Chapter 47 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 47 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 is caring for a patient with a diagnosis of diabetes. The nurse notes the patient’s toenails are thick and ingrown. Which instruction should the nurse provide?

1. Soak feet in Epsom salts daily.
2. Use a clean, sharp razor blade to trim the toenails.
3. Make an appointment with a foot care specialist.
4. Trim nails to follow the curve of the toe.

Correct Answer: 3

Rationale 1: Soaking of the feet is not advisable.

Rationale 2: Sharp instruments or razor blades should never be used to self-treat foot problems.

Rationale 3: The toenails of the patient with diabetes require careful attention. Problems should be addressed by a foot care specialist.

Rationale 4: Nails should be cut straight across and the edges filed, not cut.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 47-5

Question 2

Type: MCSA

A diabetic patient complains of frequent corns and asks for information about managing the condition. What is the nurse’s best response?

1. “Make sure you select shoes that fit correctly.”
2. “You can use corn pads to gradually remove the growths.”
3. “Corns are best treated by shaving them off.”
4. “Apply a generous amount of emollient lotion on and between the toes twice daily.”

Correct Answer: 1

Rationale 1: Corns can be prevented by wearing correctly fitting shoes.

Rationale 2: Corn pads are not an option for the diabetic patient.

Rationale 3: Shaving treatments to remove corns are not an option for the diabetic patient.

Rationale 4: Lotion can be applied if the skin is dry, but the area between the toes should be avoided.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 47-5

Question 3

Type: MCSA

A patient has been recently diagnosed with type 1 diabetes mellitus. The patient states, “I am thin and eat all the time. How can I have diabetes?” Which response by the nurse is most appropriate?

1. “Thin people can be diabetic, too.”
2. “Your condition makes it impossible for you to gain weight.”
3. “People with type 1 diabetes are usually thin or of normal weight at diagnosis.”
4. “Your lab tests indicate the presence of diabetes.”

Correct Answer: 3

Rationale 1: Although this statement is correct, it does not answer the patient’s question.

Rationale 2: It is not impossible for diabetics to gain weight.

Rationale 3: The diabetic patient is unable to obtain the needed glucose for the body’s cells, due to the lack of insulin. Patients diagnosed with type 1 diabetes mellitus experience polyphagia and are often thin.

Rationale 4: Although the laboratory tests might indicate the presence of diabetes, this response does not meet the patient’s need for teaching.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 47-2

Question 4

Type: MCSA

A newly admitted patient has a fasting serum blood glucose level of 125 mg/dL. How should the nurse interpret this value?

1. This is a critical value that should be reported immediately.
2. The patient has type 1 diabetes.
3. The patient has normal glucose metabolism.
4. The patient may be prediabetic.

Correct Answer: 4

Rationale 1: While the physician will need to be made aware of these results, there is no indication the physician needs to be contacted immediately.

Rationale 2: A single serum glucose level is not sufficient for either a diagnosis of diabetes or a determination of type of diabetes.

Rationale 3: These results are not normal.

Rationale 4: Prediabetes is defined as a fasting serum glucose value of 100–126 mg/dL. The diagnosis is made on glucose of this level drawn on two or more occasions.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47-2