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TEST BANK FOR Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single 10th Edition by Sharon L. Lewis, Linda Bucher, Margaret M. Heitkemper, Mariann M. Harding, Jeffrey Kwong & Dottie Roberts , ISBN: 9780323328524 |Chapter 1-68 Co $19.99
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TEST BANK FOR Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single 10th Edition by Sharon L. Lewis, Linda Bucher, Margaret M. Heitkemper, Mariann M. Harding, Jeffrey Kwong & Dottie Roberts , ISBN: 9780323328524 |Chapter 1-68 Co
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Test bank for Medical-Surgical Nursing 10th Edition Author: Sharon L. Lewis, Linda Bucher, Margaret M. Heitkemper, Mariann M. Harding, Jeffrey Kwong, Dottie Roberts Medical Surgical Nursing 10th Edition By Lewis Test Bank for Medical-Surgical Nursing 10th Edition By Lewis, Bucher, Heitkemper, Hardi...

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  • January 19, 2025
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TEST BANK
PR
O
FD
O
C



TEST BANK

,Table of Contents

Section One – Concepts in Nursing Practice

1. Professional Nursing Practice

2. Health Disparities and Culturally Competent Care

3. Health History and Physical Examination

4. Patient and Caregiver Teaching

5. Chronic Illness and Older Adults

6. Stress and Stress Management
PR

7. Sleep and Sleep Disorders

8. Pain
O
9. Palliative Care at End of Life

10. Substance Use Disorders
FD

Section Two – Pathophysiologic Mechanisms of Disease

11. Inflammation and Wound Healing
O

12. Genetics and Genomics
C
13. Altered Immune Responses and Transplantation

14. Infection and Human Immunodeficiency Virus Infection

15. Cancer

16. Fluid, Electrolyte, and Acid-Base Imbalances



Section Three – Perioperative Care

,17. Preoperative Care

18. Intraoperative Care ‘

19. Postoperative Care



Section Four – Problems Related to Altered Sensory Input

20. Assessment of Visual and Auditory Systems

21. Visual and Auditory Problems
PR
22. Assessment of Integumentary System

23. Integumentary Problems

24. Burns
O

Section Five – Problems of Oxygenation: Ventilation
FD

25. Assessment of Respiratory System

26. Upper Respiratory Problems
O
27. Lower Respiratory Problems

28. Obstructive Pulmonary Diseases
C

Section Six – Problems of Oxygenation: Transport

29. Assessment of Hematologic System

30. Hematologic Problems



Section Seven – Problems of Oxygenation: Perfusion

31. Assessment of Cardiovascular System

,32. Hypertension

33. Coronary Artery Disease and Acute Coronary Syndrome

34. Heart Failure 35. Dysrhythmias

36. Inflammatory and Structural Heart Disorders

37. Vascular Disorders



Section Eight – Problems of Ingestion, Digestion, Absorption, and Elimination
PR
38. Assessment of Gastrointestinal System

39. Nutritional Problems

40. Obesity
O
41. Upper Gastrointestinal Problems

42. Lower Gastrointestinal Problems
FD

43. Liver, Pancreas, and Biliary Tract Problems
O
Section Nine – Problems of Urinary Function

44. Assessment of Urinary System
C
45. Renal and Urologic Problems

46. Acute Kidney Injury and Chronic Kidney Disease



Section Ten – Problems Related to Regulatory and Reproductive Mechanisms

47. Assessment of Endocrine System

48. Diabetes Mellitus

49. Endocrine Problems

,50. Assessment of Reproductive System

51. Breast Disorders

52. Sexually Transmitted Infections

53. Female Reproductive and Genital Problems

54. Male Reproductive and Genital Problems



Section Eleven – Problems Related to Movement and Coordination
PR
55. Assessment of Nervous System

56. Acute Intracranial Problems

57. Stroke
O
58. Chronic Neurologic Problems

59. Dementia and Delirium
FD

60. Spinal Cord and Peripheral Nerve Problems

61. Assessment of Musculoskeletal System
O
62. Musculoskeletal Trauma and Orthopedic Surgery

63. Musculoskeletal Problems
C
64. Arthritis and Connective Tissue Diseases



Section Twelve – Nursing Care in Specialized Settings

65. Critical Care

66. Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

67. Acute Respiratory Failure and Acute Respiratory Distress Syndrome

68. Emergency and Disaster Nursing

,Chapter 01: Professional Nursing Practice
Lewis: Medical-Surgical Nursing, 10th Edition


MULTIPLE CHOICE

1. The nurse completes an admission database and explains that the plan of care and discharge
goals will be developed with the patient’s input. The patient states, “How is this different from
what the doctor does?” Which response would be most appropriate for the nurse to make?
a. “The role of the nurse is to administer medications and other treatments prescribed
by your doctor.”
b. “The nurse’s job is to help the doctor by collecting information and
communicating any problems that occur.”
c. “Nurses perform many of the same procedures as the doctor, but nurses are with
the patients for a longer time than the doctor.”
d. “In addition to caring for you while you are sick, the nurses will assist you to
develop an individualized plan to maintain your health.”
PR
ANS: D
This response is consistent with the American Nurses Association (ANA) definition of
nursing, which describes the role of nurses in promoting health. The other responses describe
some of the dependent and collaborative functions of the nursing role but do not accurately
describe the nurse’s role in the health care system.
O
DIF: Cognitive Level: Understand (comprehension) REF: 3
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
FD
2. The nurse describes to a student nurse how to use evidence-based practice guidelines when
caring for patients. Which statement, if made by the nurse, would be the most accurate?
a. “Inferences from clinical research studies are used as a guide.”
b. “Patient care is based on clinical judgment, experience, and traditions.”
c. “Data are evaluated to show that the patient outcomes are consistently met.”
O
d. “Recommendations are based on research, clinical expertise, and patient
preferences.”
ANS: D
C
Evidence-based practice (EBP) is the use of the best research-based evidence combined with
clinician expertise. Clinical judgment based on the nurse’s clinical experience is part of EBP,
but clinical decision making should also incorporate current research and research-based
guidelines. Evaluation of patient outcomes is important, but interventions should be based on
research from randomized control studies with a large number of subjects.

DIF: Cognitive Level: Remember (knowledge) REF: 15
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment

3. The nurse teaches a student nurse about how to apply the nursing process when providing
patient care. Which statement, if made by the student nurse, indicates that teaching was
successful?
a. “The nursing process is a scientific-based method of diagnosing the patient’s
health care problems.”
b. “The nursing process is a problem-solving tool used to identify and treat patients’

, health care needs.”
c. “The nursing process is used primarily to explain nursing interventions to other
health care professionals.”
d. “The nursing process is based on nursing theory that incorporates the
biopsychosocial nature of humans.”
ANS: B
The nursing process is a problem-solving approach to the identification and treatment of
patients’ problems. Diagnosis is only one phase of the nursing process. The primary use of the
nursing process is in patient care, not to establish nursing theory or explain nursing
interventions to other health care professionals.

DIF: Cognitive Level: Understand (comprehension) REF: 5
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment

4. A patient has been admitted to the hospital for surgery and tells the nurse, “I do not feel
comfortable leaving my children with my parents.” Which action should the nurse take next?
a. Reassure the patient that these feelings are common for parents.
PR
b. Have the patient call the children to ensure that they are doing well.
c. Gather more data about the patient’s feelings about the child-care arrangements.
d. Call the patient’s parents to determine whether adequate child care is being
provided.
ANS: C
Because a complete assessment is necessary in order to identify a problem and choose an
O
appropriate intervention, the nurse’s first action should be to obtain more information. The
other actions may be appropriate, but more assessment is needed before the best intervention
can be chosen.
FD

DIF: Cognitive Level: Apply (application) REF: 6
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
MSC: NCLEX: Psychosocial Integrity

5. A patient who is paralyzed on the left side of the body after a stroke develops a pressure ulcer
O
on the left hip. Which nursing diagnosis is most appropriate?
a. Impaired physical mobility related to left-sided paralysis
b. Risk for impaired tissue integrity related to left-sided weakness
C
c. Impaired skin integrity related to altered circulation and pressure
d. Ineffective tissue perfusion related to inability to move independently
ANS: C
The patient’s major problem is the impaired skin integrity as demonstrated by the presence of
a pressure ulcer. The nurse is able to treat the cause of altered circulation and pressure by
frequently repositioning the patient. Although left-sided weakness is a problem for the patient,
the nurse cannot treat the weakness. The “risk for” diagnosis is not appropriate for this patient,
who already has impaired tissue integrity. The patient does have ineffective tissue perfusion,
but the impaired skin integrity diagnosis indicates more clearly what the health problem is.

DIF: Cognitive Level: Apply (application) REF: 7
TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity

,6. A patient with a bacterial infection has a nursing diagnosis of deficient fluid volume related to
excessive diaphoresis. Which outcome would the nurse recognize as appropriate for this
patient?
a. Patient has a balanced intake and output.
b. Patient’s bedding is changed when it becomes damp.
c. Patient understands the need for increased fluid intake.
d. Patient’s skin remains cool and dry throughout hospitalization.
ANS: A
This statement gives measurable data showing resolution of the problem of deficient fluid
volume that was identified in the nursing diagnosis statement. The other statements would not
indicate that the problem of deficient fluid volume was resolved.

DIF: Cognitive Level: Apply (application) REF: 7
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity

7. A nurse asks the patient if pain was relieved after receiving medication. What is the purpose
of the evaluation phase of the nursing process?
PR
a. To determine if interventions have been effective in meeting patient outcomes
b. To document the nursing care plan in the progress notes of the medical record
c. To decide whether the patient’s health problems have been completely resolved
d. To establish if the patient agrees that the nursing care provided was satisfactory
ANS: A
Evaluation consists of determining whether the desired patient outcomes have been met and
O
whether the nursing interventions were appropriate. The other responses do not describe the
evaluation phase.
FD
DIF: Cognitive Level: Understand (comprehension) REF: 5
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Environment

8. The nurse interviews a patient while completing the health history and physical examination.
What is the purpose of the assessment phase of the nursing process?
a. To teach interventions that relieve health problems
O
b. To use patient data to evaluate patient care outcomes
c. To obtain data with which to diagnose patient problems
d. To help the patient identify realistic outcomes for health problems
C
ANS: C
During the assessment phase, the nurse gathers information about the patient to diagnose
patient problems. The other responses are examples of the planning, intervention, and
evaluation phases of the nursing process.

DIF: Cognitive Level: Understand (comprehension) REF: 5
TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment

9. Which nursing diagnosis statement is written correctly?
a. Altered tissue perfusion related to heart failure
b. Risk for impaired tissue integrity related to sacral redness
c. Ineffective coping related to response to biopsy test results
d. Altered urinary elimination related to urinary tract infection

, ANS: C
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
a patient’s response to a health problem that can be treated by nursing. The use of a medical
diagnosis as an etiology (as in the responses beginning “Altered tissue perfusion” and
“Altered urinary elimination”) is not appropriate. The response beginning “Risk for impaired
tissue integrity” uses the defining characteristic as the etiology.

DIF: Cognitive Level: Understand (comprehension) REF: 7
TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care Environment

10. The nurse admits a patient to the hospital and develops a plan of care. What components
should the nurse include in the nursing diagnosis statement?
a. The problem and the suggested patient goals or outcomes
b. The problem with possible causes and the planned interventions
c. The problem, its cause, and objective data that support the problem
d. The problem with an etiology and the signs and symptoms of the problem
ANS: D
When writing nursing diagnoses, this format should be used: problem, etiology, and signs and
PR
symptoms. The subjective, as well as objective, data should be included in the defining
characteristics. Interventions and outcomes are not included in the nursing diagnosis
statement.

DIF: Cognitive Level: Remember (knowledge) REF: 7
O
TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care Environment

11. A nurse is caring for a patient with heart failure. Which task is appropriate for the nurse to
delegate to experienced unlicensed assistive personnel (UAP)?
FD
a. Monitor for shortness of breath or fatigue after ambulation.
b. Instruct the patient about the need to alternate activity and rest.
c. Obtain the patient’s blood pressure and pulse rate after ambulation.
d. Determine whether the patient is ready to increase the activity level.

ANS: C
O
UAP education includes accurate vital sign measurement. Assessment and patient teaching
require registered nurse education and scope of practice and cannot be delegated.
C
DIF: Cognitive Level: Apply (application) REF: 11
OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment

12. A nurse is caring for a group of patients on the medical-surgical unit with the help of one float
registered nurse (RN), one unlicensed assistive personnel (UAP), and one licensed
practical/vocational nurse (LPN/LVN). Which assignment, if delegated by the nurse, would
be inappropriate?
a. Measurement of a patient’s urine output by UAP
b. Administration of oral medications by LPN/LVN
c. Check for the presence of bowel sounds and flatulence by UAP
d. Care of a patient with diabetes by RN who usually works on the pediatric unit
ANS: C

, Assessment requires RN education and scope of practice and cannot be delegated to an
LPN/LVN or UAP. The other assignments made by the RN are appropriate.

DIF: Cognitive Level: Apply (application) REF: 11
OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment

13. Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse
(LPN/LVN)?
a. Complete the initial admission assessment and plan of care.
b. Document teaching completed before a diagnostic procedure.
c. Instruct a patient about low-fat, reduced sodium dietary restrictions.
d. Obtain bedside blood glucose on a patient before insulin administration.

ANS: D
The education and scope of practice of the LPN/LVN include activities such as obtaining
glucose testing using a finger stick. Patient teaching and the initial assessment and
development of the plan of care are nursing actions that require registered nurse education and
scope of practice.
PR

DIF: Cognitive Level: Apply (application) REF: 11
OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment

14. A nurse is assigned as a case manager for a hospitalized patient with a spinal cord injury. The
O
patient can expect the nurse functioning in this role to perform which activity?
a. Care for the patient during hospitalization for the injuries.
b. Assist the patient with home care activities during recovery.
FD
c. Determine what medical care the patient needs for optimal rehabilitation.
d. Coordinate the services that the patient receives in the hospital and at home.

ANS: D
The role of the case manager is to coordinate the patient’s care through multiple settings and
levels of care to allow the maximal patient benefit at the least cost. The case manager does not
O
provide direct care in either the acute or home setting. The case manager coordinates and
advocates for care but does not determine what medical care is needed; that would be
completed by the health care provider or other provider.
C
DIF: Cognitive Level: Apply (application) REF: 9
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment

15. The nurse is caring for an older adult patient who had surgery to repair a fractured hip. The
patient needs continued nursing care and physical therapy to improve mobility before
returning home. The nurse will help to arrange for transfer of this patient to which facility?
a. A skilled care facility c. A transitional care facility
b. A residential care facility d. An intermediate care facility

ANS: C

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