Chapter 33 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 33  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
Which information should the nurse consider when planning care for patients at risk for endocarditis?
1. Endocarditis does not pose a high risk for damage to affected heart valves.
2. The major treatment modality for endocarditis is open heart surgery to clean the heart valves.
3. Fever is a rare manifestation of endocarditis.
4. Endocarditis can be prevented in patients at risk by administering antibiotics prior to procedures.
Correct Answer: 4
Rationale 1: Endocarditis carries a serious risk for damage to heart valves.
Rationale 2: Surgery to clean valves may be necessary, but it is not the major treatment modality.
Rationale 3: Fever occurs in about 90% of patients with endocarditis.
Rationale 4: Prophylactic antibiotic therapy can prevent endocarditis in those at risk for developing the disease.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 33-1

Question 2
Type: MCMA
Which assessment findings would increase the nurse’s suspicion that a patient may have pericarditis?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Pericardial friction rub
2. Abdominal discomfort and nausea
3. Chest pain
4. Bradycardia
5. Distended neck veins
Correct Answer: 1,3
Rationale 1: Pericardial friction is a hallmark sign of pericarditis, in addition to fever.
Rationale 2: Abdominal discomfort and nausea are not associated with pericarditis.
Rationale 3: Chest pain is a hallmark sign of pericarditis, in addition to fever.
Rationale 4: Bradycardia is not associated with pericarditis.
Rationale 5: Distended neck veins are not associated with pericarditis.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 33-1

Question 3
Type: MCSA
The nurse, caring for a patient diagnosed with cardiac tamponade, prepares to participate in which initial treatment?
1. Antidysrhythmic drugs and oxygen
2. Oxygen and rest
3. Pericardiocentesis
4. Antibiotics
Correct Answer: 3
Rationale 1: Antidysrhythmic drugs may be necessary but are not the initial treatment.
Rationale 2: Oxygen and rest will be required but are not the initial treatment.
Rationale 3: When cardiac tamponade occurs, it is considered a medical emergency. Pericardiocentesis is performed to remove fluid or blood that has collected around the heart and is preventing the heart from pumping effectively.
Rationale 4: Antibiotic therapy may be necessary but is not the initial treatment.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 33-1

Question 4
Type: MCSA
A nurse caring for a patient with coronary artery disease (CAD) hears a murmur during auscultation of the heart. The nurse suspects which complication of CAD?
1. Valvular heart disease
2. Pericarditis
3. Cardiac tamponade
4. Heart failure
Correct Answer: 1
Rationale 1: Valvular disorders interfere with the smooth flow of blood through the heart. The flow becomes turbulent, causing a murmur, a characteristic manifestation of valvular disease.
Rationale 2: The heart sound characteristic of pericarditis is a pericardial friction rub
Rationale 3: Distant and muffled heart sounds are typical of cardiac tamponade.
Rationale 4: Extra heart sounds S3 and S4 are heard in heart failure.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 33-2