Chapter 41 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 41  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A 56-year-old female patient thinks she’s “losing her mind” because of constant anxiety, flushing, inability to sleep, and headaches. The nurse would ask assessment questions based on which condition being the most likely cause of these symptoms?
1. Premenstrual syndrome
2. Menopause
3. Postmenopause
4. Dysmenorrhea
Correct Answer: 2
Rationale 1: Manifestations of premenstrual syndrome occur 7 to 10 days prior to the start of the menstrual flow. In the United States, most women stop menstruating between 48 and 55 years of age. No information is given in the question to suggest that the woman is still menstruating.
Rationale 2: Vasomotor instability in menopause often results in hot flashes, palpitations, dizziness, and headaches. Other problems that result from vasomotor instability include insomnia, frequent awakening, and night sweats. The woman may experience irritability, anxiety, and depression as a result of these events.
Rationale 3: Postmenopause starts one year after the menstrual flow ceases. No information is given in the question about menstrual flow.
Rationale 4: These symptoms are not consistent with dysmenorrhea.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 41-1

Question 2
Type: MCSA
A female patient who is experiencing menopause is “tired of the night sweats.” Which activity can the nurse suggest to help this patient?
1. Ensure that the bedroom temperature is cool and limit sleeping attire.
2. Reduce intake of milk and milk products.
3. Suggest talking with the physician about a hysterectomy.
4. Exercise 1 hour before going to sleep.
Correct Answer: 1
Rationale 1: The underlying cause of hot flashes is not known; however, many physiologic effects of menopause are responsive to nonpharmacologic methods of relief, such as lifestyle changes and control of the environment.
Rationale 2: The recommended daily intake of calcium for women over 50 is 1,200 mg.
Rationale 3: Encouraging the patient to look into surgical intervention is outside the scope of nursing practice. A hysterectomy will further reduce the patient’s natural estrogen levels and could make night sweats worse.
Rationale 4: Exercise immediately before bedtime can interrupt sleep.
Global Rationale:

Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 41-5

Question 3
Type: MCMA
The nurse is assisting a patient with ways to reduce the severity of the monthly menstrual discomforts associated with premenstrual syndrome. Which information should the nurse review with this patient?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Avoid exercise during the days immediately before menstruation.
2. Investigate the use of alternative therapies such as black cohosh root.
3. Follow a low-carbohydrate diet
4. Increase sodium intake.
5. Restrict caffeine intake.
Correct Answer: 2,5
Rationale 1: Regular exercise may provide some relief from symptoms.
Rationale 2: Alternative and complementary therapies such as black cohosh root, chasteberry, evening primrose oil, wild yam root, and dong quai may help to relieve anxiety and depression.
Rationale 3: The diet should be high in complex carbohydrates.
Rationale 4: Sodium should be restricted to minimize fluid retention.
Rationale 5: Caffeine restriction reduces irritability.
Global Rationale:

Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 41-5

Question 4
Type: MCSA
The mother of a 16-year-old female reports that the teen began menstruating at age 14 but has stopped for about 5 months. Which response would be the highest priority for the nurse to make to this mother?
1. “That’s normal for a 16-year-old. That happened to me when I was 16.”
2. “Does she have a boyfriend?”
3. “It’s probably psychological.”
4. “Have you noticed any other changes in diet, activity, or weight loss?”
Correct Answer: 4
Rationale 1: The condition reported by the parent is not normal.
Rationale 2: It is not appropriate for the nurse to assume that the girl is sexually active. Having a boyfriend does not necessarily indicate sexual activity.
Rationale 3: The nurse has no basis for this statement without further assessment.
Rationale 4: Secondary amenorrhea, which is the absence of menses for at least 3 months in a previously menstruating female, may be caused by anorexia nervosa, excessive athletic activity or training, or a large weight loss. Other causes include hormonal imbalances and ovarian tumors. Pregnancy is also a cause of secondary amenorrhea but should not be the first assumption.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 41-1