Chapter 56 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 56 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

Which statement would the nurse manager of a hematology clinic evaluate as indicating that a newly employed nurse understands the process of thrombopoiesis?

1. Thrombopoiesis is a response to extrinsic factors that initiates the clotting cascade.
2. Thrombopoiesis is the process that mitigates blood loss due to injury to any blood vessel.
3. Thrombopoiesis is the development of three blood cell lines.
4. Thrombopoiesis is platelet development from hematopoietic stem cells to fully mature platelets.

Correct Answer: 4

Rationale 1: Thrombopoiesis does not describe the initiation of the clotting cascade.

Rationale 2: The process that mitigates blood loss due to injury to any blood vessel is called hemostasis.

Rationale 3: Hematopoiesis refers to blood cell development.

Rationale 4: Thrombopoiesis refers to platelet development, one component of blood cell development.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 56-1

Question 2

Type: MCMA

The nurse is providing discharge instructions to a patient who has a clotting disorder. Which instructions should the nurse reinforce?

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

Standard Text: Select all that apply.

1. Brush teeth only once per day.
2. Avoid drinking carbonated beverages.
3. Monitor skin condition.
4. Shave with an electric razor.
5. Assess the color of stools with each bowel movement.

Correct Answer: 3,4,5

Rationale 1: The number of times teeth are brushed is irrelevant and does not precipitate bleeding.

Rationale 2: There is no indication that carbonated beverages should be avoided.

Rationale 3: The patient should be taught to assess the skin for signs of bleeding such as petechiae and ecchymoses.

Rationale 4: The patient with a bleeding disorder should use an electric razor to prevent accidental injury.

Rationale 5: The patient with a clotting disorder should be taught to assess stools for color and presence of blood.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 56-5

Question 3

Type: MCMA

A patient is admitted with a diagnosis of generalized anemia. The nurse would conduct assessment for which types of associated disorders?

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

Standard Text: Select all that apply.

1. Disorders that cause defective oxygenation in the lungs
2. Disorders that result in disruption in erythrocyte volume
3. Disorders that include airway obstruction as a major manifestation
4. Disorders that cause erythrocyte destruction
5. Disorders characterized by abnormal absorption of vitamin C

Correct Answer: 2,4

Rationale 1: Defective oxygenation in the lungs does not result in anemia but may result in overproduction of erythrocytes.

Rationale 2: A reduced erythrocyte volume results in anemic hypoxia or reduced oxygen availability to the tissues, specifically due to decreased concentration of functional hemoglobin or a reduced number of red blood cells.

Rationale 3: Airway obstruction disorders do not cause anemia.

Rationale 4: Disorders in which red blood cells are destroyed lead to anemia.

Rationale 5: Abnormal absorption of vitamin C is not related to anemia.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 56-3

Question 4

Type: MCMA

A patient is admitted with thrombocytopenia. Which assessment findings would the nurse expect?

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

Standard Text: Select all that apply.

1. Increased platelet count
2. Rashlike discoloration of the skin
3. Mucosal bleeding
4. Positive fecal occult test
5. A tendency to bleed after any invasive procedure

Correct Answer: 2,3,4,5

Rationale 1: Thrombocytopenia results from a decrease in the number of circulating platelets.

Rationale 2: Skin discoloration is caused by bleeding into the tissues, an effect of decreased platelets.

Rationale 3: Thrombocytopenia is defined as a decrease in the number of circulating platelets caused by impaired or suppressed production of platelets or accelerated destruction of platelets. This results in a clotting failure and the tendency to bleed when tissue is aggravated.

Rationale 4: Patients with thrombocytopenia may have gastrointestinal bleeding that results in positive fecal occult tests.

Rationale 5: Thrombocytopenia is defined as a decrease in the number of circulating platelets caused by impaired or suppressed production of platelets or accelerated destruction of platelets. This results in a clotting failure and the tendency to bleed.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 56-4