Chapter 39 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 39  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A female patient asks the nurse about ways to prevent recurrent cystitis. What is an appropriate nursing response?
1. “Void before and as soon as possible after sexual intercourse.”
2. “Clean the perineal area from back to front.”
3. “Soak in a bathtub at least once a week.”
4. “Wear clean, nylon underpants.”
Correct Answer: 1
Rationale 1: Voiding before and as soon as possible after sexual intercourse flushes contaminants that may have entered the urethra.
Rationale 2: Women should be instructed to cleanse the perineal area from front to back after voiding and defecating.
Rationale 3: The patient should avoid tub baths.
Rationale 4: Measures to maintain the integrity of perineal tissues include wearing cotton briefs.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 39-3

Question 2
Type: MCSA
A male patient comes to the emergency department with symptoms of renal colic. The nurse realizes that this patient most likely has a calculus that is obstructing which structure?
1. Ureter
2. Bladder
3. Renal pelvis
4. Urethra
Correct Answer: 1
Rationale 1: Renal colic is acute, severe flank pain on the affected side. It develops when a stone, or renal calculus, obstructs the ureter and causes ureteral spasm.
Rationale 2: A calculus in the bladder would not cause renal colic.
Rationale 3: A calculus in the renal pelvis would cause chronic dull pain rather than colicky pain.
Rationale 4: A calculus in the urethra would not cause renal colic.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 39-3

Question 3
Type: MCSA
A male patient is admitted for removal of a bladder papilloma. Which assessment finding would the nurse evaluate as having increased the patient’s risk of this disorder?
1. History of cigarette smoking
2. Low daily fluid intake
3. Weak pedal pulses
4. Decreased appetite level
Correct Answer: 1
Rationale 1: Approximately 50% of those diagnosed with bladder cancer are smokers.
Rationale 2: Daily fluid intake is an important assessment, but this finding would not indicate an increased risk for bladder papilloma.
Rationale 3: Pedal pulses are an important assessment, but this finding would not indicate an increased risk for bladder papilloma.
Rationale 4: Appetite is an important assessment, but this finding would not indicate an increased risk for bladder papilloma.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 39-3

Question 4
Type: MCSA
A patient had a renal stent removed. Which intervention is the priority of care for this patient?
1. Monitor urine output.
2. Encourage ambulation.
3. Ensure an adequate protein intake.
4. Monitor blood pressure.
Correct Answer: 1
Rationale 1: Urine output is closely monitored for the first 24 hours after stents or ureteral catheters are removed. Edema or stricture of ureters may impede output and lead to hydronephrosis and kidney damage.
Rationale 2: Ambulation is important in the care of this patient; however, it is not the highest priority.
Rationale 3: Adequate protein intake is important in the care of this patient; however, it is not the highest priority.
Rationale 4: Blood pressure monitoring is important in the care of this patient; however, it is not the highest priority.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 39-3