Chapter 4 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 4  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A nurse has been working with Mrs. Griffin, a 71-year-old patient whose poorly controlled type 1 diabetes has led to numerous health problems. Over the past several years Mrs. Griffin has had several admissions to the hospital medical unit, and the nurse has often carried out health promotion interventions. Who is ultimately responsible for maintaining and promoting Mrs. Griffin’s health?

  1. A)  The medical nurse
  2. B)  The community health nurse who has also worked with Mrs. Griffin
  3. C)  Mrs. Griffin’s primary care provider
  4. D)  Mrs. Griffin

Ans: D

Feedback:

American society places a great importance on health and the responsibility that each of us has to maintain and promote our own health. Therefore, the other options are incorrect.

2. An elderly female patient has come to the clinic for a scheduled follow-up appointment. The nurse learns from the patient’s daughter that the patient is not following the instructions she received upon discharge from the hospital last month. What is the most likely factor causing the patient not to adhere to her therapeutic regimen?

  1. A)  Ethnic background of health care provider
  2. B)  Costs of the prescribed regimen
  3. C)  Presence of a learning disability
  4. D)  Personality of the physician

Ans: B

Feedback:

Variables that appear to influence the degree of adherence to a prescribed therapeutic regimen include gender, race, education, illness, complexity of the regimen, and the cost of treatments. The ethnic background of the health care provider and the personality of the physician are not considered variables that appear to influence the degree of adherence to a prescribed therapeutic regimen. A learning disability could greatly affect adherence, but cost is a more likely barrier.

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3. A gerontologic nurse has observed that patients often fail to adhere to a therapeutic regimen. What strategy should the nurse adopt to best assist an older adult in adhering to a therapeutic regimen involving wound care?

  1. A)  Demonstrate a dressing change and allow the patient to practice.
  2. B)  Provide a detailed pamphlet on a dressing change.
  3. C)  Verbally instruct the patient how to change a dressing and check for comprehension.
  4. D)  Delegate the dressing change to a trusted family member.

Ans: A

Feedback:

The nurse must consider that older adults may have deficits in the ability to draw inferences, apply information, or understand major teaching points. Demonstration and practice are essential in meeting their learning needs. The other options are incorrect because the elderly may have problems reading and/or understanding a written pamphlet or verbal instructions. Having a family member change the dressing when the patient is capable of doing it impedes self-care and independence.

4. A 20-year-old man newly diagnosed with type 1 diabetes needs to learn how to self- administer insulin. When planning the appropriate educational interventions and considering variables that will affect his learning, the nurse should prioritize which of the following factors?

  1. A)  Patient’s expected lifespan
  2. B)  Patient’s gender
  3. C)  Patient’s occupation
  4. D)  Patient’s culture

Ans: D

Feedback:

One of the major variables that influences a patient’s readiness to learn is the patient’s culture, because it affects how a person learns and what information is learned. Other variables include illness states, values, emotional readiness, and physical readiness. Lifespan, occupation, and gender are variables that are usually less salient.

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5. The nurse is planning to teach a 75-year-old patient with coronary artery disease about administering her prescribed antiplatelet medication. How can the nurse best enhance the patient’s ability to learn?

  1. A)  Provide links to Web sites that contain evidence-based information.
  2. B)  Exclude family members from the session to prevent distraction.
  3. C)  Use color-coded materials that are succinct and engaging.
  4. D)  Make the information directly relevant to the patient’s condition.

Ans: D

Feedback:

Studies have shown that older adults can learn and remember if the information is paced appropriately, relevant, and followed by appropriate feedback. Family members should be included in health education. The nurse should not assume that the patient’s color vision is intact or that the patient possesses adequate computer skills.

6. A nurse is planning care for an older adult who lives with a number of chronic health problems. For which of the following nursing diagnoses would education of the patient be the nurse’s highest priority?

  1. A)  Risk for impaired physical mobility related to joint pain
  2. B)  Functional urinary incontinence related decreased mobility
  3. C)  Activity intolerance related to contractures
  4. D)  Risk for ineffective health maintenance related to nonadherence to therapeutic regimen

Ans: D

Feedback:

For some nursing diagnoses, education is a primary nursing intervention. These diagnoses include risk for ineffective management of therapeutic regimen, risk for impaired home management, health-seeking behaviors, and decisional conflict. The other options do not have patient education as the highest priority, though each necessitates a certain degree of education.

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