Chapter 14 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 14 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

While reviewing the white blood cell count differential for a patient, the nurse notes that the basophil count is elevated. What does this laboratory value indicate to the nurse?

1. The patient may be experiencing an acute hypersensitivity reaction.
2. The patient has a viral gastrointestinal infection.
3. The patient is fighting a bacterial skin infection.
4. The patient is not responding to a parasitic infection.

Correct Answer: 1

Rationale 1: Basophils are not phagocytic and contain proteins and chemicals such as heparin, histamine, bradykinin, serotonin, and leukotrienes that are released into the bloodstream during an acute hypersensitivity reaction or stress response.

Rationale 2: Basophils do not respond to viral infections.

Rationale 3: Basophils do not respond to bacterial infections.

Rationale 4: Basophils increase with parasitic infections, so an increase would indicate a response by the patient.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-6

 

Question 2

Type: MCMA

The nurse would be concerned that a patient is exhibiting signs and symptoms of inflammation after assessing which findings in a leg wound?

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

Standard Text: Select all that apply.

1. Edema
2. Pain
3. Erythema
4. Coolness of tissues
5. Decreased distal pulses

Correct Answer: 1,2,3

Rationale 1: Edema results from vasodilation and leaking of fluid into the surrounding tissues.

Rationale 2: Pain results from swelling and prostaglandin release.

Rationale 3: Erythema is related to vasodilation and is a cardinal sign of inflammation.

Rationale 4: Warmth at the site is a sign of inflammation.

Rationale 5: Decreased distal pulses are not a typical sign of inflammation.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-6

 

Question 3

Type: MCSA

Which finding would indicate that a patient is experiencing a systemic reaction associated with an inflammatory response?

1. Fever
2. Erythema
3. Edema
4. Pain

Correct Answer: 1

Rationale 1: Fever is a sign that the inflammatory response has become systemic.

Rationale 2: Erythema indicates a local reaction.

Rationale 3: Edema indicates a local reaction.

Rationale 4: Pain indicates a local reaction.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-6

 

Question 4

Type: MCSA

The nurse is planning care for a patient at risk for developing an infection. Which intervention is the most important for the nurse to include in this patient’s plan of care?

1. Wash hands prior to providing care to the patient.
2. Provide prophylactic antibiotic therapy as prescribed.
3. Wear a mask when caring for the patient.
4. Wear a gown and gloves when changing the patient’s linen.

Correct Answer: 1

Rationale 1: Prevention is the most important control measure for nosocomial infections. The pathogens causing these infections are transmitted primarily by contact with hospital personnel and contaminated inanimate objects. Effective hand hygiene is the single most important measure in infection control.

Rationale 2: Prophylactic antibiotic therapy could lead to the development of bacteria-resistant microorganisms and should not be performed.

Rationale 3: The use of a mask is not needed to prevent the onset of infection in the patient.

Rationale 4: The use of a gown and gloves is not needed to prevent the onset of infection in the patient.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 14-3