Chapter 23 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Chapter 23 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

In order to care for adults with Alzheimer’s disease (AD), the nurse recognizes which common signs?

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

Standard Text: Select all that apply.

1. Poor or impaired judgment
2. Declining job skills
3. Inability to be comfortable in social situations
4. Obsession with organization
5. Focus on abstract thoughts

Correct Answer: 1,2,3

Rationale 1: Poor or impaired judgment is a warning sign of AD. This change may make the patient uncomfortable in social situations.

Rationale 2: Memory loss that negatively affects job skills is a warning sign of AD. This change may make the patient uncomfortable in social situations.

Rationale 3: The cognitive changes typical of AD may make the patient uncomfortable in social situations.

Rationale 4: Obsession with organization is not usually associated with Alzheimer’s.

Rationale 5: A focus on abstract thoughts is not usually associated with Alzheimer’s.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23-2

 

Question 2

Type: MCSA

Which medication would the nurse anticipate administering as treatment for mild Alzheimer’s disease (AD)?

1. Donepezil (Aricept)
2. Adrenocorticotropic hormone (ACTH)
3. Olanzapine (Zyprexa)
4. Memantine (Namenda)

Correct Answer: 1

Rationale 1: Donepezil (Aricept) is used to improve the ability to carry out activities of daily living. It decreases agitation and delusions and improves cognitive function.

Rationale 2: Adrenocorticotropic hormone is a natural hormone, but it has no known ability to treat Alzheimer’s.

Rationale 3: Olanzapine is used to treat the delusions, hallucinations, agitation, and combativeness characteristic of severe Alzheimer’s disease. It is not used for mild symptoms.

Rationale 4: Memantine is approved by the U.S. Food and Drug Administration for the treatment of moderate to severe AD.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-3

 

Question 3

Type: MCMA

The nurse is having a conversation with an older adult with Parkinson’s disease. What would this patient most likely exhibit during the conversation?

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

Standard Text: Select all that apply.

1. A low-pitched monotone voice
2. Bubbly, spirited discussion
3. Jumbled words that do not make sense
4. Angry, loud talk
5. Slurring and poor articulation of words

Correct Answer: 1,5

Rationale 1: Voice amplitude and vocal articulation are affected by the neuromuscular effects of Parkinson’s disease. The voice becomes very monotone with progression of the disease. Patients need to be reminded to speak loudly.

Rationale 2: The changes associated with Parkinson’s disease may make the patient appear to lack emotion or have a depressed affect.

Rationale 3: Muscular ability may make speech difficult, but the patient will retain cognitive ability, so communication should make sense.

Rationale 4: The voice tends to become muffled and softer.

Rationale 5: Voice amplitude and vocal articulation are affected by the neuromuscular effects of Parkinson’s disease.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23-2

 

Question 4

Type: MCSA

A patient who was diagnosed with Parkinson’s disease is exhibiting hypomimia. What will the nurse likely observe in this patient?

1. Slow movements of the arms and legs
2. Falling when attempting to step backward
3. Blank facial expression
4. Very slow talk

Correct Answer: 3

Rationale 1: Hypomimia does not affect the arms and legs.

Rationale 2: Patients with Parkinson’s disease have difficulty with retropulsion, but this is not described as hypomimia.

Rationale 3: Bradykinesia and stiff facial muscles combine to create the “masked” facial expression associated with Parkinson’s disease. This is hypomimia.

Rationale 4: Patients with Parkinson’s do talk slowly, but this is not associated with hypomimia.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23-2