Chapter 38 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 38 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nurse should instruct the patient with a diagnosis of cholelithiasis to make which lifestyle modification to alleviate symptoms?

1. Reduce sodium intake.
2. Increase fluids.
3. Reduce smoking.
4. Reduce fat consumption.

Correct Answer: 4

Rationale 1: While all patients should be instructed to reduce sodium intake, this practice will not assist in reducing cholelithiasis or its pain.

Rationale 2: Increasing fluids will not assist in reducing cholelithiasis or its pain.

Rationale 3: While all patients should cease smoking, there is no relationship between smoking and cholelithiasis.

Rationale 4: The patient who has cholelithiasis should be instructed on the relationship between increased fat consumption and the severity of pain associated with cholelithiasis.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-1

 

Question 2

Type: MCSA

When assessing a patient who has cirrhosis, which finding would best indicate the patient is developing ascites?

1. Accumulation of fluid in the abdomen
2. Yellow skin
3. Ecchymosis
4. Upper-right-quadrant pain

Correct Answer: 1

Rationale 1: Ascites is the accumulation of the fluid in the abdomen and is a result of portal hypertension.

Rationale 2: Yellow skin is a manifestation of jaundice and is associated with hepatic disorders.

Rationale 3: The patient experiencing hepatic problems might have bleeding and bruising issues due to inadequate vitamin K.

Rationale 4: Obstructed biliary flow could be the cause of upper-right-quadrant pain.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-2

 

Question 3

Type: MCSA

A patient with hepatitis has a prescription for alpha interferon. Which manifestation would indicate that the patient is experiencing an untoward effect of this medication?

1. Jaundice
2. Flulike syndrome
3. Gallbladder pain
4. Clay-colored stools

Correct Answer: 2

Rationale 1: Jaundice is yellow-tinged skin associated with hepatitis.

Rationale 2: The patient who is receiving alpha interferon may experience a flulike syndrome.

Rationale 3: Gallbladder pain is the result of stones in the gallbladder.

Rationale 4: Clay-colored stool are associated with liver or biliary disease.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 38-1

 

Question 4

Type: MCMA

The nurse is teaching a patient about strategies for reducing the risk of hepatitis B transmission. Which statements by the patient indicate understanding of the nurse’s instruction?

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

Standard Text: Select all that apply.

1. “I will wash my hands frequently to prevent fecal-oral transmission.”
2. “I will avoid alcohol.”
3. “I will avoid contact with blood and body fluids.”
4. “I will avoid contaminated food and water.”
5. “I will use safe sex techniques.”

Correct Answer: 3,5

Rationale 1: The hepatitis A virus, not hepatitis B virus, is spread by fecal-oral transmission.

Rationale 2: Alcohol use does not cause hepatitis B transmission.

Rationale 3: Hepatitis B is contracted through contaminated blood and body fluids. Strategies that reduce exposure to blood and body fluids of others reduce the risk of hepatitis B transmission.

Rationale 4: The hepatitis A virus, not hepatitis B virus, is spread through contaminated food and water.

Rationale 5: Hepatitis B is contracted through contaminated blood and body fluids. Strategies that reduce exposure to blood and body fluids of others, including safe sex techniques, will reduce the risk of hepatitis B transmission.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 38-1