Chapter 11 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Chapter 11 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A terminally ill patient is experiencing dyspnea. What should the nurse do to help the patient feel more comfortable?

1. Raise the head of the bed.
2. Gently massage the patient.
3. Replace the oxygen cannula with a face mask.
4. Provide oral care.

Correct Answer: 1

Rationale 1: Elevating the head of the bed reduces choking sensations and promotes expansion of the lungs.

Rationale 2: Massage has not been shown to reduce dyspnea, but will help reduce discomfort from accumulating edema in the extremities.

Rationale 3: Face masks often make the patient more dyspneic.

Rationale 4: Providing oral care is not the best answer for reducing dyspnea.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11-4

 

Question 2

Type: MCSA

A competent elderly patient has a living will that specifies avoiding resuscitation and heroic life support measures. The family members are not supportive of this directive. Which action by the nurse is most appropriate?

1. Consider the document valid and document its existence in the medical record.
2. Contact the Social Services department.
3. Notify the hospital attorney.
4. Explain to the patient that the conflict could invalidate the document.

Correct Answer: 1

Rationale 1: The patient is competent. The nurse should consider this document valid and should advocate for the patient’s wishes by including the information in the medical record.

Rationale 2: If there are concerns about the authenticity of the document, the Social Services department or the unit supervisor will need to be contacted.

Rationale 3: The nurse would not contact the hospital attorney but would make the situation known to the unit supervisor.

Rationale 4: A lack of support by the family does not invalidate the document.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11-2

 

Question 3

Type: MCSA

While preparing for the discharge of an elderly, terminally ill patient, the family asks for information concerning the most appropriate time to become involved with a hospice agency. Which action by the nurse is most appropriate?

1. Assist the family in making contact with a hospice agency at this time.
2. Estimate the patient’s life expectancy to gauge when contact with hospice should be made.
3. Encourage the family to “hold off” making the contact until death is very close.
4. Determine what expectations the family has of the hospice agency.

Correct Answer: 1

Rationale 1: Hospice agencies provide vital services to patients who are facing death and to their families. Referrals should be prompt.

Rationale 2: Even though a hospice is generally considered appropriate in the last 6 months of life, it is not appropriate for the nurse to make that determination.

Rationale 3: Waiting until the time of death is at hand does not leave much time for the hospice agency to assist the family.

Rationale 4: Determining the family’s expectations is an action more appropriate for the hospice intake nurse.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11-5

 

Question 4

Type: MCSA

A terminally ill patient is receiving palliative care. How would the nurse explain the purpose of this type of care to the family?

1. “Palliative care is designed to alleviate suffering and promote quality of life.”
2. “Palliative care reduces pain and prevents medical complications.”
3. “Palliative care’s purpose is to control the side effects of illness while postponing death.”
4. “Palliative care involves withdrawing all medical care to allow natural death.”

Correct Answer: 1

Rationale 1: The purpose of palliative care is to provide comprehensive care focused on alleviating suffering and promoting quality of life.

Rationale 2: Medical complications can be controlled by palliative care, but not prevented. Palliative care can also help control pain.

Rationale 3: The purpose of palliative care is not specifically to postpone death.

Rationale 4: Withdrawing all medical care would be inappropriate, as it would cause more suffering.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11-6