Chapter 34 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Chapter 34 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A 60-year-old male patient is being seen in the clinic for an annual physical. Which assessment finding would the nurse discuss with the patient in regard to preventing future heart failure?

1. High hemoglobin A1C
2. Blood pressure 119/78
3. Father-in-law died from heart disease a year ago
4. Male

Correct Answer: 1

Rationale 1: Elevated hemoglobin A1C indicates possible diabetes. Diabetes is a risk factor for development of heart failure.

Rationale 2: Hypertension is a modifiable risk factor, but a blood pressure of 119/78 is not hypertensive.

Rationale 3: An in-law’s death from cardiac disease is unrelated to the patient’s risk factors.

Rationale 4: Being male is a risk factor but is not modifiable.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 34-1

 

Question 2

Type: MCSA

A patient with heart failure has orthopnea, tachycardia, fatigue, and activity intolerance. How would the nurse explain the presence of these findings?

1. “You are not coping with your body’s changing health.”
2. “Your body’s protective mechanisms are malfunctioning.”
3. “You have not been following instructions on caring for yourself.”
4. “Your body is trying to maintain an adequate blood pressure and oxygen supply.”

Correct Answer: 4

Rationale 1: These findings are not related to the patient’s coping mechanisms.

Rationale 2: The patient’s inherent compensatory mechanisms are not malfunctioning, but instead continue to attempt to maintain homeostasis.

Rationale 3: These symptoms are not caused by the patient’s noncompliance with instructions.

Rationale 4: The patient’s compensatory mechanisms attempt initially to compensate for the falling blood pressure and oxygen levels. At the outset, these mechanisms are able to keep up with the body’s demands. However, over the long term, they create bigger problems.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 34-3

 

Question 3

Type: MCSA

The nurse assesses that a patient is more anxious than usual. The patient states, “I don’t understand how I can still be alive when my heart has failed.” Which nursing response is indicated?

1. “Heart failure is a common problem in the United States. Many people have it. They all have problems such as yours.”
2. “Heart failure doesn’t mean your heart has quit, just that it no longer is as efficient as it once was.”
3. “You seem upset. Would you like for me to call the health care provider to explain this to you?”
4. “Heart failure is pretty complicated. It means the heart is failing to work.”

Correct Answer: 2

Rationale 1: Stating that the problem is common does not help the patient understand the condition.

Rationale 2: Helping the patient understand that the heart is still functioning may help alleviate concerns about imminent death.

Rationale 3: Contacting the health care provider is not necessary; the nurse should know how to respond to this question.

Rationale 4: This response does not provide the patient with enough information.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 34-7

 

Question 4

Type: MCSA

Which nursing diagnosis would the nurse add to the care plan of a patient diagnosed with acute systolic heart failure?

1. Disturbed Body Image
2. Imbalanced Nutrition: More than Body Requirements
3. Excess Fluid Volume
4. Ineffective Airway Clearance

Correct Answer: 3

Rationale 1: Disturbed Body Image is not a likely nursing diagnosis for this patient.

Rationale 2: If there is an imbalance in nutrition, it is more likely to be less than body requirements.

Rationale 3: Acute systolic heart failure is typically characterized by Excess Fluid Volume.

Rationale 4: Ineffective Airway Clearance is not applicable, as these patients do not have issues with clearing the airway as much as with impaired gas exchange.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 34-6