Test Bank for Medical-Surgical Nursing: Critical Thinking in Patient Care 4th Edition by LeMone and Burke Full PDF
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Course
Medical surgical nursing
Institution
Medical Surgical Nursing
Download Test Bank for Medical-Surgical Nursing: Critical Thinking in Patient Care 4th Edition by LeMone and Burke Full PDF
Sample Questions:
Chapter 1
1. The registered nurse is caring for four patients on a medical–surgical unit. Which
patient shouldthe registered nurse see initially?
1. ...
Test Bank for Medical-Surgical Nursing: Critical Thinking
in Patient Care 4th Edition
,Chapter 1
1. The registered nurse is caring for four patients on a medical–surgical unit. Which
patient shouldthe registered nurse see initially?
1.
A patient admitted with hepatitis A who has had severe diarrhea for
thelast 24 hours
2.
A patient admitted with pneumonia who is has small amounts
ofyellow productive sputum
3.
A patient admitted with fever of unknown origin (FUO) who
hasbeen without fever for the last 48 hours
4.
A patient admitted with a wound infection whose WBC is 8,500 mm3
CORRECT CHOICE ✔✔ 1
EXPLANATION: The registered nurse must decide which patient should be seen on the
initial rounds of theday. The registered nurse must remember that the first patient
to be seen should be the patient who needs the attention of the registered nurse
initially. A patient with hepatitis A does experience diarrhea, but diarrhea for the
last 24 hours could cause the patient to have a problem with dehydration and
experience a state of fluid volume deficit.
2. The registered nurse is preparing to administer influenza vaccines to a mass drive-
through clinic. Which statement by a patient would indicate further questioning prior to
giving thepatient the influenza vaccine?
1. “I am allergic to horse hair.”
2. “I try to get my vaccine every year.”
3. “I am not allergic to anything except eggs.”
4. “My husband had a severe allergic reaction after he received his influenza
vaccine.”
CORRECT CHOICE ✔✔ 3
EXPLANATION: Influenza vaccines are recommended for person at high risk for
serious sequelae of influenza. The registered nurse should be aware that patient
with a sensitivity toeggs should not receive the vaccine. Vaccines prepared
from chicken or duck embryos are contraindicated in patients who are allergic
to eggs.
Cognitive Level: Application
Patient Needs: Safe, Effective Care Environment
,Nursing Process: Assessment
3. The registered nurse is caring for four patients on a medical–surgical unit. The
secretary gives the registered nurse the morning labs. Which of the following labs
would require that the registered nurse call the physician and inform the healthcare
provider about the patient’s abnormalities?
1.
WBC 14,600 mm3
2.
Serum protein 6.9 g/dL
3.
I & D (incision and drainage) showing no growth for the last 24 hours
4.
Albumin 4.2 g/dL
CORRECT CHOICE ✔✔ 1
EXPLANATION: When the registered nurse is caring for several patients, all of the
labs should be checked frequently throughout the shift to assess for any abnormalities.
The WBC in option 1 is abnormal. (Normal WBC 4,000–10,000 mm3.) All of the other
lab results are within acceptable range; therefore, the results should not be called in to
the physician.
4. The registered nurse is orienting a new graduate. The registered nurse is
reinforcing the importance ofstandard precautions. Which of the following
observations by the registered nurse would require further education regarding
standard precautions?
1. The graduate registered nurse understands to wash hands when
entering andexiting the patient’s room.
2. The graduate registered nurse wears gloves when serving
breakfast trays to various patients.
3. The graduate registered nurse wears a gown, gloves, and goggles when
suctioninga patient.
4. The graduate registered nurse leaves all supplies in the room of a
patient who is in contact isolation.
CORRECT CHOICE ✔✔ 2
EXPLANATION: The registered nurse must have an understanding of standard
precautions. Prevention is the most important measure to prevent nosocomial
infections. Standard precautions were published in 1996 that provide guidelines
for the handling of blood and other body fluids. These guidelines are used with
all patients, regardlessof whether they have a known infectious disease. Standard
precautions are used by all healthcare workers who have direct contact with
patients or with their body
, fluids. It is not necessary for the registered nurse to wear gloves while delivering
food traysto the patient, because there is not contact with the patient.
5. The admitting department alerts the registered nurse on a medical–surgical unit that a
patient withactive tuberculosis (TB) is being admitted to the unit. Which type of
isolation is appropriate based on the patient’s diagnosis?
In addition to handwashing and standard precautions, the nature and spread of some
infectious diseases require that special techniques be used to protect uninfected
patientsand workers. The patient with pulmonary tuberculosis will be placed in
airborne precautions. The patient should be placed in a private room with special
ventilation that does not allow air to circulate to general hospital ventilation; a mask or
special filter respirators will be used for everyone entering the room.
6. A patient is receiving IV vancomycin for the treatment of Clostridium difficile.
Theregistered nurse understands that the patient who develops flushing, tachycardia,
and hypotension during the infusion of vancomycin indicates:
1. Ototoxicity effect.
2. Superinfection.
3. Red man syndrome.
4. Hives.
CORRECT CHOICE ✔✔ 3
EXPLANATION: Vancomycin inhibits cell wall synthesis, and is used for serious
infections. It isonly effective against gram-positive bacteria, especially Staphylococcus
aureus and Staphylococcus epidermidis. The registered nurse should infuse this medication
slowly over 60 minutes or more to avoid “red man” syndrome. The syndrome is
characterized by
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