Chapter 34 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 34  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A 60-year-old male patient is being seen in the clinic for an annual physical. Which assessment finding would the nurse discuss with the patient in regard to preventing future heart failure?
1. High hemoglobin A1C
2. Blood pressure 119/78
3. Father-in-law died from heart disease a year ago
4. Male
Correct Answer: 1
Rationale 1: Elevated hemoglobin A1C indicates possible diabetes. Diabetes is a risk factor for development of heart failure.
Rationale 2: Hypertension is a modifiable risk factor, but a blood pressure of 119/78 is not hypertensive.
Rationale 3: An in-law’s death from cardiac disease is unrelated to the patient’s risk factors.
Rationale 4: Being male is a risk factor but is not modifiable.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 34-1

Question 2
Type: MCSA
A patient with heart failure has orthopnea, tachycardia, fatigue, and activity intolerance. How would the nurse explain the presence of these findings?
1. “You are not coping with your body’s changing health.”
2. “Your body’s protective mechanisms are malfunctioning.”
3. “You have not been following instructions on caring for yourself.”
4. “Your body is trying to maintain an adequate blood pressure and oxygen supply.”
Correct Answer: 4
Rationale 1: These findings are not related to the patient’s coping mechanisms.
Rationale 2: The patient’s inherent compensatory mechanisms are not malfunctioning, but instead continue to attempt to maintain homeostasis.
Rationale 3: These symptoms are not caused by the patient’s noncompliance with instructions.
Rationale 4: The patient’s compensatory mechanisms attempt initially to compensate for the falling blood pressure and oxygen levels. At the outset, these mechanisms are able to keep up with the body’s demands. However, over the long term, they create bigger problems.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 34-3

Question 3
Type: MCSA
The nurse assesses that a patient is more anxious than usual. The patient states, “I don’t understand how I can still be alive when my heart has failed.” Which nursing response is indicated?
1. “Heart failure is a common problem in the United States. Many people have it. They all have problems such as yours.”
2. “Heart failure doesn’t mean your heart has quit, just that it no longer is as efficient as it once was.”
3. “You seem upset. Would you like for me to call the health care provider to explain this to you?”
4. “Heart failure is pretty complicated. It means the heart is failing to work.”
Correct Answer: 2
Rationale 1: Stating that the problem is common does not help the patient understand the condition.
Rationale 2: Helping the patient understand that the heart is still functioning may help alleviate concerns about imminent death.
Rationale 3: Contacting the health care provider is not necessary; the nurse should know how to respond to this question.
Rationale 4: This response does not provide the patient with enough information.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 34-7