Chapter 26 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 26 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 tells the nurse he has a “cold” every spring that lasts for 8 to 10 weeks. The nurse suspects that the patient is experiencing which condition?

1. Acute viral rhinitis
2. Allergic rhinitis
3. Vasomotor rhinitis
4. Atrophic rhinitis

Correct Answer: 2

Rationale 1: Acute viral rhinitis is the common cold and should resolve within 7 to 10 days.

Rationale 2: Allergic rhinitis, or hay fever, results from a sensitivity reaction to allergens such as plant pollens. It tends to occur seasonally and lasts longer than a common cold.

Rationale 3: Causes of vasomotor rhinitis include cold air, strong odors, stress, and inhaled irritants. Symptoms resolve more quickly than several weeks.

Rationale 4: Atrophic rhinitis is characterized by changes in the mucous membrane of the nasal cavities. Symptoms resolve more quickly than several weeks.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 26-2

 

Question 2

Type: MCSA

A patient says, “My nose is always congested, and it just seems to get worse with the nasal spray I’ve been using.” The nurse realizes that this patient is describing which situation?

1. Incorrect administration of the nasal spray
2. An acute sinus infection that needs to be treated with antibiotics
3. Side effect of the nasal spray
4. Rebound nasal congestion

Correct Answer: 4

Rationale 1: There is no indication that the patient is not administering the nasal spray correctly.

Rationale 2: No other signs indicate that the patient has a bacterial sinus infection.

Rationale 3: The worsening nasal congestion is not considered a side effect of nasal spray.

Rationale 4: Chronic use of nasal sprays may lead to rhinitis medicamentosa, a rebound phenomenon of drug-induced nasal irritation and inflammation.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 26-2

 

Question 3

Type: MCSA

A patient being seen for a cough tells the nurse, “After I leave here, I need to get to the dentist. My upper teeth are hurting and I don’t know why.” Which nursing action is indicated?

1. End the visit so the patient can get to the dentist.
2. Assess the patient for a sinus infection.
3. Reschedule the appointment for another time.
4. Tell the patient there is nothing wrong with his teeth.

Correct Answer: 2

Rationale 1: The patient has a medical need and is in a medical setting. It would not be appropriate to end the appointment.

Rationale 2: Manifestations of sinusitis include pain and tenderness across the infected sinuses, plus headache, fever, and malaise. The pain usually increases when the patient leans forward. When the maxillary sinuses are involved, pain and pressure are felt over the cheek. The pain may be referred to the upper teeth.

Rationale 3: The patient has a medical need and is in a medical setting. It would not be appropriate to reschedule the appointment.

Rationale 4: Until an assessment is performed and a diagnosis is made or ruled out, it would be incorrect to tell the patient that nothing is wrong.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 26-2

 

Question 4

Type: MCMA

The nurse suspects that a patient is demonstrating signs of tonsillitis. Which findings are indicative of this disorder?

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

Standard Text: Select all that apply.

1. Pain on swallowing
2. Thirst
3. Nuchal rigidity
4. Enlarged lymph nodes in the neck
5. Fever

Correct Answer: 1,4,5

Rationale 1: Odynophagia, or painful swallowing, is an indicator of tonsillitis.

Rationale 2: Thirst is not suggestive of tonsillitis.

Rationale 3: Nuchal rigidity (pain when bending the neck) is not suggestive of tonsillitis.

Rationale 4: Enlarged, tender lymph nodes in the neck are an indicator of infection, possibly in the tonsils.

Rationale 5: Fever is an indicator of infection, possibly in the tonsils.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 26-3