Chapter 33 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Chapter 33 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

Which information should the nurse consider when planning care for patients at risk for endocarditis?

1. Endocarditis does not pose a high risk for damage to affected heart valves.
2. The major treatment modality for endocarditis is open heart surgery to clean the heart valves.
3. Fever is a rare manifestation of endocarditis.
4. Endocarditis can be prevented in patients at risk by administering antibiotics prior to procedures.

Correct Answer: 4

Rationale 1: Endocarditis carries a serious risk for damage to heart valves.

Rationale 2: Surgery to clean valves may be necessary, but it is not the major treatment modality.

Rationale 3: Fever occurs in about 90% of patients with endocarditis.

Rationale 4: Prophylactic antibiotic therapy can prevent endocarditis in those at risk for developing the disease.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 33-1

 

Question 2

Type: MCMA

Which assessment findings would increase the nurse’s suspicion that a patient may have pericarditis?

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

Standard Text: Select all that apply.

1. Pericardial friction rub
2. Abdominal discomfort and nausea
3. Chest pain
4. Bradycardia
5. Distended neck veins

Correct Answer: 1,3

Rationale 1: Pericardial friction is a hallmark sign of pericarditis, in addition to fever.

Rationale 2: Abdominal discomfort and nausea are not associated with pericarditis.

Rationale 3: Chest pain is a hallmark sign of pericarditis, in addition to fever.

Rationale 4: Bradycardia is not associated with pericarditis.

Rationale 5: Distended neck veins are not associated with pericarditis.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 33-1

 

Question 3

Type: MCSA

The nurse, caring for a patient diagnosed with cardiac tamponade, prepares to participate in which initial treatment?

1. Antidysrhythmic drugs and oxygen
2. Oxygen and rest
3. Pericardiocentesis
4. Antibiotics

Correct Answer: 3

Rationale 1: Antidysrhythmic drugs may be necessary but are not the initial treatment.

Rationale 2: Oxygen and rest will be required but are not the initial treatment.

Rationale 3: When cardiac tamponade occurs, it is considered a medical emergency. Pericardiocentesis is performed to remove fluid or blood that has collected around the heart and is preventing the heart from pumping effectively.

Rationale 4: Antibiotic therapy may be necessary but is not the initial treatment.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 33-1

 

Question 4

Type: MCSA

A nurse caring for a patient with coronary artery disease (CAD) hears a murmur during auscultation of the heart. The nurse suspects which complication of CAD?

1. Valvular heart disease
2. Pericarditis
3. Cardiac tamponade
4. Heart failure

Correct Answer: 1

Rationale 1: Valvular disorders interfere with the smooth flow of blood through the heart. The flow becomes turbulent, causing a murmur, a characteristic manifestation of valvular disease.

Rationale 2: The heart sound characteristic of pericarditis is a pericardial friction rub

Rationale 3: Distant and muffled heart sounds are typical of cardiac tamponade.

Rationale 4: Extra heart sounds S3 and S4 are heard in heart failure.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 33-2