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Medical_Surgical_Nursing_Critical_Thinking_in_Client_Care__4th_Edition_Priscilla LeMon Test Bank |ALL CHAPTERS COVERED| COMPLETE GUIDE WITH RATIONALES 2024$17.99
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Medical_Surgical_Nursing_Critical_Thinking_in_Client_Care__4th_Edition_Priscilla LeMon Test Bank |ALL CHAPTERS COVERED| COMPLETE GUIDE WITH RATIONALES 2024
Medical_Surgical_Nursing_Critical_Thinking_in_Client_Care__4th_Edition_Priscilla LeMon Test Bank |ALL CHAPTERS COVERED| COMPLETE GUIDE WITH RATIONALES 2024
Medical_Surgical_Nursing_Critical_Thinking_in_Client_Care__4th_Edition_Priscilla LeMon Test Bank |ALL CHAPTERS COVERED| COMPLETE GUIDE WIT...
Medical_Surgical_Nursing_Critical_Thinking_in_Client_Care__4th_Edition_
Priscilla LeMon ALL CHAPTERS COVERED COMPLETE GUIDE
WITH RATIONALES 2024
,Chapter 1
1. The nurse practitioner is caring for four patients on a medical–surgical unit. Which
patient should the nurse practitioner see initially?
1.
A patient admitted with hepatitis A who has had severe diarrhea for
the last 24 hours
2. A patient admitted with pneumonia who is has small amounts
of yellow productive sputum
3.
A patient admitted with fever of unknown origin (FUO) who
has been without fever for the last 48 hours
4.
A patient admitted with a wound infection whose WBC is 8,500 mm3
CORRECT: 1
Feedback: The nurse practitioner must decide which patient should be seen on the initial
rounds of the day. The nurse practitioner must remember that the first patient to
be seen should be the patient who needs the attention of the nurse practitioner
initially. A patient with hepatitis A does experience diarrhea, but diarrhea for the
last 24 hours could cause the patient to have a problem with dehydration and
experience a state of fluid volume deficit.
2. The nurse practitioner is preparing to administer influenza vaccines to a mass drive-
through clinic. Which statement by a patient would indicate further questioning prior to
giving the patient the influenza vaccine?
1. “I am allergic to horse hair.”
2. “I try to get my vaccine every year.”
3. “I am not allergic to anything except eggs.”
4. “My husband had a severe allergic reaction after he received his influenza
vaccine.”
CORRECT: 3
Feedback: Influenza vaccines are recommended for person at high risk for serious
sequelae of influenza. The nurse practitioner should be aware that patient with a
sensitivity to eggs should not receive the vaccine. Vaccines prepared from
chicken or duck embryos are contraindicated in patients who are allergic to eggs.
Cognitive Level: Application
Patient Needs: Safe, Effective Care Environment
,Nursing Process: Assessment
3. The nurse practitioner is caring for four patients on a medical–surgical unit. The
secretary gives the nurse practitioner the morning labs. Which of the following labs would
require that the nurse practitioner call the physician and inform the healthcare provider
about the patient’s abnormalities?
1. WBC 14,600 mm3
2. Serum protein 6.9 g/dL
3.
I & D (incision and drainage) showing no growth for the last 24 hours
4.
Albumin 4.2 g/dL
CORRECT: 1
Feedback: When the nurse practitioner is caring for several patients, all of the labs should
be checked frequently throughout the shift to assess for any abnormalities. The WBC in
option 1 is abnormal. (Normal WBC 4,000–10,000 mm3.) All of the other lab results are
within acceptable range; therefore, the results should not be called in to the physician.
4. The nurse practitioner is orienting a new graduate. The nurse practitioner is
reinforcing the importance of standard precautions. Which of the following
observations by the nurse practitioner would require further education regarding
standard precautions?
1. The graduate nurse practitioner understands to wash hands when
entering and exiting the patient’s room.
2. The graduate nurse practitioner wears gloves when serving
breakfast trays to various patients.
3. The graduate nurse practitioner wears a gown, gloves, and goggles
when suctioning a patient.
4. The graduate nurse practitioner leaves all supplies in the room of a
patient who is in contact isolation.
CORRECT: 2
Feedback: The nurse practitioner must have an understanding of standard precautions.
Prevention is the most important measure to prevent nosocomial infections.
Standard precautions were published in 1996 that provide guidelines for the
handling of blood and other body fluids. These guidelines are used with all
patients, regardless of whether they have a known infectious disease. Standard
precautions are used by all healthcare workers who have direct contact with
patients or with their body
, fluids. It is not necessary for the nurse practitioner to wear gloves while delivering
food trays to the patient, because there is not contact with the patient.
5. The admitting department alerts the nurse practitioner on a medical–surgical unit that
a patient with active tuberculosis (TB) is being admitted to the unit. Which type of
isolation is appropriate based on the patient’s diagnosis?
In addition to handwashing and standard precautions, the nature and spread of some
infectious diseases require that special techniques be used to protect uninfected patients
and workers. The patient with pulmonary tuberculosis will be placed in airborne
precautions. The patient should be placed in a private room with special ventilation that
does not allow air to circulate to general hospital ventilation; a mask or special filter
respirators will be used for everyone entering the room.
6. A patient is receiving IV vancomycin for the treatment of Clostridium difficile.
The nurse practitioner understands that the patient who develops flushing,
tachycardia, and hypotension during the infusion of vancomycin indicates:
1. Ototoxicity effect.
2. Superinfection.
3. Red man syndrome.
4. Hives.
CORRECT: 3
Feedback: Vancomycin inhibits cell wall synthesis, and is used for serious infections. It is
only effective against gram-positive bacteria, especially Staphylococcus aureus and
Staphylococcus epidermidis. The nurse practitioner should infuse this medication slowly
over 60 minutes or more to avoid “red man” syndrome. The syndrome is characterized by
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