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FULL TEST BANK
TEST BANK FOR MEDICAL SURGICAL NURSING,
10TH EDITION, DONNA D. IGNATAVICIUS, LINDA
WORKMAN, CHERIE R. REBAR & NICOLE M.
HEIMGARTNER




1

,TABLE OF CONTENTS

Section I: Concepts of medical-Surgical NURSING
1. Overview of Professional Nursing Concepts for Medical-Surgical Nursing
2. Clinical Judgment and Systems Thinking
3. Overview of Health Concepts for Medical-Surgical NURSING
4. Common Health Problems of Older Adults
5. Assessment and Care of Patients With Pain
6. Concepts of Genetics and Genomics
7. Concepts of Rehabilitation for Chronic and Disabling Health
8. Concepts of Care for Patients at End of Life
9. Concepts of Care for Perioperative Patients

Section II: Concepts of Emergency Care and Disaster Preparedness
10. Concepts of Emergency and Trauma NURSING
11. Concepts of Care for Patients With Common Environmental Emergencies
12. Concepts of Disaster Preparedness

Section III: Concepts of patients with Problems of Fluid, Electrolyte, and Acid-
Base Balance
13. Concepts of Fluid and Electrolyte Balance
14. Concepts of Acid–Base Balance
15. Concepts of Infusion Therapy

Section IV: Interprofessional Collaboration for Patients with Problems of
Immunity
16. Concepts of Inflammation and Immunity
17. Concepts of Care for Patients With HIV Disease
18. Concepts of Care for Patients With Hypersensitivity (Allergy) and Autoimmunity
19. Concepts of Cancer Development
20. Concepts of Care for Patients With Cancer
21. Concepts of Care for Patients With Infection

Section V: Interprofessional Collaboration for Patients with Problems of Skin,
Hair and Nails
22. Assessment of the Skin, Hair, and Nails
23. Concepts of Care for Patients With Skin Problems

Section VI: Interprofessional Collaboration for Patients with Problems of
Respiratory System
24. Assessment of the Respiratory System
25. Concepts of Care for Patients Requiring Oxygen Therapy or Tracheostomy
26. Concepts of Care for Patients With Noninfectious Upper Respiratory Problems
27. Concepts of Care for Patients With Noninfectious Lower Respiratory Problems
28. Concepts of Care for Patients With Infectious Respiratory Problems
2

,29. Critical Care of Patients With Respiratory Emergencies


Section VII: Interprofessional Collaboration for Patients with Problems of the
Cardiovascular System
30. Assessment of the Cardiovascular System
31. Concepts of Care for Patients With Dysrhythmias
32. Concepts of Care for Patients With Cardiac Problems
33. Concepts of Care for Patients With Vascular Problems
34. Critical Care of Patients With Shock
35. Critical Care of Patients With Acute Coronary Syndromes

Section VIII: Interprofessional Collaboration for Patients with Problems of the
Hematologic System
36. Assessment of the Hematologic System
37. Concepts of Care for Patients With Hematologic Problems

Section IX: Interprofessional Collaboration for Patients with Problems of the
Nervous System
38. Assessment of the Nervous System
39. Care for Patients With Problems of the Central Nervous System: The Brain
40. Care for Patients With Problems of the Central Nervous System: The Spinal Cord
41. Critical Care of Patients With Neurologic Emergencies

Section X: Interprofessional Collaboration for Patients with Problems of the
Sensory System
42. Assessment and Care of Patients With Eye and Vision Problems
43. Assessment and Care of Patients With Ear and Hearing Problems

Section XI: Interprofessional Collaboration for Patients with Problems of the
Musculoskeletal System
44. Assessment of the Musculoskeletal System
45. Concepts of Care for Patients With Musculoskeletal Problems
46. Concepts of Care for Patients With Arthritis and Total Joint Arthroplasty
47. Concepts of Care for Patients With Musculoskeletal Trauma

Section XII: Interprofessional Collaboration for Patients with Problems of the
Gastrointestinal System
48. Assessment of the Gastrointestinal System
49. Concepts of Care for Patients With Oral Cavity and Esophageal Problems
50. Concepts of Care for of Patients With Stomach Disorders
51. Concepts of Care for Patients With Noninflammatory Intestinal Disorders
52. Concepts of Care for Patients With Inflammatory Intestinal Disorders
53. Concepts of Care for Patients With Liver Problems
54. Concepts of Care for Patients With Problems of the Biliary System and Pancreas
3

,55. Concepts of Care for Patients With Malnutrition: Undernutrition and Obesity

Section XIII: Interprofessional Collaboration for Patients with Problems of the Endocrine
System
56. Assessment of the Endocrine System
57. Concepts of Care for Patients With Pituitary and Adrenal Gland Problems
58. Concepts of Care for Patients With Problems of the Thyroid and Parathyroid Glands
59. Concepts of Care for Patients With Diabetes Mellitus

Section XIV: Interprofessional Collaboration for Patients with Problems of the Rena/Urinary
System
60. Assessment of the Renal/Urinary System
61. Concepts of Care for Patients With Urinary Problems
62. Concepts of Care for Patients with Kidney Disorders
63. Concepts of Care for Patients with Acute Kidney Injury and Chronic Kidney Disease

Section XV: Interprofessional Collaboration for Patients with Problems of the Reproductive
System
64. Assessment of the Reproductive System
65. Concepts of Care for Patients with Breast Disorders
66. Concepts of Care for Patients With Gynecologic Problems
67. Concepts of Care for Clients With Male Reproductive Problems
68. Concepts of Care for Transgender Patients
69. Concepts of Care for Patients With Sexually Transmitted Infections




4

,Chapter 01: Overview Of Professional Nursing Concepts For Medical-Surgical
Nursing Ignatavicius: Medical-Surgical Nursing, 10th Edition


MULTIPLE CHOICE

1. A New Nurse Is Working With A Preceptor On A Medical-Surgical Unit. The Preceptor
Advises TheNew Nurse That Which Is The Priority When Working As A Professional
Nurse?
a. Attending To Holistic Client Needs
b. Ensuring Client Safety
c. Not Making Medication Errors
d. Providing Client-Focused Care
ANS: B
All Actions Are Appropriate For The Professional Nurse. However, Ensuring Client Safety Is
ThePriority. Health Care Errors Have Been Widely Reported For 25 Years, Many Of Which
Result InClient Injury, Death, And Increased Health Care Costs. There Are Several National
And International Organizations That Have Either Recommended Or Mandated Safety
Initiatives.
Every Nurse Has The Responsibility To Guard The Client’s Safety. The Other Actions Are
Important For Quality Nursing, But They Are Not As Vital As Providing Safety. Not Making
Medication Errorsdoes Provide Safety, But Is Too Narrow In Scope To Be The Best Answer.

DIF: Understanding TOP: Integrated Process: NURSING Process:
Interventionkey: Client Safety
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control

2. A Nurse Is Orienting A New Client And Family To The Medical-Surgical Unit. What
InformationDoes The Nurse Provide To Best Help The Client Promote His Or Her Own
Safety?
a. Encourage The Client And Family To Be Active Partners.
b. Have The Client Monitor Hand Hygiene In Caregivers.
c. Offer The Family The Opportunity To Stay With Theclient.
d. Tell The Client To Always Wear His Or Her Armband.
ANS: A
Each Action Could Be Important For The Client Or Family To Perform. However,
Encouraging The Client To Be Active In His Or Her Health Care As A Safety Partner Is The
Most Critical. The Other Actions Are Very Limited In Scope And Do Not Provide The Broad
Protection That Being Active AndInvolved Does.

DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Client Safety
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control

3. A Nurse Is Caring For A Postoperative Client On The Surgical Unit. The Client’s Blood
Pressure Was 142/76 Mm Hg 30 Minutes Ago, And Now Is 88/50 Mm Hg. What Action
Would The NurseTake First?
a. Call The Rapid Response Team.
b. Document And Continue To Monitor.
c. Notify The Primary Health Provider
d. Repeat The Blood Pressure In 15 Minutes.
ANS: A
5

, The Purpose Of The Rapid Response Team (RRT) Is To Intervene When Clients Are
DeterioratingBefore They Suffer Either Respiratory Or Cardiac Arrest. Since The Client Has
Manifested A Significant Change, The Nurse Would Call The RRT. Changes In Blood
Pressure, Mental Status, Heart Rate, Temperature, Oxygen Saturation, And Last 2 Hours’
Urine Output Are Particularly Significant And Are Part Of The Modified Early Warning
System Guide. Documentation Is Vital, But The Nurse Must Do More Than Document. The
Primary Health Care Provider Would Be Notified, But This Is Not More Important Than
Calling The RRT. The Client’s Blood Pressure Would Be Reassessed Frequently, But The
Priority Is Getting The Rapid Care To The Client.

DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Rapid Response Team (RRT), Clinical Judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation

4. A Nurse Wishes To Provide Client-Centered Care In All Interactions. Which Action By The
Nurse
Best Demonstrates This Concept?
a. Assesses For Cultural Influences Affecting Health Care.
b. Ensures That All The Client’s Basic Needs Are Met.
c. Tells The Client And Family About All Upcoming Tests.
d. Thoroughly Orients The Client And Family To Theroom.
ANS: A
Showing Respect For The Client And Family’s Preferences And Needs Is Essential To
Ensure A Holistic Or “Whole-Person” Approach To Care. By Assessing The Effect Of The
Client’s Culture OnHealth Care, This Nurse Is Practicing Client-Focused Care. Providing
For Basic Needs Does Not Demonstrate This Competence. Simply Telling The Client About
All Upcoming Tests Is Not Providing Empowering Education. Orienting The Client And
Family To The Room Is An ImportantSafety Measure, But Not Directly Related To
Demonstrating Client-Centered Care.

DIF: Understanding TOP: Integrated Process: Culture And Spirituality
KEY: Client-Centered Care, Culture MSC: Client Needs Category: Psychosocial Integrity

5. A Client Is Going To Be Admitted For A Scheduled Surgical Procedure. Which Action
Does TheNurse Explain Is The Most Important Thing The Client Can Do To Protect
Against Errors?
a. Bring A List Of All Medications And What They Are For.
b. Keep The Provider’s Phone Number By The Telephone.
c. Make Sure That All Providers Wash Hands Before Entering The Room.
d. Write Down The Name Of Each Caregiver Who Comes In The Room.
ANS: A
Medication Reconciliation Is A Formal Process In Which The Client’s Actual Current
MedicationsAre Compared To The Prescribed Medications At The Time Of Admission,
Transfer, Or Discharge. This National Client Safety Goal Is Important To Reduce
Medication Errors. The Client Would Not Have To Be Responsible For Providers Washing
Their Hands, And Even If The Client Does So, This Is Too Narrow To Be The Most
Important Action To Prevent Errors. Keeping The Provider’s Phone Number Nearby And
Documenting Everyone Who Enters The Room Also Do Not Guarantee Safety.

DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Client Safety, Informatics
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control


6

, ANS: A
The Purpose Of The Rapid Response Team (RRT) Is To Intervene When Clients Are
DeterioratingBefore They Suffer Either Respiratory Or Cardiac Arrest. Since The Client Has
Manifested A Significant Change, The Nurse Would Call The RRT. Changes In Blood
Pressure, Mental Status, Heart Rate, Temperature, Oxygen Saturation, And Last 2 Hours’
Urine Output Are Particularly Significant And Are Part Of The Modified Early Warning
System Guide. Documentation Is Vital, But The Nurse Must Do More Than Document. The
Primary Health Care Provider Would Be Notified, But This Is Not More Important Than
Calling The RRT. The Client’s Blood Pressure Would Be Reassessed Frequently, But The
Priority Is Getting The Rapid Care To The Client.

DIF: Applying TOP: Integrated Process: Communication And
DocumentationKEY: Rapid Response Team (RRT), Clinical Judgment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation

6. A Nurse Wishes To Provide Client-Centered Care In All Interactions. Which Action By The
Nurse
Best Demonstrates This Concept?
a. Assesses For Cultural Influences Affecting Health Care.
b. Ensures That All The Client’s Basic Needs Are Met.
c. Tells The Client And Family About All Upcoming Tests.
d. Thoroughly Orients The Client And Family To Theroom.
ANS: A
Showing Respect For The Client And Family’s Preferences And Needs Is Essential To
Ensure A Holistic Or “Whole-Person” Approach To Care. By Assessing The Effect Of The
Client’s Culture OnHealth Care, This Nurse Is Practicing Client-Focused Care. Providing
For Basic Needs Does Not Demonstrate This Competence. Simply Telling The Client About
All Upcoming Tests Is Not Providing Empowering Education. Orienting The Client And
Family To The Room Is An ImportantSafety Measure, But Not Directly Related To
Demonstrating Client-Centered Care.

DIF: Understanding TOP: Integrated Process: Culture And Spirituality
KEY: Client-Centered Care, Culture MSC: Client Needs Category: Psychosocial Integrity

7. A Client Is Going To Be Admitted For A Scheduled Surgical Procedure. Which Action
Does TheNurse Explain Is The Most Important Thing The Client Can Do To Protect
Against Errors?
a. Bring A List Of All Medications And What They Are For.
b. Keep The Provider’s Phone Number By The Telephone.
c. Make Sure That All Providers Wash Hands Before Entering The Room.
d. Write Down The Name Of Each Caregiver Who Comes In The Room.
ANS: A
Medication Reconciliation Is A Formal Process In Which The Client’s Actual Current
MedicationsAre Compared To The Prescribed Medications At The Time Of Admission,
Transfer, Or Discharge. This National Client Safety Goal Is Important To Reduce
Medication Errors. The Client Would Not Have To Be Responsible For Providers Washing
Their Hands, And Even If The Client Does So, This Is Too Narrow To Be The Most
Important Action To Prevent Errors. Keeping The Provider’s Phone Number Nearby And
Documenting Everyone Who Enters The Room Also Do Not Guarantee Safety.

DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Client Safety, Informatics
MSC: Client Needs Category: Safe And Effective Care Environment: Safety And Infection Control
7

, 8. Which Action By The Nurse Working With A Client Best Demonstrates Respect For Autonomy?
a. Asks If The Client Has Questions Before Signing A Consent.
b. Gives The Client Accurate Information When Questioned.
c. Keeps The Promises Made To The Client And Family.
d. Treats The Client Fairly Compared To Otherclients.
ANS: A
Autonomy Is Self-Determination. The Client Would Make Decisions Regarding Care. When
The Nurse Obtains A Signature On The Consent Form, Assessing If The Client Still Has
Questions Is Vital,Because Without Full Information The Client Cannot Practice Autonomy.
Giving Accurate Information Is Practicing With Veracity. Keeping Promises Is Upholding
Fidelity. Treating The Client Fairly Is Providing Social Justice.

DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, Autonomy
MSC: Client Needs Category: Safe And Effective Care Environment: Management Of
Care

9. A Nurse Asks A More Seasoned Colleague To Explain Best Practices When Communicating
With APerson From The Lesbian, Gay, Bisexual, Transgender, And Questioning/Queer
(LGBTQ) Community. What Answer By The Faculty Is Most Accurate?
a. Avoid Embarrassing The Client By Asking Questions.
b. Don’t Make Assumptions About His Or Her Health Needs.
c. Most LGBTQ People Do Not Want To Share Information.
d. No Differences Exist In Communicating With This Population.

ANS: B
Many Members Of The LGBTQ Community Have Faced Discrimination From Health Care
Providers And May Be Reluctant To Seek Health Care. The Nurse Would Never Make
Assumptions About The Needs Of Members Of This Population. Rather, Respectful
Questions Are Appropriate. IfApproached With Sensitivity, The Client With Any Health
Care Need Is More Likely To Answer Honestly.

DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Health Care Disparities, LGBTQ MSC: Client Needs Category: Psychosocial Integrity

10. A Nurse Is Calling The On-Call Health Care Provider About A Client Who Had A
Hysterectomy 2Days Ago And Has Pain That Is Unrelieved By The Prescribed Opioid
Pain Medication. Which Statement Comprises The Background Portion Of The SBAR
Format Forcommunication?
a. “I Would Like You To Order A Different Pain Medication.”
b. “This Client Has Allergies To Morphine And Codeine.”
c. “Dr. Smith Doesn’t Like Nonsteroidal Anti-Inflammatorymeds.”
d. “This Client Had A Vaginal Hysterectomy 2 Days Ago.”
ANS: B




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