TEST BANK
Brunner & Suddarth's Canadian Textbook of Medical-Surgical
Nursing
Mohamed El Hussein and Joseph Osuji
4th Edition
,Table of Contents
Chapter 01 Health Care Delivery and Nursing Practice 1
Chapter 02 Community-Based Nursing Practice 11
Chapter 03 Critical Thinking, Ethical Decision Making, and the Nursing Process 24
Chapter 04 Health Education and Health Promotion 42
Chapter 05 Adult Health and Nutritional Assessment 58
Chapter 06 Delegation 77
Chapter 07 Spirituality in Nursing Practice 94
Chapter 08 Perspectives in Transcultural Nursing 105
Chapter 09 Homeostasis, Stress, and Adaptation 120
Chapter 10 Individual and Family Considerations Related to Illness 139
Chapter 11 Genetics and Genomics Perspectives in Nursing 158
Chapter 12 Chronic Ilness and Disabilities 176
Chapter 13 Principles and Practices of Rehabilitation 187
Chapter 14 Health Care of the Older Adult 204
Chapter 15 Hospice, Palliative, and End-of-Life Care 221
Chapter 16 Pain Management 238
Chapter 17 Fluid and Electrolytes-Balance and Disturbance 250
Chapter 18 Shock and Multiple Organ Dysfunction Syndrome 271
Chapter 19 Preoperative Nursing Management 290
Chapter 20 Intraoperative Nursing Management 310
Chapter 21 Postoperative Nursing Management 327
Chapter 22 Assessment of Respitory Function 346
Chapter 23 Management of Patients With Upper Respiratory Tract Disorders 363
Chapter 24 Management of Patients With Chest and Lower Respiratory Tract Disorders 380
Chapter 25 Management of Patients With Chronic Obstructive Pulmonary Disease 397
Chapter 26 Respiratory Care Modalities 413
Chapter 27 Assessment of Cardiovascular Function 430
Chapter 28 Management of Patient With Dysrhythmias and Conduction Problems 446
Chapter 29 Management of Patients With Coronary Vascular Disorders 462
Chapter 30 Management of Patients With Structural, Infections, and Inflammatory
Cardiac Disorders 480
Chapter 31 Management of Patients With Complication from Heart Disease 496
Chapter 32 Assessment and Management of Patients With Vascular Disorders and
Peripheral Circulation Concerns 512
Chapter 33 Assessment and Management of Patients With Hypertension 530
Chapter 34 Assessment of Digestive and Gastrointestinal Function 537
Chapter 35 Management of Patients With Oral and Esophageal Disorders 553
Chapter 36 Gastrointestinal Intubation and Special Nutritional Modalities 571
Chapter 37 Management of Patients With Gastric and Duodenal Disorders 582
Chapter 38 Management of Patients With Intestinal and Rectal Disorders 599
Chapter 39 Assessment and Management of Clients With Hepatic Disorders 616
,Chapter 40 Assessment and Management of Patients With Biliary Disorders 633
Chapter 41 Assessment and Management of Patients With Diabetes Mellitus 650
Chapter 42 Assessment and Management of Patients With Obesity 667
Chapter 43 Assessment and Management of Patients With Endocrine Disorders 676
Chapter 44 Assessment of Renal and Urinary Tract Function 691
Chapter 45 Management of Patients With Kidney Disorders 707
Chapter 46 Management of Patients With Urinary Disorders 725
Chapter 47 Assessment and Management of Female Physiologic Processes 736
Chapter 48 Management of Patients With Female Reproductive Disorders 752
Chapter 49 Management of Patients With Breast Disorders 768
Chapter 50 Assessment and Management of Problems Related to Male Reproductive
Disorders 785
Chapter 51 Assessment of Immune Function 796
Chapter 52 Management of Patients With Immune Deficiency Disorders 812
Chapter 53 Assessment and Management of Patients With Allergic Disorders 834
Chapter 54 Assessment and Management of Patients With Hematologic Disorders 844
Chapter 55 Management of Patients With Infectious Diseases 860
Chapter 56 Assessment and Management of Patients With Rheumatic Disorders 875
Chapter 57 Assessment of Integumentary Function 886
Chapter 58 Management of Patients With Dermatologic Conditions 896
Chapter 59 Management of Patients With Burn Injury 909
Chapter 60 Assessment and Management of Patients With Eye and Vision Disorders 920
Chapter 61 Assessment and Management of Patients With Hearing and Balance Disorders 932
Chapter 62 Assessment of Neurologic Function 943
Chapter 63 Management of Patients With Neurologic Dysfunction 957
Chapter 64 Management of Patients With Cerebrovascular Disorders 973
Chapter 65 Management of Patients With Neurologic Trauma 990
Chapter 66 Management of Patients With Neurologic Infections, Autoimmune Disorders,
and Neuropathies 1007
Chapter 67 Management of Patients With Oncologic or Degenerative Disorders 1023
Chapter 68 Oncology-Nursing Management in Cancer Care 1039
Chapter 69 Assessment of Musculoskeletal Function 1056
Chapter 70 Musculoskeletal Care Modalities 1071
Chapter 71 Management of Patients With Musculoskeletal Disorders 1087
Chapter 72 Management of Patients With Musculoskeletal Trauma 1104
Chapter 73 Emergency Nursing 1121
Chapter 74 Terrorism, Mass Casualty, and Disaster Nursing 1137
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Test Bank - Brunner and Suddarth's Canadian Textbook of Medical-Surgical Nursing, 4th Edition (El Hussein, 2019)
Chapter 1, Health Care Delivery and Nursing Practice
MULTIPLE CHOICE
1. Health may be defined as which of the following?
A) Being disease free
B) Having fulfilling relationships
C) Having a clean drinking source and nutritious food
D) Being connected in body, mind, and spirit
ANS: D
Feedback: The World Health Organization defines health as a “state of complete physical,
mental, and social well-being.” This state of well-being can include strong relationships,
food, and freedom from disease. However, these components are not the essence of the
concept of health; it is possible for a person to experience health even in the absence of
these.
PTS: 1 DIF: Easy REF: Page and Header: 7, Wellness
OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
2. Which of the following characteristics would an effective nurse have?
A) Sensitivity to cultural differences
B) Mainly team nursing approach
C) Strict adherence to routine
D) One set cultural practice
ANS: A
Feedback: To promote effective nursing, care must be culturally competent, appropriate, and
sensitive to cultural differences. Cultural practices and nursing routines must be
individualized because different circumstances require different approaches. Team nursing
is appropriate in some, but not all, circumstances.
PTS: 1 DIF: Moderate REF: Page and Header: 8, Cultural Diversity
OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
3. What is the most common type of health problem seen in the health care system?
A) Poor prenatal care
B) Lack of information available to clients
C) Immobility
D) Increased rate of chronic disease
ANS: D
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Test Bank - Brunner and Suddarth's Canadian Textbook of Medical-Surgical Nursing, 4th Edition (El Hussein, 2019)
Feedback: The decline in the birth rate and the increase in life span have given us an older
population. This population is living longer because of a variety of factors. This longevity
contributes to the increase in chronic diseases. The other listed problems are present in the
Canadian health care system, but are not as prevalent or salient at the increasing rates of
chronic disease.
PTS: 1 DIF: Moderate
REF: Page and Header: 8, Population Demographics OBJ: 4
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
4. The need for self-fulfillment fits in which level of Maslow’s hierarchy of basic needs?
A) Physiologic
B) Safety and security
C) Love and belonging
D) Self-actualization
ANS: D
Feedback: Self-actualization, which is at the top of Maslow’s hierarchy, may be reached
through self-fulfillment, desire to know and understand, and aesthetic needs.
PTS: 1 DIF: Moderate
REF: Page and Header: 6, Maslow’s Hierarchy OBJ: 1
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter Number: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: Understand
5. What has been the main focus of health care providers in the last 50 years?
A) Treatment of disease
B) Promotion
C) Prevention
D) Treatment of childhood disease
ANS: A
Feedback: The health care system of Canada has been disease oriented. For this reason,
treatment has been prioritized over prevention and health promotion. Pediatrics has not been
the main focus over the past half century.
PTS: 1 DIF: Moderate
REF: Page and Header: 6, Health Care in Transition OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
6. Which of the following is the best type of disease prevention?
A) Immunizations
B) Yearly physicals
C) Community social events
D) Behaviour that promotes health
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Test Bank - Brunner and Suddarth's Canadian Textbook of Medical-Surgical Nursing, 4th Edition (El Hussein, 2019)
ANS: D
Feedback: Health is seen as a lifestyle that is oriented toward wellness. The lifestyle is
accomplished through health-promoting behaviours. This type of lifestyle includes
components such as social interaction, physical check-ups, and immunizations, but these do
not take the place of overall lifestyle behaviours that are consistent with lifelong health.
PTS: 1 DIF: Moderate REF: Page and Header: 7, Wellness
OBJ: 4 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
7. Continuous quality improvement programs exist for what purpose?
A) To establish accountability on the part of health care professionals
B) To focus on the process used to provide care
C) To identify incidents rather than processes
D) To justify health care costs
ANS: B
Feedback: Continuous quality improvement programs focus on the processes used to
provide care with the aim of improving quality by improving the processes. Accountability
is a part of such programs, but not the primary purpose. Similarly, costs may be justified by
the results of a quality improvement program, but this is not the main purpose for which
they exist. Processes, rather than individual incidents, are the focus of quality improvement.
PTS: 1 DIF: Difficult
REF: Page and Header: 9, Continuous Quality Improvement and Evidence-Based Practice
OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
8. The following principles are principles of the Canada Health Act except one. Which one is
not?
A) Universality
B) Portability
C) Appropriate technology
D) Public administration
ANS: C
Feedback: Appropriate technology is a principle of primary health care but not of the
Canada Health Act. The Act’s principles include public administration, universality, and
portability.
PTS: 1 DIF: Easy
REF: Page and Header: 6, The Canada Health Act OBJ: 2
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
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Test Bank - Brunner and Suddarth's Canadian Textbook of Medical-Surgical Nursing, 4th Edition (El Hussein, 2019)
9. Which of the following information sources is most important in the development of a
clinical pathway?
A) Current literature and professional expertise
B) Legal responsibilities of the health care institution
C) The health and wellness philosophy of the caregivers
D) Cost considerations of hospitals and health authorities
ANS: A
Feedback: A clinical pathway should be based primarily on current literature and expertise.
These evidence sources are prioritized over legal realities, caregivers’ philosophies, and
cost. These are realities that must be addressed, but they are not foundational information
sources.
PTS: 1 DIF: Moderate
REF: Page and Header: 10, Clinical Pathways and Care Mapping
OBJ: 6
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
10. A nurse researcher is conducting a study about the effects of noise on client pain levels
while hospitalized. The primary purpose of nursing research is to:
A) involve clients in their care while hospitalized.
B) contribute to the scientific base of nursing practice.
C) draw conclusions about the quality of client care.
D) explain ongoing medical studies to clients.
ANS: B
Feedback: Nursing research may be conducted by direct care providers or nurse researchers.
The primary purpose of nursing research is to contribute to the scientific base of nursing and
improve nursing practice based on evidence. This consideration supersedes the need to
involve clients in their care, evaluate quality, or explain studies to clients.
PTS: 1 DIF: Moderate REF: Page and Header: 11, Research Role
OBJ: 5
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
11. Home health care is becoming one of the largest practice areas for nursing. What has
contributed to this?
A) Chronic nursing shortage
B) Focus on treatment of disease
C) Increase in hospital stays
D) More critically ill clients being released home
ANS: D
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Test Bank - Brunner and Suddarth's Canadian Textbook of Medical-Surgical Nursing, 4th Edition (El Hussein, 2019)
Feedback: As a result of decreased hospital stays and more critically ill clients being
released to home, home health care is becoming one of the largest practice areas for nursing.
This is not known to be leading to increased hospital stays or a focus on disease treatment.
This phenomenon is not known to exacerbate the nursing shortage.
PTS: 1 DIF: Moderate
REF: Page and Header: 6, Health Care in Transition OBJ: 6
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
12. A nurse is practicing in an oncology clinic. The role of this nurse includes clinical practice,
education, management, consultation, and research. Which of the following would most
accurately describe this nurse’s title?
A) Midwife
B) Clinical nurse specialist
C) Independent practice nurse
D) General duty nurse
ANS: B
Feedback: Clinical nurse specialists practice within a circumscribed area of care (e.g.,
cardiac), and most practice in acute care settings. This goes beyond the focus on a general
duty nurse. Midwives focus solely on obstetrical practice. An independent practice nurse
would not practice in the context of a clinic.
PTS: 1 DIF: Moderate
REF: Page and Header: 11, Advanced Nursing Practice Roles OBJ: 7
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze
13. Which of the following would be an example of an interdisciplinary, advanced practice
model?
A) The nurse and the physician discussing and jointly making clinical decisions
B) The nurse accompanying the physician on rounds
C) The nurse making a referral on behalf of the client
D) The nurse attending an appointment with the client
ANS: A
Feedback: One of the goals of advanced practice models is to increase professional and
collegial relationships with physicians, a phenomenon exemplified by joint decision-making
and discussion. This transcends the formerly unequal roles in nursing, such as simply
accompanying a physician on rounds or making an appointment. Referrals often take place
even when there is no interdisciplinary model in place.
PTS: 1 DIF: Moderate
REF: Page and Header: 11, Advanced Nursing Practice Roles OBJ: 6
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze
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Test Bank - Brunner and Suddarth's Canadian Textbook of Medical-Surgical Nursing, 4th Edition (El Hussein, 2019)
14. The nurse is caring for a client dying of lung cancer. According to Maslow’s hierarchy of
needs, which dimension of care is considered primary in importance when caring for a
dying client?
A) Spiritual
B) Social
C) Physiologic
D) Emotional
ANS: C
Feedback: Physical care is an individual’s most basic need according to Maslow’s hierarchy
of needs. When physiologic needs are met and the client feels comfortable, other
dimensions of care can be addressed. The higher level needs in the domains of emotion,
spirituality, and social interaction cannot be adequately addressed when physiologic needs
remain unmet.
PTS: 1 DIF: Easy
REF: Page and Header: 6, Maslow’s Hierarchy OBJ: 1
NAT: Client Needs: Physiological Integrity: Basic Care and Comfort
TOP: Chapter Number: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: Understand
15. When prioritizing a client’s care plan based on Maslow’s hierarchy of needs, the nurse’s
first priority would be:
A) allowing the family to see a newly admitted client.
B) ambulating the client in the hallway.
C) administering pain medication.
D) using two nurses to transfer the client.
ANS: C
Feedback: In Maslow’s hierarchy of needs, pain relief is on the first layer. Activity (e.g.,
ambulation) is on the second layer. Safety (e.g., using two nurses to transfer a client) is on
the third layer. Love and belonging (e.g., allowing family to see a client) are on the fourth
layer.
PTS: 1 DIF: Moderate
REF: Page and Header: 6, Maslow’s Hierarchy OBJ: 1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply
16. Which of the following statements best captures the way in which responsibility for health
care is organized in Canada?
A) The federal government is responsible for health care but normally consults with
the provinces.
B) Health care is under federal jurisdiction, with daily operations delegated to the
provinces.
C) The provinces are responsible for health care, but coordination on a federal level is
necessary to ensure national policies.
D) Jurisdiction over health is shared equally between the provincial and the federal
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Test Bank - Brunner and Suddarth's Canadian Textbook of Medical-Surgical Nursing, 4th Edition (El Hussein, 2019)
governments.
ANS: C
Feedback: The Constitution Act of 1982 explicitly confirmed that health care is a provincial
responsibility. Coordination at a federal level is often necessary to establish policies that
have a national scope.
PTS: 1 DIF: Moderate
REF: Page and Header: 6, Organization and Financing of Health Care Services in Canada
OBJ: 2
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze
17. Which of the following events runs contrary to the principles of the Canada Health Act?
A) A client is billed for his physiotherapy during his recovery from an ankle injury.
B) A woman from British Columbia is denied coverage in Alberta after she has
moved there owing to a job transfer.
C) Health services are less accessible to a remote village in northern Saskatchewan
than to residents living in Saskatoon.
D) Administrative responsibility for a province’s health care system lies with a public
body.
ANS: B
Feedback: The Canada Health Act dictates that services must be transferable between
provinces. Not all health services (such as physiotherapy) are 100% covered, and although
services must be accessible, some variation between locations is not contrary to the Act.
Administration is public under the Canada Health Act.
PTS: 1 DIF: Moderate
REF: Page and Header: 6, The Canada Health Act OBJ: 2
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter Number: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze
18. How are patterns of disease currently changing in Canada?
A) Chronic diseases are declining as a result of primary health and health promotion.
B) Infectious diseases are more common than in the past owing to economic
disparities.
C) Most noncommunicable diseases are being eradicated.
D) Some previously treatable conditions now have fewer treatment options.
ANS: D
Feedback: Because of increased antibiotic use, many diseases are more difficult to treat than
in the past. Chronic diseases are more common, and infectious diseases less common, than
in the past, and noncommunicable diseases continue to be the leading cause of death.
PTS: 1 DIF: Moderate
REF: Page and Header: 9, Changing Patterns of Disease OBJ: 4
NAT: Client Needs: Health Promotion and Maintenance
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