Medical Surgical Nursing Critical Thinking in Client Care Single Volume 4th Edition By Priscilla T LeMone -Test Bank
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Sample
Test
Chapter 03
1. MC A
79-year-old client is planning to have a laminectomy. In which of the following
healthcare settings is this client most likely going to have this procedure?
2. An
ambulatory care center
B.* An acute care hospital
1. An
outpatient clinic
2. A
skilled nursing facility
2. MC
The nurse is teaching a group of clients at a senior center about ways to
reduce their blood pressure through exercise and recreation. What type of care
is this nurse is providing?
3. Skilled
nursing
4. Ambulatory
5. Community
health
D.* Community-based
3. MC
The nurse is considering working as a community-based nurse. The nurse knows
this is a role that may have many contributing factors for providing care.
Which of the following factors may affect the health of a community? (Select
all that apply.)
A.* Environmental factors
B.* Economic resources
C.* Social support systems
1. Political
affiliations
E.* Community healthcare structure
4. MC
The home care nurse is planning to visit a client who is on Medicare. The nurse
realizes that care can be provided if:
5. The home
meets safety standards.
B.* The client is considered homebound.
1. The
client can use a wheelchair.
2. The
client lives alone.
5. MC
After mass on Sunday the nurse is measuring blood pressures in the church
greeting room. This nurse is most likely practicing:
A.* Parish nursing.
1. A
Sunday day care program.
2. The
first steps to a health care clinic.
3. Scheduling
parishioners for Meals-on-Wheels.
6. MC
The client is in need of home care, is on oxygen therapy, weak from surgery,
has a small surgical incision, and needs to increase activity to gain
independence. Which of the following home care providers will the nurse most
likely suggest for this client?
7. Social
worker
B.* Physical therapy
1. Occupational
therapy
2. Speech
therapy
7. MC
Upon discharge from an acute care facility, the client is referred to the
hospital’s home healthcare agency. This client will be receiving services from
which of the following types of agencies?
8. Voluntary
B.* Institution-based
1. Private
2. Public
8. MC During
the admission of a home care client, the nurse learns the client is married,
has no pets, a mother who is homebound and in the home, and has two daughters
who do not reside with the client. Which of the following would the nurse
consider as the client’s family?
A.* The husband and daughters
1. The
husband only
2. No
one
3. The
husband and mother
9. MC A
client who is being prepared for discharged from the hospital is identified as
needing more care. The family is refusing a transfer to a skilled nursing facility.
Which of the following can the nurse do to help this client?
A.* Suggest home care.
1. Ignore
the family and schedule the client for transfer.
2. Nothing
3. Contact
protective services because the client is at risk.
10. MC
The nurse is completing the home health admission for a client. Which one of
the following initial actions should the nurse take with the plan of care
created from the admission information?
11. Place
it in the client’s medical record.
12. Keep
it in the client’s home.
C.* Send it to the physician for review and
approval.
1. Keep
it during every visit.
11. MC
During the first home care visit, the nurse reviews with the client all of the
information about privacy and informed consent. Which of the following
documents should the nurse include in this review?
A.* Bill of Rights
1. HIPAA
standards
2. ANA
standards for community health nursing
3. ANA
standards for home health nursing
12. MC
During a phone call to coordinate a time for the first home care visit, the
nurse learns the client is on home oxygen therapy, uses a walker for
ambulation, and has minimal strength in her lower extremities. This information
will be used:
13. To
evaluate how well the client is doing since arriving home.
14. To
arrange transportation for the client.
15. To
schedule a physical therapy evaluation.
D.* To plan nursing diagnoses.
13. MC
After the initial assessment of a home care client, the nurse identifies areas
in which the client can improve their health status. What should the nurse do
with this information? (Select all that apply.)
14. Contract
with the client to meet the goals.
B.* Work with the client to set goals.
C.* Write this information in the plan of care.
1. Discuss
with the family what to do with the information.
14. MC
The home care nurse sees that a family member is not adhering to the client’s
prescribed plan of care and reviews the plan with this family member. The
nursing is functioning in which capacity with the family?
A.* Advocate
1. Educator
2. Coordinator
of services
3. Provider
of direct care
15. MC
During the home care visit, the nurse learns the client cannot remember what
they were taught about bathing and wound care. The nurse realizes this client:
16. Cannot
read.
17. Is
hard of hearing.
18. Is
cognitively challenged.
D.* Forgot what was taught.
16. MC
The home care nurse sees that the client uses a walker and oxygen. During the
home assessment, the nurse finds several safety issues. Which of the following
should the nurse be most concerned about in the client’s home?
17. Large
spaces between the furniture in the living room
B.* Throw rugs everywhere in the home
1. Light
switches at arms’ length
2. Grab
bars in the bathroom
17. MC
The nurse learns that the family has been throwing dirty dressings in with the
family’s regular trash. Which of the following would be appropriate for the
nurse to instruct the family about this practice?
A.* Bag the dressing so as not to cause infection of
other family members with the soiled dressing.
1. No
instruction is necessary, because this is what the family was taught.
2. Make
sure they are wearing sterile gloves when throwing the dressing away.
3. Store
the used dressings in a bag in the client’s room.
lemone_koeplin_msn_4e_ch04
1. MC A
client is being transferred from the operating room to the recovery room. The
nurse in the recovery room will be providing which phase of nursing care?
2. Restorative
3. Intraoperative
C.* Postoperative
1. Preoperative
2. MC A
client is signing a surgical consent. Afterwards, the nurse also signs the
form. What is the meaning of the nursing signature?
A.* It means the client was alert and aware of what
was being signed.
1. It
means there is a likelihood of a successful outcome.
2. It
means the surgeon was too busy to wait for the client to sign the form.
3. It
means the client understood the procedure as described by the nurse.
3. MC An
elderly client is being prepared for orthopedic surgery. The nurse realizes
this client is at risk for which of the following?
4. Increased
hypotensive effects of anesthesia
5. Wound
dehiscence
C.* Decreased tolerance of general anesthesia
1. Prolonged
effects of anesthesia because of herbal supplements
4. MC An
elderly client is completing preoperative diagnostic testing. The nurse notes
that the client’s carbon dioxide level is elevated. Which of the following
nursing interventions would be indicated for this client?
5. Monitor
intake and output.
B.* Monitor respiratory status and arterial blood
gases.
1. Monitor
serum sodium level.
2. Monitor
serum potassium level.
5. MC An
elderly postoperative client is given an antiemetic for nausea. Which of the
following signs would indicate this client is experiencing a possible reaction
to the medication?
A.* Involuntary muscle movements
1. Confusion
2. Dry
mouth
3. Breakthrough
vomiting
6. MC A client’s
endotracheal tube is being removed after the surgical procedure. The
intra-operative nurse realizes this client is in which phase of the general
anesthesia process?
7. Maintenance
B.* Emergence
1. Induction
2. Reduction
7. MC A
client has received conscious sedation for a surgical procedure. The nurse
realizes this client will most likely:
8. Not
respond to any stimuli.
B.* Respond to physical and verbal stimuli.
1. Need
blood product replacements.
2. Need
an endotracheal tube inserted.
8. MC A client
is prescribed patient-controlled analgesia for postoperative pain. Which of the
following should the nurse instruct the client about this analgesia?
9. “Use
this analgesia every hour on the hour.”
10. “Use
this analgesia only when the pain is extremely severe.”
11. “Avoid
the use of this because of the risk of addiction.”
D.* “Use this analgesia regularly.”
9. MC A
client is in the recovery room. Which of the following members of the
healthcare team should the nurse contact regarding the client’s level of pain
control?
A.* The anesthesiologist
1. The
circulating nurse
2. The
surgeon
3. The
scrub nurse
10. MC A
recovery room nurse is consulting with a circulating nurse about a client who
is having a surgical procedure. These nurses are most likely in which zone of
the surgical department?
11. Semi-restricted
12. Banned
13. Restricted
D.* Unrestricted
11. MC A
client is being positioned for a hip replacement procedure. In which of the
following positions will this client most likely be placed?
A.* Lateral chest
1. Dorsal
recumbent
2. Prone
3. Semi-sitting
12. MC A
postoperative client tells the nurse, “A book I read said that I should not eat
after surgery for at least a week.” Which of the following statements would be
an appropriate nursing response?
13. “That’s
true.”
14. “You
don’t need any food to heal anyway.”
15. “I’ll
be giving you intravenous feedings anyway.”
D.* “That’s not true. You could get an infection in
your stomach.”
13. MC A
client is being scheduled for surgery. Which of the following should be
included in the preoperative teaching provided by the nurse?
14. Cost
of the procedure
15. The
credentials of the anesthesiologist
C.* Planned length of stay at the hospital
1. Information
concerning the surgical procedure which will be performed by the surgeon
14. MC A client
has just arrived in the recovery room. How often should the nurse assess the
client?
15. Every
two hours.
16. Every
15 minutes for 30 minutes and then every one hour afterwards.
C.* Every 15 minutes for the first hour.
1. Every
hour.
15. MC A
client is demonstrating signs of postoperative hemorrhage. Which of the
following would be an appropriate nursing intervention at this time?
16. Slow
the intravenous fluid administration rate.
B.* Apply sterile pads and a snug pressure dressing
to the area.
1. Support
the client’s physiologic mechanism for dissolving clots.
2. Raise
the head of the client’s bed.
16. MC
The nurse is assisting a postoperative client in using an incentive spirometer.
Which of the following postoperative complications is this nurse attempting to
avoid with this client?
17. Deep
vein thrombosis
18. Hemorrhage
19. Pulmonary
embolism
D.* Atelectasis
17. MC A
client is in his fifth postoperative day and has sanguineous drainage with a
thick, reddish appearance. The nurse realizes this client’s wound is in which
stage of healing?
18. Stage
III
B.* Stage II
1. Stage
I
2. Stage
IV
18. MC A
client who is recovering from abdominal surgery has a penrose drain. Which of
the following should the nurse include in the care of this client?
19. Remove
the drain four hours postoperatively.
20. Clean
the wound with normal saline every two hours.
C.* Make sure there is a safety pin on the end of
the drain.
1. Empty
the drain every 30 minutes.
19. MC
During the assessment of a postoperative client’s bowel sounds, the nurse
auscultates high-pitched sounds over all four abdominal quadrants. The nurse
realizes this finding could indicate:
20. The
onset of flatus.
21. The
onset of stool.
C.* Paralytic ileus.
1. Normal
bowel function.
20. MC A
client is scheduled for removal of a cataract. The nurse realizes this client’s
procedure is classified as being:
21. Minor
diagnostic.
22. Major
elective.
23. Major
constructive.
D.* Minor elective.
21. MC A
client who is being admitted for surgery asks the nurse why information is
being collected about the client’s use of herbal and natural supplements. Which
of the following statements is an appropriate nursing response?
A.* “Herbal supplements may interact with anesthesia
agents.”
1. “Herbal
remedies may cause pain relievers to be ineffective.”
2. “The
physician is in charge of medications.”
3. “There
is no need to take these preparations.”
22. MC A
client is complaining of discomfort after a surgical procedure. The client
voices fear of addition with taking analgesics as prescribed. What information
should be provided to the client regarding these concerns? (Select all that
apply.)
23. “Clients
should be screened for addiction potential prior to being given narcotics.”
B.* “Pain tolerance and the need for opioid
analgesics is individualized.”
C.* “Psychological tolerance is not commonly
experienced by clients who take narcotic analgesics during the postoperative
experience.”
D.* “Addiction to opioid analgesics is rare when
used for short-term postoperative pain management.”
23. MC
The client who is preparing for surgery asks the nurse to keep their glasses
and hearing aid in-place until they are under anesthesia. Which of the
following statements by the nurse demonstrates accurate, therapeutic
communication?
24. “The
policies in the surgery unit will not allow it.”
25. “You
cannot keep those in.”
26. “Certainly,
you can keep them for that time.”
D.* “I will contact the surgery department to
discuss you requests.”
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