Test Bank For Lewis’s Medical Surgical Nursing 11th Edition Harding 1 Test Bank For Lewis’s Medical Surgical Nursing 11th Edition Harding 2
Table of Contents Chapter 51: Breast Disorders 650
Chapter 52: Sexually Transmitted InfectionsChapter 662
Table of Contents 1 53: Female Reproductive ProblemsChapter 54: 671
Chapter 01: Professional Nursing 3 Male Reproductive Problems Chapter 55: 693
Chapter 02: Health Equity and Culturally Competent CareChapter 13 Assessment: Nervous System Chapter 56: Acute 708
03: Health History and Physical Examination Chapter 04: Patient 21 Intracranial Problems Chapter 57: Stroke 717
and Caregiver Teaching 28 Chapter 58: Chronic Neurologic ProblemsChapter 734
Chapter 05: Chronic Illness and Older Adults 38 59: Dementia and Delirium 747
Chapter 06: Stress Management 48 Chapter 60: Spinal Cord and Peripheral Nerve ProblemsChapter 61: 763
Chapter 07: Sleep and Sleep Disorders 54 Assessment: Musculoskeletal System 772
Chapter 08: Pain 59 Chapter 62: Musculoskeletal Trauma and Orthopedic SurgeryChapter 787
Chapter 09: Palliative and End of Life Care 71 63: Musculoskeletal Problems 794
Chapter 10: Substance Use Disorders Chapter 11: 79 Chapter 64: Arthritis and Connective Tissue DiseasesChapter 65: 814
Inflammation and Healing Chapter 12: Genetics 91 Critical Care 825
Chapter 13: Immune Responses and TransplantationChapter 14: 101 Chapter 66: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome 845
Infection 105 Chapter 67: Acute Respiratory Failure and Acute Respiratory Distress SyndromeChapter 864
Chapter 15: Cancer 117 68: Emergency and Disaster Nursing 877
Chapter 16: Fluid, Electrolyte, and Acid-Base ImbalancesChapter 129 889
17: Preoperative Care 148
Chapter 18: Intraoperative Care 165
Chapter 19: Postoperative Care 175
Chapter 20: Assessment and Management: Visual Problems Chapter 21: 184
Assessment and Management: Auditory ProblemsChapter 22: Assessment: 196
Integumentary System 216
Chapter 23: Integumentary Problems
Chapter 24: Burns
227
233
Test Bank For
Chapter 25: Assessment: Respiratory System 245
Chapter 26: Upper Respiratory Problems Chapter 27: 259 Lewis’s Medical Surgical
Lower Respiratory Problems Chapter 28: Obstructive 270
Pulmonary Diseases Chapter 29: Assessment: 282 Nursing 11th Edition
Hematologic SystemChapter 30: Hematologic
Problems
305
325
Harding
Chapter 31: Assessment: Cardiovascular SystemChapter 32: 332
Hypertension 353
Chapter 33: Coronary Artery Disease and Acute Coronary Syndrome 364
Chapter 34: Heart Failure 375
Chapter 35: Dysrhythmias 394
Chapter 36: Inflammatory and Structural Heart DisordersChapter 406
37: Vascular Disorders 420
Chapter 38: Assessment: Gastrointestinal SystemChapter 39: 435
Nutritional Problems 450
Chapter 40: Obesity 458
Chapter 41: Upper Gastrointestinal Problems 469
Chapter 42: Lower Gastrointestinal Problems 478
Chapter 43: Liver, Biliary Tract, and Pancreas ProblemsChapter 499
44: Assessment: Urinary System 523
Chapter 45: Renal and Urologic Problems 543
Chapter 46: Acute Kidney Injury and Chronic Kidney DiseaseChapter 47: 553
Assessment: Endocrine System 573
Chapter 48: Diabetes Mellitus 590
Chapter 49: Endocrine Problems 600
Chapter 50: Assessment: Reproductive System 622
642
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Chapter 01: Professional Nursing 3. The nurse completes an admission database and explains that the plan of care and discharge goals will be
developed with the patients input. The patient states, How is this different from what the doctor does? Which
Test Bank response would be most appropriate for the nurse to make?
MULTIPLE CHOICE a. The role of the nurse is to administer medications and other treatments prescribed by your doctor.
1. 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? b. The nurses job is to help the doctor by collecting information and communicating any problems
that occur.
a. The nursing process is a scientific-based method of diagnosing the patients health care problems.
c. Nurses perform many of the same procedures as the doctor, but nurses are with the patients for a
b. The nursing process is a problem-solving tool used to identify and treat patients health care needs. longer time than the doctor.
c. The nursing process is based on nursing theory that incorporates the biopsychosocial nature of d. In addition to caring for you while you are sick, the nurses will assist you to develop an
humans. individualized plan to maintain your health.
d. The nursing process is used primarily to explain nursing interventions to other health care ANS: D
professionals.
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
ANS: B collaborative functions of the nursing role but do not accurately describe the nurses role in the health care
system.
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, DIF: Cognitive Level: Understand (comprehension)
not to establish nursing theory or explain nursing interventions to other health care professionals.
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
DIF: Cognitive Level: Understand (comprehension)
4. A patient who is paralyzed on the left side of the body after a stroke develops a pressure ulcer on the left hip
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment Which nursing diagnosis is most appropriate?
2. The nurse describes to a student nurse how to use evidence-based practice guidelines when caring for
a. Impaired physical mobility related to left-sided paralysis
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. Risk for impaired tissue integrity related to left-sided weakness
b. Patient care is based on clinical judgment, experience, and traditions. c. Impaired skin integrity related to altered circulation and pressure
c. Data are evaluated to show that the patient outcomes are consistently met. d. Ineffective tissue perfusion related to inability to move independently
d. Recommendations are based on research, clinical expertise, and patient preferences. ANS: C
The patients major problem is the impaired skin integrity as demonstrated by the presence of a pressure ulcer.
ANS: D 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
Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician diagnosis is not appropriate for this patient, who already has impaired tissue integrity. The patient does have
expertise. Clinical judgment based on the nurses clinical experience is part of EBP, but clinical decision ineffective tissue perfusion, but the impaired skin integrity diagnosis indicates more clearly what the health
making should also incorporate current research and research-based guidelines. Evaluation of patient outcomes problem is.
is important, but interventions should be based on research from randomized control studies with a large
number of subjects. DIF: Cognitive Level: Apply (application)
DIF: Cognitive Level: Remember (knowledge) TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment 5. 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?
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d. To establish if the patient agrees that the nursing care provided was satisfactory
a. Reassure the patient that these feelings are common for parents.
ANS: A
b. Have the patient call the children to ensure that they are doing well.
Evaluation consists of determining whether the desired patient outcomes have been met and whether the
c. Gather more data about the patients feelings about the child-care arrangements. nursing interventions were appropriate. The other responses do not describe the evaluation phase.
DIF: Cognitive Level: Understand (comprehension)
d. Call the patients parents to determine whether adequate child care is being provided.
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Environment
ANS: C 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?
Since a complete assessment is necessary in order to identify a problem and choose an appropriate
intervention, the nurses first action should be to obtain more information. The other actions may be a. To teach interventions that relieve health problems
appropriate, but more assessment is needed before the best intervention can be chosen.
DIF: Cognitive Level: Apply (application) b. To use patient data to evaluate patient care outcomes
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
c. To obtain data with which to diagnose patient problems
MSC: NCLEX: Psychosocial Integrity
6. A patient with a bacterial infection has a nursing diagnosis of deficient fluid volume related to excessive d. To help the patient identify realistic outcomes for health problems
diaphoresis. Which outcome would the nurse recognize as most appropriate for this patient?
ANS: C
a. Patient has a balanced intake and output.
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.
b. Patients bedding is changed when it becomes damp.
DIF: Cognitive Level: Understand (comprehension)
c. Patient understands the need for increased fluid intake.
TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment
d. Patients skin remains cool and dry throughout hospitalization. 9. Which nursing diagnosis statement is written correctly?
a. Altered tissue perfusion related to heart failure
ANS: A
This statement gives measurable data showing resolution of the problem of deficient fluid volume that was b. Risk for impaired tissue integrity related to sacral redness
identified in the nursing diagnosis statement. The other statements would not indicate that the problem of
deficient fluid volume was resolved.
c. Ineffective coping related to response to biopsy test results
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity d. Altered urinary elimination related to urinary tract infection
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? ANS: C
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes a patients
a. To determine if interventions have been effective in meeting patient outcomes 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.
b. To document the nursing care plan in the progress notes of the medical record
DIF: Cognitive Level: Understand (comprehension)
c. To decide whether the patients health problems have been completely resolved
TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care Environment
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10. The nurse admits a patient to the hospital and develops a plan of care. What components should the nurse c. Check for the presence of bowel sounds and flatulence by UAP
include in the nursing diagnosis statement?
d. Care of a patient with diabetes by RN who usually works on the pediatric unit
a. The problem and the suggested patient goals or outcomes
ANS: C
b. The problem with possible causes and the planned interventions
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.
c. The problem, its cause, and objective data that support the problem
DIF: Cognitive Level: Apply (application)
d. The problem with an etiology and the signs and symptoms of the problem OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
ANS: D
13. Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/LVN)?
When writing nursing diagnoses, this format should be used: problem, etiology, and signs and 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. a. Complete the initial admission assessment and plan of care.
DIF: Cognitive Level: Remember (knowledge)
b. Document teaching completed before a diagnostic procedure.
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 c. Instruct a patient about low-fat, reduced sodium dietary restrictions.
experienced unlicensed assistive personnel (UAP)?
d. Obtain bedside blood glucose on a patient before insulin administration.
a. Monitor for shortness of breath or fatigue after ambulation.
ANS: D
b. Instruct the patient about the need to alternate activity and rest.
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
c. Obtain the patients blood pressure and pulse rate after ambulation. actions that require registered nurse education and scope of practice.
DIF: Cognitive Level: Apply (application)
d. Determine whether the patient is ready to increase the activity level.
OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
ANS: C MSC: NCLEX: Safe and Effective Care Environment
UAP education includes accurate vital sign measurement. Assessment and patient teaching require registered 14. A nurse is assigned as a case manager for a hospitalized patient with a spinal cord injury. The patient can
nurse education and scope of practice and cannot be delegated. expect the nurse functioning in this role to perform which activity?
DIF: Cognitive Level: Apply (application)
a. Care for the patient during hospitalization for the injuries.
OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment b. Assist the patient with home care activities during recovery.
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 c. Determine what medical care the patient needs for optimal rehabilitation.
(LPN/LVN). Which assignment, if delegated by the nurse, would be inappropriate?
d. Coordinate the services that the patient receives in the hospital and at home.
a. Measurement of a patients urine output by UAP
ANS: D
b. Administration of oral medications by LPN/LVN
The role of the case manager is to coordinate the patients care through multiple settings and levels of care to
