Chapter 16 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 16 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

A patient’s peripheral intravenous catheter has infiltrated several times during an 8-hour shift. The nurse realizes that the patient needs a central venous access device. Which intravascular devices could a properly trained nurse insert under the guidelines of the infusion nursing standards of practice?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. A triple-lumen catheter
2. A peripherally inserted central catheter
3. A tunneled noncuffed catheter
4. An implanted port
5. A midline catheter

Correct Answer: 2,5

Rationale 1: A triple-lumen catheter is inserted by a physician.

Rationale 2: This catheter can be inserted by nurses educated and skilled in the procedure.

Rationale 3: A tunneled noncuffed catheter is used for long-term therapy and requires an operative procedure for insertion.

Rationale 4: An implanted port is used for long-term therapy and requires an operative procedure for insertion.

Rationale 5: A midline catheter can be inserted by nurses educated and skilled in the procedure.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-1

 

Question 2

Type: MCSA

Which nursing diagnosis would explain the purpose of using a self-sheathing stylet catheter?

1. Risk for Fluid Volume Deficit
2. Risk for Injury
3. Risk for Altered Nutrition
4. Risk for Infection

Correct Answer: 2

Rationale 1: Using a self-sheathing stylet catheter does not improve therapy for fluid volume deficit.

Rationale 2: Risk for Injury is the nursing diagnosis that explains the purpose of the self-sheathing catheter. It is engineered with a safety mechanism that encases the needle in a protective chamber upon removal from the inserted catheter, thus preventing a needle-stick injury.

Rationale 3: The use of a self-sheathing stylet catheter is not related to nutritional status.

Rationale 4: The self-sheathing stylet catheter does not prevent infection.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-1

 

Question 3

Type: MCSA

The nurse is preparing to discharge a patient after infusing chemotherapy through an implanted port. What instructions for port care would the nurse provide?

1. Apply a nonadhering dressing weekly.
2. Apply a sterile dressing every 2 days.
3. Place a clean bandage daily.
4. No dressings are necessary.

Correct Answer: 4

Rationale 1: Use of a nonadhering dressing is not recommended.

Rationale 2: There is no need to use a sterile dressing.

Rationale 3: Bandaging is not necessary.

Rationale 4: No dressings are necessary because the port is completely under the skin.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-3

 

Question 4

Type: MCSA

A patient receiving peripheral intravenous therapy is mobile but having difficulty maneuvering the intravenous infusion pump. The nurse would choose which add-on device to allow greater mobility for the patient?

1. A multiflow adapter
2. An extension set
3. A stopcock
4. A filter device

Correct Answer: 2

Rationale 1: A multiflow adapter is used for the administration of two or more infusates simultaneously and does not increase tubing length.

Rationale 2: An extension set is a device that adds length to the existing administration set and allows the patient to move more freely without having to push the intravenous pump.

Rationale 3: A stopcock is used to direct flow of an infusate and would not increase tubing length.

Rationale 4: A filter device provides sterility to the infused parenteral medication or solution but does not increase the tubing length.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-3