Chapter 57 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 57 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

A patient shows the nurse a new sore on the forearm that has been increasing in size and will not heal. The nurse knows that which sign could also point to a diagnosis of malignant neoplasm?

1. The lesion is darker than the surrounding skin.
2. The shape of the lesion is asymmetric.
3. The lesion is raised.
4. The lesion is 4 mm in diameter.

Correct Answer: 2

Rationale 1: Many cutaneous lesions are a different color than surrounding skin. This finding is not specific to malignancy.

Rationale 2: An asymmetrical shape is an indicator of malignancy.

Rationale 3: Many benign cutaneous lesions are raised above skin level.

Rationale 4: Lesions that surpass 6 mm in diameter should raise concern about malignancy.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-1

Question 2

Type: MCSA

After learning that he has a benign tumor in his abdomen, a patient is overheard telling his wife that he has cancer. What should the nurse say to the patient and spouse?

1. “You do have a growth in your abdomen, but it is encapsulated and, after being removed, will not come back.”
2. “This type of cancer is easily treated.”
3. “This type of cancer will not spread to other tissues.”
4. “Even though this growth has invaded other tissues, it can be contained.”

Correct Answer: 1

Rationale 1: A benign tumor is encapsulated, slow-growing, and, once removed, does not recur.

Rationale 2: The patient does not have cancer but rather a benign tumor.

Rationale 3: Even though benign tumors do not spread to other tissues, the nurse should not refer to the growth as cancer.

Rationale 4: The growth has not invaded other tissues.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-2

Question 3

Type: MCSA

A patient tells the nurse that she has a benign tumor that has spread into her lymph glands and that surgery is planned. How should the nurse respond?

1. “What did your doctor tell you about the tumor?”
2. “I hope the tumor can be removed before it spreads any further.”
3. “That’s a good thing that the tumor is benign.”
4. “If the tumor is benign, why are you going to have surgery to remove it?”

Correct Answer: 1

Rationale 1: The patient believes that the tumor is benign; however, benign tumors do not spread; they are encapsulated and can be easily removed. As the patient seems to have conflicting information, the nurse should ask what the physician explained about the tumor.

Rationale 2: Benign tumors do not spread into other tissues. The nurse should not reinforce incorrect information.

Rationale 3: The nurse should not reinforce the patient’s belief that the tumor is benign.

Rationale 4: This response does not address the apparent confusion revealed by the patient’s statement.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-2

Question 4

Type: MCSA

A patient who was treated for colorectal cancer last year now has a malignant tumor in the lung. The nurse realizes that this patient is most likely experiencing which phenomenon?

1. Metastasis
2. Contact inhibition
3. Differentiation
4. Hypertrophy

Correct Answer: 1

Rationale 1: Malignant cells from the primary tumor may travel through the blood or lymph to invade other tissues and organs and form a secondary tumor. This process is called metastasis. Malignant neoplasms can recur after surgical removal of the primary and secondary tumors and after other treatments.

Rationale 2: Contact inhibition is a characteristic of benign neoplasms. It does not describe the phenomenon the patient is experiencing.

Rationale 3: Differentiation is the process whereby cells mature into their intended role. Differentiation is lost in malignant tumors.

Rationale 4: Hypertrophy refers to an increase in a cell’s size. There is no way the nurse can tell if this is a characteristic of this tumor.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-2