Chapter 33 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 33  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A nurse is caring for a patient who has sickle cell anemia and the nurse’s assessment reveals the possibility of substance abuse. What is the nurse’s most appropriate action?

  1. A)  Encourage the patient to rely on complementary and alternative therapies.
  2. B)  Encourage the patient to seek care from a single provider for pain relief.
  3. C)  Teach the patient to accept chronic pain as an inevitable aspect of the disease.
  4. D)  Limit the reporting of emergency department visits to the primary health care provider.

Ans: B

Feedback:

The patient should be encouraged to use a single primary health care provider to address health care concerns. Emergency department visits should be reported to the primary health care provider to achieve optimal management of the disease. It would inappropriate to teach the patient to simply accept his or her pain. Complementary therapies are usually insufficient to fully address pain in sickle cell disease.

2. A patient newly diagnosed with thrombocytopenia is admitted to the medical unit. After the admission assessment, the patient asks the nurse to explain the disease. What should the nurse explain to this patient?

  1. A)  There could be an attack on the platelets by antibodies.
  2. B)  There could be decreased production of platelets.
  3. C)  There could be impaired communication between platelets.
  4. D)  There could be an autoimmune process causing platelet malfunction.

Ans: B

Feedback:

Thrombocytopenia can result from a decreased platelet production, increased platelet destruction, or increased consumption of platelets. Impaired platelet communication, antibodies, and autoimmune processes are not typical pathologies.

3. A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The patient is not responding to conservative treatments, and his condition is now becoming life threatening. The nurse is aware that a treatment option in this case may include what?

  1. A)  Hepatectomy
  2. B)  Vitamin K administration
  3. C)  Platelet transfusion
  4. D)  Splenectomy

Ans: D

Feedback:

A splenectomy may be the course of treatment if autoimmune hemolytic anemia does not respond to conservative treatment. Vitamin K administration is treatment for vitamin K deficiency and does not resolve anemia. Platelet transfusion may be the course of treatment for some bleeding disorders. Hepatectomy would not help the patient.

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4. A nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?

  1. A)  Take the iron with dairy products to enhance absorption.
  2. B)  Increase the intake of vitamin E to enhance absorption.
  3. C)  Iron will cause the stools to darken in color.
  4. D)  Limit foods high in fiber due to the risk for diarrhea.

Ans: C

Feedback:

The nurse will inform the patient that iron will cause the stools to become dark in color. Iron should be taken on an empty stomach, as its absorption is affected by food, especially dairy products. Patients should be instructed to increase their intake of vitamin C to enhance iron absorption. Foods high in fiber should be consumed to minimize problems with constipation, a common side effect associated with iron therapy.

5. The nurse is assessing a new patient with complaints of overwhelming fatigue and a sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs and symptoms associated with what form of what hematologic disorder?

  1. A)  Sickle cell anemia
  2. B)  Hemophilia
  3. C)  Megaloblastic anemia
  4. D)  Thrombocytopenia

Ans: C

Feedback:

A red, smooth, sore tongue is a symptom associated with megaloblastic anemia. Sickle cell disease, hemophilia, and thrombocytopenia do not have symptoms involving the tongue.

6. A patient with renal failure has decreased erythropoietin production. Upon analysis of the patient’s complete blood count, the nurse will expect which of the following results?

  1. A)  An increased hemoglobin and decreased hematocrit
  2. B)  A decreased hemoglobin and hematocrit
  3. C)  A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW)
  4. D)  An increased MCV and RDW

Ans: B

Feedback:

The decreased production of erythropoietin will result in a decreased hemoglobin and hematocrit. The patient will have normal MCV and RDW because the erythrocytes are normal in appearance.

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