Description

Test Bank for Brunner Suddarth Medical Surgical 14th edition by L. Hinkle, Kerry H

Brunner Suddarth Medical Surgical 14th edition Test Bank

Chapter 68:
Managemen t
o f
Patients
with
Neurologic
Trauma
1276
Chapter 69: Management of Patients with Neurologic Infections,
Autoimmune Disorders,
and Neuropathies
1294
Chapter 70: Management o f Patients With Oncologic or
Degenerative Neurologic Disorders
1312
Chapter 71: Management o f Patients With Infectious Diseases
Chapter 72: Emergency Nursing
Chapter 73: Terrorism, Mass Casualty , and Disaster Nursing
1331
1349
1367
Chapter 01: Health Care Delivery and Evidence-Based
Nursing Practice
1. The public health nurse is presenting a health promotion class to
a group of new mothers. How should the nurse best define
health?
A) Health is being disease free.
B) Health is having fulfillment in all domains of life.
C) Health is having psychological and physiological harmony.
D) Health is being connected in body, mind, and spirit.
Ans: D
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Feedback:
The World Health Organization (WHO) defines health in the preamble to
its constitution as a state of complete physical, mental, and
social well-being and not merely the absenceof disease and infirmity.
The other answersare incorrect because they are not congruent
with the WHO definition of health.
2. Anurse is speaking to a group of prospective nursing students
about what it is like to be a nurse. What is one
characteristic the nurse would cite as necessary to possess to be
an effective nurse?
A) Sensitivity to cultural differences
B) Team-focused approach to problem-solving
C) Strict adherence to routine
D) Ability to face criticism
Ans: A
Feedback:
To promote an effective nurse-patient relationship and positive
outcomes of care, nursing care must be culturally competent,
appropriate, and sensitive to cultural differences. Team-focused nursing
and strict adherence to routine are not characteristics needed to be an
effective nurse. The ability to handle criticismis important, but to
a lesser degree than cultural competence.
3. With increases in longevity, people have had to becomemore
knowledgeable about their health and the professional health care that they
receive.One outcome of this phenomenon is the development of
organized self-care education programs. Which of the following do
these programs prioritize?
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A) Adequate prenatalcare
B) Government advocacy and lobbying
C) Judicious use of online communities
D) Management of illness
Ans: D
Feedback:
Organizedself-care education programs emphasize health promotion,
disease prevention, management of illness, self-care, and judicious use of
the professional health care system. Prenatal care, lobbying, and
Internet activities are secondary.
4. The home health nurse is assisting a patient and his family in
planning the patients return to work after surgery and the
development of postsurgical complications. The nurse is preparing a
plan of care that addresses the patientsmultifaceted needs. To which
level of Maslows hierarchy of basic needs does the patients
need for self-fulfillment relate?
A) Physiologic
B) Transcendence
C) Love and belonging
D) Self-actualization
Ans: D
Feedback:
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Maslows highest level of human needs is self-actualization, which includes
self-fulfillment, desire to knowand understand, and aesthetic needs. The
other answersare incorrect because self-fulfillment does not relate directly to
them.
5. The view that health and illness are not static states but that
they exist on a continuum is central to professional health care
systems. When planning care, this view aids the nurse in
appreciating which of the following?
A) Careshould focus primarily on the treatment of disease.
B) A persons state of health is ever-changing.
C) A person can transition from health to illness rapidly.
D) Careshould focus on the patients compliance with interventions.
Ans: B
Feedback:
By viewinghealth and illness on a continuum, it is possible
to consider a person as being neither completely healthy nor
completely ill. Instead, a persons state of health is ever-changing
and has the potential to range from high-level wellness to
extremely poor health and imminent death. The other answers are
incorrect becausepatient care should not focus just on the treatment
of disease.Rapid declines in health and compliance with treatment
are not key to this view of health.
6. A group of nursing students are participating in a
community health clinic. When providing care in this context, what
should the students teach participants about disease prevention? A) It
is best achieved through attending self-help groups.
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B) It is best achieved by reducing psychological stress.
C) It is best achieved by being an active participant in
the community.
D) It is best achieved by exhibiting behaviors that promote
health.
Ans: D
Feedback:
Today, increasing emphasis is placed on health, health promotion,
wellness, and self-care. Health is seen as resulting from a
lifestyleoriented toward wellness. Nurses in community health clinics do
not teach that disease prevention is best achieved through attending
self-help groups, by reducing stress, or by being an active
participant in the community, though each of these activities is
consistent with a healthy lifestyle.
7. Anurse on a medical-surgical unit has asked to represent
the unit on the hospitals quality committee. When describing
quality improvement programs to nursing colleagues and members of
other health disciplines, what characteristic should the nurse cite?
A) These programs establish consequences for health care
professionals actions.
B) These programs focus on the processes used to provide
care.
C) These programs identify specific incidents related to quality.
D) These programs seek to justify health care costs and systems.
Ans: B
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Feedback:
Numerousmodels seek to improve the quality of health care delivery.
A commonality among them is a focus on the processes that
are used to provide care. Consequences, a focus on incidents,
and justificationfor health care costs are not universal characteristics of
quality improvement efforts.
8. Nurses in acute care settings must work with other health care team
members to maintain quality care while facing pressures to
care for patientswho are hospitalized for shorter periods of time
than in the past. To ensure positivehealth outcomes when patients
return to their homes, what action should the nurse prioritize?
A) Promotion of health literacy during hospitalization
B) Close communication with insurers
C) Thorough and evidence-based discharge planning
D) Participationin continuing education initiatives
Ans: C
Feedback:
Followingdischarges that occur after increasingly short hospital stays, nurses in
the community care for patients who need high-technology acute
care servicesas well as long-term care in the home. This is
dependenton effective discharge planning to a greater degree
than continuing education, communication with insurers, or promotion
of health literacy.
9. You are admitting a patient to your medicalunit after the
patient has been transferred from the emergency department. What is
your priority nursing action at this time?
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A) Identifying the immediate needs of the patient
B) Checking the admitting physicians orders
C) Obtaining a baseline set of vital signs
D) Allowing the family to be with the patient
Ans: A
Feedback:
Among the nurses important functions in health care delivery,
identifying the patients immediate needs and working in concert
with the patient to address them is most important. The other
nursing functions are important, but they are not the most important
functions.
10. Anurse on a postsurgical unit is providing care based on a
clinical pathway. When performing assessments and interventions with the
aid of a pathway, the nurse should prioritize what goal?
A) Helping the patient to achieve specific outcomes
B) Balancing risks and benefitsof interventions
C) Documenting the patients response to therapy
D) Staying accountable to the interdisciplinary team
Ans: A
Feedback:
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Pathways are an EBP tool that is used primarily to move
patients toward predetermined outcomes. Documentation, accountability, and balancing
risks and benefits are appropriate, but helping the patient achieve outcomes
is paramount.
11. Staff nurses in an ICU setting have noticed that their patients required
lower and fewer doses of analgesia when noise levels on the unit
were consciously reduced. They informed an advanced practice
RN of this and asked the APRN to quantify the effects of
noise on the pain levels of hospitalized patients. How does this
demonstrate a role of the APRN?
A) Involving patients in their care while hospitalized
B) Contributingto the scientific basis of nursing practice
C) Critiquing the quality of patient care
D) Explaining medical studies to patients and RNs
Ans: B
Feedback:
Research is within the purview of the APRN. The activity described
does not exemplify explaining studies to RNs, critiquing care, or
involving patients in their care.
12. Nurses now have the option to practice in a variety of settings
and one of the fastest growing venues of practice for the
nurse in todays health care environment is home health care. What is
the main basis for
the growth in this health care setting?
A) Chronic nursing shortage
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B) Western focus on treatment of disease
C) Nurses preferences for day shifts instead of eveningor night
shifts
D) Discharge of patientswho are more critically ill
Ans: D
Feedback:
With shorter hospital stays and increased use of outpatient health
care services, more nursing care is provided in the home and
community setting. The other answersare incorrect because they are
not the basis for the growth in nursing care delivered in
the home setting.
13. Nurses have different educational backgrounds and function under
many titles in their practice setting. If a nurse practicing in an
oncology clinic had the goal of improving patient outcomes
and nursing care by influencing the patient, the nurse, and the health
care system, what would most accurately describe this nurses title?
A) Nursing care expert
B) Clinical nurse specialist
C) Nurse manager
D) Staff nurse
Ans: B
Feedback:
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Clinical nurse specialists are prepared as specialists who practice
within a circumscribed area of care (e.g., cardiovascular, oncology).
They define their roles as having five major components: clinical practice,
education, management, consultation, and research. The other answers
are incorrect because they are not the most accurate titles
for this nurse.
14. Nursing continues to recognize and participate in collaboration
with other health care disciplines to meet the complex needs of
the patient. Which of the following is the best example of
a collaborative practice model?
A) The nurse and the physician jointly making clinical decisions.
B) The nurse accompanying the physician on rounds.
C) The nurse making a referral on behalf of the patient.
D) The nurse attending an appointment with the patient.
Ans: A
Feedback:
The collaborative model, or a variation of it, promotes
shared participation, responsibility, and accountability in a health care
environment that is striving to meet the complex health care
needs of the public. The other answersare incorrect because they
are not examples of a collaborative practicemodel.
15. Ahospice nurse is caring for a patient who is dying of
lymphoma. According to Maslows hierarchy of needs, what
dimension of care should the nurse consider primaryin
importance when caring for a dying patient?
A) Spiritual
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B) Social
C) Physiologic
D) Emotional
Ans: C
Feedback:
Maslow ranked human needs as follows: physiologic needs; safety and
security; sense of belonging and affection; esteem and self-respect;
and self-actualization, which includes self-fulfillment, desire to know and
understand, and aesthetic needs. Such a hierarchy of needs is
a useful framework that can be applied to the various nursing
models for assessment of a patients strengths, limitations, and
need for nursing interventions. The other answersare incorrect because
they are not of primaryimportance when caring for a dying
patient, though each should certainly be addressed.
16. Anurse is planning a medical patients care with consideration of
Maslows hierarchy of needs. Within this framework of
understanding, what would be the nurses first priority?
A) Allowing the family to see a newly admitted patient
B) Ambulating the patient in the hallway
C) Administering pain medication
D) Teaching the patient to self-administer insulin safely
Ans: C
Feedback:
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InMaslows hierarchy of needs, pain relief addresses the patients
basic physiologic need. Activity, such as ambulation, is a higher
level need above the physiologic need. Allowing the patient to
see family addresses a higher level need related to love and
belonging. Teaching the patient is also a higher level need
related to the desire to know and understand and is not
appropriate at this time, as the basic physiologic need of
pain control must be addressed before the patient can address these
higher level needs.
17. Amedical-surgical nurse is aware of the scope of practice as
defined in the state where the nurse provides care. This nurses
compliance with the nurse practice act demonstrates adherence to
which of the following?
A) National Councilof Nursings guidelines for care
B) National League for Nursings Code of Conduct
American Nurses Associations Social Policy Statement
C)
Department of Health and Human Services White Paper on Nursing
D)
Ans: C
Feedback:
Nurses have a responsibility to carry out their role as described
in the Social Policy Statement to comply with the nurse practice
act of the state in which they practice and to comply with
the Code of Ethics for Nurses as spelled out by the ANA
(2001) and the International Councilof Nurses (International Council of
Nurses [ICN], 2006). The other answersare incorrect; the Code of
Ethics for nursing is not included in the ANAs white paper. The
DHHS has not published a white paper on nursing nor has
the NLN published a specific code of conduct.
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18. Nursing is, by necessity, a flexible profession. It has adapted to
meet both the expectations and the changing health needs of our
aging population. What is one factor that has impacted the
need for certified nurse practitioners (CNPs)?
A) The increased need for primarycare providers
B) The need to improve patient diagnostic services
C) The push to drive institutional excellence
D) The need to decrease the number of medical errors
Ans: A
Feedback:
CNPs who are educationally prepared with a population focus in
adult-gerontology or pediatrics receive additional focused training in
primarycare or acute care. CNPs help meet the need for primary
care providers. Diagnostic services, institutional excellence, and reduction
of medical errors are congruent with the CNP role, but these
considerations are the not primaryimpetus for the increased role
for CNPs.
19. Anurse is providing care for a patient who is postoperative
day one following a bowel resection for the treatment of
colorectal cancer. How can the nurse best exemplify the QSEN
competency of quality improvement?
A) By liaising with the members of the interdisciplinary care
team
B) By critically appraising the outcomes of care that is
provided
C) By integrating the patients preferences into the plan of care
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D) By documenting care in the electronic health record in a
timely fashion
Ans: B
Feedback:
Evaluation of outcomes is central to the QSEN competency of
quality improvements. Each of the other listed activities is a
component of quality nursing care, but none clearly exemplifies quality
improvement activities.
20. Professional nursing expands and grows becauseof factors driven by
the changing needs of health care consumers.Which of the following
is a factor that nurses should reflect in the planning and
provision of health care?
A) Decreased access to health care information by individuals
B) Gradual increases in the cultural unity of the American
population
C) Increasing mean and median age of the American population
D) Decreasing consumer expectations related to health care outcomes
Ans: C
Feedback:
The decline in birth rate and the increase in lifespandue to
improved health care have resultedin fewer school-age children
and more senior citizens, many of whom are women.
The population has becomemore culturally diverse as increasing
numbers of people from different national backgrounds enter the
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country.Access to information and consumer expectations continue to
increase.
21. Apublic health nurse has been commissioned to draft a health promotion
program that meets the health care needs and expectations of
the community. Which of the following focuses is most likely to
influence the nurses choice of interventions?
A) Management of chronic conditions and disability
B) Increasing need for self-care among a younger population
C) A shifting focus to disease management
D) An increasing focus on acute conditions and rehabilitation
Ans: A
Feedback:
Inresponse to current priorities, health care must focus more on
management of chronic conditions and disability than in previous
times. The other answersare incorrect because the change in focus of
health care is not an increasing need for self-care among
our aging population; our focus is shifting away from disease
management, not toward it; and we are moving away from the
management of acute conditions to managing chronic conditions.
22. Acommunity health nurse has witnessed significant shifts in patternsof
disease over the course of a four-decade career. Which of the following
focuses most clearly demonstrates the changing pattern of disease in
the United States?
A) Type 1 diabetes management
B) Treatment of community-acquired pneumonia
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