Chapter 37 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 37  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. Since the emergence of HIV/AIDS, there have been significant changes in epidemiologic trends. Members of what group currently have the greatest risk of contracting HIV?

  1. A)  Gay, bisexual, and other men who have sex with men
  2. B)  Recreational drug users
  3. C)  Blood transfusion recipients
  4. D)  Health care providers

Ans: A

Feedback:

Gay, bisexual, and other men who have sex with men remain the population most affected by HIV and account for 2% of the population but 61% of the new infections. This exceeds the incidence among drug users, health care workers, and transfusion recipients.

2. A clinic nurse is caring for a patient admitted with AIDS. The nurse has assessed that the patient is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what complication?

  1. A)  HIV encephalopathy
  2. B)  B-cell lymphoma
  3. C)  Kaposi’s sarcoma
  4. D)  Wasting syndrome

Ans: A

Feedback:

HIV encephalopathy is a clinical syndrome characterized by a progressive decline in cognitive, behavioral, and motor functions. The other listed complications do not normally have cognitive and behavioral manifestations.

3. A nurse is assessing a 28-year-old man with HIV who has been admitted with pneumonia. In assessing the patient, which of the following observations takes immediate priority?

  1. A)  Oral temperature of 100°F
  2. B)  Tachypnea and restlessness
  3. C)  Frequent loose stools
  4. D)  Weight loss of 1 pound since yesterday

Ans: B

Feedback:

In prioritizing care, the pneumonia would be assessed first by the nurse. Tachypnea and restlessness are symptoms of altered respiratory status and need immediate priority. Weight loss of 1 pound is probably fluid related; frequent loose stools would not take short-term precedence over a temperature or tachypnea and restlessness. An oral temperature of 100°F is not considered a fever and would not be the first issue addressed.

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4. A patient has come into the free clinic asking to be tested for HIV infection. The patient asks the nurse how the test works. The nurse responds that if the testing shows that antibodies to the AIDS virus are present in the blood, this indicates what?

  1. A)  The patient is immune to HIV.
  2. B)  The patient’s immune system is intact.
  3. C)  The patient has AIDS-related complications.
  4. D)  The patient has been infected with HIV.

Ans: D

Feedback:

Positive test results indicate that antibodies to the AIDS virus are present in the blood. The presence of antibodies does not imply an intact immune system or specific immunity to HIV. This finding does not indicate the presence of AIDS-related complications.

5. A hospital patient is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test?

  1. A)  Arrange for a portable x-ray machine to be used.
  2. B)  Have the patient wear a mask to the x-ray department.
  3. C)  Ensure that the radiology department has been disinfected prior to the test.
  4. D)  Send the patient to the x-ray department, and have the staff in the department wear

    masks.

Ans: A

Feedback:

A patient who is immunocompromised is at an increased risk of contracting nosocomial infections due to suppressed immunity. The safest way the test can be facilitated is to have a portable x-ray machine in the patient’s room. This confers more protection than disinfecting the radiology department or using masks.

6. The mother of two young children has been diagnosed with HIV and expresses fear of dying. How should the nurse best respond to the patient?

  1. A)  “Would you like me to have the chaplain come speak with you?”
  2. B)  “You’ll learn much about the promise of a cure for HIV.”
  3. C)  “Can you tell me what concerns you most about dying?”
  4. D)  “You need to maintain hope because you may live for several years.”

Ans: C

Feedback:

The nurse can help the patient verbalize feelings and identify resources for support. The nurse should respond with an open-ended question to help the patient to identify fears about being diagnosed with a life-threatening chronic illness. Immediate deferral to spiritual care is not a substitute for engaging with the patient. The nurse should attempt to foster hope, but not in a way that downplays the patient’s expressed fears.

 

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