Chapter 51 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 51  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCMA
The nurse is preparing for a community education session on autoimmune disorders. The nurse should review information about which diseases?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Scleroderma
2. Rheumatoid arthritis (RA)
3. Gouty arthritis
4. Systemic lupus erythematosus (SLE)
5. Reactive arthritis
Correct Answer: 1,2,4
Rationale 1: The cause of scleroderma is unknown, but it is thought to be autoimmune.
Rationale 2: Rheumatoid arthritis is thought to be an autoimmune disorder.
Rationale 3: Gouty arthritis is thought to have a hereditary component, with a defect in purine metabolism. It is not an autoimmune disorder.
Rationale 4: SLE is a chronic inflammatory autoimmune disease that attacks connective tissue or organs.
Rationale 5: Reactive arthritis is a type of arthritis that develops soon after or during an infection somewhere else in the body.
Global Rationale:

Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 51-1

Question 2
Type: MCMA
A patient diagnosed with rheumatoid arthritis (RA) is reluctant to start some recommended therapies. The nurse tells the patient that early intervention is crucial for long-term health. What rationales would the nurse provide for this statement?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Early intervention is instrumental in bringing about long-term remission of symptoms.
2. Beginning treatment early can help control pain generated by the disorder.
3. If the disease is not treated, tissue and joint damage can be extreme.
4. Early and aggressive exercise will help keep joints mobile.
5. If treatment is started early, joint deformity can be avoided.
Correct Answer: 2,3
Rationale 1: RA is a chronic condition without a cure or long-term remission.
Rationale 2: RA is a painful condition that requires a combination of therapeutic approaches to treatment. Early treatment of pain helps maintain joint function.
Rationale 3: Treatment can help reduce the amount of tissue and joint damage. If treatment is started earlier, rather than later, tissue and joint damage can be minimized.
Rationale 4: Exercise should be balanced with rest, and joints should be safeguarded.
Rationale 5: Joint deformity is likely to occur despite early treatment.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 51-2

Question 3
Type: MCSA
A patient diagnosed with gouty arthritis is prescribed the drug colchicine to reduce symptoms. Which medication education should the nurse provide?
1. There is a possibility of orthostatic hypotension.
2. A diet with fewer restrictions on purine ingestion may be adopted.
3. The pain will diminish, but the joint will remain swollen and red.
4. Vomiting and/or diarrhea are common side effects of this medication.
Correct Answer: 4
Rationale 1: Orthostatic hypotension is not a typical side effect of colchicines.
Rationale 2: The patient should remain on a low-purine diet as part of the treatment plan.
Rationale 3: Colchicine exerts an anti-inflammatory effect and reduces pain and swelling.
Rationale 4: Nausea, vomiting, and diarrhea are among the early signs of colchicine toxicity. These effects would necessitate changing the medication.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 51-6

Question 4
Type: MCMA
The nurse has completed a health assessment, physical examination, and interview with a patient. Which assessment data would support a diagnosis of reactive arthritis?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The conjunctiva of the right eye is reddened, with a thin, watery drainage.
2. The patient reports increased urine output.
3. The patient reports having “food poisoning” 12 days ago.
4. The patient reports pain in both knees.
5. The patient’s right ankle is swollen only on the medial side.
Correct Answer: 1,3,4,5
Rationale 1: Conjunctivitis and unilateral uveitis are clinical manifestations associated with reactive arthritis.
Rationale 2: Increased urine output is not associated with reactive arthritis.
Rationale 3: Assessment data supporting a diagnosis of reactive arthritis would include gastrointestinal bacterial infection 1 to 3 weeks prior to the outbreak of symptoms.
Rationale 4: Joint pain is associated with reactive arthritis.
Rationale 5: Asymmetrical joint swelling is common in the lower extremities.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 51-5