Chapter 21 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 21 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A patient comes to the clinic complaining of repetitive episodes of sudden severe pain on the right side of the face. The nurse anticipates additional testing for which disorder?

1. Trigeminal neuralgia
2. Parkinson’s disease
3. Bell’s palsy
4. Myasthenia gravis

Correct Answer: 1

Rationale 1: The cause of trigeminal neuralgia is not known, but contributing factors are recent flulike illness, trauma or infection of the teeth or jaw, and arteriosclerotic changes of an artery close to the nerve. It is manifested by repetitive episodes of sudden severe pain on the affected side of the face.

Rationale 2: The facial symptom associated with Parkinson’s disease is decreased facial movement resulting in a masklike presentation. Severe facial pain is not associated with Parkinson’s disease.

Rationale 3: Bell’s palsy results in paralysis of one side of the face. Severe espisodic facial pain is not associated with Bell’s palsy.

Rationale 4: Myasthenia gravis results in drooping of the eyelid. Severe espisodic facial pain is not associated with myasthenia gravis.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-1

 

Question 2

Type: MCSA

A patient has just been diagnosed with trigeminal neuralgia. What would the nurse teach this patient about treatment for this disorder?

1. Drugs used to treat seizure disorders are generally effective.
2. Drug therapy will begin with a trial of antiviral drugs.
3. The primary treatment focus will be on supporting respiratory function until the condition resolves.
4. Gargling with hot salt water will help reduce pain and keep tissues moistened.

Correct Answer: 1

Rationale 1: Trigeminal neuralgia is treated by a pharmacologic approach to pain control with anticonvulsants such as carbamazepine (Tegretol).

Rationale 2: There is no evidence that trigeminal neuralgia is a viral illness or that antiviral drugs are indicated.

Rationale 3: Respiratory support is not necessary to treat this condition.

Rationale 4: Contact with hot or cold substances is often a trigger that induces pain and should be avoided.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-1

 

Question 3

Type: MCMA

A 25-year-old female is diagnosed with tic douloureux. How should the nurse describe this disorder to the patient?

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

Standard Text: Select all that apply.

1. “This condition is also called Bell’s palsy.”
2. “You are the typical age for onset of this condition.”
3. “More women than men have this condition.”
4. “More testing will be necessary.”
5. “The treatment for this condition is to allow it to run its course, which is typically 5 to 7 days.”

Correct Answer: 3,4

Rationale 1: The other name for this condition is trigeminal neuralgia.

Rationale 2: The condition generally begins after age 40, with the typical onset at 60 to 70 years in approximately 90% of patients.

Rationale 3: This condition affects twice as many women as men.

Rationale 4: Occurrence of this condition in people 20 to 40 years of age may indicate other diseases such as multiple sclerosis.

Rationale 5: This condition does not abate untreated. Pharmacotherapy is necessary. If pharmacotherapy is not successful, surgical treatments are considered.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-1

 

Question 4

Type: MCSA

A patient is in the emergency department following a head injury. The nurse would assess for which sign indicating early increased intracranial pressure?

1. Decreasing level of consciousness
2. Elevated diastolic blood pressure
3. Decreasing respiratory rate
4. Tachycardia

Correct Answer: 1

Rationale 1: The brain is very sensitive to the level of oxygenation. As the pressure inside the skull increases, hypoxia develops, which negatively affects the level of consciousness.

Rationale 2: A change in blood pressure is generally a widening pulse pressure that would include increased systolic blood pressure.

Rationale 3: A change in respiratory rate is a late sign of increased ICP.

Rationale 4: Bradycardia is the most common indicator of increased ICP.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-2