Chapter 32 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Chapter 32 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

The nurse is discussing coronary heart disease risk factors with a group of factory employees. Which risk factors would the nurse identify as modifiable?

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

Standard Text: Select all that apply.

1. Hypertension
2. Diabetes mellitus
3. Obesity
4. Age
5. Heredity

Correct Answer: 1,2,3

Rationale 1: Hypertension can be controlled through medications, weight control, diet, and exercise.

Rationale 2: Diabetes mellitus can be controlled through medications, weight control, diet, and exercise.

Rationale 3: Obesity can be modified through medications, weight control, diet, and exercise.

Rationale 4: The role of age in coronary heart disease cannot be changed.

Rationale 5: The role of heredity in coronary heart disease cannot be changed.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 32-1

 

Question 2

Type: MCSA

An otherwise healthy patient admitted with chest pain is scheduled for diagnostic testing. The nurse anticipates that the results of which test will provide the best information about the patient’s coronary artery status?

1. Coronary angiography
2. Stress electrocardiography
3. Echocardiography
4. Nuclear persantine (dipyridamole) stress test

Correct Answer: 1

Rationale 1: The gold standard for evaluating coronary arteries is coronary angiography, which allows visualization of the arteries.

Rationale 2: Stress electrocardiography may be used to detect CAD but does not offer specific information about the arteries.

Rationale 3: Echocardiography reveals structural changes in the heart, but not specific information about the coronary arteries.

Rationale 4: This test is used for patients who are unable to walk on a treadmill. There is no indication that this is the case with this patient.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 32-5

 

Question 3

Type: MCSA

Aspirin has been prescribed for a patient following a myocardial infarction. What should the nurse include in teaching about this drug?

1. Watch for signs of bleeding, such as bruising.
2. Report any itching that develops after 7 days of taking the drug.
3. Take aspirin as a substitute for clopidrogrel (Plavix).
4. Do not skip any scheduled appointments to have blood drawn for labs.

Correct Answer: 1

Rationale 1: Aspirin is an antiplatelet agent, so the patient should watch for signs of bleeding.

Rationale 2: Itching is not a common side effect of aspirin therapy.

Rationale 3: Aspirin is not a substitute for clopidrogrel.

Rationale 4: No lab appointments will be made for aspirin monotherapy.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 32-4

 

Question 4

Type: MCSA

The nurse is assessing a patient who is 6 hours postoperative from coronary artery bypass graft (CABG) surgery. The patient’s heart rate is 120, blood pressure is 90/50, urine output is decreased, chest tube output is decreased, heart sounds are muffled, and peripheral pulses are diminished. What action should the nurse take first?

1. Notify the physician immediately.
2. Recheck vital signs in 15 minutes.
3. Reposition the patient.
4. Increase the intravenous fluids.

Correct Answer: 1

Rationale 1: The patient is exhibiting signs of cardiac tamponade. This is a medical emergency, and the physician must be notified immediately.

Rationale 2: Delaying the response by 15 minutes will be ineffective.

Rationale 3: Repositioning the patient will be ineffective.

Rationale 4: No change in intravenous fluids should be made until a physician order is given to do so.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 32-7