Test Bank For Phipps Medical Surgical 8th Editin By Monahan

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Monahan Phipps Medical Surgical 8th

Monahan: Phipps’ Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 1: Scope of Medical-Surgical Nursing

 

MULTIPLE CHOICE

 

  1.    A current trend in American society that will impact future nursing practice is:
1. More physicians graduating from medical schools
2. Increased need for child day care
3. Growth of the elderly population
4. Increased inpatient services

 

 

ANS: 3                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1.    A major factor in rising health care costs is:
1. High-technology health care
2. Workplace violence
3. Prevention care
4. Nursing salaries

 

 

ANS: 1                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Health Promotion and Maintenance

 

  1.    Health care in industrialized countries other than the United States differs from U.S. health care in that other industrialized countries:
1. Provide health insurance for everyone with a full-time job
2. Have more highly qualified physicians
3. Have healthier citizens
4. Guarantee basic health care to all

 

 

ANS: 4                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Health Promotion and Maintenance

 

  1.    One major factor in the current nursing shortage is:
1. A growing pool of inactive nurses
2. Ineffective international recruitment
3. Elevated entrance standards in nursing programs
4. More women pursuing medical rather than nursing degrees

 

 

ANS: 2                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Health Promotion and Maintenance

 

  1.    In an effort to reduce cost, health care delivery has shifted to which type of care?
1. Emergent
2. Episodic–acute
3. Hospital-based
4. Community-based

 

 

ANS: 4                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1.    The aspect of current hospital nursing practice that nurses most frequently express dissatisfaction with is:
1. Decline in the caring aspect of nursing
2. Lack of autonomy in delivering nursing care
3. Increasing complexity of patient care
4. Rapid advances in technology

 

 

ANS: 1                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Psychosocial Integrity

 

Monahan: Phipps’ Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 3: Healthy Lifestyles

MULTIPLE CHOICE

 

  1.    During a regular physical examination, a clinical nurse specialist counsels a patient on tobacco cessation. This type of preventive action is classified as:
1. Primary
2. Secondary
3. Tertiary
4. Screening

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Respiratory

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1.   Which of the following is a form of secondary prevention?
1. Tetanus booster
2. 10-pound weight loss
3. Mammography and Pap smear
4. Physical therapy for a neck strain

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Women’s health

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1.    Which meal selection coincides most closely with the Healthy People 2010 goals for nutrition?
1. Vegetable lasagna, lettuce salad, whole wheat roll, 2% milk
2. 6-oz pork chop, creamed peas, au gratin potatoes, coffee
3. BLT sandwich, french fries, 8-oz whole milk
4. Pasta alfredo, garlic bread, 8-oz cola

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Gastrointestinal

TOP:  Nursing Process: Planning             MSC: Client Needs: Health Promotion and Maintenance

 

  1.   A patient’s 24-hour diet history includes four servings of bread, three servings of fruit, one serving of vegetables, three servings of beef or chicken, and one glass of whole milk. A nurse concludes that the diet is:
1. Low in complex carbohydrates, vegetables, and milk products
2. Meeting requirements of the Food Guide Pyramid
3. Adequate for all food groups except vegetables
4. Low in milk products, proteins, and fruits

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Gastrointestinal

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1.    A 56-year-old man with a 45-year history of smoking expresses a desire to quit smoking. An appropriate nursing diagnosis is:
1. Ineffective individual coping related to stress
2. Health-seeking behavior (desire to quit smoking)
3. Ineffective health maintenance related to inadequate support system
4. Impaired gas exchange related to decreased functional lung tissue

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Respiratory

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Health Promotion and Maintenance

 

  1.    An appropriate weight reduction goal for any obese adult would be:
1. Reduce body fat to approximately 25%
2. Limit calories to 900 per day
3. Increase physical activity
4. Lose 5 pounds per week

 

 

ANS: 3                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Planning             MSC: Client Needs: Physiological Integrity

 

  1.   A 50-year-old woman is planning an exercise program. Her target heart rate for exercise should be:
1. 100 to 120 beats/min
2. 119 to 145 beats/min
3. 38 to 166 beats/min
4. 180 to180 beats/min

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.    Which exercise plan reflects basic health goals for cardiovascular fitness?
1. Low-impact aerobics for 60 minutes once a week
2. Brisk walking for 20 minutes four times a week
3. Bicycling for 30 minutes every weekend
4. Weight lifting once a week

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Planning             MSC: Client Needs: Health Promotion and Maintenance

 

  1.    When planning care for a middle-aged man with insomnia, it might be helpful to include:
1. Vigorous exercise before bedtime to promote fatigue
2. A relaxing activity before bedtime, such as reading
3. Afternoon naps to avoid extremes in fatigue
4. A hearty bedtime snack

 

 

ANS: 2                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Planning             MSC: Client Needs: Physiological Integrity

 

  1.   A 55-year-old man stops taking his antihypertensive medication because his blood pressure has been normal. To promote adherence to the therapeutic regimen, the nurse should:
1. Instruct his wife to administer the medication
2. Ask family members to remind and monitor him
3. Review the rationale for taking blood pressure medication with the patient
4. Contract with the patient to take the medication if his blood pressure becomes elevated again

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Planning             MSC: Client Needs: Health Promotion and Maintenance

 

  1.   Instruction on the safe use of nicotine gum should include teaching the patient that:
1. She or he should gradually reduce smoking while chewing the gum
2. She or he should chew the gum until “peppery” taste appears, then discard
3. Chewing too quickly can cause dizziness
4. Soreness of the mouth is expected

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Respiratory

TOP:  Nursing Process: Planning             MSC: Client Needs: Health Promotion and Maintenance

Monahan: Phipps’ Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 11: Community-Based Care

 

MULTIPLE CHOICE

 

  1. The major driving force behind growth in community-based care is:
1. Hospital-based costs
2. Quality of acute care
3. Increased rate of recovery
4. Rising incidence of in-hospital infection

 

 

ANS: 1                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1. A client requires physical therapy and speech therapy following hospital discharge. An essential initial question for the health care team to ask is:
1. How close to the rehabilitation center does the client live?
2. Are family members willing to care for the client at home?
3. Where does the client transact financial business?
4. Who has power of attorney?

 

 

ANS: 2                    PTS:   1

DIF:   Category: Emotional needs related to health problems

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which activity is essential to preventing a gap in home care services following discharge from an acute care setting?
1. Purchase of supplemental insurance by the patient
2. Commencement of discharge planning upon admission of patient
3. Prediction of total days of home care services required
4. Integration of family into planning process once the patient is discharged

 

 

ANS: 2                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Planning             MSC: Client Needs: Health Promotion and Maintenance

 

  1. The wife of a homebound patient states how difficult it is to care for her husband. The most appropriate response by the nurse is to:
1. Schedule the home health aide to come more often
2. Further assess reactions of all family members
3. Arrange for food and cleaning services
4. Refer her to a caregiver support group

 

 

ANS: 2                    PTS:   1

DIF:   Category: Emotional needs related to health problems

TOP:  Nursing Process: Implementation  MSC: Client Needs: Psychosocial Integrity

 

  1. During an initial phone contact with a patient, a home care nurse gives her name, a phone number, and the agency she represents, and negotiates an arrival time. An important question the nurse has omitted to ask in this initial interaction is:
1. How many family members will be there when she visits?
2. Does the home have a personal computer?
3. Which pharmacy does the family use?
4. How should she enter the home?

 

 

ANS: 4                    PTS:   1

DIF:   Category: Emotional needs related to health problems

TOP:  Nursing Process: Implementation  MSC: Client Needs: Psychosocial Integrity

 

  1. Which is an example of a behaviorally oriented education program to enhance self-care in the home?
1. Providing the family with handouts on self care
2. Teaching whatever information the client wants to learn first
3. Reinforcing on each visit what was taught on each previous visit
4. Asking where to place the nightstand to facilitate personal hygiene

 

 

ANS: 4                    PTS:   1

DIF:   Category: Emotional needs related to health problems

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. A mother of three teenage children is caring for a child with a brain tumor. Which factor will most likely have a negative impact on the mother’s ability to cope?
1. Length of time home care is required
2. Ability of her child to participate in care
3. Amount of personal care her child requires
4. Demands placed on her by the other children

 

 

ANS: 1                    PTS:   1

DIF:   Category: Emotional needs related to health problems

TOP:  Nursing Process: Assessment        MSC: Client Needs: Psychosocial Integrity

 

  1. The family caregiver of a woman in the advanced stages of COPD tells the home care nurse that he is depressed and very fatigued. The nurse should:
1. Assure the caregiver that he is doing a good job
2. Call the family pastor to arrange for care volunteers
3. Assess awareness of and openness to the possibility of external support
4. Make arrangements to transfer the client to a long-term care facility

 

 

ANS: 3                    PTS:   1

DIF:   Category: Emotional needs related to health problems

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which chart entry best reflects the essential elements for home care documentation?
1. “Provided emotional support to patient and family”
2. “Client ambulated to the kitchen with walker; gait steady”
3. “Increased dyspnea; unable to manage portable O2; arranged for O2 concentrator”
4. “Gained 3 pounds after 1 week on TPN therapy; swallowing continues to improve”

 

 

ANS: 3                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. The largest group of clients treated in the home environment are those who have:
1. Cancer
2. Diabetes
3. Peripheral vascular disease
4. Chronic obstructive pulmonary disorder

 

 

ANS: 1                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which criterion is essential for Medicare to pay for posthospital home care services?
1. Care is intermittent.
2. The client is over 65 years old.
3. Skilled nursing care is not required.
4. Services are not covered by any other insurance policy.

 

 

ANS: 1                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Safe Effective Care Environment

 

Monahan: Phipps’ Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 21: Immunologic Problems

 

MULTIPLE CHOICE

 

  1. The patient at greatest risk for suppressed immunity is the patient who:
1. Is receiving chemotherapy for cancer
2. Is recovering from an appendectomy
3. Has been exposed to chickenpox
4. Has a history of allergies

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Persons with B-cell deficiencies experience reduced:
1. Ability to stop the immune response
2. Numbers of circulating antibodies
3. Production of white blood cells
4. Myoglobulin levels

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which are diagnostic tests for immunodeficiency?
1. Antibody titer, bone scan
2. White blood cell count, hematocrit
3. Erythrocyte sedimentation rate, antibody titer
4. Complete blood count, serologic culture

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Persons visiting an immunodeficient patient are advised to:
1. Leave if the patient begins coughing or sneezing
2. Make sure their immunizations are up to date
3. Wash their hands before entering the room
4. Wear gloves before touching the patient

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which is an appropriate gift for a neutropenic patient?
1. Potted mums
2. Fresh-cut flowers
3. A basket of fresh fruit
4. Flavored bottled water

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Planning             MSC: Client Needs: Safe Effective Care Environment

 

  1. Multiple myeloma is characterized by:
1. Hypokalemia and leukopenia
2. Hypercalcemia and hypouricemia
3. Hypocalcemia and hyperuricemia
4. Thrombocytopenia and hyperkalemia

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which is the best diet for a person with multiple myeloma?
1. High-phosphate, low-magnesium diet
2. High-potassium, high-fluid diet
3. High-calcium, low-purine diet
4. Low-calcium, low-purine diet

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Planning             MSC: Client Needs: Safe Effective Care Environment

 

  1. Which manifestations are typical of type I systemic anaphylaxis?
1. Dyspnea, wheezing, laryngeal edema
2. Itching, hypertension, tachycardia
3. Labored breathing, rales, hives
4. Nausea, diaphoresis, chest pain

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which drug is used during initial treatment for systemic anaphylaxis?
1. Dobutamine 250 mg IV
2. Diphenhydramine 50 mg IM
3. 1:1000 epinephrine 0.3 ml SC
4. Methylprednisolone 300 mg IV

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Hyposensitization therapy is most successful when used for persons who are allergic to:
1. Snake venom and foods
2. Shellfish and bee stings
3. Pollens and house dust
4. Trees and grasses

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Planning             MSC: Client Needs: Physiological Integrity

 

  1. Which objective data support the presence of hypersensitivity?
1. Reported exposure to a known allergen
2. Complaints of chest tightness
3. Familial history of allergies
4. Audible wheezing

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.   Which nursing action facilitates effective airway clearance during an allergic reaction?
1. Turing the patient to the side
2. Increasing the patient’s fluid intake
3. Placing the patient in a high Fowler’s position
4. Percussing the patient’s back during coughing episodes

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which is a clinical example of a type II hypersensitivity reaction?
1. Blood transfusion reaction
2. Rash from poison ivy
3. Serum sickness
4. Hay fever

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which blood can the person with Rh-negative, type O blood receive safely?
1. A, B, AB, or O
2. A, B, or AB
3. AB or O
4. O

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Planning             MSC: Client Needs: Physiological Integrity

 

  1. Which nursing actions take priority when a person begins experiencing chills, tachycardia, and back pain during a transfusion?
1. Provide warm blankets and take the patient’s temperature.
2. Administer oxygen and raise the head of the bed.
3. Stop the transfusion and notify the physician.
4. Assess vital signs and notify the laboratory.

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which blood product can be safely administered to a patient with a history of febrile nonhemolytic reactions?
1. Whole blood
2. Packed red blood cells
3. Fresh frozen red blood cells
4. Leukocyte-poor red blood cells

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which clinical manifestations are associated with circulatory overload in patients receiving blood?
1. Hypertension, chest tightness, jugular vein distention
2. Fever, abdominal cramping, increased urine output
3. Flushing, tachycardia, hypotension
4. Nausea, vomiting, low back pain

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which action prevents bacterial contamination during a blood transfusion?
1. Administering the blood within 4 hours of obtaining from blood bank
2. Making certain the blood product and patient’s blood type match
3. Washing hands thoroughly before hanging the blood
4. Using medical asepsis when handling the blood

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1.   Which is the appropriate therapy for serum sickness (type III hypersensitivity)?
1. Intravenous gamma globulins
2. Antihistamines and salicylates
3. Oral glucocorticosteroids
4. Epinephrine and steroids

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which is a type IV hypersensitivity reaction?
1. Allograft rejection
2. Allergic rhinitis
3. Wheal and flare
4. Atopic allergy

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Patients with contact dermatitis are taught to:
1. Use antibiotic creams
2. Avoid scratching the lesions
3. Coat their hands with lanolin
4. Soak their hands in mild detergent

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which laboratory findings will likely be encountered when caring for patients with autoimmune disorders?
1. Reduced red blood cell count
2. Elevated total serum complement levels
3. Presence of antinuclear or autoantibodies
4. Decreased erythrocyte sedimentation rate (ESR)

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Clinical manifestations commonly associated with chronic fatigue syndrome (CFS) include:
1. Chronic infections
2. Insomnia and sore throat
3. Rash and hyperexcitability
4. Dysrhythmias and hypertension

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

Monahan: Phipps’ Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 31: Vascular Problems

 

MULTIPLE CHOICE

 

  1. Which situation meets the criteria for diagnosing hypertension?
1. High BP during routine physical examination with complaint of fatigue
2. BP normal with complaint of early morning headaches
3. BP 144/94 mm Hg supine and sitting for 3 consecutive weeks
4. BP 176/88 mm Hg on a screening examination

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. Which is a common cause of primary hypertension?
1. Genetics
2. Pyelonephritis
3. Aldosteronism
4. Hyperthyroidism

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1. One mechanism that is responsible for blood pressure elevation is:
1. Decrease in catecholamine secretion by the sympathetic nervous system
2. Reduction in plasma volume and aldosterone
3. Impaired renal control with release of renin
4. Augmented kidney perfusion pressure

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. A patient asks how long he will need to take blood pressure medication. The nurse’s response is based on the fact that antihypertensive agents:
1. Are used until the patient reports side effects
2. Are stopped when blood pressure reaches normal levels
3. Must be taken until the physician discontinues the prescription
4. Can be adjusted by the patient depending on side effects and blood pressure readings

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. The nurse suggests which nonpharmacologic measure to reduce blood pressure in a patient with moderate hypertension?
1. Exercise daily for three 10-minute periods of high intensity.
2. Add weight lifting to a daily exercise program.
3. Begin isometric exercises and reduce smoking.
4. Reduce table salt and alcohol intake.

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. A patient is starting a new prescription of atenolol (Tenormin). Which symptom, if present, is a result of the beta1 blockade effects of the drug?
1. Sedation
2. Headache
3. Constipation
4. Difficulty breathing

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. Under what circumstances is the administration of a nonselective beta-blocker such as propranolol (Inderal) to a hypertensive patient contraindicated?
1. As an initial drug choice
2. In a patient who has COPD
3. In combination with other vasodilators
4. Concurrently with calcium channel blockers

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. A patient tells the nurse he has stopped taking clonidine (Catapres) because he is feeling better. His BP is 130/88 mm Hg and he has gained 2 pounds. Based on these data, the most appropriate nursing diagnosis is:
1. Ineffective individual coping related to lifelong need for therapy
2. Anxiety related to sexual side effects of clonidine
3. Ineffective therapeutic regimen management
4. Excess fluid volume related to weight gain

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Health Promotion and Maintenance

 

  1. An important component of teaching appropriate for all patients receiving drug therapy for hypertension is that the patient:
1. Report any weight loss
2. Change positions slowly
3. Take the drug at bedtime
4. Take over-the-counter laxatives

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. A patient with arterial occlusive disease has a 20-year smoking history. Which nicotine fact does the nurse include in the teaching plan? Nicotine:
1. Decreases artery size and elevates blood pressure
2. Creates excessive nitrogen in the tissues
3. Enhances plaque formation in arteries
4. Increases release of epinephrine

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Planning             MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which individual is at greatest risk for developing arterial occlusive disease?
1. 45-year-old woman with gallbladder disease
2. 60-year-old woman who is obese
3. 75-year-old man with hypertension
4. 85-year-old man with Alzheimer’s disease

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Health Promotion and Maintenance

 

  1. A patient complains of left calf pain after walking around the block. The pain is immediately relieved when the patient sits down. The nurse analyzes this as:
1. Muscle cramps
2. Deconditioning
3. Nerve impingement
4. Intermittent claudication

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. Which pain complaint from a patient with arterial occlusive disease concerns the nurse most?
1. Leg pain that awakens patient from a sound sleep
2. Calf pain when patient walks uphill
3. Hip pain when patient is in a sitting position
4. Aching in the arch of patient’s foot

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. Which signs and symptoms are consistent with chronic occlusive arterial disease?
1. Shiny, taut skin and sparse hair growth
2. Brown, brawny skin discoloration
3. Thick, tough skin and dermatitis
4. Edema and blistering

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. In patients with arterial occlusive disease, the nurse expects which effect when elevating an extremity above the level of the heart?
1. Reddish discoloration
2. Pale, blanched skin
3. Mottling
4. Cyanosis

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which prescribed medication has the highest probability of achieving improved supply of oxygenated blood to ischemic tissue?
1. Nifedipine (Procardia)
2. Pentoxifylline (Trental)
3. Dipyridamole (Persantine)
4. Acetylsalicylic acid (aspirin)

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Physiological Integrity

 

  1. Which nursing diagnosis is the highest priority for a newly admitted patient with acute arterial occlusion?
1. Decreased cardiac output
2. Ineffective tissue perfusion
3. Activity intolerance
4. Deficient knowledge

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. Which nursing instruction is beneficial to all persons with impaired arterial blood flow?
1. Do not cross legs.
2. Elevate legs when sitting.
3. Massage legs to reduce pain.
4. Maintain a cool environment.

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. During a teaching session, the nurse emphasizes which aspect of foot care to the patient with arterial occlusive disease?
1. Wear nylon socks to bed.
2. Soak feet in hot water daily.
3. Examine the feet daily for skin breaks.
4. Apply alcohol-based lotion to feet twice daily.

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. A patient with arterial insufficiency calls the nurse clinician complaining of a painful corn on her little toe. The nurse’s best reply is:
1. “Come into the office today.”
2. “File the corn with a coarse nail file.”
3. “Carefully remove the corn with clean nail clippers.”
4. “Soak the foot in hot water and then trim the outer edge.”

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. While visiting a patient with peripheral vascular disease, the nurse evaluates the patient’s exercise log as follows: “Days 1-3, walked two blocks, pain subsided in 3 minutes; days 4-7, walked five blocks until pain began; days 8-14, walked six blocks without pain.” The nurse concludes that:
1. The patient has achieved maximum tissue perfusion
2. Blood flow to ischemic tissues has improved
3. Another form of activity should be used
4. Exercise tolerance is unsatisfactory

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Health Promotion and Maintenance

 

  1. A patient with newly diagnosed Raynaud’s disease is referred to the nurse clinician for teaching. The teaching plan should include strategies to help prevent vasospasm, such as:
1. Drinking hot coffee
2. Soaking the fingers in cool water
3. Wearing gloves when handling ice
4. Avoiding activities involving pressure on the fingertips

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which finding is the highest priority for reporting to the physician? An extremity that is:
1. Warm with bounding pulses
2. Edematous with slow capillary refill
3. Pale, cool to touch, with diminished pulses
4. Showing postural color changes and ankle-brachial index of 1

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Safe Effective Care Environment

 

  1. Two hours following a femoral bypass graft, which assessment of the involved extremity is reported immediately?
1. Doppler pedal pulses and temperature of 99° F
2. 1+ peripheral edema and pain at the incision site
3. Weakening pedal pulse and progressive skin pallor
4. Slight serous drainage from the incision and small hematoma

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which observation calls for a revision in nursing care for the patient who is 2 days post–femoral-popliteal bypass surgery of the left leg?
1. The patient is in bed with the leg placed on a sheepskin.
2. Two pillows are positioned under the left knee.
3. The head of the bed is elevated 10 degrees.
4. An overbed cradle is in place.

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Safe Effective Care Environment

 

  1. Which lab finding indicates an impending complication following aortic aneurysm resection with graft placement and should be reported immediately?
1. Sodium 145 mEq/L, potassium 4.0 mEq/L
2. BUN 25 mg/dl, creatinine 2.0 mg/dl
3. Hematocrit 36, hemoglobin 12 g/dl
4. PTT 30 seconds, PT 12 seconds

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Safe Effective Care Environment

 

  1. Primary strategies for prevention of aneurysm include:
1. Controlling hypertension and quitting smoking
2. Increasing exercise and reducing calorie intake
3. Decreasing cholesterol levels and increasing iron intake
4. Scheduling yearly physical examinations that include ultrasound screening

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. A patient complains of pain in the foot of a leg that was recently amputated. The nurse evaluates this pain as:
1. An abnormal response that needs immediate reporting
2. Not uncommon, requiring medication for relief
3. Psychological, requiring a psychiatric referral
4. Imaginary, needing no treatment

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which position is contraindicated following an above-knee amputation?
1. Head of bed elevated approximately 15 degrees
2. On operative side with knees flexed
3. Bed in the flat position
4. Prone position

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. The nurse emphasizes which point when teaching a patient correct crutch-walking technique?
1. The crutch should extend into the axilla.
2. Weight bearing should occur at the palms, not the axillae.
3. Hand grips should be adjusted so that elbows are fully extended.
4. The torso should be tilted slightly forward before bearing weight.

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which factor would contribute to the development of deep vein thrombosis?
1. Age and gender
2. Use of the diaphragm
3. Standing for long periods at work
4. 75 pounds above recommended weight

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Health Promotion and Maintenance

 

  1. A patient with five children travels on a bus tour to Mexico 2 months after fracturing her left femur. While there, she becomes dehydrated and develops deep vein thrombosis. The least likely explanation for the development of the patient’s DVT is:
1. Dehydration
2. Recent fracture of the femur
3. History of multiple pregnancies
4. Increased immobility during travel

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Health Promotion and Maintenance

 

  1. The nurse notes no tenderness or swelling, and Homans’ sign is negative 2 days after initiation of heparin therapy for deep vein thrombosis of the right calf. The most appropriate conclusion is that:
1. The thrombus has been dissolved
2. Many patients are asymptomatic
3. Thrombolytic therapy should be discontinued
4. The patient can be switched to oral anticoagulants

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. A priority nursing diagnosis for the patient receiving heparin therapy is:
1. Decreased cardiac output
2. Ineffective tissue perfusion
3. Risk for injury
4. Anxiety/fear

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Safe Effective Care Environment

 

  1. The purpose of applying external periodic calf compression devices following major surgery is to:
1. Enhance vasodilation and blood flow to the tissues
2. Passively exercise the lower extremities
3. Promote arterial blood flow
4. Promote venous return

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. The purpose of heparin therapy in treating deep vein thrombosis is to:
1. Reduce vein inflammation
2. Inhibit new clot formation
3. Reestablish blood flow
4. Dissolve the thrombus

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. The plan of care for the patient with deep vein thrombosis of the right calf should include:
1. Ambulation from the moment of admission
2. Application of ice packs to the affected area
3. Measurement of calf circumference at the same site each shift
4. Application of thigh-high compression stockings to the right leg

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Planning             MSC: Client Needs: Safe Effective Care Environment

 

  1. What is the antidote for Coumadin?
1. Vitamin K
2. Ferrous sulfate
3. Potassium chloride
4. Protamine sulfate

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. The patient receiving Coumadin should be taught to avoid:
1. Aspirin and alcohol
2. Tylenol and caffeine
3. Ibuprofen and Benadryl
4. Maalox and multivitamins

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. The nurse teaches the patient taking Coumadin who is going home to maintain a moderate daily intake of:
1. Fresh fruits
2. Organ meats
3. High-fiber foods
4. Dark green leafy vegetables

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which statement made by the patient taking Coumadin indicates a need for further teaching?
1. “I’ll only take my support hose off before going to bed.”
2. “The swelling in my leg will eventually subside.”
3. “I expect my stools to be somewhat black.”
4. “I’ll call the office if I cut myself.”

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which chart entry for a patient with venous insufficiency records appropriate nursing intervention?
1. “Compression stockings removed before getting out of bed”
2. “Wound cleansed with hydrogen peroxide”
3. “Dangled legs three times for 20 minutes”
4. “Legs elevated while up in chair”

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. Bathing the affected leg is contraindicated in the patient with a venous ulcer in the presence of:
1. A hydrocolloid dressing
2. Elastic stockings
3. Steroid creams
4. Unna’s boot

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

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