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Test Bank - Brunner and Suddarths Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010), Chapter 1-72 | All Chapters

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TEST BANK
Brunner and Suddarth's Textbook of Medical Surgical Nursing


Suzanne C. Smeltzer, Brenda G. Bare, Janice L. Hinkle, and Kerry H. Cheever

12th Edition

,Table of Contents

Chapter 01 Health Care Delivery and Nursing Practice 1
Chapter 02 Community-Based Nursing Practice 23
Chapter 03 Critical Thinking, Ethical Decision Making, and the Nursing Process 43
Chapter 04 Health Education and Health Promotion 71
Chapter 05 Adult Health and Nutritional Assessment 94
Chapter 06 Homeostasis, Stress, and Adaptation 119
Chapter 07 Individual and Family Considerations Related to Illness 144
Chapter 08 Perspectives in Transcultural Nursing 170
Chapter 09 Genetics and Genomics Perspectives in Nursing 192
Chapter 10 Chronic Illness and Disability 216
Chapter 11 Principles and Practices of Rehabilitation 239
Chapter 12 Health Care of the Older Adult 266
Chapter 13 Pain Management 291
Chapter 14 Fluid and Electrolytes Balance and Disturbance 317
Chapter 15 Shock and Multiple Organ Dysfunction Syndrome 344
Chapter 16 Oncology-Nursing Management in Cancer Care 369
Chapter 17 End-of-Life Care 393
Chapter 18 Preoperative Nursing Management 418
Chapter 19 Intraoperative Nursing Management 444
Chapter 20 Postoperative Nursing Management 468
Chapter 21 Assessment of Respiratory Function 493
Chapter 22 Management of Patients With Upper Respiratory Tract Disorders 516
Chapter 23 Management of Patients With Chest and Lower Respiratory Tract Disorders 539
Chapter 24 Management of Patients With Chronic Pulmonary Disease 563
Chapter 25 Respiratory Care Modalities 586
Chapter 26 Assessment of Cardiovascular Function 610
Chapter 27 Management of Patients With Dysrhythmias and Conduction Problems 634
Chapter 28 Management Of Patients With Coronary Vascular Disorders 656
Chapter 29 Management of Patients With Structural, Infectious, and Inflammatory
Cardiac Disorders 680
Chapter 30 Management of Patients with Complications from Heart Disease 704
Chapter 31 Assessment and Management of Patients With Vascular Disorders and
Problems of Peripheral Circulation 727
Chapter 32 Assessment and Management of Patients With Hypertension 752
Chapter 33 Assessment and Management of Patients With Hematologic Disorders 775
Chapter 34 Assessment of Digestive and Gastrointestinal Function 798
Chapter 35 Management of Patients with Oral and Esophageal Disorders 820
Chapter 36 Gastrointestinal Intubation and Special Nutritional Modalities 844
Chapter 37 Management Of Patients With Gastric And Duodenal Disorders 867
Chapter 38 Management of Patients With Intestinal and Rectal Disorders 891
Chapter 39 Assessment and Management of Patients With Hepatic Disorders 914

,Chapter 40 Assessment and Management of Patients With Biliary Disorders 937
Chapter 41 Assessment and Management of Patients with Diabetes Mellitus 960
Chapter 42 Assessment And Management Of Patients With Endocrine Disorders 984
Chapter 43 Assessment of Renal and Urinary Tract Function 1005
Chapter 44 Management of Patients With Renal Disorders 1029
Chapter 45 Management of Patients With Urinary Disorders 1054
Chapter 46 Assessment and Management of Female Physiologic Processes 1078
Chapter 47 Management of Patients with Female Reproductive Disorders 1102
Chapter 48 Assessment and Management of Patients with Breast Disorders 1124
Chapter 49 Assessment and Management of Problems Related to Male Reproductive
Processes 1149
Chapter 50 Assessment of Immune Function 1174
Chapter 51 Management of Patients With Immunodeficiency 1196
Chapter 52 Management of Patients With HIV Infection and AIDS 1218
Chapter 53 Assessment and Management of Patients With Allergic Disorders 1242
Chapter 54 Assessment and Management of Patients With Rheumatic Disorders 1266
Chapter 55 Assessment of Integumentary Function 1289
Chapter 56 Management of Patients With Dermatologic Problems 1312
Chapter 57 Management of Patients With Burn Injury 1334
Chapter 58 Assessment and Management of Patients With Eye and Vision Disorders 1358
Chapter 59 Assessment and Management of Patients with Hearing and Balance Disorders 1381
Chapter 60 Assessment of Neurologic Function 1404
Chapter 61 Management of Patients With Neurologic Dysfunction 1425
Chapter 62 Management of Patients With Cerebrovascular Disorders 1448
Chapter 63 Management of Patients With Neurologic Trauma 1472
Chapter 64 Management of Patients With Neurologic Infections, Autoimmune Disorders,
and Neuropathies 1495
Chapter 65 Management of Patients With Oncologic or Degenerative Neurologic
Disorders 1518
Chapter 66 Assessment of Musculoskeletal Function 1541
Chapter 67 Musculoskeletal Care Modalities 1563
Chapter 68 Management of Patients With Musculoskeletal Disorders 1586
Chapter 69 Management of Patients With Musculoskeletal Trauma 1608
Chapter 70 Management of Patients With Infectious Diseases 1632
Chapter 71 Emergency Nursing 1655
Chapter 72 Terrorism, Mass Casualty, and Disaster Nursing 1678

,______________________________________________________________________________________________
Test Bank - Brunner and Suddath's Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010)




Import Settings:
Base Settings: Brownstone Default
Information Field: Chapter
Information Field: Client Needs
Information Field: Cognitive Level
Information Field: Difficulty
Information Field: Integrated Process
Information Field: Objective
Information Field: Page and Header
Highest Answer Letter: E
Multiple Keywords in Same Paragraph: No




Chapter: Chapter 01: Health Care Delivery and Nursing Practice




Multiple Choice




1. The school nurse is presenting a health promotion class to a group of high school students.
How does the nurse define health?
A) Health is being disease free.
B) Health is having fulfilling relationships.
C) Health is having a clean drinking source and nutritious food.
D) Health is being connected in body, mind, and spirit.

Ans: D
Chapter: 1
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 1
Page and Header: 6, Health, Wellness, and Health Promotion

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
absence of disease and infirmity.” The other answers are incorrect because they are not how
WHO defines health.



______________________________________________________________________________________________
1|Page

,______________________________________________________________________________________________
Test Bank - Brunner and Suddath's Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010)




2. A nurse is speaking to a group of high school 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 nursing approach
C) Strict adherence to routine
D) One set cultural practice

Ans: A
Chapter: 1
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Caring
Objective: 2
Page and Header: 7, Influences on Health Care Delivery

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. “One set” cultural practice is nonexistent.




3. With the changing population and increased longevity, people have had to become more
knowledgeable about their health and the professional health care they receive. A development
that has been born of this trend is organized self-care education programs. What is one thing
these programs emphasize?
A) Good prenatal care
B) An abundance of information
C) Judicious use of internet self-help groups
D) Management of illness

Ans: D
Chapter: 1
Client Needs: D-3
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 6, Health, Wellness, and Health Promotion




______________________________________________________________________________________________
2|Page

,______________________________________________________________________________________________
Test Bank - Brunner and Suddath's Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010)




Feedback: Organized self-care education programs emphasize health promotion, disease
prevention, management of illness, self-care, and judicious use of the professional health care
system. The other answers are incorrect because they are not emphasized by self-care education
programs.




4. The home health nurse is assisting a patient and his family in planning the patient's return to
work after an extensive illness. On which level of Maslow's hierarchy of basic needs does the
patient's need for self-fulfillment fit?
A) Physiologic
B) Safety and security
C) Love and belonging
D) Self-actualization

Ans: D
Chapter: 1
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Page and Header: 5, The Health Care Industry and the Nursing Profession

Feedback: Maslow's highest level of human needs is self-actualization, which includes
self-fulfillment, desire to know and understand, and aesthetic needs. The other answers are
incorrect because self-fulfillment does not fit on any of them.




5. The view that health and illness are not static states but lie on a continuum is not just a
nursing concept; it runs throughout the professional health care system. What does this view aid
the nurse in understanding?
A) That care should focus on the treatment of disease
B) That a person's state of health is ever changing
C) That a person does not have varying degrees of illness
D) That care should focus on the patient's response to medications

Ans: B
Chapter: 1
Client Needs: B
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Caring



______________________________________________________________________________________________
3|Page

,______________________________________________________________________________________________
Test Bank - Brunner and Suddath's Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010)




Objective: 1
Page and Header: 6, Health, Wellness, and Health Promotion

Feedback: By viewing health and illness on a continuum, it is possible to consider a person as
being neither completely healthy nor completely ill. Instead, a person's 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 because patient care should not focus just
on the treatment of disease, people do have varying degrees of illness, and care should not focus
on the response to medications but on the patient's response to all aspects of nursing care.




6. What does the nurse, working in a community health clinic, teach about disease prevention?
A) That it is best achieved through attending self-help groups
B) That it is best achieved by taking yearly physicals
C) That it is best achieved by being an active participant in the community
D) That it is best achieved by exhibiting behaviors that promote health

Ans: D
Chapter: 1
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 1
Page and Header: 6, Health, Wellness, and Health Promotion

Feedback: Today, increasing emphasis is placed on health, health promotion, wellness, and
self-care. Health is seen as resulting from a lifestyle oriented toward wellness. The other answers
are incorrect because nurses in community health clinics do not teach that disease prevention is
best achieved through attending self-help groups, or by taking yearly physicals or by being an
active participant in the community.




7. A nurse on a medical-surgical unit has asked to represent her unit on the hospital's
Continuous Quality Improvement (CQI) committee. In researching CQI programs, what has the
nurse found?
A) CQI programs establish accountability on the part of health care professionals.
B) CQI programs focus on the process used to provide care.
C) CQI programs identify incidents rather than processes.
D) CQI programs justify health care costs.

Ans: B



______________________________________________________________________________________________
4|Page

,______________________________________________________________________________________________
Test Bank - Brunner and Suddath's Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010)




Chapter: 1
Client Needs: A-1
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: 2
Page and Header: 8, Influences on Health Care Delivery

Feedback: Unlike QA, which focuses on individual incidents or errors and minimal
expectations, CQI focuses on the processes used to provide care, with the aim of improving
quality by assessing and improving those processes that most affect patient care outcomes and
patient satisfaction. The other answers are incorrect because CQI programs do not focus on the
accountability of the health care professionals, they do not identify incidents rather than
processes, and they do not justify health care costs.




8. Because of managed health care there have been many significant changes in the health care
delivery system. What is one major effect managed health care has had on the patient
population?
A) Patients are in the hospital for a longer period of time.
B) Patients are locked into prenegotiated payment rates that have remained unchanged.
C) Patients with high home-care needs are being discharged into the community.
D) Patient use of ambulatory care has decreased.

Ans: C
Chapter: 1
Client Needs: A-1
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: 2
Page and Header: 9, Influences on Health Care Delivery

Feedback: Managed care has contributed to a dramatic reduction in inpatient hospital days,
continuing expansion of ambulatory care, fierce competition, and marketing strategies that
appeal to consumers as well as to insurers and regulators. It has also resulted in patients returning
to the community with more health care needs, many of which are complex. The other answers
are incorrect because patients are not in the hospital for longer periods of time; patients are not
locked into payment rates that have remained unchanged; and patient use of ambulatory care has
not decreased, it has increased.




______________________________________________________________________________________________
5|Page

,______________________________________________________________________________________________
Test Bank - Brunner and Suddath's Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010)




9. You are the nurse admitting a patient to your unit. What is your most important nursing
function at this time?
A) Identifying the immediate needs of the patient
B) Checking the admitting physician's orders
C) Obtaining a baseline set of vital signs
D) Allowing the family to be with the patient

Ans: A
Chapter: 1
Client Needs: A-2
Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Caring
Objective: 3
Page and Header: 5, The Health Care Industry and the Nursing Profession

Feedback: Among the nurse's important functions in health care delivery, identifying the
patient's 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
function.




10. Many institutions use clinical pathways to direct patient care for certain diagnosis-related
groups (DRGs). When a nurse gives care based on a clinical pathway, she knows that to achieve
the desired outcomes specific care must be given within what?
A) The designated time frame of the clinical pathway
B) The auspices of the nurse manager of the unit
C) The modifications made by that specific care unit
D) The timeframe designated by the nurse initiating the clinical pathway

Ans: A
Chapter: 1
Client Needs: A-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: 4
Page and Header: 8, Influences on Health Care Delivery

Feedback: The pathways indicate key events, such as diagnostic tests, treatments, activities,
medications, consultation, and education, that must occur within specified times for patients to
achieve the desired and timely outcomes. The other answers are incorrect because care is not
given within the auspices of the units nurse manager, and a clinical pathway is not modified from
one unit to another, nor is it modified by the nurse initiating the pathway.



______________________________________________________________________________________________
6|Page

, ______________________________________________________________________________________________
Test Bank - Brunner and Suddath's Textbook of Medical Surgical Nursing, 12th Edition (Smeltzer, 2010)




11. Staff nurses in an ICU setting have noticed that their patients required fewer interventions
for pain when the ICU was quiet. They passed their observations on to a nurse researcher and
asked the researcher to design a study about the effects of noise on the pain levels of hospitalized
patients. How does this demonstrate the primary purpose of nursing research?
A) Nursing research involves patients and their care while hospitalized.
B) Nursing research contributes to the scientific base of nursing practice.
C) Nursing research draws conclusions about the quality of patient care.
D) Nursing research explains ongoing medical studies to patients.

Ans: B
Chapter: 1
Client Needs: A-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: 3
Page and Header: 10, Roles of the Nurse

Feedback: The primary task of nursing research is to contribute to the scientific base of nursing
practice. Studies are needed to determine the effectiveness of nursing interventions and nursing
care. The science of nursing grows through research, leading to the generation of scientifically
based rationale for nursing practice and patient care. The other answers are incorrect because
they are not the primary purpose of nursing research.




12. Nurses now have the option to practice in a variety of settings. One of the fastest growing
venues of practice for the nurse in today's health care environment is home health care. What is
the basis for the growth in this health care setting?
A) The chronic nursing shortage
B) The focus on treatment of disease
C) The preference of nurses to work during the day instead of evening or night shifts
D) The discharge of patients who are more critically ill

Ans: D
Chapter: 1
Client Needs: A-1
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3



______________________________________________________________________________________________
7|Page

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