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Test Bank Medical Surgical Nursing Clinical Reasoning Patient Care 6th Edition, LeMone
CHAPTER 1
Question 1
Type: MCSA
The nurse is instructing a patient on the role of diet, exercise, and medication to control type 2 diabetes mellitus. Which core competency for healthcare professionals is the nurse implementing?
Question 2
Type: MCSA
The nurse is planning to utilize the core competency use informatics when providing patient care. Which action should the nurse perform when using this core competency?
Question 3
Type: MCMA
The nurse plans to implement evidence-based practice when providing patient care. Which activities should the nurse perform?
Standard Text: Select all that apply.
Question 4
Type: MCSA
The community health nurse is planning to meet with several community members during a health fair. Which nursing activity exemplifies the core competency patient-centered care?
Question 5
Type: MCSA
The nurse is instructing a patient on weight reduction and smoking cessation. Which code of nursing practice is the nurse implementing?
Question 6
Type: MCSA
The nurse is providing patient care within the American Nurses Association Standards of Professional Performance. Which activity is the nurse implementing?
Question 7
Type: MCSA
The nurse prescribes strategies and alternatives to assist a patient achieve expected outcomes. Within which American Nurses Association standard is the nurse practicing?
Question 8
Type: MCSA
A patient with a terminal illness is concerned about pain control. If the International Council of Nurses Code of Ethics for Nurses is followed, what should the nurse plan for the patient?
Question 9
Type: MCSA
A patient is angry after waiting over an hour for pain medication. What should the nurse respond to the patient that demonstrates critical thinking?
Question 10
Type: MCSA
The nurse is reviewing data collected from a patient during an assessment. Which activity demonstrates that the nurse is using divergent thinking when analyzing this data?
CHAPTER 2
Question 1
Type: MCSA
After purchasing a personal computer for use at home, the nurse enrolls in classes at the local community college to learn more about using the device. Which building block of informatics competencies is this nurse demonstrating?
Question 2
Type: MCSA
While participating in the electronic communication committee, the nurse makes a recommendation to alter one aspect of the system to support nursing documentation. Which informatics competency is this nurse practicing?
Question 3
Type: MCMA
The manager is evaluating a beginning nurses ability to use the computerized documentation system. Which observations indicate that the beginning nurse needs additional training on the computer?
Standard Text: Select all that apply.
Question 4
Type: MCMA
The staff development trainer is preparing a seminar for experienced nurses on the computerized clinical documentation system. What should the trainer include in this presentation?
Standard Text: Select all that apply.
Question 5
Type: MCSA
A patient asks why the nurse is playing with an iPad in the midst of providing care. What should the nurse respond to this patient?
Question 6
Type: MCSA
The computerized clinical documentation system installed in a healthcare organization has a feature that alerts staff to potential safety hazards. Which computer message should the nurse interpret as a safety warning when providing patient care?
Question 7
Type: MCSA
While documenting care provided to a patient in the home, the nurse encounters a problem with the electronic medical record. Which action indicates that the nurse was able to troubleshoot and address the problem?
Question 8
Type: MCMA
The nurse is a member of a committee charged with selecting a computerized clinical information system for an organization. Which features should the nurse recommend be included in this system to support patient care needs?
Standard Text: Select all that apply.
Question 9
Type: MCMA
The manager is on a committee that is investigating the implementation of evidenced-based practice for the nursing staff. Which outcomes should the manager highlight as expected when this approach is implemented?
Standard Text: Select all that apply.
Question 10
Type: MCMA
The nurse is implementing evidence-based practice when caring for a patient with a chronic illness. Which actions indicate that the nurse is implementing this approach appropriately?
Standard Text: Select all that apply.
CHAPTER 3
Question 1
Type: MCSA
When planning holistic care for a patient admitted with heart failure, what should the nurse include?
Question 2
Type: MCSA
A patient tells the nurse that he has been fortunate since he has never experienced any major illnesses and has enjoyed good health without much effort. How should the nurse realize this patient is defining good health?
Question 3
Type: MCSA
A patient tells the nurse that he often is concerned with his declining mobility status even though he continues to experience no major health issues. When planning care according to the wellness framework, what should the nurse include for this patient?
Question 4
Type: MCSA
The nurse has provided care to a patient according to the concept of wellness. Which outcome indicates that care has been successful for this patient?
Question 5
Type: MCSA
During an assessment, the nurse learns that a patient has a genetic predisposition to the development of several disease processes. Which illness should the nurse realize is associated with genetic makeup?
Question 7
Type: MCSA
During an assessment, a patient tells the nurse that she is lactose intolerant. The nurse realizes that this food intolerance is common within which cultural groups?
Question 9
Type: MCSA
The nurse is collecting data at the immunization clinic. Which disclosure by the patient would cause the nurse to withhold the administration of the varicella vaccine?
Question 10
Type: MCMA
The nurse is reviewing the goals for Healthy People 2020 with a group of patients in an outpatient clinic. What should the nurse include in this presentation?
Standard Text: Select all that apply.
CHAPTER 4
Question 1
Type: MCSA
A patient tells the nurse that he must be having minor surgery since it will be done as an outpatient. How should the nurse respond to this patient?
Question 2
Type: MCSA
A patient scheduled for outpatient surgery asks the nurse why he will not be admitted to the hospital for the surgery. What should the nurse explain as an advantage of having outpatient surgery?
Question 3
Type: MCMA
The nurse is preparing to discharge a patient after having outpatient surgery. Which criteria should the nurse use to determine whether the patient is eligible to be discharged?
Standard Text: Select all that apply.
Question 4
Type: MCSA
The nurse in the same-day surgical care area is preparing a patient for surgery. What should the nurse do to ensure that this patient has a successful recovery from the surgery?
Question 5
Type: MCSA
The nurse is providing care to a patient during the preoperative phase of surgery. Which of the following interventions would be appropriate for the nurse to provide during this time?
Question 6
Type: MCSA
A patient was instructed on exercises to perform as part of preoperative teaching. While recovering from surgery, the patient experiences a deep vein thrombosis (DVT). Which preoperative exercise should the nurse identify as not having been effective for this patient?
Question 7
Type: MCSA
The nurse is assessing a patient who has returned to the care area after surgery. What should the nurse do to ensure the patient receives appropriate care?
Question 8
Type: MCSA
After providing a patient with a preoperative sedative, the nurse notes that the surgical consent form has not been signed by the patient. What should the nurse do?
Question 9
Type: MCSA
A patient being prepared for surgery has been diagnosed with dehydration. Which laboratory values support the diagnosis for this patient?
Question 10
Type: MCSA
A patient diagnosed with emphysema is being prepared for surgery. What laboratory value should the nurse review to obtain information about the patients respiratory status?
CHAPTER 5
Question 1
Type: MCSA
The brother of a terminally ill patient states, Ill donate a million dollars to the hospital if they cure my brother. The nurse realizes this statement indicates which phase of Kbler-Rosss stages of loss?
Question 2
Type: MCSA
A patient tells the nurse that her husband passed away a year ago and she is now beginning to realize that he is truly gone. The patient is planning to begin a new job and possibly move to a new community. The nurse realizes that this patient is in which stage of Bowlbys theory of attachment?
Question 3
Type: MCSA
A patient tells the nurse that since his wife died he has not been able to sleep and sees no reason to continue living. According to Freuds theory on grief and loss, what should the nurse realize this patient is experiencing?
Question 4
Type: MCSA
A patient has decided to join a support group for surviving spouses of victims of violent crime. According to Engels theory of grief and loss, the nurse identifies that this patient is in which stage?
Question 5
Type: MCSA
A 30-year-old terminally ill patient is concerned about how her 7-year-old child will perceive her death. What advice from the nurse would be most beneficial?
Question 6
Type: MCSA
A patient of Native American descent is expected to die. The family arrives at the hospital and wants to observe their religious and cultural traditions. Which intervention by the nursing staff would be most appropriate?
Question 7
Type: MCSA
A patient tells the nurse that her estranged husband died a little over a year ago and states, I am not sure why this is so difficult. I really couldnt stand him near the end. Which response by the nurse is most appropriate?
Question 8
Type: MCSA
A terminally ill patient is demonstrating signs of spiritual distress. Which should the nurse do first to assist this patient?
Question 9
Type: MCSA
After an unsuccessful resuscitation attempt, a patient dies. What should the nurse do first?
Question 10
Type: MCSA
A terminally ill patient is experiencing secretions pooling in the back of the throat. What can the nurse do to help this patient feel more comfortable?
CHAPTER 6
Question 1
Type: MCSA
A patient tells the nurse that both of his parents are alcoholics and wonders about the likelihood of becoming an alcoholic as well. How should the nurse respond to the patient?
Question 2
Type: MCSA
The mother of a patient admitted with alcohol abuse tells the nurse that alcohol is not consumed at home and the patient is adopted. What should the nurse suspect about the patient?
Question 3
Type: MCSA
A patient tells the nurse that she started to have a glass of wine every evening at home after work to unwind and then realized that she cannot continue with her day unless she has the wine. The nurse realizes that this patient uses wine to
Question 4
Type: MCSA
While analyzing data collected during an assessment, the nurse realizes that a patients risk for alcohol abuse is low. What information did the nurse use to come to this conclusion?
Question 5
Type: MCSA
A nurse is concerned about potential substance abuse by a coworker. What behavior warrants further investigation?
Question 6
Type: MCSA
A nurse consistently arrives to work wearing a long-sleeved blouse despite the temperature being in the 90s and the air humid. When colleagues mention her attire, the nurse becomes defensive and isolates herself from others. What does the nurses behavior suggest?
Question 7
Type: MCMA
The nurse manager is concerned that one staff nurse is demonstrating signs of substance abuse. Which behaviors did the manager observe in the staff nurse?
Standard Text: Select all that apply.
Question 8
Type: MCSA
The nurse is concerned that a colleague is experiencing depression from substance abuse. What does the nurse observe to make this assumption?
Question 9
Type: MCSA
A patient recovering from outpatient carpal tunnel surgery returns to the surgical center the next day and tells the nurse that she is having trouble attending to daily activities and the pain is excruciating, so she wants stronger pain medication immediately. What should this patients behavior suggest to the nurse?
Question 10
Type: MCSA
A patient complaining of back pain tells the nurse that he needs several refills on any prescription since he takes the medication more frequently than prescribed. What should this information suggest to the nurse?
CHAPTER 7
Question 1
Type: MCSA
A school bus transporting a local universitys basketball team has just crashed in the rain on the side of the road. The bus was transporting approximately 60 people. Which classification should the nurse use to describe the situation?
Question 2
Type: MCSA
The nurse is caring for a patient with injuries received in an earthquake. Which type of incident should the nurse identify as causing this patients injuries?
Question 3
Type: MCSA
A small commuter plane lost an engine and crashed into a shopping mall. The estimated number of injured people from this accident is 500. Which classification of incident should the nurse use when determining the care needed for these victims?
Question 4
Type: MCSA
A train derailed in a local community. The contents of the train caused a hazardous spill, and noxious gasses are being released into the environment. All local and surrounding fire control and Hazmat teams have been mobilized and the event is considered under control. Which type of situation should the nurse prepare for?
Question 5
Type: MCSA
The nurse is caring for patients when a dirty bomb detonates at a nearby shopping mall. Which types of injuries should the nurse expect to see in the victims?
Question 6
Type: MCSA
Several patients are admitted after being exposed to a substance that was released in their manufacturing plant. The patients are demonstrating flu-like symptoms, unproductive cough, and fever. These patients should be assessed for which type of exposure?
Question 7
Type: MCSA
The nurse is caring for a patient who was brought into the emergency department after an explosion at a nuclear power plant. The patient is confused and keeps repeating that his skin is on fire. What does this information indicate to the nurse?
Question 8
Type: MCSA
A patient is brought into the emergency department complaining of blindness after an explosion at an atomic power plant. What should the nurse explain to this patient?
Question 9
Type: MCSA
The nurse is caring for a patient who experienced a blast injury to the eye. Which intervention would be appropriate?
Question 10
Type: MCSA
The nurse is admitting the second patient in 2 days who is experiencing malaise, high fever, and headache. Both patients attended a local air show the previous weekend. What should the nurse do?
CHAPTER 8
Question 1
Type: MCSA
A female patient tells the nurse that she is genetically predisposed to type 2 diabetes. What is the most important information that the nurse should provide?
Question 2
Type: MCSA
A patient tells the nurse that she does not want to pass on a disease that is genetic in origin to any future children. How should the nurse respond to this patient?
Question 3
Type: MCSA
A patient expresses concern about transmitting genetic illnesses to any future children. What can the nurse do to help the patient determine which diseases might be transmitted?
Question 4
Type: MCSA
At the completion of a genetic assessment, the nurse learns that a patient has three family members diagnosed with rectal cancer before the age of 40 years. What should the nurse discuss with the patient?
Question 5
Type: MCSA
While assessing a patient, the nurse notes an irregularity that has been observed in other patients, but on an inconsistent basis. What did the nurse most likely discover in this patient?
Question 6
Type: MCSA
A patient has been told that her unborn child will most likely have Down syndrome. The nurse realizes this diagnosis is consistent with which genetic finding?
Question 7
Type: MCSA
A nurse is planning to teach the parents of a child with cystic fibrosis about the disorder. Which statement should the nurse include in this explanation?
Question 8
Type: MCSA
A patient tells the nurse that many of her family members have a type of anemia that is genetic. What should the nurse realize will occur in this patient?
Question 9
Type: MCSA
At the completion of genetic testing it has been determined that a patients baby will have Down syndrome. What should the nurse say to the patient after learning this information?
Question 10
Type: MCSA
The nurse is developing a teaching plan for parents who need genetic counseling. Which statement by a parent indicates the need for further education?
CHAPTER 9
Question 1
Type: MCSA
The nurse is assessing a patients response to pain. Why should the nurse do this for every patient situation?
Question 2
Type: MCSA
After assessing a patient for pain, the nurse concludes that the pain is caused by a mechanical stimulus. What should the nurse consider as a possible cause of this patients pain?
Question 3
Type: MCSA
The nurse is using the neuromatrix theory when determining a patients pain. What should the nurse consider when assessing a patients pain?
Question 4
Type: MCSA
A patient tells the nurse that he has had deep, burning muscle pain for most of his adult life. What does this information tell the nurse about how the patients pain is being transmitted in the body?
Question 5
Type: MCSA
A patient asks the nurse why he felt pain prior to a myocardial infarction primarily in his left arm. How should the nurse respond?
Question 6
Type: MCSA
A patient is being treated for chronic pain. What should the nurse keep in mind when assessing this patients level of pain?
Question 7
Type: MCSA
The nurse is managing care for a group of patients with pain. For which health problem should the nurse expect the patient to experience acute pain?
Question 8
Type: MCSA
The nurse is planning care for a patient with chronic pain. Which pain control goal would be most appropriate for this patient?
Question 9
Type: MCSA
A patient scheduled for knee surgery tells the nurse, I know I wont feel as much pain with this knee surgery as I did with the other one when I was 20 years younger. What should the nurse respond to this patient?
Question 10
Type: MCSA
A female patient tells the nurse that at times the pain she has is so severe that she cannot move or get out of bed at home. What should the nurse realize is contributing to this patients pain?
CHAPTER 10
Question 1
Type: MCSA
The nurse is caring for an older patient who is occasionally confused. What should be the nurses primary concern regarding fluid and electrolytes when caring for this patient?
Question 2
Type: MCSA
The nurse is planning care for a patient with severe burns. What condition should the nurse realize that this patient could develop?
Question 3
Type: MCSA
A patient experiencing multisystem fluid volume deficit has tachycardia; pale, cool skin; and decreased urine output. The nurse realizes these findings are most likely a direct result of which process?
Question 4
Type: MCSA
A pregnant patient is admitted with excessive thirst and increased urination. For which problem should the nurse focus the care of this patient?
Question 5
Type: MCSA
A patient recovering from surgery has an indwelling urinary catheter. For which 24-hour urine output volumes should the nurse notify the patients healthcare provider?
Question 6
Type: MCSA
A patient is receiving intravenous fluids postoperatively following cardiac surgery. On which potential postoperative complication should the nurse focus the assessment of this patient?
Question 7
Type: MCSA
A patient is diagnosed with severe hyponatremia. The nurse realizes this patient will mostly likely need precautions implemented for what event?
Question 8
Type: MCSA
A patient is diagnosed with hypokalemia. After reviewing the patients current medications, which drug should the nurse consider that might have contributed to the patients health problem?
Question 9
Type: MCSA
A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which electrolyte imbalance?
Question 10
Type: MCSA
The nurse is planning care for a patient with fluid volume overload and hyponatremia. What should be included in this patients plan of care?
CHAPTER 11
Question 1
Type: MCSA
A patient is brought to the emergency department with injuries sustained in a motor vehicle crash. What should the nurse consider as the cause of this patients injuries?
Question 2
Type: MCSA
The spouse of a patient admitted with a gunshot wound asks the nurse when her husband will be discharged so that they can resume their life together. How should the nurse respond?
Question 3
Type: MCMA
An older patient is admitted after falling on the steps at home. Which components of trauma should the nurse consider when planning care for the patient?
Standard Text: Select all that apply.
Question 4
Type: MCSA
A patient comes into the emergency department with leg pain after falling on ice. For which classification of injuries should the nurse expect to plan care for this patient?
Question 5
Type: MCSA
A patient is brought to the emergency department with injuries sustained when a wall collapsed in the home. The nurse recognizes that this patients injuries were most likely caused by which mechanism of injury?
Question 6
Type: MCSA
A patient was admitted with a head injury caused by rapid acceleration and deceleration. How should the nurse expect this patients injuries to be classified?
Question 7
Type: MCSA
A patient is admitted with a thermal injury. Which mechanism of injury should the nurse consider as the most likely cause of this patients injuries?
Question 8
Type: MCSA
A pediatric patient is admitted after ingesting a household cleaning solution. The nurse should plan care for this patients injuries based on which energy source?
Question 9
Type: MCSA
A patient recovering from a motor vehicle accident tells the nurse that the other car barely hit him and asks why he has so many injuries. How should the nurse respond?
Question 10
Type: MCSA
A construction worker was admitted after falling from the roof of a building. The nurse should plan care for this patients injuries based on which energy source?
CHAPTER 12
Question 1
Type: MCSA
The nurse is reviewing the white blood cell count differential for a patient and notes that the basophil count is elevated. What should this laboratory value indicate to the nurse?
Question 2
Type: MCSA
The nurse is caring for a patient recovering from a splenectomy. What should the nurse realize will occur regarding this patients immunity?
Question 3
Type: MCSA
A patients white blood cell count is 11,000/mm3. What does the nurse understand this value to represent?
Question 4
Type: MCSA
A patient sustains fractures to the ribs, both femurs, and one humerus. When planning care for this patients immunologic status, what should the nurse include?
Question 5
Type: MCSA
A patient is diagnosed with a positive tuberculosis skin test. The nurse understands that this response is due to what?
Question 6
Type: MCSA
A patient tells the nurse that hes happy that his wife did not catch the same cold from which he has recently recovered. The nurse realizes that what most likely occurred in his wife?
Question 7
Type: MCSA
The nurse is caring for a patient diagnosed with a lung infection. Which immunoglobulin level should the nurse expect to be elevated in this patient?
Question 8
Type: MCSA
A patient who just delivered a newborn baby is concerned that the baby will catch a cold from a healthcare provider who was coughing and sneezing in the delivery room. How should the nurse respond?
Question 9
Type: MCMA
The nurse is concerned that a patient is exhibiting signs and symptoms of inflammation. What did the nurse assess to come to this conclusion?
Standard Text: Select all that apply.
Question 10
Type: MCSA
An older patient has a small pressure ulcer on the coccyx. What should the nurse do to promote healing of the wound?
CHAPTER 13
Question 1
Type: MCSA
A patient is admitted to receive a kidney transplant from a live sibling. The nurse realizes that what must have occurred for this surgery to be planned?
Question 2
Type: MCSA
A patient in isolation for an incompetent immune system asks the nurse what disease he has that requires placement in isolation. How should the nurse respond?
Question 3
Type: MCSA
A patient tells the nurse that she used to get the common cold at least three times a year but now cant remember the last time she had one. What should the nurse realize this patient is describing?
Question 4
Type: MCSA
An older patient tells the nurse that he develops pneumonia easily; however, his wife of the same age rarely gets sick. How should the nurse respond?
Question 5
Type: MCSA
A patient comes into the emergency department with itching, swelling, and slight shortness of breath after being stung by a bee. The nurse realizes this patient is experiencing which type of hypersensitivity reaction?
Question 6
Type: MCSA
A patient is diagnosed with a type IV delayed hypersensitivity reaction. What is an example of this type of reaction?
Question 7
Type: MCSA
A patient develops hemolytic anemia after receiving a dose of penicillin. What action should the nurse realize is indicated for this patient?
Question 8
Type: MCSA
A patient develops a fever, rash, joint and muscle pain, and swollen lymph nodes after receiving a sulfonamide. What should these symptoms suggest to the nurse?
Question 9
Type: MCSA
A patient who has received a bone marrow transplant develops a maculopapular rash on the palms of both hands and the soles of the feet. The patient complains of severe abdominal pain with bloody diarrhea. What should the nurse suspect this patient is experiencing?
Question 10
Type: MCSA
A patient is diagnosed with valvular heart disease after experiencing rheumatic heart fever. The nurse understands this disorder is caused by what action?
CHAPTER 14
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 a malignant neoplasm?
Question 2
Type: MCSA
After learning that he has a benign tumor in his abdomen, the patient is overheard telling his wife that he has cancer. What should the nurse say to the patient and spouse?
Question 3
Type: MCSA
A patient tells the nurse that he has a benign tumor that has spread into his lymph glands. How should the nurse respond to this patient?
Question 4
Type: MCSA
A patient with a history of cancer is surprised to learn that new cancer has been diagnosed in another body part. What should the nurse realize this patient is experiencing?
Question 5
Type: MCSA
A patient asks the nurse how his cancer developed. Which statement should the nurse avoid in responding to this patient?
Question 6
Type: MCSA
A patient with a history of smoking is diagnosed with cancer. If applying the cellular mutation theory of cancer to this patients diagnosis, the nurse realizes that smoking impacted which stage?
Question 7
Type: MCSA
A female patient asks the nurse why she needs a procedure to remove part of her cervix that was infected with a virus. What should the nurse explain to this patient?
Question 8
Type: MCSA
A patient with a history of using recreational cocaine tells the nurse that he would rather be addicted to cocaine than be diagnosed with cancer. What should the nurse respond with to this patient?
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