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TEXTBOOK OF MEDICAL-SURGICAL
NURSING, 15TH EDITION BY HINKLE
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,Table of Contents
Chapter 01 Professional Nursing Practice
Chapter 02 Medical-Surgical Nursing
Chapter 03 Health Education and Health Promotion
Chapter 04 Adult Health and Physical, Nutritional, and Cultural Assessment
Chapter 05 Stress and Inflammatory Responses
Chapter 06 Genetics and Genomics in Nursing
Chapter 07 Disability and Chronic Illness
Chapter 08 Management of the Older Adult Patient
Chapter 09 Pain Management
Chapter 10 Fluid and Electrolytes
Chapter 11 Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
Chapter 12 Management of Patients with Oncologic Disorders
Chapter 13 Palliative and End-of-Life Care
Chapter 14 Preoperative Nursing Management
Chapter 15 Intraoperative Nursing Management
Chapter 16 Postoperative Nursing Management
Chapter 17 Assessment of Respiratory Function
Chapter 18 Management of Patients with Upper Respiratory Tract Disorders
Chapter 19 Management of Patients with Chest and Lower Respiratory Tract Disorders
Chapter 20 Management of Patients with Chronic Pulmonary Disease
Chapter 21 Assessment of Cardiovascular Function
Chapter 22 Management of Patients with Arrhythmias and Conduction Problems
Chapter 23 Management of Patients with Coronary Vascular Disorders
Chapter 24 Management of Patients with Structural, Infectious, and Inflammatory Cardiac
Disorders
Chapter 25 Management of Patients with Complications from Heart Disease
Chapter 26 Assessment and Management of Patients with Vascular Disorders and Problems
of Peripheral Circulation
Chapter 27 Assessment and Management of Patients with Hypertension
Chapter 28 Assessment of Hematologic Function and Treatment Modalities
Chapter 29 Management of Patients with Nonmalignant Hematologic Disorders
Chapter 30 Management of Patients with Hematologic Neoplasms
Chapter 31 Assessment of Immune Function
Chapter 32 Management of Patients with Immune Deficiency Disorders
Chapter 33 Assessment and Management of Patients with Allergic Disorders
Chapter 34 Assessment and Management of Patients with Inflammatory Rheumatic Disorders
Chapter 35 Assessment of Musculoskeletal Function
Chapter 36 Management of Patients with Musculoskeletal Disorders
,Chapter 37 Management of Patients with Musculoskeletal Trauma
Chapter 38 Assessment of Digestive and Gastrointestinal Function
Chapter 39 Management of Patients with Oral and Esophageal Disorders
Chapter 40 Management of Patients with Gastric and Duodenal Disorders
Chapter 41 Management of Patients with Intestinal and Rectal Disorders
Chapter 42 Assessment and Management of Patients with Obesity
Chapter 43 Assessment and Management of Patients with Hepatic Disorders
Chapter 44 Management of Patients with Biliary Disorders
Chapter 45 Assessment and Management of Patients with Endocrine Disorders
Chapter 46 Management of Patients with Diabetes
Chapter 47 Assessment of Kidney and Urinary Function
Chapter 48 Management of Patients with Kidney Disorders
Chapter 49 Management of Patients with Urinary Disorders
Chapter 50 Assessment and Management of Patients with Female Physiologic Processes
Chapter 51 Management of Patients with Female Reproductive Disorders
Chapter 52 Assessment and Management of Patients with Breast Disorders
Chapter 53 Assessment and Management of Patients with Male Reproductive Disorders
Chapter 54 Assessment and Management of Patients Who Are LGBTQ
Chapter 55 Assessment of Integumentary Function
Chapter 56 Management of Patients with Dermatologic Disorders
Chapter 57 Management of Patients with Burn Injury
Chapter 58 Assessment and Management of Patients with Eye and Vision Disorders
Chapter 59 Assessment and Management of Patients with Hearing and Balance Disorders
Chapter 60 Assessment of Neurologic Function
Chapter 61 Management of Patients With Neurologic Dysfunction
Chapter 62 Management of Patients With Cerebrovascular Disorders
Chapter 63 Management of Patients with Neurologic Trauma
Chapter 64 Management of Patients with Neurologic Infections, Autoimmune Disorders, and
Neuropathies
Chapter 65 Management of Patients with Oncologic or Degenerative Neurologic Disorders
Chapter 66 Management of Patients with Infectious Diseases
Chapter 67 Emergency Nursing
Chapter 68 Disaster Nursing
,Chapter 1: Professional Nursing Practice
1. A nurse has been offered a position on an obstetric unit and has learned that the
unit offers therapeutic abortions, a procedure that contradicts the nurse's personal
beliefs. What is the nurse's ethical obligation to these clients?
A. The nurse should adhere to professional standards of practice and offer service
to these clients.
B. The nurse should make the choice to decline this position and pursue a different
nursing role.
C. The nurse should decline to care for the clients considering abortion.
D. The nurse should express alternatives to women considering terminating their
pregnancy.
ANSWER: B
Feedback: To avoid facing the ethical dilemma of providing care that contradicts
thenurse’s personal beliefs, the nurse should consider working in an area of
nursing that would not pose this dilemma. The nurse should not provide care to
the clientbecause it is a conflict of personal values. The nurse should not deny
care to theseclients as this would be a breach in the Code of Ethics for nurses. If
the client is notrequesting information for alternatives to abortions, then the
nurse should not beproviding this information.
POINTS: 1 REFER TO;PAGE.27
NAT: CLIENT NEEDS: Safe, Effective Care Environment: Management of Care
TOPIC; Chapter 1: Professional Nursing Practice KEY: INTEGRATED
PROCESS: CaringBLOOM’S: COGNITIVE LEVEL: Apply NOT: Multiple Choice
2. An 80-year-old client is admitted with a diagnosis of community-acquired
pneumonia. During admission the client states, "I have a living will." What
implication of this should the nurse recognize?
A. This document is always honored, regardless of circumstances.
B. This document specifies the client's wishes before hospitalization.
C. This document is binding for the duration of the client's life.
,D. This document has been drawn up by the client's family to determine DNR
status.
ANSWER: B
Feedback: A living will is one type of advance directive. In most situations, living
wills are limited to situations in which the client's medical condition is deemed
terminal. The other answers are incorrect because living wills are not always
honored in every circumstance, they are not binding for the duration of the client's
life, and they are not drawn up by the client's family.
POINTS: 1 REFER TO;PAGE.29
NAT: CLIENT NEEDS: Safe, Effective Care Environment: Management of Care
TOPIC; Chapter 1: Professional Nursing Practice
KEY: INTEGRATED PROCESS: Communication and Documentation BLOOM’S:
COGNITIVE LEVEL: Analyze
NOT: Multiple Choice
3. A nurse has been providing ethical care for many years and is aware of the need
to maintain the ethical principle of no maleficence. Which of the following actions
would be considered a violation of this principle?
A. Discussing a DNR order with a terminally ill client
B. Assisting a semi-independent client with ADLs
C. Refusing to administer pain medication as prescribed
D. Providing more care for one client than for another
ANSWER: C
Feedback: The duty not to inflict as well as prevent and remove harm is termed
no maleficence. Discussing a DNR order with a terminally ill client and assisting a
client with ADLs would not be considered contradictions to the nurse's duty of no
maleficence. Some clients justifiably require more care than others.
POINTS: 1 REFER TO;PAGE.25
NAT: CLIENT NEEDS: Safe, Effective Care Environment: Management of Care
,TOPIC; Chapter 1: Professional Nursing Practice
KEY: INTEGRATED PROCESS: Nursing Process BLOOM’S: COGNITIVE
LEVEL: AnalyzeNOT: Multiple Choice
4. A nurse has begun creating a client's plan of care shortly after the client's
admission. The nurse knows that it is important that the wording of the chosen
nursing diagnoses falls within the taxonomy of nursing. Which organization is
responsible for developing the taxonomy of a nursing diagnosis?
A. American Nurses Association (ANA)
B. North American Nursing Diagnosis Association (NANDA)
C. National League for Nursing (NLN)
D. Joint Commission
ANSWER: B
Feedback: NANDA International is the official organization responsible for
developing the taxonomy of nursing diagnoses and formulating nursing diagnoses
acceptable for study. The ANA, NLN, and Joint Commission are not charged with the
task of developing the taxonomy of nursing diagnoses.
POINTS: 1 REFER TO;PAGE.15
NAT: CLIENT NEEDS: Safe, Effective Care Environment: Management of Care
TOPIC; Chapter 1: Professional Nursing Practice
KEY: INTEGRATED PROCESS: Nursing Process BLOOM’S: COGNITIVE
LEVEL: UnderstandNOT: Multiple Choice
5. A medical nurse has obtained a new client's health history and has completed the
admission assessment. The nurse followed this by documenting the results and
creating a care plan for the client. Which of the following is the most important
rationale for documenting the client's care?
A. It provides continuity of care.
B. It creates a teaching log for the family.
C. It verifies appropriate staffing levels.
D. It keeps the client fully informed.
,ANSWER: A
Feedback: This record provides a means of communication among members of
thehealth care team and facilitates coordinated planning and continuity of care.
It serves as the legal and business record for a health care agency and for the
professional staff members who are responsible for the client's care.
Documentation is not primarily a teaching log; it does not verify staffing; and it is
not intended to provide the client with information about treatments.
POINTS: 1 REFER TO;PAGE.14
NAT: CLIENT NEEDS: Safe, Effective Care Environment: Management of Care
TOPIC; Chapter 1: Professional Nursing Practice
KEY: INTEGRATED PROCESS: Communication and Documentation BLOOM’S:
COGNITIVE LEVEL: Understand
NOT: Multiple Choice
6. The nurse has been assigned to care for a client admitted with an opportunistic
infection secondary to AIDS. The nurse informs the clinical nurse leader that the
nurse refuses to care for a client with AIDS. The nurse has an obligation to this
client under which of the following?
A. Good Samaritan Act
B. Nursing Interventions Classification (NIC)
C. The nurse practice act in the nurse's jurisdiction
D. International Council of Nurses (ICN) Code of Ethics for Nurses
ANSWER: D
Feedback: The ethical obligation to care for all clients is included in the Code of
Ethics for Nurses. The Good Samaritan Act relates to lay people helping others in
need. The NIC is a standardized classification of nursing treatment that includes
independent and collaborative interventions. Nurse practice acts primarily address
scope of practice.
POINTS: 1 REFER TO;PAGE.27
NAT: CLIENT NEEDS: Safe, Effective Care Environment: Management of Care
, TOPIC; Chapter 1: Professional Nursing Practice
KEY: INTEGRATED PROCESS: Nursing Process BLOOM’S: COGNITIVE
LEVEL: UnderstandNOT: Multiple Choice
7. The nurse, in collaboration with the client's family, is determining priorities
related to the care of the client. The nurse explains that it is important to consider
the urgency of specific problems when setting priorities. What should the nurse
adopt as the best framework for prioritizing client problems?
A. Availability of hospital resources
B. Family member statements
C. Maslow hierarchy of needs
D. The nurse's skill set
ANSWER: C
Feedback: The Maslow hierarchy of needs provides a useful framework for
prioritizing problems, with the first level given to meeting physical needs of the
client. Availability of hospital resources, family member statements, and nursing
skill do not provide a framework for prioritization of client problems, though each
may be considered.
POINTS: 1 REFER TO;PAGE.6
NAT: CLIENT NEEDS: Safe, Effective Care Environment: Management of Care
TOPIC; Chapter 1: Professional Nursing Practice
KEY: INTEGRATED PROCESS: Nursing Process BLOOM’S:
COGNITIVE LEVEL: ApplyNOT: Multiple Choice
8. A medical nurse is caring for a client who is receiving palliative care following
cancer metastasis. The nurse is aware of the need to uphold the ethical principle of
beneficence. How can the nurse best exemplify this principle in the care of this
client?
A. The nurse tactfully regulates the number and timing of visitors as per the client's
wishes.
B. The nurse stays with the client during their death.
