Nursing textbooks medical-surgical practice questions, set 35
Nursing textbooks · medical-surgical
Nursing textbooks medical-surgical practice questionsset 35
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
Which family theory is described as a series of tasks for the family throughout its life span?
A. Exchange theory
B. Developmental theory
C. Structural-functional theory
D. Symbolic interactional theory
Show answer and rationale
Correct answer: B — Developmental theory
In developmental systems theory, the family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others. Exchange theory assumes that humans, families, and groups seek rewarding statuses so that rewards are maximized while costs are minimized. Structural-functional theory states that the family performs at least one societal function while also meeting family needs. Symbolic interactional theory describes the family as a unit of interacting persons with each occupying a position within the family.
Question 2
Children may believe that they are responsible for their parents divorce and interpret the separation as punishment. At which age is this most likely to occur?
A. 1 year
B. 4 years
C. 8 years
D. 13 years
Show answer and rationale
Correct answer: B — 4 years
Preschool-age children are most likely to blame themselves for the divorce. A 4-year-old child will fear abandonment and express bewilderment regarding all human relationships. A 4-year-old child has magical thinking and believes his or her actions cause consequences, such as divorce. For infants, divorce may increase their irritability and interfere with the attachment process, but they are too young to feel responsibility. School-age children will have feelings of deprivation, including the loss of a parent, attention, money, and a secure future. Adolescents are able to disengage themselves from the parental conflict.
Question 3
Which type of family should the nurse recognize when a mother, her children, and a stepfather live together?
A. Traditional nuclear
B. Blended
C. Extended
D. Binuclear
Show answer and rationale
Correct answer: B — Blended
A blended family contains at least one stepparent, stepsibling, or half-sibling. A traditional nuclear family consists of a married couple and their biologic children. No other relatives or nonrelatives are present in the household. An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children.
Question 4
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?
A. Pallative therapy
B. Maintenance therapy
C. Empirric therapy
D. Supplmental therapy
Show answer and rationale
Correct answer: A — Pallative therapy
The goal of palliative therapy is to make the patient as comfortable as possible. It is typically used in the end stages of illnesses when all attempts at curative therapy have failed. Maintenance therapy is used for the treatment of chronic illnesses such as hypertension. Empirric therapy is based on clinical probabilities and involves drug administration when a certain pathologic condition has an uncertain but high likelihood of occurrence based on the patient's initial presenting symptoms. Supplemental therapy (or replacement therapy) supplies the body with a substance needed to maintain normal function.
Question 5
A central venous catheter has been inserted in the right subclavian vein of the client. Which of the following would be the priority nursing action before total parenteral nutrition (TPN) can be started?
A. Call for a portable chest $x$-ray.
B. Assess for swelling, redness, and drainage of the site.
C. Allow the TPN solution to warm to room temperature.
D. Assess blood sugar via a glucometer.
Show answer and rationale
Correct answer: A — Call for a portable chest $x$-ray.
Insertion of a central venous access device in the subclavian can result in an accidental puncture of the pleural membrane, resulting in a pneumothorax. Verification of the insertion site is completed before TPN is started. Swelling, redness, and drainage are symptoms of infection which would not be present immediately following insertion. Hyperglycemia is a common occurrence with the use of hypertonic solutions such as those found in TPN, but because the TPN has not been started, this is not a priority assessment. Cold solutions can result in venous spasms but letting the solution warm is not the priority.
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Question 6
When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
A. Parental control should be consistent.
B. Withdrawal of love and approval is effective at this age.
C. Children as young as 4 years rarely need to be disciplined.
D. One should expect rules to be followed rigidly and unquestioningly.
Correct answer:
For effective discipline, parents must be consistent and must follow through with agreed-on actions. Withdrawal of love and approval is never appropriate or effective. The 4-year-old child will test limits and may misbehave. Children of this age do not respond to verbal reasoning. Realistic goals should be set for this age group. Discipline is necessary to reinforce these goals. Discipline strategies should be appropriate to the childs age and temperament and the severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old child.
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs have the same concentration of the active ingredient. Which term is used to identify this principle?
A. Bioequivalent
B. Synergistic
C. Proddrugs
D. Steady state
Correct answer:
Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have the same bioavailability; thus, they are bioequivalent. A drug's steady state is the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed from each dose. The term synergistic refers to two drugs, given together, with a resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug is an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body.
The nurse is caring for an infant who will be discharged on home phototherapy. What instructions should the nurse include in the discharge teaching to the parents?
A. Apply an oil-based lotion to the infants skin two times per day to prevent the skin from drying out under the phototherapy light.
B. Keep the eye shields on the infants eyes even when the phototherapy light is turned off.
C. Take the infants temperature every 2 hours while the newborn is under the phototherapy light.
D. Make a follow-up visit with the health care provider within 2 or 3 days after your infant has been on phototherapy.
Correct answer:
With short hospital stays, infants may be discharged with a prescription for home phototherapy. It is the responsibility of the nurse planning discharge to include important information such as the need for a follow-up visit with the health care provider in 2 or 3 days to evaluate feeding and elimination pattern and to have blood work done if needed. The parents should be taught to not apply oil or lotions to prevent increased tanning; the babys eye shields can come off when the phototherapy lights are turned off, and the infants temperature needs to be monitored but not taken every 2 hours.
When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient's blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction?
A. Adverse effect
B. Allergic reaction
C. Idosyncratic reaction
D. Pharmacologic reaction
Correct answer:
A pharmacologic reaction is an extension of a drug's normal effects in the body. In this case, the antihypertensive drug lowered the patient's blood pressure levels too much. The other options do not describe a pharmacologic reaction. An adverse effect is a predictable, well-known adverse drug reaction that results in minor or no changes in patient management. An allergic reaction (also known as a hypersensitivity reaction) involves the patient's immune system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal response to normal dosages of a drug.
A mother brings her 6-week-old infant in with complaints of poor feeding, lethargy, fever, irritability, and a vesicular rash. What does the nurse suspect?
A. Impetigo
B. Candidiasis
C. Neonatal herpes
D. Congenital syphilis
Correct answer:
Neonatal herpes is one of the most serious viral infections in newborns, with a mortality rate of up to 60% in infants with disseminated disease. Bullous impetigo is an infectious superficial skin condition most often caused by Staphylococcus aureus infection. It is characterized by bullous vesicular lesions on previously untraumatized skin. Candidiasis is characterized by white adherent patches on the tongue, palate, and inner aspects of the cheeks. Congenital syphilis has multisystem manifestations, including hepatosplenomegaly, lymphadenopathy, hemolytic anemia, and thrombocytopenia.
Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together?
A. Blended
B. Nuclear
C. Extended
D. Binuclear
Correct answer:
An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. A blended family contains at least one stepparent, stepsibling, or half-sibling. A nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children.
To avoid complications of blood transfusion reaction, which nursing action is most important?
A. Matching numbers on blood bag to client bracelet
B. Making sure IV catheter size is 20 gauge or larger
C. Hanging normal saline before and after blood infusion
D. If patient verbalizes feeling unusual, decrease rate by one half
Correct answer:
When the laboratory draws a sample of blood for typing and crossmatching, an identification bracelet is attached to the client and must match to confirm the correct blood at time of administration. A 20-gauge needle or greater is preferred for administration of blood but not a priority for avoiding transfusion reaction. Normal saline is the isotonic solution used with transfusions but not indicated for prevention of reactions. If the patient verbalized of feeling unusual, immediate assessment would be completed by the nurse and the infusion would be stopped, not decreased by half.
What is an important nursing intervention for a full-term infant receiving phototherapy?
A. Observing for signs of dehydration
B. Using sunscreen to protect the infants skin
C. Keeping the infant diapered to collect frequent stools
D. Informing the mother why breastfeeding must be discontinued
Correct answer:
Dehydration is a potential risk of phototherapy. The nurse monitors hydration status to be alert for the need for more frequent feedings and supplemental fluid administration. Lotions are not used; they may contribute to a frying effect. The infant should be placed nude under the lights and should be repositioned frequently to expose all body surfaces to the lights. Breastfeeding is encouraged. Intermittent phototherapy may be as effective as continuous therapy. The advantage to the mother and father of being able to hold their infant outweighs the concerns related to clearance.
The nurse is caring for a breastfed full-term infant who was born after an uneventful pregnancy and delivery. The infants blood glucose level is 36 mg/dL. Which action should the nurse implement?
A. Bring the infant to the mother and initiate breastfeeding.
B. Place a nasogastric tube and administer 5% dextrose water.
C. Start a peripheral intravenous line and administer 10% dextrose.
D. Monitor the infant in the nursery and obtain a blood glucose level in 4 hours.
Correct answer:
A full-term infant born after an uncomplicated pregnancy and delivery who is borderline hypoglycemic, as indicated by a blood glucose level of 36 mg/dL, and who is clinically asymptomatic should probably reestablish normoglycemia with early institution of breast or bottle feeding. The newborn does not require a nasogastric tube and 5% dextrose water or a peripheral intravenous line with 10% dextrose because the blood glucose level is only borderline. The infant does need to be monitored, but breastfeeding should be started and the blood glucose level checked in 1 to 2 hours.
The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?
A. Limit explanation of procedures because the child is preschool aged.
B. Ask that all family members leave the room when performing procedures.
C. Allow the child to choose the type of juice to drink with the administration of oral medications.
D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective.
Correct answer:
The overriding goal in providing atraumatic care is first, do no harm. Allowing the child a choice of juice to drink when taking oral medications provides the child with a sense of control. The preschool child should be prepared before procedures, so limiting explanations of procedures would increase anxiety. The family should be allowed to stay with the child during procedures, minimizing stress. Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should plan to use the prescribed cream in time for morning laboratory draws to minimize pain.
About these Nursing textbooks medical-surgical questions
Nursing textbooks medical-surgical practice questions, set 35 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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