized by the body. Hot foods are eaten when a person has a cold illness such as cancer, headache, stomach cramps, and a cold. Based on this information, the patient would select chicken noodle soup with crackers, fruit crisp, and hot tea as these are hot foods. The other options are cold foods and are eaten when a patient has a hot illness such as a fever, rash, sore throat, ulcer, or infection.
When caring for an Indigenous patient, which of the following actions is the best initial approach in relation to eye contact for the nurse to take?
A. Avoid all eye contact with the patient.
B. Observe the patient's use of eye contact.
C. Look directly at the patient when interacting.
D. Ask the family about the patient's cultural beliefs.
Correct answer:
Eye contact varies greatly among and within cultures so the nurse's initial action is to assess the patient's use of eye contact. Although nurses are often taught to maintain direct eye contact, patients who are Asian, Arab, or Indigenous may avoid direct eye contact and consider direct eye contact disrespectful or aggressive. Looking directly at the patient or avoiding eye contact may be appropriate, depending on the patient's individual cultural beliefs. The nurse should assess the patient, rather than asking family members about the patient's beliefs.
Which of the following statements represents a health inequity currently experienced in Canada?
A. Indigenous adults are less likely to smoke tobacco than other adults in Canada
B. Overall suicide rate among First Nation communities is about twice the rate of the general population.
C. Individuals from lower income neighbourhoods undergo preventive health screening more that their higher income counterparts.
D. Recent immigrants are more likely to have a primary care physician than Canadian-born individuals.
Correct answer:
Suicide rates are five to seven times higher among Indigenous youth than among non-Indigenous youth. Suicide rates among Indigenous youth are among the highest in the world, at 11 times the national average. Smoking rates are more than two times higher among the three Indigenous groups than among the non-Indigenous population. Individuals from higher income neighbourhoods undergo preventive health screening more than those from lower income neighbourhoods. Recent immigrants are less likely to have a primary care physician than Canadian-born individuals.
The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects?
A. The patient should be discouraged from using folk remedies and rituals.
B. The nurse will expect the patient to value protective bracelets and -root doctorsl as healers.
C. The nurse will remember that the balance among body, mind, and environment is important for this patient's health beliefs.
D. The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing.
Correct answer:
All beliefs need to be considered clearly so as to prevent a conflict from arising between the goals of nursing and health care and the dictates of a patient's cultural background. Assessing religious practices and beliefs is part of a thorough cultural assessment. The other options are incorrect. The nurse should not ignore a patient's cultural practices. The concept of balance among body, mind, and environment and the valuing of protective bracelets and root doctors reflect beliefs or practices that usually do not apply to the Hispanic cultural group.
Which is a process by which the nurse consistently works in the cultural context of the client, family, and community?
A. Stereotyping
B. Ethnicity
C. Cultural competence
D. Subculture
Correct answer:
Providing culturally competent care is a process by which the nurse consistently endeavors to work in the cultural context and client's family, culture and community. Stereotyping means assuming that all people in a particular cultural, racial, or ethnic group share the same values and beliefs, behave similarly, and are basically like. Ethnicity is the bond or kinship that people feel with their country of birth or place of ancestral origin. Subculture refers to a particular group that shares characteristics identifying the group as a distinct entity.
What is descriptive of the social development of school-age children?
A. Identification with peers is minimum.
B. Children frequently have best friends.
C. Boys and girls play equally with each other.
D. Peer approval is not yet an influence for the child to conform.
Correct answer:
Identification with peers is a strong influence in childrens gaining independence from parents. Interaction among peers leads to the formation of close friendships with same-sex peersbest friends. Daily relationships with age mates in the school setting provide important social interactions for school-age children. During the later school years, groups are composed predominantly of children of the same sex. Conforming to the rules of the peer group provides children with a sense of security and relieves them of the responsibility of making decisions.
The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Which of the following actions should the nurse take when a family's cultural beliefs include the use of massage for pain control, but the nurse is feeling frustration because of the number of family members in the patient's room?
A. Ask the nurse about personal beliefs about health and health care.
B. Suggest that the nurse ask family members to leave the room during the massage.
C. Have the nurse explain to family that too many visitors will tire the patient.
D. Remind the nurse that this cultural practice is important to the family and patient.
Correct answer:
The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help to achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses (suggest that the nurse ask family members to leave the room, and have the nurse explain to family that too many visitors will tire the patient) are not culturally appropriate for this patient.
During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindindation to that drug. The nurse may be liable for which of these?
A. Medical negligence
B. Nursing negligence
C. Nonmaleficeence
D. Autonomy
Correct answer:
Negligence is the failure to act in a reasonable and prudent manner or failure of the nurse to give the care that a reasonably prudent (cautious) nurse would render or use under similar circumstances. Nurses are expected to assess patients thoroughly before medications are given, and to be familiar with medications they are administering. In this case, nursing negligence applies to nurses, not medical negligence. Nonmaleficence is defined as the duty to do no harm, autonomy is defined as the right to make one's own decisions, or self-determination.
The nurse is instructing an adolescent female client who is not sexually active on potential vaccinations available. Which vaccination would the nurse state that decreases the risk of cervical cancer?
A. Hepatitis B
B. Human papilloma viral (HPV)
C. Herpes zoster
D. Meningococcal
Correct answer:
Human papilloma viral (HPV) infection is the most commonly transmitted sexual disease in the United States. A strain of this infection can cause cervical cancer. An HPV vaccine is available to both females and males. For females, the vaccine decreases the risk of cervical cancer and genital warts. For males, the vaccine decreases the risk of genital warts and anal cancers. Hepatitis B vaccine protects against a liver disease. Herpes zoster is the vaccine for shingles. The meningococcal vaccine protects against several diseases including meningitis.
Which statement about the biomedical health belief system is true?
A. Life processes can be manipulated by humans by mechanical interventions.
B. Life processes cannot be manipulated by humans by mechanical interventions.
C. Disease has a nonspecific cause onset course and treatment.
D. Disease is only caused by failure of body parts and chemical imbalances.
Correct answer:
Characteristic of the biomedical health belief system includes the beliefs that life is regulated by biomedical and physical processes. Life processes can be manipulated by humans by mechanical interventions. Health is the absence of disease or signs and symptoms of disease. Disease is an alteration of the structure and function of the body. Disease has a specific cause, onset, course, and treatment. It is caused by trauma, pathogens, chemical imbalances, or failure of body parts. Treatment focuses on the use of physical and chemical treatments.
About these Nursing textbooks medical-surgical questions
Nursing textbooks medical-surgical practice questions, set 34 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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