Chapter 40 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition


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Chapter 40  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition



Complete Chapter Questions And Answers

Sample Questions


1. A nurse on the orthopedic unit is assessing a patient’s peroneal nerve. The nurse will perform this assessment by doing which of the following actions?

  1. A)  Pricking the skin between the great and second toe
  2. B)  Stroking the skin on the sole of the patient’s foot
  3. C)  Pinching the skin between the thumb and index finger
  4. D)  Stroking the distal fat pad of the small finger

Ans: A


The nurse will evaluate the sensation of the peroneal nerve by pricking the skin centered between the great and second toe. None of the other listed actions elicits the function of one of the peripheral nerves.

2. A public health nurse is organizing a campaign that will address the leading cause of musculoskeletal-related disability in the United States. The nurse should focus on what health problem?

  1. A)  Osteoporosis
  2. B)  Arthritis
  3. C)  Hip fractures
  4. D)  Lower back pain

Ans: B


The leading cause of musculoskeletal-related disability in the United States is arthritis.

3. A nurse is providing care for a patient whose pattern of laboratory testing reveals longstanding hypocalcemia. What other laboratory result is most consistent with this finding?

  1. A)  An elevated parathyroid hormone level
  2. B)  An increased calcitonin level
  3. C)  An elevated potassium level
  4. D)  A decreased vitamin D level

Ans: A


In the response to low calcium levels in the blood, increased levels of parathyroid hormone prompt the mobilization of calcium and the demineralization of bone. Increased calcitonin levels would exacerbate hypocalcemia. Vitamin D levels do not increase in response to low calcium levels. Potassium levels would likely be unaffected.

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4. A nurse is caring for a patient whose cancer metastasis has resulted in bone pain. Which of the following are typical characteristics of bone pain?

  1. A)  A dull, deep ache that is “boring” in nature
  2. B)  Soreness or aching that may include cramping
  3. C)  Sharp, piercing pain that is relieved by immobilization
  4. D)  Spastic or sharp pain that radiates

Ans: A


Bone pain is characteristically described as a dull, deep ache that is “boring” in nature, whereas muscular pain is described as soreness or aching and is referred to as “muscle cramps.” Fracture pain is sharp and piercing and is relieved by immobilization. Sharp pain may also result from bone infection with muscle spasm or pressure on a sensory nerve.

5. A nurse is assessing a patient who is experiencing peripheral neurovascular dysfunction. What assessment findings are most consistent with this diagnosis?

  1. A)  Hot skin with a capillary refill of 1 to 2 seconds
  2. B)  Absence of feeling, capillary refill of 4 to 5 seconds, and cool skin
  3. C)  Pain, diaphoresis, and erythema
  4. D)  Jaundiced skin, weakness, and capillary refill of 3 seconds

Ans: B


Indicators of peripheral neurovascular dysfunction include pale, cyanotic, or mottled skin with a cool temperature; capillary refill greater than 3 seconds; weakness or paralysis with motion; and paresthesia, unrelenting pain, pain on passive stretch, or absence of feeling. Jaundice, diaphoresis, and warmth are inconsistent with peripheral neurovascular dysfunction.

6. An older adult patient has symptoms of osteoporosis and is being assessed during her annual physical examination. The assessment shows that the patient will require further testing related to a possible exacerbation of her osteoporosis. The nurse should anticipate what diagnostic test?

  1. A)  Bone densitometry
  2. B)  Hip bone radiography
  3. C)  Computed tomography (CT)
  4. D)  Magnetic resonance imaging (MRI)

Ans: A


Bone densitometry is considered the most accurate test for osteoporosis and for predicting a fracture. As such, it is more likely to be used than CT, MRI, or x-rays.

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